Biomedical Therapies

1. Biomedical Therapies

2. Drug Therapy: Anti-anxiety Drugs • Also called minor tranquilizers or anxiolytics • Effects: • Reduces anxiety • Produces calmness • Reduces muscle tension • Effect on GABA receptors • Examples: • Valium, Librium, Xanax

3. Drug Therapy: Antidepressants • Increases availability of neurotransmitters • Serotonin, norepinephrine • Major types: • Tricyclics • MAO inhibitors • Selective serotonin-reuptake inhibitors • Therapeutic benefits for both depression and anxiety disorders • Questionable efficacy- is it a placebo effect?

4. Drug Therapy: Antipsychotics and Mood Stabilizers • Sometimes called major tranquilizers • Used to treat schizophrenia and other psychotic disorders • Many actions • Act on Serotonin, Norepinephrine and dopamine receptors • Newer drugs block the action of dopamine at receptor sites in brain. • Mood stabilizers to reduce mood swings • e.g., Lithium • Stimulants used to improve attention spans and reduce disruptive behavior in hyperactive children • e.g., Ritalin, Cylert

5. Drug Treatment • Antipsychotic medication • Older/typical • Thorazine (chlorpromazine) • Stelazine • Mellaril • Serentil • Newer Atypical antipsychotics • Clozapine (clozaril) • Respiridone (Risperidal) • Olanzapine (Zyprexa) • Quetiapine (Seroquel) • Ziprasidone (Geodon) • Aripiprazole (Ability)

6. Side effects of psychotropic medications? • All medication has side effects • SSRIs, DASRIs, NESRIs, etc. • Sexual side effects • Headache and Nausea • Weight gain • Can elicit mania • Antipsychotics • All of the above • Tardive dyskinesia • Neuroleptic Malignant Syndrome (NMS) • Alternatives or adjunctives? • Exercise • Cognitive behavior therapy • Interpersonal therapy

7. Evaluating Psychotropic Drugs • Limitations: • May reduce or control symptoms, but not a cure • Does not teach how to resolve problems or develop necessary life skills • Risks of adverse side effects • Some drugs can lead to psychological or physical dependence. • Relapses common when taking drugs stopped • May be seen as a “quick fix” • Useful for temporary relief • Usually used in tandem with psychotherapy

8. Electroconvulsive Therapy (ECT) • Can produce dramatic relief from severe depression • High rates of relapse in weeks and months following treatment • May produce permanent memory loss • Many view as treatment of last resort

9. Psychosurgery • Involves surgically altering the brain to control deviant or violent behavior • Prefrontal lobotomy a widely practiced form in the past • More sophisticated techniques have been introduced in recent years. • But still, procedures rarely used and only as a treatment of last resort

10. Other or combination therapies

11. Community-Based Care • Social policy of deinstitutionalization • Resulted in the back wards of many mental hospitals being vacated • Community-based mental health centers offer a variety of services. • Has deinstitutionalization been successful? • A work in progress

12. Group Therapy • People brought together to explore and resolve problems • Advantages: • Less costly • Helps with interpersonal problems, social skills • Share coping strategies • Drawbacks: • No individual attention • Reluctance to disclose personal problems to group • Feelings of inhibition

13. Family Therapy • Helps troubled families learn to communicate better and resolve their differences • Family, not the individual, is the unit of treatment. • Individual problems symptomatic of family system breakdown

14. Couples Therapy • The couple is the unit of the treatment. • Goal is to build healthier relationships: • Acquire more effective communication and problem-solving skills • Resolve power struggles • Aim is to help open channels of communication between partners.

15. Choosing a therapist

16. Choosing a Therapist • Seek recommendations from respected sources. • Seek a referral from a local medical center or local community mental health center. • Seek consultation from college counseling center or health services • Contact professional organizations for recommendations. • Can use local Yellow Pages, but be wary. • Check for proper licensing • Ask about type of therapy being provided. • Ask about provider’s background and experience.

17. Working with the Therapist • Discuss diagnosis and treatment plan before committing. • Ask about costs and insurance. • Find out about policies for missed or canceled sessions. • If medication is to be prescribed, inquire about delay, side effects. • Openly discuss concerns about treatment. • Request a second opinion if in doubt. • Be wary of online therapy services.

18. But, is therapy effective? • Yes and no… • General statistic is that people in therapy show 80% more improvement than those in control group • Pharmacologicals are more questionable • Current studies suggest many antidepressant effects may be placebo • Even if placebo- works! • Still, at what cost to system?

19. Effectiveness of Psychotherapy

20. Examples of Empirically Supported Treatments

21. Nonspecific Factors Accounting for the Benefits of Psychotherapy • Interpersonal relationship with therapist • Therapeutic alliance • Expectation of improvement • Self-fulfilling prophecy • Placebo or expectancy effects

22. Multicultural Issues • Psychotherapy designed around Americans of Western European descent. • How does it work for: • African Americans • Asian Americans • Hispanic Americans • Native Americans

23. Conclusions • Psychology is a huge and diverse discipline • We are like biology and medicine combined • Not separate out basic research from practice • Perhaps this is a good thing • We are a very young science • Don’t know very much • We are learning more by leaps and bounds

24. The Future • We have made tremendous gains in our first 100 years • We have a long way to go • It is up to you: • Become a psychologist • Become a researcher • Support Brain Science efforts • Be a good consumer of psychological services • It is cool to be a brain scientist!!!