Chapter 16: Treatments

The nature of therapy

• Types of treatment:

– Psychotherapy:

• An interactive experience with

a trained professional, working on

understanding and changing behaviour, thinking,

relationships, and emotions

– Biological therapy:

• The use of medications and other procedures acting

directly on the body to reduce the symptoms of mental disorders

Biological treatments

• Interventions in the brain and body can affect mood and behavior

• Biological treatments alter the brain’s functioning by changing its chemistry with medications, or affecting its circuitry with electrical or magnetic impulses or surgery

– Drug therapy

– Electroconvulsive therapy

– Psychosurgery

Drug Therapy

Psychotropic drug = drug that acts (primarily) on the brain

• Most prescriptions for anti-anxiety drugs, antidepressants, mood stabilizers, and antipsychotics

Anti-anxiety drugs

• Valium, Xanax, Prozac

• Designed to reduce anxiety without affecting alertness or concentration

• Slows down excitatory synaptic activity

• Side effects: drowsiness, lethargy, dependence

• Newer drugs: enhances inhibitory GABA, fewer side effects

Antidepressants

• Elavil, Nardil, Prozac, Paxil, Zoloft

• Designed to improve mood and reduce other symptoms of depression

• Work by increasing levels of serotonin, norepinephrine, and dopamine

Three types of antidepressants

– MAO inhibitors, tricyclics, and selective serotonin reuptake inhibitors (SSRIs)

Mood stabilizers

• Lithonate (lithium)

– Standard treatment for bipolar disorder from 1950’s – 1980’s

– Many serious side effects

• Designed to improve intense shifts in mood from one extreme state to another

– Antipsychotics = major tranquilizers

• Thorazine, Clozaril, Risperdal

• Designed to reduce symptoms of schizophrenia, especially ‘positive’ symptoms (eg: delusions & hallucinations)

• Work by decreasing the action of dopamine

• Side effects: obesity, diabetes, movement problems

– Tardive dyskinesia = odd facial, tongue and body movements

Electroconvulsive therapy (ECT)

– Used to treat depression by sending an electrical current through the brain, producing a brain seizure

• Effects can be immediate

• 60 – 70% improve

– Can cause memory problems

– Procedure:

• Patient given sedative and muscle relaxant

• Placed on well-padded mattress

• Shocked less than 1 second, causing seizure of CNS

Transcranial magnetic stimulation

– A noninvasive procedure used to treat depression

– Stimulates a focal area of the frontal lobes with a powerful magnetic field

Vagus nerve stimulation

– An implanted pulse generator sends electrical signals to a specific region of the brain

– Helps reduce depression in many people

Psychosurgery

– Procedures that remove or destroy parts of the brain

• Least used of biomedical procedures

Lobotomy

• Destroy nerve tracts to frontal lobes

– Treatment for schizophrenia in the 1930’s and 1940’s

Psychodynamic therapies

– Psychoanalysis, short-term psychodynamic therapy, relational psychoanalytic therapy

– Goal is to help patients release tension of repression and resolve unconscious inner conflicts

Behaviour therapies

• focus on behaviour

– Abnormal behaviours are learned

– Maladaptive behaviours can be unlearned

through:

• Classical conditioning

• Operant conditioning

• Modelling

• is often effective for treating phobias and anxiety issues

• Classical conditioning techniques:

– Exposure approach:

• Treat phobias through exposure to feared CS (stimulus) without being allowed to escape

– Eliminate anxiety through extinction

Cognitive-behavioural therapies

• Therapy that works on problem thoughts and

behaviours

– Behavioural – work on gaining skills that they may

be lacking

– Cognitive – work on building more functional

thinking habits

Humanistic and existential therapies

• Humanists – we are all born with the tools to

fulfill our potential

• Existentialists – accept responsibility for our

lives and choices

• Gestalt therapy – guide clients toward self-

acceptance by challenging and frustrating

them