Treatment of Psychological Disorders

1. Treatment of Psychological Disorders Jeff Qian and Taylor Whitehead

2. Treatment Approaches Insight into true nature of a disorder can be derived from examining the strategy that is most effective in treating the disorder.

3. Insight Therapies: Psychoanalytic and Humanistic Psychoanalytic approach to treatment of abnormal behavior is rooted in the concept of insight. Psychoanalysis (Psychoanalytic Therapy) • Developed by Freud • Focuses on probing past defense mechanisms of repression and rationalization to understand the unconscious cause of a problem • Free Association: patient reports any and all conscious thoughts and ideas • This hints to the nature of unconscious conflict • Dreams: images and occurrences in dreams are actually symbols representing the truly meaningful content of dreams • Transference: patient pushes thoughts and feelings about certain people or events onto therapist • Reveals nature of patient’s conflicts Risks • *Countertransference*: occurs when therapist pushes his/her feelings onto patient Therapist strives to remain detached from the patient: resists emotional/personal involvement

4. Insight Therapies: Psychoanalytic and Humanistic (cont.) Instead of treating the person seeking help as a patient, the humanistic approach treats the individual. Humanistic Therapy • Client-Centered Therapy • Invented by Carl Roger • Clients can only be understood in terms of their own reality • Focuses on client’s present perception of reality • Goal is to help client realize full potential through self-actualization • Therapist is open, honest, and expressive rather than being detached • Therapist provides unconditional positive regard to help client reach a state of unconditional self-worth • Final key to success is the therapist’s ability to view world from client’s eyes • Gestalt Therapy • Developed by Fritz Perls • Combines both physical and mental therapies • Blend awareness of unconscious tensions with the belief that one must become aware of and deal with those tensions by taking personal responsibility • Physically act out conflicts • Empty Chair Technique

5. Behavioral Therapy Behavioral Therapy • Short-term process • Treats symptoms (no deep underlying cause of problem) • Abnormal behavior is the symptom and problem • Counterconditioning: technique where a response to a given stimulus is replaced by a different response • Aversion Therapy: aversive stimulus is repeatedly paired with the behavior the client wishes to stop • Systematic Desensitization: replace one response with another response Other Forms of Behavioral Therapy • Extinction Procedure: weaken Maladaptive responses • Flooding: exposing client to the stimulus that causes the undesirable response • Implosion: Client imagines disruptive stimuli rather than confronting it • Operant Conditioning: positive and negative reinforcement • Behavioral Contracting: therapist and client draw up a contract that they both agree to abide by • Modeling: clients watch someone act in a certain way and then receive a reward

6. Cognitive Therapy Cognitive Therapy • Changing the ways people think about situations in order to change behaviors • Rational-Emotive Behavior Therapy (REBT) • Developed by Albert Ellis • Confronted with situations, people will recite statements to themselves that express maladaptive thoughts • Goal is to change maladaptive thoughts and emotional response by confronting the irrational thoughts directly • Cognitive Therapy • Developed by Aaron Beck • Focus on maladaptive schemas • Goal is to eliminate or modify the individual’s maladaptive schemas

7. Biological Therapies Biological Therapies • Medical approaches to behavioral problems • Used in conjunction with other forms of treatment • Electroconvulsive Therapy • High voltages of electricity are passed across a patient’s head • Successful in treatment of major depression, however only used if all other treatments for depression have failed • Risks • Temporary Amnesia • More permanent memory loss • Can result in seizures • Psychosurgery • Most well-known form is the prefrontal lobotomy • Parts of frontal lobes are cut off from the rest of the brain • Risks • Patients are left in catatonic state

8. Biological Therapies (cont.) • Psychopharmacology • Treatment of psychological and behavioral maladaptives with drugs • Antipsychotics (Clozapine, Thorazine, Haldol) • Reduce symptoms of Schizophrenia by blocking neural receptors of dopamine • Risks • Jerky movements • Tremors • Muscle Stiffness • Clinician decides if disorder or side effects are worse • Antidepressant Drugs • MAO Inhibitors (Eutron) • Increase serotonin and norepinephrine in the synaptic cleft • Produce increase by blocking monoamine oxidase which are responsible for the breakdown of many neurotransmitters • Risks • Effective however toxic, require special dietary modifications

9. Biological Therapies (cont.) • Tricyclics (Norpramin) • Used frequently • Amitriptyline and Imipramine (other drugs) increase amount of serotonin and norepinephrine • Selective Reuptake Inhibitors (Prozac) • Increase amount of neurotransmitters at the synaptic cleft • Block the reuptake mechanism of the cell that released neurotransmitters • Indirect mechanism of action means fewer side effects • Anxiolytics (Xanax) • Depress central nervous system and reduce anxiety while increasing feeling of well-being and reducing insomnia • Risks • Include barbiturates which are rarely used because of their potential for addiction and danger when mixed with other drugs • Benzodiazepines (Valium and Librium) • Cause muscle relaxation and feeling of tranquility • Lithium Carbonate (A Salt) • Treats Bipolar Disorder • Mechanism of action is not known

10. Modes of Therapy Modes of Therapy • Group Therapy • Clients meet together with a therapist as an interactive group • Group members learn from each other • Therapist is moderator • Advantages • Less expensive • Group dynamic is therapeutic in itself • Disadvantage • Psychological effect is diluted because attention is focused on group rather than individual • Twelve Step Programs • Not moderated by professional psychotherapists • Combination of spirituality and group therapy • Focus on strong support system

11. Modes of Therapy (cont.) • Couples or Family Therapy • Treatment arose out of simple observation that dysfunctional behavior affects the afflicted person’s loved ones • Help with communication and resolve conflicts • Focus on whole family instead of just “ill patient” • Couples Therapy • Approach couple dyad as a system that involves complex interactions • Family Therapy • Allows family members to express their feelings to each other and to therapist • Encourages family members to listen to each other • Therapy doesn’t minimize or get rid of stress but teaches family to overcome the stress

12. Vocabulary • Manifest Content: images and occurrences • Latent Content: truly meaningful, content of dreams • Genuineness: Therapist is open, honest, and expressive • Accurate Empathic Understanding: therapist’s ability to view the world from the eyes of the client • Negative Triad: involves negative view of self, of the world, and of the future, these views are learned from experience • Arbitrary Inference: person draws conclusion without evidence • Dichotomous Thinking: involves all-or-none conceptions of situations