Psychological Disorders Treatment Approaches

Approaches to Treating Psychological Disorders

• Clinical psychology integrates science and theory to prevent and treat psychological disorders.
• Psychotherapy is a non-medical process using various strategies to treat psychological disorders.
• Biological therapies (biomedical therapies) aim to alter bodily functions to reduce or eliminate psychological disorders.
• Psychotherapy and biological therapies share the goal of relieving suffering but differ in focus and practitioners.

The Psychological Approach to Therapy

• Psychotherapy is practiced by various mental health professionals (clinical psychologists, counselors, social workers).
• State licensing and credentialing regulate these professionals.
• Clinical psychology PhD graduates work under supervision and complete clinical internships.
• Psychotherapy can be combined with medication.

The Biological Approach to Therapy

• Biological therapies require medical doctor training (MD).
• Psychiatrists are medical doctors specializing in treating psychological disorders.
• Psychiatrists complete additional 4 years of psychiatric residency after medical school.
• Psychologists in some states (Idaho, Illinois, Iowa, Louisiana, New Mexico) can prescribe medication.
• Prescribing rights for psychologists are a subject of debate.

Psychotherapy

Central Issues in Psychotherapy

• Psychotherapy is effective
  • Research shows improvement following 12-14 sessions versus placebo or no treatment.
• No single therapy is demonstrably better than others.
  • Best therapy depends on diagnosis.
  • Empirically supported treatment is crucial.
  • Evidence-based practice integrates research, expertise, and client preferences.
• Factors in effective psychotherapy:
  • Therapeutic Alliance: Trust, respect, cooperation crucial.
  • Therapist: Expertise, style-client match important.
  • Client: Active participation, strengths are key.

How Psychotherapies Differ

• Insight versus symptom/skill focus
• Directive versus non-directive approaches

Psychodynamic Therapies

• Emphasize unconscious mind, interpretation, and early childhood experiences.
• Goal is to gain insight into unconscious conflicts.
  • Psychoanalysis (Freud):
    • Free association, dream analysis, transference.
  • Contemporary Psychodynamic Therapies:
    • Shift from solely sexual conflicts; focus on current relationships and self-awareness.

Humanistic Therapies

• Focus on self-understanding, growth, conscious thoughts, and self-fulfillment.
• Client-centered therapy (Rogers):
  • Warm, supportive atmosphere for self-growth.
  • Goal is congruence (actual self close to ideal self).
  • Reflective speech, unconditional positive regard, empathy, and genuineness.

Behavior Therapies

• Focus on learning to reduce/eliminate maladaptive behavior.
• Focus on overt behavior, not underlying thoughts/emotions.
  • Classical Conditioning Techniques:
    • Systematic desensitization: Relaxation paired with anxiety-producing situations.
    • Aversive conditioning: Pairing undesirable behavior with aversive stimuli.
  • Operant Conditioning Techniques:
    • Applied behavior analysis: Modifying consequences for adaptive behavior.

Cognitive Therapies

• Emphasize thoughts as the source of psychological problems.
• Goal: Replace maladaptive thoughts with healthy ones.
  • Cognitive restructuring: Changing maladaptive thought patterns.
  • Cognitive Behavior Therapy (CBT): Combining cognitive and behavior therapy.
    • Self-instruction methods: Using reinforcing statements to cope with stress.
    • Self-efficacy: Mastering situations through adaptive behavior.

Therapy Integrations

• Integrative therapy combines techniques from various therapies.
• Dialectical behavior therapy (DBT) is effective for borderline personality disorder.
• Psychotherapy and medication are often combined.

Biological Therapies

• Treatments that alter bodily functions to reduce/eliminate psychological disorders.

Drug Therapy

• Antianxiety drugs (tranquilizers):
  • Benzodiazepines (Xanax, Valium, Librium) are fast-acting but carry potential risks like addiction.
  • Beta-blockers are safer alternatives.
• Antidepressant drugs:
  • Different classes (tricyclics, tetracyclics, MAO inhibitors, SSRIs) target neurotransmitters.
  • SSRIs are often the first choice due to fewer side effects.
• Bipolar disorder medication: Lithium.
• Antipsychotic drugs: Reduce agitation, hallucinations.
  • Potential side effects: Tardive dyskinesia, metabolic syndrome.

Electroconvulsive Therapy (ECT) and Transcranial Magnetic Stimulation (TMS)

• ECT: Treats severe depression.
  • Causes brain seizures.
  • Side effects include memory loss.
• TMS: Alternative to ECT.
  • Uses magnets to affect the brain.
  • FDA-approved for treatment-resistant depression.

Psychosurgery

• Removes or destroys brain tissue to improve adjustment.
• Prefrontal lobotomies are no longer performed.

Sociocultural Approaches and Issues in Treatment

Group Therapy

• Shared experiences and social support benefit individuals with shared psychological problems.

Family and Couples Therapy

• Family and couples therapy focus on relationships’ problems.

Self-Help Support Groups

• Voluntary groups discussing common issues.
• Offer social support and resources.

Community Mental Health

• Community mental health focuses on supporting individuals within their communities.
• Deinstitutionalization has resulted in homelessness in affected communities.
• Empowerment helps individuals manage their lives.

Cultural Perspectives

• Cultural factors are crucial in psychotherapy.
• Therapists should develop cross-cultural competence and cultural humility.
• Multicultural perspective promotes diverse needs and social justice.
• Therapy goals that involve more connectedness are important.
• Therapist-client matching is important on ethnic similarities.

Therapies and Health and Wellness

• Psychotherapy can address health concerns beyond mental illness.
• Psychotherapy can prevent mental and physical health issues.
• Well-being therapy (WBT) focuses on savoring positive experiences.
• Psychological wellness is important for resilience.