Treatments
History of Treatments
• Early treatments brutal
transitioned to more
humane methods
• Dorthea Dix–
• Today - Biomedical Drugs
and better therapy has led
deinstitutionalization.
Categories of Therapy
2 Main Categories
1. Psychotherapy – interaction between
–
Example: Psychotherapist trained therapist
who uses
psychological techniques to assist
someone to overcome
•
Example:
2. Biomedical Therapy –
prescription meds that act on
– Example:
Biopsychosocial Approach
Eclectic Approach– uses a
variety of psych theories and
approaches to treat mental
illness
•
Psychotherapy integration –
combining a selection of
assorted techniques into a
•
Example:
Perspectives and Disorders
Psychological
School/Perspective
Psychoanalytic/Psychody
namic
Cause of the Disorder
Treatments
Internal, unconscious
drives and conflicts
Psychoanalytic
Psychodynamic
Humanistic
Failure to strive to one’s
potential or being out of
touch with one’s feelings.
Insight Therapy
Client Centered Therapy
Behavioral
Reinforcement history, the
environment.
Behavioral Therapies
Classical – counterconditioning,
exposure therapy, flooding,
systematic desensitization, virtual
reality, aversive
Operant – behavior modification,
Token economy
Cognitive
Irrational, dysfunctional
thoughts or ways of
thinking.
Cognitive Therapy
Dysfunctional Society
Group or Family Therapy
Sociocultural
Biomedical/Neuroscience Organic problems,
biochemical imbalances,
genetic predispositions.
Biomedical Drug Therapy
Insight Therapies
• Insight therapies – try to improve
mental state by increasing client’s
awareness of underlying motives and
defenses
Psychoanalytic Therapy
• Psychoanalysis – uncovering
childhood experiences to gain
insight into the unconscious
origins of the disorder
– dream analysis – manifest and
latent
– free association – uncensored
reporting of any thoughts that come
to mind.
• Resistance –
– Example:
Psychoanalytic Therapy
– Transferring expression toward a
therapist of feelings
linked with earlier
relationships
• Example
Psychoanalytic Therapy
• Criticisms
– Interpretations can’t
be
–
(2 or more
sessions/week for 2
or more years)
Psychodynamic Therapy
• Psychodynamic therapy - try to
understand patients' current
symptoms by
in their interpersonal relationships
– Patients gain insight into unconscious
conflicts
• Interpersonal psychotherapy effective in treating depression by
helping patients improve
– variation of psychodynamic therapy
– 14-16 sessions
– Example:
Humanistic Therapy
• Humanistic Therapy - emphasize the
importance of self-awareness and
take responsibility for own feelings
and actions to improve mental state
– seek to promote
• Client-Centered Therapy (Rogers) patients' discover their own ways of
effectively dealing with difficulties
– non-directive therapies –
– Unconditional Positive Regard
– Active listening –
Behavioral Therapies
Behavior Therapies – applies
learning principles to
unwanted behaviors
• Classical Conditioning
• Operant Conditioning
Behavioral Therapy
• Classical Conditioning
– Counterconditioning (Pavlov)procedure that trains people to
make
– 2 Types
1.
Exposure Therapies
2. Aversive Conditioning
Exposure Therapies
• Exposure Therapies - Repeatedly introducing
people to things they fear and avoid
1. Flooding – forced exposure to the stimulus that
is feared
•
Example:
2. Systematic Desensitization – gradual exposure to
the actual stimulus by replacing a positive
response with a negative response.
•
Progressive relaxation – imagined scene is repeatedly
paired with
•
Example:
Exposure Therapies
3. Virtual Reality
Therapy –
progressively
exposing people to
simulations of their
greatest fears
–
Example:
Aversion Therapy
• Aversion Therapy – unwanted
behavior systematically
associated with
– Examples:
– Problem:
Operant Conditioning
1. Behavior Modification desired behaviors, giving
for undesired behaviors
–
Example:
2. Token Economy – earning a token for
desired behavior that can be traded
in for privileges
–
Example:
Cognitive Therapy
• Cognitive Therapy – change the way
patient thinks (change schemas)
–
–
– Example:
• Beck’s Therapy for Depression
• Stress Inoculation Training
Cognitive-Behavioral Therapy
• Cognitive Behavioral Changes the way we think
and act
– Example:
Family and Group Therapy
• Group Therapy
– Offered for: family
conflict, stressful
relationships,
– Improves communication
skills and conflict resolution
• Examples:
– Family Therapy – unwanted
behaviors are influenced by
other family members
Example:
Evaluating Psychotherapy
• Placebo effect –
• Regression toward the mean – the
tendency for unusual events or
emotion to return to their ave. state .
• Selective Justification –
overestimating the actual benefits
(both patients and therapists)
• Eysenck and Eysenck –
Evaluating Psychotherapy
• Randomized Clinical Trials –
• Meta-analysis –
• Bottom line –
Comparison of Psychotherapies
Evidence Based Practices - Clinical decision making that integrates the
best available research with clinical expertise and an understanding of
patient characteristics
**Scientifically Unsupported Therapies -
Alternative Therapies
• EMDR (Eye Movement
Desensitization and Reprocessing Rapidly moving one's eyes while
recalling traumatic experiences
– similar to
– Originally developed for
– Value in placebo effect and exposure
therapy
• Light Exposure Therapy – exposure
to intense light that mimics outdoor
light
– activity
– Seasonal Affective Disorder –
depression caused by lack of exposure
to natural light
Biomedical Therapy
Biomedical Therapy – drugs, or
treatments that
–
–
–
–
–
Examples:
Drugs,
Electroconvulsive therapy,
Magnetic impulses
Psychosurgery
Biomedical Therapy
Psychopharmacology – study of
the effects of
– Antipsychotics
(thorazine,Chlorpromazine,
Clozapine)
– Anti-anxiety ( Xanax,
Ativan d-cycloserine)
– Anti-depressants (Paxil,
Prozac, Zoloft – SSRI’s)
– Mood Stabilizers Bipolar
(lithium, Depakote)
Brain Stimulation
• 3 Types Used to Treat
Depression
1.
ECT (Electroconvulsive therapy) –
electric shock therapy for patients
with severe
1.
Can trigger
2. rTMS (repetitive transcranial
magnetic stimulation)- repeated
pulses of magnetic energy to brain’s
surface
1.
2.
No
Triggers
3. Deep Brain Stimulation – uses
implanted electrodes to inhibit
activity in an
Psychosurgery
• Psychosurgery – removes
or destroys brain tissue
– Lobotomy - cut the nerves
connecting the frontal lobes
to the
– MRI-guided precision
surgery – cut brain circuits
Preventing Psychological
Disorders
• Therapeutic Lifestyle Change
– reverses the symptoms of
psychological disorders
–
– Resilience – ability to cope with
stress and recover from
adversity