Psychological Treatments

Psychotherapy

= any type of therapy/treatment based on a psychological explanation (rather than physical) for the disorder

Psychiatrist

= a medical doctor with a specialty in mental health

• can prescribe medication (because they hold an M.D.)

Clinical Psychologist

= medical doctor

• CAN’T prescribe medication (because they hold a doctoral degree (PhD) instead of a medical degree (M.D.))
  • have to refer to others to prescribe

Psychoanalyst

= a certain kind of clinician whose techniques are based on the ideas of Freud or neo-Freudians

• known for talk therapy rather than prescribing medication

1) diagnose problem

• use objective or projective tests (MMPI-2, IQ, or TAT test)
• interview about patient’s life
• medical tests to rule out other problems
  • ex. eye exam for supposed stress headaches
• collect symptoms and consult the DSM-5

2) Determine appropriate strategy for treatment

• (diff. schools of thought recommend diff. approaches)

Steps to diagnose a disorder?

1) person who voluntarily starts therapy is someone who already recognizes a problem and seeks to improve

2) social contact

(with therapist of other patients in group therapy)

→ helps reduce stress and isolation

3) Opening up about emotions

→ helps improve mood and lower blood pressure

4) talking about a negative event/feeling

→ helps make it less threatening

5) Placebo effect + Novelty

→ doing anything is better than doing nothing

Why does therapy work?

Individual Therapy

a treatment format

= one on one client to therapist

Group Therapy

a treatment format

benefits:

• decreases isolation
• connect with others who have had similar experiences
• less expensive than one-on-one therapy
• sharing advice from your experience provides a sense of purpose and deepens relationships

Family/Couples therapy

a treatment format

= beings members of family together to explore dynamics within the complex group

• focuses on improving communication or analyzing power structures

Community Therapy

a treatment format

• focuses on prevention and early intervention rather than on therapy to prevent onset of mental health issues
• often in under served communities (socioeconomic issues, crime, etc.)

to gain insight into unconscious conflicts

to break down unhealthy defense mechanisms

Purpose of psychoanalytic and psychodynamic therapy?

Dream Analysis

a way to interpret client’s symptoms

= interpreting latent (hidden) content of dreams from manifest content (storyline

Free Association

a way to interpret client’s symptoms

= clients let their minds roam freely to express whatever comes to mind without hesitation

Resistance

= when patient is reluctant to say what they want to say

might be indication that therapist is getting closer to uncovering a meaningful conflict

Word Association

= therapist presents stimulus word, client presents response word → shows subconscious associations

Transference

a way to interpret client’s symptoms

= over a lengthy analysis (many years), when patients express feelings for the analyst that actually represent feeling they have toward a significant person in their lives

Counter-Transference

= when therapist projects own unresolved conflicts onto client

ex.

Therapist: “so basically you have a foot fetish”

but client is actually just shopping for shoes, and it’s the therapist who has a foot fetish!

Psychodynamic Therapy

= more modern and condensed version of the traditional psychoanalytic approach (Freud)

• developed by neo-Freudians (Alfred Adler and Carl Jung)

Carl Rogers

“To my mind, ==empathy== is in itself a healing agent”

• one of the founders of humanistic psychology
• client-centered therapy

client-centered therapy

a type of therapy

= where therapist provides genuine, non-judgmental acceptance and empathy as the client works toward self-acceptance

• therapist doesn’t tell client what to do, only help their client gain insight into how they can improve
• client is the one in charge of their own progress

Acceptance

Genuineness

Empathy

Active Listening

psychotherapeutic technique

= therapist listens to a client closely, asking questions as needed,

→ in order to fully understand the content of the message and the depth of the client's emotion

Unconditional Positive Regard

= showing complete support and acceptance of a person no matter what that person says or does

Gestalt Therapy

a humanistic approach

= help client become more WHOLE by pulling together the separate parts of one’s self

• using the whole person (their strengths) to help achieve their goals

Existential Therapy

= a type of therapy that helps people finding meaning in their lives

Pros of Humanist Therapy

• Unconditional positive regard, active listening, and a more trusting, balanced relationship between individual and professional has spread to other fields

• It helps with milder forms of anxiety and depression

• It helps people build their strengths

Cons of Humanist Therapy

• It’s not very useful to treat serious forms of many disorders

Behavioral Therapy

a type of therapy

• believes the symptoms were learned and that they ARE the disorder itself (AKA not any other underlying causes)

• believes the treatment is to use counter-conditioning (AKA extinction) to “unlearn” negative behaviors

there are 3 subcategories:

• classical conditioning methods
• operant conditioning methods
• and social learning methods

Exposure Therapy

Behavioral Therapy > Classical Conditioning Methods > Therapy

= a type of classical conditioning method

In this form of therapy, psychologists create a safe environment in which to “expose” individuals to the things they fear and avoid. The exposure to the feared objects, activities or situations in a safe environment helps reduce fear and decrease avoidance

Systematic Desensitization

Behavioral Therapy > Classical Conditioning Methods > Exposure Therapy > ____ __ ____

= a type of exposure therapy where client works their way up through levels of fear, starting with the least fearful exposure

• used to normalize the body's response to particular sensations

Virtual Reality Exposure Therapy

Using virtual reality instead of the actual trigger of a phobia

Ex. People scared of flying go on virtual reality flights, not the real flight

Flooding

Behavioral Therapy > Classical Conditioning Methods > Exposure Therapy > ____ __ ____

= a type of exposure therapy

Instead of starting systematic desensitization at the least scary object, the patient is exposed to the MOST SCARY scenario. (That’s why it might be unethical.) It might happen in an emergency.

ex. a person who is very afraid of leaving the house might be forced to flee a fire or natural disaster

Aversion Therapy

Behavioral Therapy > Classical Conditioning Methods > _

= a type of classical conditioning method using an unpleasant stimulus to break an unwanted behavior.

• Ex. Hot sauce on your thumb or fingernails to stop thumb sucking or nail biting

Token Economy

Behavioral Therapy > Operant Conditioning Methods > _

= authority figure gives out some stars or poker chips that kids, students, etc can later redeem for an actual prize.

• helps to reinforce good behaviors
• encourages delayed gratification.

Social Learning

a type of behavioral therapy method

• Model – This is a person who actually performs the desired behaviors.

• Verbal Instruction – This occurs when a person describes the desired behaviors (in detail) and then instructs you to demonstrate those behaviors.

• Symbolic – This involves taking an in-depth look at how the media, movies, television, internet, books, plays and poems and music influence how you think, feel and behave.

Pros of Behavioral Therapy

• Effective with phobias and some anxiety

• Works well when paired with cognitive therapy

Cons of Behavioral Therapy

• Because the treatments do not address the underlying problem, changing a behavior won’t work once the person returns to the environment(s) that trigger the behavior

Cognitive-Behavioral Therapy

= help a person become aware of automatic ways of thinking that are inaccurate or harmful (for example, having a low opinion of one’s abilities) and then finding ways to question those thoughts, understand how the thoughts affect their emotions and behavior, and change self-defeating patterns

• believes causes of disorder to be incorrect beliefs like:
  • Negative filter (aka selective abstraction)
  • over-generalization/globalization (from Seligman)
  • learned helplessness (also from Seligman)
  • magnification of small problems/minimization of successes
  • Personalization (blame yourself when something bad happens to someone else)
  • see only absolutes (ex. “if it’s not an A, it’s a failure”)

Treatments = help people form more rational conclusions about their experiences and interpretations of others’ actions,

Rational Emotive Therapy

a type of Cognitive therapy by Albert Ellis

He proposed the ABC model

to depict how irrational responses can impact people’s thinking and feeling about themselves.

The DEF addition to the model = the therapy portion

Beck’s cognitive therapy

a type of Cognitive therapy by Aaron Beck

• used for depression

• believed:

causes for maladaptive thoughts = cognitive triad

treatment = cognitive restructuring (changing the way you think)

Cognitive Triad

a negative feedback loop where negative feelings about one’s current situation ”predicts” a negative future

cognitive restructuring

changing the way you think

Dialectical Behavioral Therapy

a type of talk therapy

• based on cognitive behavioral therapy (CBT) ,
  • but specially adapted for people who experience [negative] emotions very intensely
• helps accept the reality of their lives and their behaviors,
• helps them change their lives, including their unhelpful behaviors

helps people cope with the reality that their lives ==were/are harder than many other people’s.== but ALSO acknowledge that %%life can be better with the proper coping strategies%%.

DBT is based on the contrasting ideas: life can be both ==hard== and %%enjoyable%%

Cognitive Therapy Pros

• has the most research supporting its efficacy and insurance companies only pay for evidence-based treatments
• helps with a wider variety of psychological disorders than the other treatment strategies
• Cognitive therapists often pair treatment with medications to address the biological aspects of many disorders. The medication helps improve a person’s depression, anxiety, etc enough that they can begin to focus on the underlying thoughts contributing to the disorder

Cognitive Therapy Cons

• Humanists believe that Cognitive therapists focus only on a person’s weaknesses

Biomedical Therapy

a type of therapy

causes of disorder = brain structure or function problem; chemical imbalances

Treatment = brain surgery or brain stimulation or medication to bring the chemicals into a better balance or to try to reduce the problems caused by brain structure irregularities

• medications, brain surgery, or electromagnetic stimulation.
• lifestyle changes
  • healthy food choices, physical activity, time in nature, social engagement, and adequate sleep → changes in hormones and/or neurotransmitters that lead to better mental health

Psychopharmacology

using drugs (AKA psychotropic medications) to improve mental health

Anti-anxiety medications

a category are central nervous system depressants

• reduce heart-rate, breathing and other symptoms of an overly-active sympathetic nervous system
• most common:
  • Benzodiazepines (sedation and hypnosis, relieve anxiety and muscle spasms, and reduce seizures)
  • Barbiturates

Benzodiazepines

a type of Anti-anxiety medication

= sedation and hypnosis, relieve anxiety and muscle spasms, and reduce seizures

how is it different than barbituates?

• ____ do not stimulate the GABA receptor directly, they simply make GABA receptors more efficient
• don't have as depressive an effect on the central nervous system as barbiturates do

Barbituates

a type of Anti-anxiety medication

= slow down the central nervous system and cause sleepiness

Antidepressants

medications used to treat depression

• take time to work—usually 4 to 8 weeks—and symptoms such as problems with sleep, appetite, energy, or concentration sometimes improve before mood lifts

selective serotonin reuptake inhibitors (SSRIs)

a type of Antidepressant medication

= AKA increase serotonin levels in the brain

• block the reabsorption (reuptake) of serotonin into neurons.

 called “selective” because they mainly affect serotonin, not other neurotransmitters

serotonin-norepinephrine reuptake inhibitors (SNRIs)

a type of Antidepressant medication

= increase serotonin and norepinephrine levels

• block the reabsorption (reuptake) of the neurotransmitters serotonin and norepinephrine in the brain

norepinephrine-dopamine reuptake inhibitors (NDRIs)

a type of Antidepressant medication

= increase the levels of active norepinephrine and dopamine neurotransmitters throughout the brain

Antipsychotics

medications used to treat psychosis

• AKA neuroleptics
• Most are dopamine antagonists – those drugs reduce the level of dopamine in the brain.

psychosis

a condition that involves some loss of contact with reality

• delusions (false beliefs)
• hallucinations (hearing or seeing things others do not see or hear)

Stimulants

medications used to treat ADHD and narcolepsy

• increase alertness, attention, and energy.
• elevate blood pressure, heart rate, and breathing.

Lobotomy

= a type of psychosurgery (procedures that involve the physical removal or alteration of part of the brain) that was used to treat mental health conditions such as mood disorders and schizophrenia

operating on the brain is a LAST resort for psychological disorders

Transcranial magnetic stimulation (TMS)

a type of biomedical treatment

= magnetic fields to stimulate nerve cells in the brain to improve symptoms of major depression

Deep Brain Stimulation

surgically implanting a “brain peacemaker” that sends out electrical impulses to specific parts of the brain