Treatment 3

INTERVENTION-BASED THERAPIES

Cognitive/Behavioral Therapy (CBT)

  • First Wave: Behavioral Therapy
    • Focus on replacing maladaptive behaviors with adaptive ones.
  • Second Wave: Cognitive Therapy
    • Focus on changing maladaptive thoughts (cognitive distortions) to adaptive thoughts.
  • Third Wave: Acceptance-Based Therapy
    • Emphasizes flexibility, acceptance of thoughts, and adherence to client values.

CBT Overview

  • Type: Intervention-based psychotherapy.
  • Mechanism: Alters automatic thoughts and behaviors causing disorder.
  • Effectiveness: Most effective type of psychotherapy when combined with medication.
  • Used for: A wide range of mental health issues.

Unique Features of CBT

  1. Strongly rooted in scientific research.
  2. Focuses on psychoeducation (teaching basic psychology principles).
  3. Skills development over narrative exploration.
  4. Homework assignments for practice outside therapy.
  5. Short-term focus (typically 12 sessions over 3-6 months).

CBT Techniques

  • Operant Conditioning: Rewarding positive behaviors; rarely using punishment.

    • Token Economy: Clients earn tokens for good behavior, redeems for rewards.
    • Monetary Punishment: Clients set aside money that therapists can withhold for undesirable behaviors.

  • Exposure Therapy: Repeatedly confronting emotional stimuli to decrease fear responses.

  • Response Prevention: Preventing maladaptive coping to show that resistance is safe.

  • Cognitive Restructuring: Techniques to challenge and remove negative automatic thoughts.

    • Socratic Questioning: Questions to clarify thoughts, provide evidence, predict consequences, and assess significance of questions.

Dialectical Behavioural Therapy (DBT)

  • Focus: Emotional regulation, acceptance of thoughts, and self-compassion through mindfulness.
  • Type: Intervention-based psychotherapy.
  • Mechanism: No identification with thoughts, better management of emotions.
  • Effectiveness: Emerging evidence; gaining popularity.
  • Used for: BPD, self-harm, PTSD, depression, eating disorders.

DBT Techniques

  • Mindfulness Meditation: Accepting emotions without control.
  • Distress Tolerance: Accepting distress instead of resorting to maladaptive strategies.
  • Interpersonal Effectiveness: Asking for help while maintaining relationships.
  • Emotional Regulation: Managing diverse emotions to prevent negative behaviors.

Best Treatment for Each Disorder

  • Phobia, PTSD, Panic Disorder: CBT (exposure therapy) + Anti-Depressants.

  • Generalized Anxiety Disorder (GAD): CBT (cognitive restructuring) + Anti-Depressants, Buspirone.

  • OCD: CBT + Anti-Depressants.

  • Mood Disorders: CBT + Anti-Depressants.

  • Bipolar Disorder: Mood Stabilizers, Anti-psychotics.

  • Schizophrenia: Anti-psychotics, CBT, ECT.

  • Borderline Personality: DBT; Psychodynamic Therapy.

  • ADHD: Psychostimulants.

  • Autism: No widely accepted treatment yet; Structured Behavioral Intervention.