Treatment of Psychological Disorders

Psychotherapy is a treatment involving psychological techniques; consists of interactions between a trained therapist and someone seeking to overcome psychological difficulties or achieve personal growth.

Biomedical therapy is the use of prescribed medications or procedures that act directly on the person’s physiology.

The eclectic approach to psychotherapy uses techniques from a variety of different therapies to treat a patient.

Deinstitutionalization: the process of releasing individuals from psychiatric hospitals and other institutions into the community, often with the aim of providing them with alternative mental health care and support

Movement began in the 1950s and coincided with the development of the first psychiatric medications

Desire to reduce costs

Positive outcomes: 

• Reduced institutionalization rates

• Improved access to mental health care in the community

• Increased focus on individual rights and autonomy 

Negative outcomes:

• Increased homelessness and criminal justice involvement among individuals with mental illness

• Lack of adequate community support and resources for some individuals

• Challenges in coordinating care and ensuring continuity of treatment 

Championed by Sigmund Freud, psychoanalysis is a therapeutic approach which involves techniques to uncover content from the patient’s unconscious mind. These techniques include free association and dream interpretation to release previously repressed feelings, allowing the patient to gain self-insight. Psychoanalysts will use interpretation (notes on hidden meanings,repressed content or dreams) to help patients achieve this. 

Challenges to Psychoanalysis:

• Resistance: blocking from consciousness of anxiety-laden material

• Transference: misplaced feelings for one’s therapist (anger, resentment, love, lust, etc.)

Psychodynamic therapy is derived from psychoanalysis and views the individuals as responding to unconscious forces and childhood experiences, and seeks to enhance self-insight.

Behavior therapy applies learning principles to the elimination of unwanted behaviors. 

This can involve counterconditioning, or procedures that use classical conditioning to evoke new responses to stimuli that are triggering unwanted behaviors, or operant conditioning procedures, such as modeling, positive reinforcement, or token economies, where patients earn points or tokens for exhibiting desired behaviors that can be exchanged for rewards. 

• Exposure therapy: forcing patients to confront their fears

  • Virtual Reality

  • Ex. Forcing someone with a fear of spiders to hold one

• Systematic desensitization: in a relaxed state  incrementally expose the person to the object of anxiety

  • Ex. Slowly reducing a fear of dogs through increasing steps of exposure. First they have to hold a picture of a dog, then a stuffed animal, then be in the same room as a live dog, until finally they can pet a dog without extreme fear.

• Aversive conditioning: substitute a negative response with a positive one by pair undesirable behavior with negative stimulus

  • Ex. being prescribed medication that makes you ill if you ingest alcohol to curb addiction

Cognitive therapy teaches people new, more adaptive ways of thinking. This approach is based on the assumption that thoughts intervene between events and our emotional reactions. 

Biofeedback: a technique that helps individuals gain voluntary control over involuntary bodily functions, such as heart rate, muscle tension, and brain waves

A popular integrative therapy combines the technique of changing one’s thinking with techniques to change one’s actions known as cognitive-behavioral therapy (CBT). Like cognitive therapy, CBT works to make patients aware of their negative thinking while also practicing more positive behavior, as seen in behavior therapies.

• Helps patients act out their new and improved ways of thinking and behaving before putting it into practice

• Helpful for the treatment of OCD, depression, and eating disorders

  Dialectical behavior therapy (DBT) is a type of psychotherapy that helps people learn to manage intense emotions and improve relationships

  Rational-emotive behavior therapy (REBT) is a confrontational cognitive therapy developed by Albert Ellis that vigorously challenges people’s illogical, self-defeating attitudes and assumptions. 

  "Social skills training" - a therapeutic approach that aims to improve a person's interpersonal abilities by teaching them effective communication skills, including verbal and nonverbal cues, active listening, assertiveness, empathy, and conflict resolution techniques, often through role-playing exercises to build confidence in social situations
  

The humanistic approach to therapy was championed by Carl Rogers and emphasizes people’s innate potential for self-fulfillment. To achieve this goal, humanistic therapists try to give clients new insights, thus their techniques are often referred to as insight therapies (aim to improve psychological functioning by increasing a person’s awareness of underlying motives and defenses). 

Carl Rogers developed the widely-used technique of client-centered therapy, in which the therapist uses techniques such as active listening (hearing a client without providing judgment, opinion, or interruption while repeating or clarifying key points to demonstrate you have been paying attention) within an accepting, genuine, and empathetic environment to facilitate a client’s growth. Rogers also encouraged therapists to demonstrate unconditional positive regard (a caring, accepting, nonjudgmental attitude) for their clients.

Group therapy, or treatment conducted in with several patients at once, can provide benefits through group interaction.

• Shows patients they’re not alone or abnormal

• Saves time & money

• Allows for patients to practice and develop social skills

• Gives variety of feedback

A special type of group therapy is family therapy, which treats people in the context of their family system, viewing an individual’s unwanted behaviors as influenced by and/or a by-product of the family dynamic.

Hypnosis therapy, also known as hypnotherapy, is a psychological treatment that uses hypnosis to help with mental and physical health conditions

What it can treat 

• Pain, such as from burns, cancer, childbirth, and headaches

• Stress and anxiety

• Depression

• Phobias

• Post-traumatic stress

• Hot flashes

• Side effects of chemotherapy or radiation

• Smoking cessation

• Weight loss

Not all people can enter a state of hypnosis

Since the 1950s, discoveries in psychopharmacology (the study of the effects of drugs on the mind and behavior) have revolutionized the treatment of people with severe disorders. There are two types of biomedical treatment - medication and procedures.

Medications:

• Antipsychotics

• Anti-anxiety

• Antidepressants

• Mood stabilizers