5.5 Treatment of Psychological Disorders Part 1 - Psychotherapies

Treatment of Psychological Disorders

Psychotherapy vs. Biomedical Therapy

  • Psychotherapy: Involves psychological techniques through interactions between a trained therapist and a client to overcome difficulties or achieve personal growth.
    • Techniques may include exploring early relationships, adopting new ways of thinking, and changing old behaviors.
  • Biomedical Therapy: Involves prescribed medications or procedures that directly affect physiology.
    • Examples include antidepressants and electroconvulsive therapy (ECT).

Historical Overview of Psychological Treatment

  • Ancient Practices: Trephination (drilling holes in the skull) to release spirits.
  • Middle Ages: Practices included exorcisms.
  • 1700s: Treatments involved bloodletting, forced purging, physical restraints, and mutilations.
  • Early 1900s: First lobotomies conducted.

The Eclectic Approach

  • Combines techniques from different forms of therapy.
  • Example: A therapist may use dream interpretation and cognitive restructuring in sessions.

Ethical Principles in Therapy

  • Nonmaleficence: Therapy should benefit the client without harm.
  • Fidelity: Build trust and maintain professional conduct.
  • Integrity: Must be honest and accurate.
  • Respect: Acknowledge clients’ rights to privacy and self-determination.

Approaches to Therapy

Psychodynamic Therapy
  • Originated from Freud's psychoanalysis aimed at achieving healthier lives by accessing unconscious conflicts.
  • Techniques include free association and dream analysis.
Free Association
  • Encourages clients to speak freely to uncover unconscious conflicts.
  • Goal: Facilitate self-awareness and emotional healing.
Dream Analysis
  • Analyzes dreams to uncover hidden conflicts by distinguishing between manifest (actual content) and latent (symbolic meaning) content.
Humanistic Therapy
  • Focuses on growth potential and self-awareness.
    • Clients referred to as "clients" instead of "patients".
    • Emphasizes conscious thoughts and present/future rather than past traumas.
Person-Centered Therapy
  • Developed by Carl Rogers, uses active listening and unconditional positive regard.
    • Client leads the discussion while the therapist listens non-judgmentally.
Active Listening Techniques
  • Paraphrasing: Summarizing the client’s words.
  • Inviting Clarifications: Asking for examples to deepen understanding.
  • Reflecting Feelings: Echoing the emotional tone perceived from the client.

Cognitive Therapy

  • Focuses on teaching new, adaptive ways of thinking.
  • Conducts cognitive restructuring to challenge negative thoughts and improve emotional responses.
Aaron Beck’s Contributions
  • Developed cognitive therapy highlighting the importance of challenging automatic negative thoughts.
  • Established the Cognitive Triad: self, world, future.
Cognitive-Behavioral Therapy (CBT)
  • Integrates cognitive and behavioral approaches to alter thought patterns and behaviors.

Behavioral Therapies

Applied Behavior Analysis
  • Applies conditioning principles to address behaviors.
Exposure Therapies
  • Gradual exposure to feared situations to reduce anxiety responses.
  • Includes systematic desensitization and fear hierarchies.
Systematic Desensitization
  • Pairs relaxation techniques with anxiety-inducing stimuli in a graduated manner.
Aversive Therapy
  • Associates unpleasant feelings with unwanted behaviors (e.g., nausea with alcohol use).
Behavior Modification
  • Reinforces desirable behaviors through techniques like token economies to encourage positive actions.

Biofeedback

  • Utilizes feedback mechanisms to help clients control bodily reactions and improve functions.

Effective Therapies for Specific Disorders

  • Cognitive and CBT: Effective for anxiety, PTSD, insomnia, and major depression.
  • Behavioral Therapies: Effective for specific behavioral issues like phobias.
  • Psychodynamic Therapy: Useful for depression and anxiety.
  • Nondirective Counseling: Effective for mild to moderate depression.

Evidence-Based Practice

  • Integrates best research with clinical expertise and patient preferences.
  • Ensures that treatments are suitable and effective for individual needs.

Therapeutic Alliance

  • Establishes a bond of trust between therapist and client for effective therapy.

Cultural Considerations

  • Individualistic vs. collectivist values can affect therapy effectiveness and approach. Therapists should practice cultural humility.

Common Trouble Signals for Seeking Help

  • Feelings of hopelessness
  • Lasting depression
  • Self-destructive behaviors
  • Disruptive fears
  • Mood swings
  • Suicidal thoughts
  • Compulsive behaviors

Therapist Training

  • Clinical Psychologists: Ph.D. or Psy.D. with research or therapy focus.
  • Psychiatrists: Medical doctors who may prescribe medication.
  • Social Workers: Master's training with supervision for therapy.
  • Counselors: Various specializations depending on training.