Psych 301 10 10 3 Treatment I How is mental illness treated Psychotherapy is based on psychological principles Psychodynamic psychotherapy Theory based on uncovering unconscious feelings and drives that produce maladaptive thought and behaviors Techniques Free association Dream analysis Insight uncovers hidden motives and makes change possible Humanistic psychotherapy Theory Emphasizes personal experience and belief systems Techniques Reflective listening Unconditional positive regard Clients are encouraged to fulfill their potential for personal growth Behavioral psychotherapy Theory Maladaptive behaviors are learned so they can be unlearned and replaced Techniques Behavior modification Social skills training Exposure with response prevention Systematic desensitization Cognitive psychotherapy Theory Distorted thoughts produce maintain maladaptive thoughts and behaviors Techniques Cognitive restructuring Rational emotive therapy Cognitive behavioral therapy CBT Especially effective for anxiety and mood disorders Group therapy Theory Social support and shared experiences can have therapeutic benefits Techniques Highly structured groups are useful for disorders like bulimia and OCD Groups are frequently organized around issues shared by all members e g sexual abuse alcoholism Family therapy Theory People are part of a larger social system Changing problems requires changing that system Treatment Group and individual sessions Family members can learn new ways to interact think and behave Studies show that family has a major impact on likelihood of relapse Biological therapies Theory Mental illness is based on imbalances in neurotransmitters malfunctions of brain regions Surgery now only in extreme cases Psychotropic medication Drugs that affect mental processes Act by changing neurochemistry to alter neural signalling Categories of psychotropic drugs Anti anxiety drugs Tranquilizers Used for short term treatment of anxiety Increase activity of GABA an inhibitory neurotransmitter Antidepressants MAO inhibitors Tricyclic antidepressants Selective serotonin reuptake inhibitors Antipsychotics Also called neuroleptics Reduce symptoms such as delusions and hallucinations Bind block dopamine receptors Older versions have serious side effects such as tardive dyskinesia Common factors important to treatment success Factors reported as most important for success of treatment Insight into problems Relationship with caring therapist Opportunity to vent emotions Development of self confidence There is evidence that the act of expressing reactions to emotional experiences is therapeutic What are the most effective treatments Treatments for anxiety disorders Specific phobias respond to systematic desensitization Develop a fear hierarchy Relaxation training Exposure therapy Virtual environments can be effective Cognitive work on awareness of thought processes can support behavioral treatment Treatments for panic disorders Tricyclic antidepressants can prevent panic attacks fail to reduce anticipatory anxiety Cognitive therapy Goal to break the association between trigger symptoms and resulting panic Inducing symptoms e g through hyperventilation without panic allows for relearning responses Treatments for OCD Drug therapy Anti anxiety drugs ineffective Clomipramine SRI Cognitive therapy Exposure Response prevention Treatments for Depression Antidepressants Cognitive behavioral treatment Goal is to help people think more adaptively Identify and learn to change automatic negative thoughts Alternative treatments for Depression Phototherapy Useful for treating seasonal affective depression SAD Daily exposure to high intensity light source Regular aerobic exercise releases endorphins related to norepinephrine Electroconvulsive therapy Treatments for Bipolar disorder Lithium Very effective but not well understood Seems to balance levels of excitatory and inhibitory neurotransmitters Works better on mania than depression part of disorder Cognitive therapy is helpful in maintaining use of medication Drug treatments for schizophenia Clozapine Acts on receptors for a variety of neurotransmitters Treats both negative and positive symptoms No evidence of certain serious side effects associated with earlier drugs Some rare but serious side effects Other treatments for schizophenia Drugs are most effective in combination with other therapy Social skills training Training in specific cognitive skills Behavioral training in basic life skills grooming financial management etc Prognosis for schizophrenia The majority of schizophrenic patients improve as they get older The reason for improvement with age is unknown Prognosis depends on several factors Age of onset older onset is better Gender women have better prognosis Culture more severe in developed countries
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