5.5 Treatment of Psychological Disorders

Therapeutic alliance and cultural humility

Therapeutic alliance- the trusting, collaborate relationship established between the therapist and the client

Cultural humility- the therapist being respectful and open to the client’s cultural background, beliefs, values, while acknowledging and valuing the differences themselves and the client

therapists need to have therapeutic alliance and cultural humility to deliver therapy successfully

Psychotropic medication therapy

helped manage symptoms that previously kept individuals in long-term psychiatric hospitals or asylums

basically medicine and drugs used to treat mental illness

due to the effectiveness, hospitals and asylums deinstitutionalized massive numbers of people in the late 20th century. Therapists now prefer to treat in decentralized ways, often with a combination of medication and psychological therapies.

Ethical principles that must be followed

Psychologists in clinical or therapeutic situations must follow ethical guidelines established by the APA

this includes nonmaleficence, fidelity, integrity, and respect for people’s rights and dignity

Psychodynamic therapies

use free association and dream interpretation to uncover the unconscious mind

Cognitive therapies

cognitive restructuring or fear hierarchies to combat negative thinking

people should focus on the cognitive triad- negative thoughts about oneself, the world, and the future

Applied behavior analysis therapies

using conditioning to address mental disorders and developmental disabilities

includes exposure therapies and aversion therapies(counter-conditioning), and token economies

Exposure therapies- behavioral techniques, such a systematic desensitization and virtual reality exposure therapy, that treat anxieties by exposing people (in imaginary or actual situations) to the things they fear and avoid

systematic desensitization-a type of exposure therapy that associates a pleasant relaxed state with gradually increasing anxiety-triggering stimuli. Commonly used to treat phobias. ex thinking about a spider while taking deep breaths

virtual reality exposure therapy- a counter-conditioning technique that treats anxiety through creative electronic simulations in which people can safely face their greatest fears, such as airplane flying, spiders, or public speaking

Aversion therapies- unwanted behavior is paired with an unwanted stimulus. ex putting bad taste in alcohol so the drinker associates that bad taste with alcohol

Token economies- when clients earn tokens for displaying desired behaviors(operant conditioning), uses positive reinforcement for targeted behaviors, when a client gets a token they can use the token later to gain different rewards

Biofeedback- uses principles of conditioning to help clients regulate body systems (such as the sympathetic and parasympathetic nervous systems) that contribute to feelings of anxiety or depression, uses electronic monitoring to convey info about physiological processes. ex helps person became aware of their anxiety increasing their sympathetic nervous system activity, so the person focuses on relaxation techniques

Cognitive-behavioral therapies

combine techniques from the cognitive and behavioral perspectives to treat mental and behavioral disorders

includes dialectical behavior therapy and rational-emotive behavior therapy

Dialectical behavior therapy- originally developed to treat borderline (BPD), but is now used for a variety of disorders that involve emotional dysregulation

focuses on mindfulness, distress tolerance, emotion regulation, interpersonal and effectiveness. helps clients remain in the moment, improve their coping skills, help manage overwhelming emotions, and improve communication and relationship skills. helps people manage intense emotions, reduce self destructive behaviors, and improve their interpersonal skills

Rational-emotive behavior therapy- focuses on disputing irrational beliefs that lead to negative emotions or self-defeating behaviors, Albert ellis

Humanistic therapies

commonly referred to as person centered therapy

employs active-listening and unconditional positive regard

Group therapy vs individual therapy

Group therapy- conducted with groups rather than individuals, providing benefits from group interaction

pros are it saves therapists time, offers a social laboratory for exploring social behaviors and developing social skills, it enables people to see that others share their problems, and it provides feedback as clients try out new ways of behaving

Hypnosis

a state of focused attention, heightened suggestibility, and deep relaxation

research supports effectiveness in treating pain and anxiety

research does not support the use of hypnosis to retrieve accurate memories or regress in age

Psychoactive medication

interact with specific neurotransmitters in the central nervous system to address possible biochemical causes of mental disorders

includes antidepressants, antianxiety drugs, lithium, or antipsychotic medications

can have side effects such as tardive dyskinesia( a movement disorder related to the regulation of dopamine in the nervous system)

Antidepressants- SSRIs(selective serotonin reuptake inhibitors) that treat depression, anxiety, OCD, and PTSD

Antianxiety drugs- seek to enhance the action of GABA,a neurotransmitter that produces a calming effect, thereby reducing anxiety symptoms

Lithium- helps stabilize mood swings, mainly used to treat bipolar disorder and help with swings between mania and depression

Antipsychotic medication- drugs used to treat schizophrenia and other forms of severe thought disorder, reduce dopamine

Surgical or invasive interventions

includes psychosurgery, TMS(transcranial magnetic stimulation), or electroconvulsive therapy

Psychosurgery- surgery that removes or destroys brain tissue in an effort to change behavior

TMS- the application of repeated pulses of magnetic energy to the brain; used to stimulate or suppress brain activity

Electroconvulsive therapy- a biomedical therapy for severely depressed patients in which a brief electric current is sent through the brain of an anesthetized patient

the lobotomy was a form of psychosurgery that was popular in the mid-20th century but is rarely, if ever, performed today