TREATMENT OF PSYCHOLOGICAL DISORDERS

Psychodynamic Therapies Psychodynamic therapies revolve around: Insight –Understanding one’s own psychological processes Therapist-patient relationship –Assist a patient to become “captain of my own ship”

Insight Maladaptive ways of viewing self and relationships Unconscious conflicts and compromises among competing wishes and fears Maladaptive ways of dealing with unpleasant emotions

Therapeutic Techniques Free Association –Patient responds to verbal/visual cues with the first thing that comes to mind Interpretation –Clinician interprets patient responses –Resistance involves patient’s efforts to hide the unconscious conflict

Therapist-Patient Relationship Therapist as authority figure Transference –Patients have similar thoughts, feelings, fears, wishes and conflicts in new relationships as existed in past relationships Patient tries to please therapist in the same way he/she tried to please parent Fears that your new partner will cheat on you just like your last partner cheated on you

Psychodynamic Therapies Psychoanalysis –Patient on couch and therapist on chair behind couch –Intense discussions over a long period of time –Goal is exploration of unconscious processes Psychodynamic Psychotherapy –Sessions are face to face –Discussion is less intense, more conversational, than in psychoanalysis –Goal is still exploration of unconscious processes

Cognitive-Behavioral Therapies Phobia –Irrational fear of a given stimulus Behavioral analysis –Determine the symptom (s) and the stimuli or thoughts associated with it which then become the targets of treatment Systematic desensitization –Gradual exposure of a phobic stimulus as a means of neutralizing the impact of the stimulus

Systematic Desensitization Step 1 –Therapist teaches patient relaxation techniques Step 2 –Therapist questions patient about fears & then constructs a hierarchy of feared stimuli Step 3 –Desensitization process begins possibly with the use of virtual reality therapy Step 4 –Patient encouraged to face feared stimuli in real life

Cognitive-Behavioral Therapies Exposure Techniques –Present patients with actual phobic stimulus in real life rather than imagine it Flooding –Patient confronts the phobic stimulus all at once

Social Learning Techniques Participatory modeling –Therapist models the behavior and gradually induces the patient to participate in the behavior Role playing Skills training –Involves teaching the behaviors necessary to accomplish relevant goals Teaching someone how to dance

Cognitive Therapy –Focus on changing cognitions that underlie a psychological disorder –Learn to perceive things in a different manner Cognition Therapy –Focus on cognitive distortions View things differently

Cognitive Therapies Rational-emotive therapy –Mediates between activating conditions and maladaptive emotional reactions “ I won’t let his mean behavior get to me anymore!”

Humanistic Therapies Gestalt therapy –Focus on awareness of one’s own feelings versus our attempts to conform to social expectations –Goal is for patient to respond to their true “inner voice” and thus become more authentic –Focus on present state rather than historical contributors to one’s present state

Humanistic Therapies Client-centered therapy –Clients versus patients Rejects “disease” model –Solve problems not seek cures Problems develop when one’s concept of self is incongruent with their actual life experience –The basic nature of humans is to grow and mature –Unconditional positive regard Attitude of fundamental acceptance by therapist towards client

Group Therapies Multiple individuals in same sessions Group members share same issue such as –Death of a child –Coping with cancer Cost effective

Family Therapies All members of a nuclear family participate in therapy Genogram –Map of family dynamics Couples therapy –Focus on problematic communications patterns

Biological Treatments Psychotropic medications act on the brain to affect mental processes

Antipsychotic Medications Used to treat schizophrenia and other acute psychotic states They have sedating impact by inhibiting dopamine which is linked to hallucinations Don’t work well with negative symptoms such as interpersonal difficulties Serious side effects such as tardive dyskinesia (slow motions)

Antidepressant & Mood Stabilizing Medications Tricyclic Antidepressants –70-80% improvement rate MAO Inhibitors –Works better than tricyclics for patients with depression and personality disorders –Requires food restrictions

Antidepressant & Mood Stabilizing Medications Selective serotonin reuptake inhibitors (SSRIs) –First-line medical treatment for depression –Fewer side effects than other antidepressants Lithium –Used with bipolar disease –Takes 3-4 weeks to begin having an impact

Anti-anxiety Medications Valium and Xanax are used for short term treatment of anxiety disorders Antidepressants are also used for anxiety disorders Patients can become psychologically and physiologically addicted

Electroconvulsive (ECT) Therapy & Psychosurgery Considered treatments of last resort ECT currently used to treat severe depression –Electric shocks administered to the brain –Can move patient out of a state of severe depression Psychosurgery –Lobotomy which may be used on patients with obsessive-compulsive disorders

Comparing forms of treatment Efficacy Studies –Assess treatment outcome under controlled experimental conditions (control group) Effectiveness Studies –Assess treatment as practiced by clinicians in the community