Treatments

History of Treatments Early treatments brutal transitioned to more humane methods Dorthea Dix– Today - Biomedical Drugs and better therapy has led deinstitutionalization.

Categories of Therapy 2 Main Categories 1.Psychotherapy – interaction between – Example: Psychotherapist - trained therapist who uses psychological techniques to assist someone to overcome Example: 2. Biomedical Therapy – prescription meds that act on – Example:

Biopsychosocial Approach Eclectic Approach– uses a variety of psych theories and approaches to treat mental illness Psychotherapy integration – combining a selection of assorted techniques into a Example:

Perspectives and Disorders Psychological School/Perspective Cause of the DisorderTreatments Psychoanalytic/Psychody namic Internal, unconscious drives and conflicts Psychoanalytic Psychodynamic HumanisticFailure to strive to one’s potential or being out of touch with one’s feelings. Insight Therapy Client Centered Therapy BehavioralReinforcement history, the environment. Behavioral Therapies Classical – counterconditioning, exposure therapy, flooding, systematic desensitization, virtual reality, aversive Operant – behavior modification, Token economy CognitiveIrrational, dysfunctional thoughts or ways of thinking. Cognitive Therapy SocioculturalDysfunctional SocietyGroup or Family Therapy Biomedical/NeuroscienceOrganic problems, biochemical imbalances, genetic predispositions. Biomedical Drug Therapy

Insight Therapies Insight therapies – try to improve mental state by increasing client’s awareness of underlying motives and defenses

Psychoanalytic Therapy Psychoanalysis – uncovering childhood experiences to gain insight into the unconscious origins of the disorder – dream analysis – manifest and latent – free association – uncensored reporting of any thoughts that come to mind. Resistance – – Example:

Psychoanalytic Therapy – Transferring - expression toward a therapist of feelings linked with earlier relationships Example

Psychoanalytic Therapy Criticisms – Interpretations can’t be – (2 or more sessions/week for 2 or more years)

Psychodynamic Therapy Psychodynamic therapy - try to understand patients' current symptoms by in their interpersonal relationships – Patients gain insight into unconscious conflicts Interpersonal psychotherapy - effective in treating depression by helping patients improve – variation of psychodynamic therapy – sessions – Example:

Humanistic Therapy Humanistic Therapy - emphasize the importance of self-awareness and take responsibility for own feelings and actions to improve mental state – seek to promote Client-Centered Therapy (Rogers) - patients' discover their own ways of effectively dealing with difficulties – non-directive therapies – – Unconditional Positive Regard – Active listening –

Behavioral Therapies Behavior Therapies – applies learning principles to unwanted behaviors Classical Conditioning Operant Conditioning

Behavioral Therapy Classical Conditioning – Counterconditioning (Pavlov)- procedure that trains people to make – 2 Types 1.Exposure Therapies 2. Aversive Conditioning

Exposure Therapies Exposure Therapies - Repeatedly introducing people to things they fear and avoid 1.Flooding – forced exposure to the stimulus that is feared Example: 2.Systematic Desensitization – gradual exposure to the actual stimulus by replacing a positive response with a negative response. Progressive relaxation – imagined scene is repeatedly paired with Example:

Exposure Therapies 3.Virtual Reality Therapy – progressively exposing people to simulations of their greatest fears – Example:

Aversion Therapy Aversion Therapy – unwanted behavior systematically associated with – Examples: – Problem:

Operant Conditioning 1.Behavior Modification - desired behaviors, giving for undesired behaviors – Example: 2.Token Economy – earning a token for desired behavior that can be traded in for privileges – Example:

Cognitive Therapy Cognitive Therapy – change the way patient thinks (change schemas) – – – Example: Beck’s Therapy for Depression Stress Inoculation Training

Cognitive-Behavioral Therapy Cognitive Behavioral - Changes the way we think and act – Example:

Family and Group Therapy Group Therapy – Offered for: family conflict, stressful relationships, – Improves communication skills and conflict resolution Examples: – Family Therapy – unwanted behaviors are influenced by other family members Example:

Evaluating Psychotherapy Placebo effect – Regression toward the mean – the tendency for unusual events or emotion to return to their ave. state. Selective Justification – overestimating the actual benefits (both patients and therapists) Eysenck and Eysenck –

Evaluating Psychotherapy Randomized Clinical Trials – Meta-analysis – Bottom line –

Comparison of Psychotherapies Evidence Based Practices - Clinical decision making that integrates the best available research with clinical expertise and an understanding of patient characteristics **Scientifically Unsupported Therapies -

Alternative Therapies EMDR (Eye Movement Desensitization and Reprocessing - Rapidly moving one's eyes while recalling traumatic experiences – similar to – Originally developed for – Value in placebo effect and exposure therapy Light Exposure Therapy – exposure to intense light that mimics outdoor light – activity – Seasonal Affective Disorder – depression caused by lack of exposure to natural light

Biomedical Therapy Biomedical Therapy – drugs, or treatments that – Examples: – Drugs, – Electroconvulsive therapy, – Magnetic impulses – Psychosurgery

Biomedical Therapy Psychopharmacology – study of the effects of – Antipsychotics (thorazine,Chlorpromazine, Clozapine) – Anti-anxiety ( Xanax, Ativan d-cycloserine) – Anti-depressants (Paxil, Prozac, Zoloft – SSRI’s) – Mood Stabilizers Bipolar (lithium, Depakote)

Brain Stimulation 3 Types Used to Treat Depression 1.ECT (Electroconvulsive therapy) – electric shock therapy for patients with severe 1.Can trigger 2.rTMS (repetitive transcranial magnetic stimulation)- repeated pulses of magnetic energy to brain’s surface 1.No 2.Triggers 3.Deep Brain Stimulation – uses implanted electrodes to inhibit activity in an

Psychosurgery Psychosurgery – removes or destroys brain tissue – Lobotomy - cut the nerves connecting the frontal lobes to the – MRI-guided precision surgery – cut brain circuits

Preventing Psychological Disorders Therapeutic Lifestyle Change – reverses the symptoms of psychological disorders – – Resilience – ability to cope with stress and recover from adversity