Treatment of Psychological Disorders

Overview of Treatment Approaches

• Treatment approaches for psychological disorders are categorized into two main types:
    - Psychologically-based therapy
    - Biologically-based therapy

Psychologically-Based Therapy

Types of Psychologically-Based Therapy

• Psychoanalytic therapy: Focused on uncovering conflicts and impulses from the unconscious.

• Humanistic therapy: Emphasizes personal growth and self-actualization.

• Behavioral therapy: Involves modifying maladaptive behaviors.

• Cognitive therapy: Centers on changing dysfunctional thoughts.

• Group therapies: Involves group settings for mutual support and advice sharing.

Biologically-Based Therapy

Types of Biologically-Based Therapy

• Drug therapy: Involves the use of medication to change psychological functioning.

• Psychosurgery: Surgical intervention to treat psychological disorders.

• Electric and Magnetic therapies: Utilizes electrical stimulation or magnetic fields for treatment.

Definitions and Differences

• Psychotherapy: Refers to treatments by trained professionals using psychological techniques for helping patients with psychological issues.

• Biomedical therapy: Involves medical procedures and drugs to improve psychological function, as opposed to the psychological techniques of psychotherapy.

Psychodynamic Approaches

• Psychoanalysis: Aims to bring past conflicts and impulses into consciousness, employing techniques like:
    - Defense mechanisms: Psychological strategies to cope with reality and maintain self-image.
      - Repression: Most common defense mechanism that pushes threatening thoughts into the unconscious.
    - Transference: Redirecting feelings from the patient’s childhood figures to the therapist.

Modern Psychodynamic Therapy

• Typically shorter, lasting no longer than 3 months (20 sessions).

• Can be more expensive compared to other therapies.

Behavioral Approaches

• These approaches are based on learning principles (reinforcement and extinction) to manage and modify maladaptive behaviors, positing that:
    - Both normal and abnormal behaviors are learned behaviors.
    - Some individuals may not have learned adequate coping skills or have developed harmful patterns.

Classical Conditioning Approaches

• Aversive conditioning: Reduces undesired behaviors by pairing unpleasant stimuli with those behaviors.
    - Example: Used in treating alcohol abuse, though long-term effectiveness is questioned.

• Systematic desensitization: Involves pairing anxiety-producing stimuli with relaxation techniques.

• Flooding: Intense exposure to fear-inducing stimuli without relaxation training to reduce anxiety or avoidance.

Operant Conditioning Techniques

• Based on rewarding desirable behaviors while ignoring or punishing undesirable ones.

Specific Applications of Operant Conditioning

• Behavioral Activation for Depression: Involves scheduling activities that create positive experiences to combat withdrawal.

• OCD Treatment: Identifies and regulates avoidance behaviors that maintain the disorder, focusing on confronting triggers.

• Token Economies: Used in institutions where patients earn rewards for positive behavior.

• Contingency contracting: Involves written agreements on behavior goals and consequences for achieving or failing those goals.

Evaluation of Behavioral Approaches

• Effective for anxiety disorders and phobias, and helps in social skill development.

• Criticism includes a focus on behavioral change without addressing inner psychological experiences.

• Neuroscientific evidence shows these therapies can alter brain function.

Cognitive Approaches

• Focuses on teaching adaptive thinking by modifying dysfunctional beliefs about oneself and the world.

• Cognitive-Behavioral Therapy (CBT): Integrates learning principles to change thinking patterns.

• Rational-Emotive Behavior Therapy (REBT): Aims to restructure irrational beliefs into realistic thought patterns for healthier living.

Humanistic Therapy

• Assumes individuals can control their behavior and are responsible for their problems.

• Self-actualization: The motivation to realize one's full potential is a central theme.

• Techniques include:
    - Role-playing
    - Exaggerating behaviors
    - Visualizing conflicts in an empty chair setting.

Person-Centered Therapy

• Aims to create a supportive environment for clients to explore their feelings and problems.

• Central Concept: Unconditional positive regard (offering acceptance and support regardless of what the client expresses).

Group Therapies

• Group therapy: Involves a therapist-led group discussion among individuals who share common issues (e.g., alcoholism).

• Family therapy: Treats the family as a unit and focuses on roles and patterns within the family dynamic instead of just the individual presenting issues.

Biomedical Therapy

Drug Therapy

• Medication alters neuronal functioning and neurotransmitter activity.

• Classifications of drugs and their effects:
    1. Antipsychotic drugs: Reduce symptoms like agitation and loss of reality through dopamine receptor blockade. Examples include chlorpromazine, clozapine, and risperidone.
    2. Antidepressant drugs:
       - MAO inhibitors: Prevent breakdown of neurotransmitters by inhibiting monoamine oxidase (e.g., phenelzine).
       - SSRIs: Block serotonin reuptake (e.g., fluoxetine).
    3. Antianxiety drugs: Increase GABA activity to reduce anxiety (e.g., benzodiazepines).
    4. Mood stabilizers: Alter impulse transmission in neurons (e.g., lithium, Depakote).

Other Biomedical Therapies

• Transcranial Magnetic Stimulation (TMS):
    - Non-invasive technique using magnets to adjust brain activity; used for Major Depressive Disorder (MDD) and OCD.

• Electroconvulsive Therapy (ECT):
    - Involves electrical shocks to induce localized seizures, modifying brain chemistry; modern ECT is deemed safe and effective but has a stigma due to historical practices.