Chapter 12:

Treatment

Early Treatment Methods

Early Treatment Methods

Early Treatment Methods

Early Treatment Methods

Early Treatment Methods

Treatment Categories

There are two treatment categories for

psychological disorders:

biomedical and

psychological therapies.

Psychotherapy is a general term for

psychological treatments designed to help

people resolve behavioral, emotional, and

Interpersonal problems.

Psychologically Based Therapies

Psychotherapy involves a special relationship

between a distressed person and a therapist

in which the therapist helps the client make

changes in his or her thinking, feeling, and

behavior.

Insight-Oriented Therapy

Psychoanalytic therapy

Aims to help the patient develop insight into unconscious feelings and conflicts

Psychoanalysis

First use of a “talking cure”

Developed by Sigmund Freud

Identify unconscious motivations

Free association

Dream analysis

Interpretation of resistance and transference

Insight-Oriented Therapy

Psychodynamic therapy

Similar to psychoanalytic therapy

Less frequent sessions

Lower emphasis on sexual drives

Interpretation

Resistance

Transference

Insight-Oriented Therapy

Humanistic therapy

Emphasize the ability of each person to solve his

or her problems.

Carl Rogers

Client-centered therapy

Incongruence

Real self

Ideal self

Insight-Oriented Therapy

Client-centered therapy

Seeks to develop an accepting environment for

the client.

Reflection

Empathy

Unconditional positive regard

Behavior Therapies

A type of therapy that focuses on changing observable, measurable behaviors

Behavior therapists view maladaptive behaviors as learned and rely on classical and operant conditioning and modeling to teach the client new behaviors.

Behavior Therapy

Techniques based on classical conditioning

Systematic desensitization

Progressive muscle relaxation

Exposure

Techniques based on operant conditioning

Behavior modification

Self-monitoring

Observation learning

Cognitive Therapy

A type of therapy that focuses on thoughts rather

than feelings or behaviors

Cognitive therapies are designed to change the way

the client thinks: Cognitive distortions

Cognitive Therapy

Therefore, the role of the therapist is to

challenge the client's irrational beliefs.

Psychotherapies

Among the licensed

practitioners who

provide therapy for

psychological disorders

are clinical

psychologists and

psychiatrists.

Psychopharmacology: Schizophrenia

Antipsychotic medications

Target positive symptoms

Tardive dyskinesia

Atypical antipsychotics

Newer

Target positive and negative symptoms

Early treatment

Psychopharmacology:

Mood Disorders Tricyclic antidepressants (TCAs)

Cymbalta

Monoamine oxidase inhibitors (MAOIs)

Food interactions

Selective serotonin reuptake inhibitors (SSRIs)

Prozac, Zoloft, Paxil

Serotonin/norepinephrine reuptake Inhibitors (SNRIs)

Serzone, Effexor

St. John’s wort

Lithium

Psychopharmacology:

Anxiety Disorders

Benzodiazepines

Xanax, Valium

Often for short periods

Antidepressants

TCAs

SSRIs

SNRIs

Other Forms of Treatment

Electroconvulsive therapy (ECT)

Used when medication and therapy is

ineffective

Fell out of favor

Regaining popularity

Transcranial magnetic stimulation (TMS)

New experimental technique

May replace ECT

Electroconvulsive Therapy (ECT)

Used when medication and therapy is

ineffective

Depression

Fell out of favor

Abuse

Movie, One Flew Over the Cuckoo’s Nest

Regaining popularity

Memory loss

Transcranial Magnetic Stimulation (TMS)

New technique

100- to 200-

microsecond

bursts of high-

intensity

magnetism

May replace ECT

Modalities

Individual therapy

Group therapy

Family therapy

Systems therapy

Self-help therapies

Support groups

Alcoholics Anonymous

Bibliotherapy

Books

The Effectiveness of Psychotherapy

After Eysenck concluded that psychotherapy

clients are just as likely to improve without it,

psychotherapists sought to provide better

information about the success of therapy.

Researching Psychotherapy

Meta-analysis allows researchers to combine

the results of a number of studies.

Using this technique, researchers have found

that therapy does lead to greater

improvement than no treatment and that

differences among the various forms of

therapy are not great.

The Consumer Reports Study

Treatment outcome

54% “much better”

33% “somewhat better”

Active patients had better outcomes

When treatment duration was limited by

insurance, patients did worse

No form of therapy did better than others

Psychotherapy vs. Medication

The decision to enter psychotherapy should

involve asking questions about;

the degree of distress one is experiencing

one's ability to cope with that distress,

the effect of the symptoms on oneself, one's

family, and one's work.

How to Pick a Therapist?

How much experience does the therapist

have with your problem?

Does a particular type of therapy seem like it

would be a good fit with your problem?

Insurance coverage?

Psychotherapy vs. Medication

Depression

Anxiety disorders

Other disorders

Combining psychotherapy and medication

The Future of Therapy

Managed care

Financial concerns

Brief therapy

Manual-based treatment

Bibliotherapy

Cybertherapy