Psychology Chapter 15: Therapy & Biomedical Interventions

• Chapter 15 discusses therapy
• The four topics are biomedical intervention, insight therapies, behavioral therapies, and types of therapy

Biomedical Interventions

• Consists of drug therapies, electroconvulsive therapy, and psychosurgery

Drug Therapies

• Includes antipsychotics, antidepressants, and antianxiety drugs

Antipsychotics

• Includes Chlorpromazine and is a dopamine antagonist that blocks dopamine receptors in the brain
• Treats positive symptoms of schizophrenia such as delusions and hallucinations
• Used for bipolar disorder and acute psychotic episodes
• Side effects include drowsiness, dizziness, weight gain, dry mouth, and tardive dyskinesia which involves involuntary movements

Antidepressants

• Tricyclics increase the effect of serotonin and norepinephrine
• Selective Serotonin Reuptake Inhibitors (SSRIs) include Prozac, Lexapro, Paxil, and Zoloft
• SSRIs block the reabsorption of serotonin into the neuron
• Typical onset: 2-4 weeks for mild improvements in mood, sleep, and appetite; 4-6 weeks for noticeable improvements in symptoms

Antianxiety Drugs

• Benzodiazepines like Xanax and Valium treat anxiety
• Enhances the effect of the neurotransmitter GABA (Gamma-Aminobutyric Acid), resulting in a sedating effect on the brain
• GABA is a chief inhibitory neurotransmitter that inhibits nerve transmission and reduces neuronal excitability
• Recommended for short-term use only due to the risk of dependency, approximately 2-4 weeks
• Side effects include drowsiness, headaches, dizziness, fatigue, and memory impairment

Alternative Treatments

• Ketamine Therapy is used to treat depression, anxiety disorders, PTSD, and OCD
• Transmagnetic Stimulation Therapy (TMS) is a non-invasive treatment using magnetic pulses to stimulate specific areas of the brain and is used to treat severe depression
• Electroconvulsive Therapy (ECT) uses a brief electric current to induce a controlled seizure in the brain - ECT is effective for treatment-resistant depression, though efficacy is not well understood - Side effects include memory loss and confusion

Psychosurgery

• Prefrontal lobotomy is no longer used due to causing death and serious cognitive deficits - Patients lost the ability to plan and coordinate actions
• Deep Brain Stimulation involves implanting electrodes within areas of the brain

Insight Therapies

• Insight therapies include verbal therapy designed to assist individuals in gaining self-knowledge about their inner thoughts, desires, and emotions
• Goal is to obtain a more realistic view of oneself and the world, followed by behavioral change

Psychoanalysis

• Sigmund Freud created psychoanalysis
• The unconscious mind houses primitive urges, memories, and conflicts that must be accessed
• The goal of psychoanalysis is to uncover and relive unconscious conflicts
• Free association involves relaxing and discussing whatever comes to mind
• Dream analysis is believed to offer information about primitive desires of the unconscious
• Latent content reveals the unconscious
• Manifest content includes the actual events in the dream
• Resistance involves an unconsciously motivated attempt to subvert or hinder the therapy
• Transference involves a patient redirecting feelings, attitudes, or desires from important figures in their past onto the therapist
• A modern approach = psychodynamic therapy, which is more directive, shorter, and involves the use of role-play

Cognitive Therapy

• Cognitive Therapy focuses on changing maladaptive beliefs and emphasizes on conscious belief, unlike psychoanalytic therapy
• An irrational/negative belief model is responsible for mental health disorders
  • If the beliefs change, then the symptoms reduce
  • Interpretation matters, not the events themselves
• Example: Belief: “I'm an unlovable person” Behavior: Person cancels a date -Consequential thought: “She doesn't like me... I am unlovable” -Consequential mood: sad, depressed

Rational Emotive Behavioral Therapy (REBT)

• Albert Ellis established REBT in the 1950s - REBT challenges irrational beliefs through active and aggressive confrontations - REBT replaces irrational beliefs with rational, constructive ones - REBT reinforces new rational thoughts and behaviors

Beck's Cognitive Therapy

• Approaches patients with a more subtle approach, inviting patients to identify negative thoughts on their own
• The therapist acts as an adviser or “co-investigator”
• Homework to record thoughts and create rational responses

Humanistic Therapy

• Goal: gain insight into one's own fundamental self-worth and value as a human
• Therapists believe that humans have the capability to fix their own problems and control their behaviors
• Client-centered therapy (Carl Rogers) is where the client, not the therapist, holds the key to psychological health and happiness, offering unconditional positive regard for the client
• Three Qualities of Care: Genuineness, Unconditional positive regard, Empathy

Gestalt Therapy

• Fritz Perls established it in 1969 - Clients are encouraged to express their feelings openly - Focuses on “here and now” - Understands oneself as a whole (Gestalt) - Empty chair technique
• Existential Therapies help individuals find meaning, purpose, and responsibility in life amidst uncertainty and impermanence.

Behavioral Therapies

• Behavioral therapies are used to change unwanted or maladaptive behavior through the application of basic learning principles
• Use of counterconditioning

Systematic Desensitization

• Systematic desensitization helps people reduce anxiety and fear responses by gradually exposing them to feared stimuli

Aversion Therapy

• Aversion Therapy aims to eliminate unwanted behaviors or thoughts, by associating them with unpleasant or aversive stimuli through nausea inducing methods and electric shock

Cognitive Behavioral Therapy

• A therapy used to modify thoughts, emotions, behaviours through changing perceptions

Types of Therapy

• Individual Therapy
• Group Therapy includes support groups, structured interventions, and open vs. closed groups
• Couples Therapy
• Family Therapy

Evaluating and Choosing Psychotherapy

• Meta-analysis shows a consistent and large treatment advantage, with little difference among different types of therapies

Common Factors Across Psychotherapies

• Support Factors require therapists to be willing to accept and understand clients
• Learning Factors help clients learn things about themselves
• Action Factors provide clients with a tangible course of action