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.