TREATMENT

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• TREATMENT
• OF
• PSYCHOLOGICAL
• DISORDERS

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Psychodynamic Therapies

• Psychodynamic therapies revolve around
• Insight
• Understanding ones own psychological processes
• Therapist-patient relationship
• Assist a patient to become captain of my own
  ship

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Insight

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

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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 patients efforts to hide the
  unconscious conflict

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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

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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

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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

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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

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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

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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

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Cognitive Therapy

• 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

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Cognitive Therapies

• Rational-emotive therapy
• Mediates between activating conditions and
  maladaptive emotional reactions
• I wont let his mean behavior get to me
  anymore!

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Humanistic Therapies

• Gestalt therapy
• Focus on awareness of ones 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 ones present state

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Humanistic Therapies

• Client-centered therapy
• Clients versus patients
• Rejects disease model
• Solve problems not seek cures
• Problems develop when ones 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

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Group Therapies

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

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Family Therapies

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

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Biological Treatments

• Psychotropic medications act on the brain to
  affect mental processes

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Antipsychotic Medications

• Used to treat schizophrenia and other acute
  psychotic states
• They have sedating impact by inhibiting dopamine
  which is linked to hallucinations
• Dont work well with negative symptoms such as
  interpersonal difficulties
• Serious side effects such as tardive dyskinesia
  (slow motions)

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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

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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

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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

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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

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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