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TREATMENT
OF
PSYCHOLOGICAL
DISORDERS
Psychodynamic Therapies
• Psychodynamic therapies revolve around:
• Insight
– Understanding one’s own psychological
processes
• Therapist-patient relationship
– Assist a patient to become “captain of my own
ship”
Insight
• Maladaptive ways of viewing self and
relationships
• Unconscious conflicts and compromises
among competing wishes and fears
• Maladaptive ways of dealing with
unpleasant emotions
Therapeutic Techniques
• Free Association
– Patient responds to verbal/visual cues with the
first thing that comes to mind
• Interpretation
– Clinician interprets patient responses
– Resistance involves patient’s efforts to hide the
unconscious conflict
Therapist-Patient Relationship
• Therapist as authority figure
• Transference
– Patients have similar thoughts, feelings, fears, wishes
and conflicts in new relationships as existed in past
relationships
• Patient tries to please therapist in the same way he/she tried to
please parent
• Fears that your new partner will cheat on you just like your last
partner cheated on you
Psychodynamic Therapies
• Psychoanalysis
– Patient on couch and therapist on chair behind couch
– Intense discussions over a long period of time
– Goal is exploration of unconscious processes
• Psychodynamic Psychotherapy
– Sessions are face to face
– Discussion is less intense, more conversational, than in
psychoanalysis
– Goal is still exploration of unconscious processes
Cognitive-Behavioral Therapies
• Phobia
– Irrational fear of a given stimulus
• Behavioral analysis
– Determine the symptom (s) and the stimuli or thoughts
associated with it which then become the targets of
treatment
• Systematic desensitization
– Gradual exposure of a phobic stimulus as a means of
neutralizing the impact of the stimulus
Systematic Desensitization
• Step 1
– Therapist teaches patient relaxation techniques
• Step 2
– Therapist questions patient about fears & then
constructs a hierarchy of feared stimuli
• Step 3
– Desensitization process begins possibly with the use of
virtual reality therapy
• Step 4
– Patient encouraged to face feared stimuli in real life
Cognitive-Behavioral Therapies
• Exposure Techniques
– Present patients with actual phobic stimulus in
real life rather than imagine it
• Flooding
– Patient confronts the phobic stimulus all at once
Social Learning Techniques
• Participatory modeling
– Therapist models the behavior and gradually
induces the patient to participate in the behavior
• Role playing
• Skills training
– Involves teaching the behaviors necessary to
accomplish relevant goals
• Teaching someone how to dance
Cognitive Therapy
• Cognitive Therapy
– Focus on changing cognitions that underlie a
psychological disorder
– Learn to perceive things in a different manner
• Cognition Therapy
– Focus on cognitive distortions
• View things differently
Cognitive Therapies
• Rational-emotive therapy
– Mediates between activating conditions and
maladaptive emotional reactions
• “ I won’t let his mean behavior get to me anymore!”
Humanistic Therapies
• Gestalt therapy
– Focus on awareness of one’s own feelings versus our
attempts to conform to social expectations
– Goal is for patient to respond to their true “inner voice”
and thus become more authentic
– Focus on present state rather than historical contributors
to one’s present state
Humanistic Therapies
• Client-centered therapy
– Clients versus patients
• Rejects “disease” model
– Solve problems not seek cures
• Problems develop when one’s concept of self is
incongruent with their actual life experience
– The basic nature of humans is to grow and mature
– Unconditional positive regard
• Attitude of fundamental acceptance by therapist towards client
Group Therapies
• Multiple individuals in same sessions
• Group members share same issue such as
– Death of a child
– Coping with cancer
• Cost effective
Family Therapies
• All members of a nuclear family participate
in therapy
• Genogram
– Map of family dynamics
• Couples therapy
– Focus on problematic communications patterns
Biological Treatments
• Psychotropic
medications act on the
brain to affect mental
processes
Antipsychotic Medications
• Used to treat schizophrenia and other acute
psychotic states
• They have sedating impact by inhibiting dopamine
which is linked to hallucinations
• Don’t work well with negative symptoms such as
interpersonal difficulties
• Serious side effects such as tardive dyskinesia
(slow motions)
Antidepressant & Mood
Stabilizing Medications
• Tricyclic Antidepressants
– 70-80% improvement rate
• MAO Inhibitors
– Works better than tricyclics for patients with
depression and personality disorders
– Requires food restrictions
Antidepressant & Mood
Stabilizing Medications
• Selective serotonin reuptake inhibitors
(SSRIs)
– First-line medical treatment for depression
– Fewer side effects than other antidepressants
• Lithium
– Used with bipolar disease
– Takes 3-4 weeks to begin having an impact
Anti-anxiety Medications
• Valium and Xanax are used for short term
treatment of anxiety disorders
• Antidepressants are also used for anxiety
disorders
• Patients can become psychologically and
physiologically addicted
Electroconvulsive (ECT)
Therapy & Psychosurgery
• Considered treatments of last resort
• ECT currently used to treat severe depression
– Electric shocks administered to the brain
– Can move patient out of a state of severe depression
• Psychosurgery
– Lobotomy which may be used on patients with
obsessive-compulsive disorders
Comparing forms of treatment
• Efficacy Studies
– Assess treatment outcome under controlled
experimental conditions (control group)
• Effectiveness Studies
– Assess treatment as practiced by clinicians in
the community