Chapter 15

• Psychotherapy is a treatment method for mental health issues that involves talking with a trained therapist to explore thoughts, feelings, and behaviors. It aims to improve emotional well-being and resolve psychological difficulties. Eclectic therapy is an approach that combines elements from various therapeutic modalities to tailor treatment to the individual's needs.

• Psychodynamic therapy focuses on unconscious processes and past experiences affecting current behavior. Traditional psychoanalysis often involves free association, dream analysis, and examining transference during sessions. Modern psychodynamic therapy makes adjustments to the classical approach, focusing more on present relationships and experiences than solely on early childhood.

• Behavior therapy uses reinforcement and punishment to modify specific behaviors. A token economy is a system where tokens are given as rewards for desired behaviors, which can then be exchanged for privileges or items. Exposure therapy involves gradual exposure to feared situations in a controlled way, helping individuals confront and overcome their fears.

• Cognitive therapy involves changing maladaptive thought patterns to improve mood and behavior. Cognitive restructuring is a technique used to challenge and alter negative thoughts. Mindfulness meditation is a practice of focusing on the present moment without judgment, promoting overall mental well-being.

• Cognitive Behavioral Therapy (CBT) integrates cognitive and behavioral techniques and focuses on how thoughts and behaviors impact emotions. It differs from psychodynamic approaches, which emphasize unconscious processes. CBT is particularly effective for anxiety and depression.

• Humanistic therapies emphasize personal growth, self-actualization, and the individual's capacity for self-healing. Person-centered therapy, developed by Carl Rogers, focuses on providing a supportive environment characterized by empathy, genuineness, and unconditional positive regard. The three basic qualities person-centered therapists display are empathy, congruence, and unconditional positive regard. Gestalt therapy focuses on awareness and integration of thoughts and feelings, using techniques like the empty chair technique to facilitate dialogue with unresolved issues.

• Couples’ therapy addresses relationship issues between partners, while family therapy involves treating families as units to improve communication and resolve conflicts. Group therapy allows individuals to share experiences and gain support in a group setting, with advantages including a sense of community and shared learning, and disadvantages like potential conflict and group dynamics. Self-help and support groups differ from group therapy as they are more peer-led and focus on shared experiences rather than professional guidance.

• Psychopharmacology is the study of how drugs affect mood and behavior. Antipsychotic drugs can treat conditions like schizophrenia by modulating dopamine levels, particularly first-generation antipsychotics that primarily address positive symptoms while having limited impact on negative symptoms. Newer antipsychotics, known as atypical antipsychotics, are preferred because they address both positive and negative symptoms and typically have fewer side effects.

• Antianxiety medications, such as benzodiazepines, work by enhancing the effects of neurotransmitters that calm the nervous system.

• Antidepressants vary in class but commonly include SSRIs and SNRIs, which help regulate neurotransmitters like serotonin and norepinephrine. Medications such as mood stabilizers and atypical antipsychotics are typically prescribed for bipolar disorder.

• Electroconvulsive therapy (ECT) is a procedure used primarily for treatment-resistant depression, inducing controlled seizures to alleviate symptoms. Transcranial magnetic stimulation (TMS) employs magnetic fields to stimulate nerve cells and is used for major depression. Psychosurgery involves surgical interventions to treat severe mental illness but is used rarely today due to ethical and efficacy concerns.

• Treatment illusions include spontaneous recovery, placebo effects, and outcome studies, which examine therapy effectiveness. Research indicates psychotherapy is effective for various disorders, and specific treatments are established as effective for treating certain conditions as seen in the Table 15.2 of treatments validated for some disorders.