5.5 - Treatment of Psychological Disorders

Treatment of Psychological Disorders

Types of Therapy

• Psychotherapy: "Talk therapy," using psychological techniques to treat mental health issues.

• Biomedical Therapy: Using medications or procedures that act on the nervous system to treat psychological disorders.

• Eclectic Approach: Combining different therapeutic approaches to tailor treatment to the individual's needs.

Psychoanalysis (Freud)

• Key Idea: Psychological problems stem from unconscious conflicts and repressed childhood experiences.

• Goal: Bring unconscious thoughts and feelings into conscious awareness to gain insight and resolve conflicts.

• Techniques:

  • Free Association: Patient says whatever comes to mind, revealing unconscious thoughts.

  • Resistance: The patient's blocking of anxiety-provoking thoughts during free association.

  • Transference: The patient's transfer of emotions (love or hate) linked with other relationships onto the therapist.

• Criticisms of Psychoanalysis:

  • Time-consuming and expensive: Can take years and be costly.

  • Difficult to prove or disprove: Relies heavily on interpretations of the unconscious, making it hard to scientifically validate.

Humanistic Therapies

• Goal: Help individuals achieve self-actualization and personal growth by increasing self-awareness and self-acceptance.

• Client-Centered Therapy (Carl Rogers):

  • Therapist provides a supportive and non-judgmental environment for the client.

  • Focuses on active listening and reflecting back the client's feelings and thoughts to help them gain insight and self-understanding.

Behavior Therapies

• Goal: Change unwanted behaviors using learning principles.

• Counterconditioning: Pairing a feared or unwanted stimulus with a new, more positive response.

  • Exposure Therapy: Exposing individuals to the feared stimulus gradually and repeatedly until the fear diminishes.

  • Systematic Desensitization: A specific type of exposure therapy where relaxation techniques are paired with gradually increasing exposure to the feared stimulus.

  • Aversive Conditioning: Pairing an unpleasant stimulus with an unwanted behavior to decrease its frequency. Example: Pairing nausea-inducing medication with alcohol to reduce alcohol consumption.

• Operant Conditioning:

  • Behavior Modification: Using rewards and punishments to increase or decrease specific behaviors.

  • Token Economy: A system where desired behaviors are rewarded with tokens that can be exchanged for privileges or rewards. Often used in institutional settings.

Cognitive Therapy

Goal: Change unhelpful thoughts and beliefs that contribute to psychological problems.

• Key Idea: Our thoughts influence our feelings and behaviors.

• Cognitive Therapy (Aaron Beck):

  • Helps patients identify and challenge negative thought patterns associated with depression and other disorders.

• Cognitive-Behavioral Therapy (CBT):

  • Combines cognitive therapy with techniques to change behavior.

  • Focuses on both modifying thoughts and developing coping skills.

  • Effective for a wide range of disorders.

Group Therapy

• Cost-effective.

• Provides social support and allows clients to see that others share similar struggles.

Evaluating Therapies

• Client Testimonials:

  • Clients often report positive experiences, but this may be influenced by factors like:

    • The natural course of time (crises may subside on their own).

    • The desire to justify the time and money spent on therapy.

• Research:

  • Controlled studies generally show that therapy is effective, with treated individuals faring better than untreated ones.

Types of Therapists and Their Training

• Clinical Psychologists:

  • Hold a Ph.D. or Psy.D. in psychology.

  • Trained in research, assessment, and therapy.

• Clinical or Psychiatric Social Workers:

  • Hold a Master's degree in social work.

  • Provide psychotherapy, often focusing on everyday problems and connecting clients with community resources.

Biomedical Therapies

• Antipsychotic Drugs:

  • Function: Reduce symptoms of psychosis (hallucinations, delusions) by blocking dopamine receptors.

  • Examples: Chlorpromazine (Thorazine), Clozapine

• Antimanic Drugs (Mood Stabilizers):

  • Function: Reduce manic symptoms in bipolar disorder.

  • Example: Lithium

• Antidepressant Drugs:

  • Function: Increase the availability of neurotransmitters like serotonin and norepinephrine.

  • Types:

    • SSRIs (Selective Serotonin Reuptake Inhibitors): Block reuptake of serotonin.

    • SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors): Block reuptake of both serotonin and norepinephrine.

• Antianxiety Drugs:

  • Function: Reduce anxiety and tension.

  • Example: Benzodiazepines (e.g., Xanax, Valium)

• Electroconvulsive Therapy (ECT):

  • Function: Brief electrical current is passed through the brain.

  • Used for: Severe depression that hasn't responded to other treatments.

  • Mechanism: May work by resetting brain chemistry or stimulating neurogenesis (growth of new neurons).

• Psychosurgery:

  • Function: Surgical procedures that destroy or remove brain tissue.

  • Example: Lobotomy (rarely used today)

  • Modern Use: Very limited, only for severe and treatment-resistant cases.

Hypnosis

• Effective in treating pain and anxiety.

• Not supported for retrieving accurate memories or age regression.

Biofeedback

• Uses conditioning principles to help clients regulate body systems, like the nervous system, to manage anxiety or depression.

Ethical Principles in Therapy

• Psychologists must follow APA guidelines, including nonmaleficence (do no harm), fidelity, integrity, and respect for rights and dignity.

Effectiveness of Psychotherapy

• Meta-analytic studies show that psychotherapies are generally effective.

• Psychologists often use evidence-based interventions to create treatment plans.

• Therapists should demonstrate cultural humility and build a strong therapeutic alliance with clients for successful therapy.