Studied by 0 people
Based on Notes.
Psychological treatments (psychotherapies)
conversation between the professional and the person seeking help - often combined with biological treatments
Biological treatment
have roots in our understanding of the biological factors that contribute to psychological disorders
John Case
1949 - discovered lithium salts could produce remarkable improvements in the behaviour of patients with bipolar disorder - later used for schizophrenia
Franz Anton Mesmer
First to treat Hysteria through the use of hypnosis - in many cases permanently cured it
Behaviourist perspective
observable behaviour and approached the treatment of abnormal behaviour
Humanistic psychologists
rebelled against psychodynamic thinking and the practice of psychoanalysis
Carl Rogers
Humanistic therapist who started counselling
Evidence-based practice (EBP)
combines research evidence, clinical expertise, and individual values to provide the best outcome for a patient or client
EBP - Five steps
Construct an answerable question
Clinicians conduct a search of the most current scientific literature related to the question
Clinicians critically evaluate the relevant literature
Information is then integrated with data regarding particular cases
Clinicians evaluate their performance based on the patients' outcomes and make any necessary adjustments
Clinical Assessment
Therapists need to understand the problems presented by the client before providing treatment - Interviews, observations, standardized tests
Who provides psychotherapy
General medical practitioners, psychiatrists, psychologists, social workers, nurses, and religious leaders
Psychiatrists
Training - MD degree, followed by 3-4 years specializing in psychiatry
Prescribe medication, perform medical procedures - likely to focus on biological causes of disorders
Licensed by the Canadian Psychiatric Association
Psychologists
Training - PhD or PsyD in psychology
Clinical psychology focuses on assessment, diagnosis, and treatment of psychological disorders
Clinical psychology students typically complete supervised internships
Counselors
Certified by Canadian Counselling and Psychotherapy Association (CCPA)
Often provide therapy for non-severe issues
Hypnotherapists
Hypnotherapists
Not frequently regulated but may be certified by organizations like the Canadian Federation of Clinical Hypnosis
Hypnosis is used for legitimate therapeutic purposes - practitioners should be verified
Life Coaching
Unregulated in Canada - no specific licensing requirements
Overlaps with psychotherapy - lacks the formal structure of regulated therapy
Life coaches can still help clients improve coping skills and self-regulation
Psychoanalysis
Frequent (4-5 times/week) and long-term (years)
Cognitive Behavioural Therapy (CBT)
Shorter duration (weekly for ~6 weeks)
Group Therapy
Can be homogeneous (same issue) or heterogeneous (varied diagnoses) - group size typically 6-12 individuals
Leaderless Self-Help Groups
Non-licensed members lead these groups - Ex. Alcoholics Anonymous (AA), Weight Watchers
Family Therapy
Involves multiple family members to address problems within the family dynamic - couples therapy is a subset of family therapy
Online Therapy
Offers privacy, convenience, and therapist flexibility - typically done through email, and video chat
PhD
programs emphasize research
PsyD
programs focus more on practical therapy skills - concerns about lack of emphasis on scientific methods
Psychological Clinical Science Accreditation System (PCSAS)
aims to increase scientific rigor in clinical psychology training
Psychoanalysis
Developed by Freud, focuses on uncovering unconscious conflicts affecting behaviour
Insight therapy
Assumes people improve once they understand the root of their problems
Free association
Patient speaks freely without self-censorship, allowing unconscious thoughts to surface
Dream analysis
Dreams are seen as reflections of unconscious wishes
Transference
Patient projects past relationships onto the therapist
Resistance
Patient resists uncovering unconscious material, often reflecting avoidance of painful truths
Humanistic Approaches
Humans are inherently good, with natural drives to grow and improve
Person-Centered Therapy (Carl Rogers)
Focuses on achieving congruence (alignment between ideal and real selves)
Behaviour Therapy
Based on classical and operant conditioning to change behaviours - effective for disorders like autism, schizophrenia, and habit modification
Desensitization
Gradual exposure to feared stimuli to reduce fear (e.g., phobias)
Counterconditioning
Pairing a negative behaviour with an incompatible response
Token economies
Using rewards (tokens) to reinforce positive behaviour
Cognitive Therapy
Focus on irrational beliefs that cause distress aim to replace them with rational thoughts
Rational Emotive Behavioural Therapy (REBT)
More confrontational than CBT - focusing on challenging irrational thoughts directly
Biopsychosocial Approach
Integrative approach considering biological, psychological, and social factors affecting the client - personalized treatment
Major types of biological treatments for psychological disorders
Medication, electroconvulsive therapy (ECT), psychosurgery, brain stimulation, and neurofeedback
Medication
Medications have dramatically improved outcomes for many psychological disorders - most commonly used therapy
Electroconvulsive Therapy (ECT)
Patient is anesthetized, given a muscle relaxant, and general seizures are induced by electricity
Increases responsiveness to dopamine and norepinephrine
Initially used for schizophrenia - now primarily for major depressive disorder and bipolar disorder
One-third of patients experience persistent memory loss
Psychosurgery
Trepanation - (drilling holes in the skull) was one of the first attempts at psychosurgery
Frontal Lobotomy - Popularized in the 1930s-1950s to treat psychotic disorders but often resulted in severe cognitive and personality changes
Causes impaired judgment, personality, initiative, social behaviour, and self-awareness
Modern Psychosurgery - Radiation and precise lesions used to treat conditions like MDD and OCD - focuses on specific brain areas
Deep Brain Stimulation (DBS)
Electrodes surgically implanted in the brain to treat OCD and MDD - 50% success rate in severe depression cases
Nucleus accumbens stimulation improves mood and increases engagement in pleasurable activities
Repetitive Transcranial Magnetic Stimulation (rTMS) - Non-invasive technique using low-frequency magnetic pulses to alter brain activity - treats MDD and schizophrenia
Biofeedback
Trains individuals to control physiological functions (e.g., blood pressure) that are usually unconscious
Neurofeedback
Focuses on brain activity using EEG or fMRI to train individuals to maintain certain brain activity patterns - not proven to be very effective
Treating Autism Spectrum Disorder (ASD)
Antipsychotic drugs - help with aggression, tantrums, and self-injury - have negative side effects (weight gain)
Off-label use - Antidepressants and other drugs are commonly prescribed without FDA approval for ASD symptoms
Alternative Treatments - Dietary interventions, chelation (removing heavy metals), hyperbaric oxygen therapy, sensory integration treatment - lack research
Applied Behaviour Analysis (ABA) - treating autism
Focuses on observable behaviours using operant conditioning and intensive therapy
Results in strong positive effects on language acquisition - moderate effects on social skills and daily functioning
Some adults with ASD treated with ABA as children argue that it emphasizes "normal" behaviours instead of respecting neurodiversity
Treating Attention-Deficit/Hyperactivity Disorder (ADHD)
Stimulants like methylphenidate (Ritalin), dextroamphetamine (Dexedrine), and Adderall are used
They increase dopamine and norepinephrine activity - help improve focus and behaviour - side effects weight loss, sleep disturbance, increased heart rate etc
Non-stimulants are used when stimulants don't work or cause side effects
Hyperactivity and impulsivity are believed to result from insufficient activity in the brain's basal ganglia and frontal lobes
Behavioural Parent Training
Teaches parents operant conditioning methods to manage ADHD behaviour
Behavioural Classroom Management
Applies learning principles in school to help children with ADHD
Treating Conduct Disorder
Medication is rarely used for conduct disorder
Use Cognitive Behavioural Therapy (CBT), Family Therapy, Peer Group Therapy etc - especially effective for younger kids
Multimodal Treatment (MMT) - Tailored approach using multiple treatment forms (child, family, peers, school, community)
Treating Schizophrenia
Phenothiazines (First-Generation Antipsychotics) - Block dopamine receptors, reducing psychotic symptoms (hallucinations, delusions)
Clozapine (Clozaril) (Second-Generation Antipsychotics) - Treat both positive and negative symptoms by affecting serotonin and dopamine
Deinstitutionalization
While medication helped patients leave institutions, many lacked adequate community support
Psychosocial Rehabilitation
Improved outcomes observed in developing countries, focusing on home care, meaningful work, and social skills
Treating Bipolar Disorder
Lithium Carbonate - Prevents mania recurrences, reduces suicidal behaviour, increases grey matter in the brain
Side Effects of Lithium Carbonate - Toxicity can cause nausea, vomiting, tremors, seizures, and coma
Antipsychotics may be used but are less effective than lithium in preventing hospital admissions
Psychotherapy - isn’t used as a primary treatment but can help with coping and adherence to medication
Treating Depression (MDD)
Antidepressant Medications - SSRIs (ex. Prozac, Zoloft) increase serotonin availability in the brain
SSRIs - can cause increased risk of suicidal thoughts, nausea, headaches, sexual dysfunction, weight gain, sleep disturbances etc
If SSRIs don’t work - CBT, ECT, deep brain stimulation, rTMS
Mindfulness-Based Cognitive Therapy (MBCT) - Combines CBT and mindfulness-based stress reduction
Aerobic exercise has effects comparable to medication and CBT in mild to moderate depression
Treating Anxiety Disorders
Benzodiazepines (ex. Valium, Xanax) - Commonly prescribed for anxiety, but overuse and addiction are concerns
SSRIs (Selective Serotonin Reuptake Inhibitors) and other antidepressants - often used -anxiety and depression may share common underlying causes
GABA-related medications (ex. alcohol, benzodiazepines) - aim to reduce brain activity and produce a calming effect but can be dangerous in combination
CBT - Often used for Generalized Anxiety Disorder (GAD), phobias, and panic disorder
Treating Obsessive-Compulsive Disorder (OCD)
Antidepressants (ex. SSRIs) can help reduce OCD symptoms
CBT - Highly effective, involving exposure and response prevention
CBT combined with medication is often effective
Treating Body Dysmorphic Disorder
CBT - Helps individuals restructure unrealistic thoughts about perceived physical flaws
Cosmetic surgery treatments are also common
Treating Post-Traumatic Stress Disorder (PTSD)
Exposure Therapy - most common treatment, with or without SSRIs
Addressing substance use disorders - crucial for full recovery since many with PTSD also struggle with addiction
Treating Dissociative Identity Disorder (DID)
Hypnosis is commonly used - unsupported by scientific evidence and for potentially creating false memories
Critics advocate for treating underlying stress, anxiety, and depression instead of focusing on DID
Somatic Symptom Disorders
Antidepressants and increased physical activity may help manage symptoms
CBT is the most common approach
50-80% of patients referred for therapy by physicians do not pursue it
Antisocial Personality Disorder (ASPD)
Tranquilizers, antipsychotics, and anticonvulsants may be used in institutions to manage aggression
Anger control, social skills training, character formation, and moral reasoning approaches are modestly effective in children and youth
Treatment is often limited due to patients' lack of guilt and empathy
Narcissistic Personality Disorder (NPD)
CBT is commonly used - an emphasis on building an alliance with the client
Therapy - Addressing defensiveness and help differentiate between pathological and protective behaviours
Borderline Personality Disorder (BPD)
Medications prescribed - antidepressants, antipsychotics, mood stabilizers, antianxiety medications, and anticonvulsants
CBT is widely used, focusing on stress management, emotions, and relationships
DBT shows superior outcomes compared to CBT
Dialectical Behaviour Therapy (DBT)
designed for BPD - addressing symptoms in order: reducing suicidal thoughts, preventing behaviours that interfere with therapy, and improving life quality
