Treatment of Psychological Disorders

Distinguish between the various forms of psychotherapy.
Describe alternate treatments.
List major medication treatments for psychological disorders.
List the various treatment strategies for each of the major psychological illnesses learned in Chapter 14.
Describe why these treatment methods are appropriate.
Evaluate the role of research in psychological treatment.

Psychodynamic therapy → most conversational
Behavior therapy
Cognitive therapy
Cognitive-behavioral therapy (CBT) → Behavior and Cognitive therapy are usually worked with together

Based on the (debunked) psychoanalysis.
Purpose: Help clients examine their needs, defenses, and motives as a way of understanding why they are destressed.
Commonly referred to as "Talk therapy".
Controversial: not the most empirically backed psychotherapy form.

Utilizes classical and operant conditioning to change behaviors and responses.
Behavior must be present to condition it.
Social skills training can be used to elicit desired behavior
- Modeling: Behavior is elicited through vicarious learning; it teaches new skills and behaviors by having a therapist or model demonstrate an action for a person to observe and imitate.
- Exposure Therapy: A form of behavior therapy aimed specifically at anxiety disorders.

Behavior therapy targeting anxiety, especially specific phobias and agoraphobia.
Systematic Desensitization: Main treatment strategy for specific phobias; Systematic desensitization helps patients overcome fears by gradually exposing them to anxiety-inducing situations while teaching relaxation techniques.
- Patients create a fear hierarchy, organizing a progressive set of threatening stimuli to tackle.
- Virtual Reality (VR) can expose clients to dangerous phobia triggers safely.
Over time, successful desensitization leads to lowered activation in the amygdala in response to the source of the phobia

Target population: Patients with Obsessive-Compulsive Disorder (OCD).
Patients are exposed to obsession triggers and prevented from engaging in compulsive behaviors.
- Ex: Shaking hands with someone and then stopping them from washing their hands.
Aim: Break the reinforcement loop sustaining the obsession.

Central Idea: Distortions in thinking can lead to maladaptive behaviors and emotions.
Focuses on identifying and addressing the roots of behavior rather than overtly changing it.
Cognitive Restructuring: Identifying unhelpful thoughts and replacing them with more accurate, balanced ones.
Rational-Emotive Therapy: Therapists guide clients to recognize fallacies and biases leading to cognitive distortions. Helps clients devise more adaptive strategies.
Interpersonal Therapy: Merges cognitive and psychodynamic approaches, focusing on circumstances leading to illness; Improving mood by examining relationship patterns, communication, and social role issues that influence thoughts and emotions.
Mindfulness-Based Cognitive Therapy: A way to avoid relapse after treatment. Learning to become your own coach and notice maladaptive patterns.

Integrates techniques from both cognitive and behavior therapies.
Corrects clients’ thought patterns and teaches them adaptive ways to behave and respond
Effectiveness: Especially beneficial for treating anxiety, as it addresses root causes.
Applicable for OCD, where cognitive methods supplement behavior therapy.
For disorders like depression or bipolar disorder, CBT is often paired with other treatments.

Ways to change brain function directly
- Electro-convulsive Therapy (ECT).
- Transcranial Magnetic Stimulation (TMS).
- Deep Brain Stimulation (DBS).

Methodology: Placing electrodes on a person’s head and administering an electrical current strong enough to produce a seizure
Bad reputation, but has been refined over the years to make it safer:
- Muscle Relaxants: Minimize motor convulsions.
- Anesthesia: To manage pain during the procedure.
- Hemispherical Treatment: Limit the process to one hemisphere of the brain.
Traditionally used for severe depression due to its fast-acting nature.
Side effects remain a concern despite refinements.

Methodology: Inducing an electrical current in the targeted brain region from the scalp, thereby interrupting neural function in that region
- Single Pulse TMS: Disrupts brain function momentarily during stimulation.
- Repeated TMS: Involves multiple sessions of TMS, leaving lasting effects.
Therapeutic Evidence: Repeated TMS over the left frontal region shows potential in treating depression.

Methodology: Stimulate the brain at an optimal frequency and intensity with mild electricity produced by surgically implanting electrodes deep within the brain
Initially designed to treat Parkinson’s disease by stimulating motor areas.
Noted for having fewer side effects compared to medications.
An emerging treatment option for depression and OCD.

Phototherapy (Light Therapy): Effective for Seasonal Affective Disorder (SAD).
- Cause of SAD: Due to reduced sunlight exposure.
- Phototherapy involves daily exposure to high-intensity light.
- Provides quick initial treatment, often followed by CBT to prevent recurrence.

Anxiolytic (taking away anxiety) Medication:
- Help treat anxiety can help, but do not get at the root cause, and are addictive, so they are not typically used anymore.
- They also are not effective in relieving the anxiety caused by obsessions in OCD.

MAO Inhibitors and Tricyclics:
- Early anti-depressants but had too many major side effects
SSRIs (Selective Serotonin Reuptake Inhibitors):
- Sometimes used in the treatment of anxiety. Also used in treating depression and OCD.
- For OCD, SSRIs help reduce obsessions.
- An antidepressant that is least likely to trigger mania, but still not used much in treating bipolar disorder

Lithium:
- Used in the treatment of bipolar disorder by helping balance neurotransmitters, but several unpleasant side effects.

Antipsychotics:
- Used in the treatment of schizophrenia, but it caused side effects resembling Parkinson’s and did not treat the negative symptoms.

Atypical Antipsychotics:
- Used in the treatment of bipolar disorder and schizophrenia.
- In treating schizophrenia, it targets both positive and negative symptoms, and also does not cause any of the major side effects

Randomized Control Trials: Essential for evaluating treatment outcomes.
You take random people and split them into an experimental and a placebo group.
Placebo effect: Notably stronger with the presence of minor side effects, enhancing credibility.
Challenges in effectively addressing placebo responses, particularly in therapeutic settings.

Emphasis on evidence-based treatment tailored to individual patient needs and unique illness manifestations.
Alert to potential harm from non-scientific treatments, including but not limited to:
- Encouragement to relive traumatic experiences.
- Use of fear tactics to deter juvenile crime via exposure to prisoners.
- Application of hypnosis for recovering painful memories, which can trigger distress instead of resolution.