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Transcript
TREATMENT DRUG CHART AND DRUG THERAPY NOTES Psychopharmacology – The study of drug effects on the mind and behavior. DISORDER CATEGORY DRUGS Antipsychotic drugs Thorazine, Clozaril, (neuroleptics) Haldol Antianxiety drugs (anxiolytics) Antidepressants Bensodiazephines Nonbensodiazephine (nonaddictive – up to 6 weeks to work MAO-I – Nardil, Parnate Monoamine Oxidase Inhibitors TCA’s – Tofranil, Elavil, Amitid Tricyclic Antidepressant SSRI’s – Prozac, Zoloft, Paxil, Luvox Bipolar Disorder HOW THEY WORK Occupy dopamine receptors sites to block dopamine activity (addictive, but instant) Selective Serotonin Reuptake Inhibitors - Block the reabsorption and removal of serotonin from the synapse Dual- Action Antidepressants – Serzone, Effexor, Celexa affect serotonin and norepinephrine Lithium - A mineral salt used to treat bipolar disorder No one really sure how it works WHAT THEY DO Relief of the positive Symptoms of schizophrenia Relief of symptoms of anxiety by depressing the central nervous system All of these relieve patients of the symptoms of depression Also effective on OCD Relieves patients of vast mood swings Electroconvulsive Therapy – Electrical current is applied to the scalp causing a convulsion 1. Used to treat severe depression 2. Believed to raise certain neurotransmitter levels 3. Side effects include memory loss, transient confusion, and rarely death from heart failure A new therapy called repetitive transcranial magnetic stimulation (rTMS) – Pulses surge through a coil held close to a person’s scull above the right eyebrow. It is performed on wide-awake patients for 20 – 30 minutes for 2 – 4 weeks. It causes no seizures, memory loss, or other side effects. Psychosurgery – Brain areas are removed or destroyed 1. A prefrontal lobotomy is performed when a probe is inserted in a small hole cut in the skull and brain tissue is in the frontal lobe is destroyed. 2. This is risky, sometimes fatal, and is the LAST resort after all other treatments fail and are almost never performed. Evaluating Psychoactive Drugs 1. Drugs may cover up the problem without curing it. 2. Even good drugs may be abused 3. All drugs have unwanted side-effects 4. There are different clinical effects depending on a person’s ethnic background and gender. Genetic factors and dietary factors are likely to account for these differences. Group/Family/Couples Therapy 1. Group therapy is the simultaneous treatment of several clients by a therapist who tries to facilitate interaction among group members. Advantages to group therapy 1) therapist can see how client interacts 2) client feels less alone 3) group members can raise each others’ self-confidence, selfacceptance, and expectations for improvement 4) clients can learn from each other 5) group members may become more sensitive and more willing to share feelings. 6) the group is a safe place to try out new behaviors 2. Family Therapy – Treats two or more people from the same family system 3. Couples Therapy – Communication between partners is the focus of the treatment. Is Psychotherapy Effective? Client’s Perceptions: Testimonials strongly affirm effectiveness. People often enter therapy in crisis Clients may need to believe the therapy was worth the effort. Clients generally like their therapist and speak kindly of them. Massachusetts study of 500 boys that were headed for delinquency showed that later in life when they evaluated the therapy that the control group was doing as well as the treated group. Studies have shown that boys put in “Scared Straight” were boy likely to commit new offenses. Clinician’s Perceptions: Clinicians also give strong affirmations of effectiveness. Outcome Research Meta-analysis (combining the results of many studies) indicates that 1. People who remain untreated often improve 2. Those who receive psychotherapy are more likely to improve regardless of what type of therapy they use and for how long. 3. People with clear cut, specific problems have the greatest results from therapy. 4. Placebo treatments or sympathy and friendly counsel from paraprofessionals produce more improvement than occurs when people receive no treatment. The Relative Effectiveness of Different Therapies A meta-analysis revealed no one type of therapy is superior. A study by the Society of Clinical Psychology has identified the following Cognitive therapy, interpersonal therapy and behavior therapy for depression Cognitive therapy, exposure therapy, and stress inoculation training for anxiety Cognitive behavior therapy for bulimia Behavior modification for bedwetting Behavioral conditioning for phobias, compulsions and sexual disorders Evaluating Alternative Therapies Therapeutic Touch – Move hands a few inches from body to “push energy fields into balance.” This does not seem to work and there is no credible theory that predicts why it might. Eye Movement Desensitization and Reprocessing (EMDR) – Traumatic experiences are imagined while eyes rapidly dart about. Studies suggest that although it seems to work it is probably more of a combination of exposure therapy and the placebo effect Light Exposure Therapy – Exposure to a timed daily dose of intense light used mainly for people with seasonal affective disorder. Studies indicate that exposure to morning light is beneficial and shifted the secretion of the hormone melatonin to an earlier time. Commonalities Among Psychotherapies All types of psychotherapy seem to offer three benefits New hope A fresh perspective An empathetic, trusting, caring relationship Cultures and Values in Psychotherapy In general, therapist differ in their values which in turn influence their aims. Value differences also create problems when a therapist from one culture works with a client from another culture.