Treatment

Therapy – General term for any treatment process; in psychology and psychiatry, therapy refers to a variety of psychological and biomedical techniques aimed at dealing with mental disorders or coping with problems of living

The components of therapy

In addition to the relationship between the therapist and the patient/client, the therapeutic process typically involves some or all of the following processes:

• Identifying the problem
• Identifying the cause of the problem or the conditions that maintain the problem
• Deciding on and carrying out some form of treatment

Psychological therapies –Based on psychological principles (rather than biomedical approach)

The psychological therapies are often collectively called psychotherapy

Biomedical therapies – Treatments that focus on altering the brain, especially with drugs, psychosurgery, or electroconvulsive therapy

Insight therapies – Psychotherapies in which the therapist helps patients/clients understand (gain insight into) their problems

Psychodynamic therapies – Insight therapies based on the assumption that mental disorder is caused by powerful (dynamic) mental forces and conflicts

Psychoanalysis – The form of psychodynamic therapy developed by Sigmund Freud



Analysis of transference – Analyzing and interpreting the patient’s relationship with the therapist, based on the assumption that this relationship mirrors unresolved conflicts in the patient’s past

Neo-Freudian psychodynamic therapies – Therapies developed by psychodynamic theorists who embraced some of Freud’s ideas, but disagreed with others

Humanistic therapies – Techniques based on the assumption that people have a tendency for positive growth and self actualization, which may be blocked by an unhealthy environment

Client-centered therapy – Emphasizes healthy psychological growth through self-actualization

Carl Rogers

Reflection of feeling – Paraphrasing client’s words to capture the emotional tone expressed

Cognitive therapy – Emphasizes rational thinking as the key to treating mental disorder

Cognitive therapy for depression involves

• Evaluating evidence
• Situational factors
• Alternative solutions

Group therapy – Psychotherapy with more than one client



Self-help support groups – Groups that provide social support and an opportunity for sharing ideas about dealing with common problems; typically organized/run by laypersons (not professional therapists)

Behavior therapy – Any form of psychotherapy based on the principles of behavioral learning, especially operant conditioning and classical conditioning

Systematic desensitization – Technique in which anxiety is extinguished by exposing the patient to an anxiety-provoking stimulus


Exposure therapy – Desensitization therapy in which patient directly confronts the anxiety-provoking stimulus (as opposed to imagining it)

Aversion therapy – Involves presenting individuals with an attractive stimulus paired with unpleasant stimulation in order to condition a repulsive reaction



Contingency management – Approach to changing behavior by altering the consequences, especially rewards and punishments, of behavior



Token economies – Applied to groups (e.g. classrooms, mental hospital wards) involving distribution of “tokens” contingent on desired behaviors; tokens can later be exchanged for privileges, food, or other reinforcers

Participant modeling – Therapist demonstrates and encourages a client to imitate a desired behavior

Cognitive-behavioral therapy

• Combines cognitive emphasis on thoughts with behavioral strategies that alter reinforcement contingencies
• Assumes irrational self-statements cause maladaptive behavior
• Seeks to help the the client develop a sense of self-efficacy

Rational-emotive behavior therapy – Based on the idea that irrational thoughts and behaviors are the cause of mental disorders (REBT)



Albert Ellis

Drug Therapies

Antipsychotic drugs

• Include chlorpromazine, haloperidol, and clozapine
• Usually affect dopamine pathways
• May have side effects

Tardive dyskinesia – Incurable disorder of motor control resulting from long-term use of antipsychotic drugs

Antidepressants and mood stabilizers

• Include Prozac, monoamine oxidase (MOA) inhibitors, and lithium carbonate (effective against bipolar disorder)
• Treat depression and bipolar disorder
• Usually affect serotonin and/or norepinephrine
• The use of antidepressants to deal with general feelings of unease is highly controversial

Antianxiety drugs

• Include barbiturates and benzodiazepines
• May include some antidepressant drugs which work on certain anxiety disorders
• Should not be used to relieve ordinary anxieties of everyday life
• Should not be taken for more than a few days at a time
• Should not be combined with alcohol

Stimulants suppress activity level in persons with attention-deficit/hyperactivity disorder (ADHD)

There is controversy from concern that the causes and boundaries of ADHD are vague and the potential exists for overdiagnosis

Psychosurgery –The general term for surgical intervention in the brain to treat psychological disorders

The infamous prefrontal lobotomy is no longer performed

Severing the corpus callosum, however, can reduce life-threatening seizures

Electroconvulsive therapy is used for the treatment of severe depression


Therapeutic community – Program of treating mental disorder by making the institutional environment supportive and humane for patients

Deinstitutionalization – Policy of removing patients, whenever possible, from mental hospitals

Community mental health movement – Effort to deinstitutionalize mental patients and to provide therapy from outpatient clinics