Psych 301, 10/10/3Treatment IHow is mental illness treated?Psychotherapy is based on psychological principlesPsychodynamic psychotherapyTheory : based on uncovering unconscious feelings and drives that produce maladaptive thought and behaviorsTechniques: Free association, Dream analysisInsight uncovers hidden motives and makes change possibleHumanistic psychotherapyTheory: Emphasizes personal experience and belief systemsTechniques: Reflective listening, Unconditional positive regardClients are encouraged to fulfill their potential for personal growthBehavioral psychotherapyTheory: Maladaptive behaviors are learned, so they can be unlearned and replacedTechniquesBehavior modificationSocial skills trainingExposure with response preventionSystematic desensitizationCognitive psychotherapyTheory: Distorted thoughts produce & maintain maladaptive thoughts and behaviorsTechniquesCognitive restructuringRational-emotive therapyCognitive-behavioral therapy (CBT)Especially effective for anxiety and mood disordersGroup therapyTheory: Social support and shared experiences can have therapeutic benefitsTechniquesHighly structured groups are useful for disorders like bulimia and OCDGroups are frequently organized around issues shared by all members (e.g., sexual abuse, alcoholism)Family therapyTheory: People are part of a larger social system. Changing problems requires changing that system.TreatmentGroup and individual sessionsFamily members can learn new ways to interact, think, and behaveStudies show that family has a major impact on likelihood of relapseBiological therapiesTheory: Mental illness is based onimbalances in neurotransmittersmalfunctions of brain regionsSurgery – now only in extreme casesPsychotropic medicationDrugs that affect mental processesAct by changing neurochemistry to alter neural signallingCategories of psychotropic drugsAnti-anxiety drugsTranquilizersUsed for short-term treatment of anxietyIncrease activity of GABA (an inhibitory neurotransmitter)AntidepressantsMAO inhibitorsTricyclic antidepressantsSelective serotonin reuptake inhibitorsAntipsychoticsAlso called neurolepticsReduce symptoms such as delusions and hallucinationsBind (block) dopamine receptorsOlder versions have serious side effects such as tardive dyskinesiaCommon factors important to treatment successFactors reported as most important for success of treatmentInsight into problemsRelationship with caring therapistOpportunity to vent emotionsDevelopment of self-confidenceThere is evidence that the act of expressing reactions to emotional experiences is therapeuticWhat are the most effective treatments?Treatments for anxiety disordersSpecific phobias respond to systematic desensitizationDevelop a fear hierarchyRelaxation trainingExposure therapyVirtual environments can be effectiveCognitive work on awareness of thought processes can support behavioral treatmentTreatments for panic disordersTricyclic antidepressantscan prevent panic attacksfail to reduce anticipatory anxietyCognitive therapyGoal: to break the association between trigger symptoms and resulting panicInducing symptoms (e.g., through hyperventilation) without panic allows for relearning responsesTreatments for OCDDrug therapyAnti-anxiety drugs ineffectiveClomipramine (SRI)Cognitive therapyExposureResponse preventionTreatments for DepressionAntidepressantsCognitive-behavioral treatmentGoal is to help people think more adaptivelyIdentify and learn to change automatic negative thoughtsAlternative treatments for DepressionPhototherapyUseful for treating seasonal affective depression (SAD)Daily exposure to high intensity light sourceRegular aerobic exercise – releases endorphins (related to norepinephrine)Electroconvulsive therapyTreatments for Bipolar disorderLithiumVery effective, but not well understoodSeems to balance levels of excitatory and inhibitory neurotransmittersWorks better on mania than depression part of disorderCognitive therapy is helpful in maintaining use of medicationDrug treatments for schizopheniaClozapineActs on receptors for a variety of neurotransmittersTreats both negative and positive symptomsNo evidence of certain serious side effects associated with earlier drugsSome rare but serious side effectsOther treatments for schizopheniaDrugs are most effective in combination with other therapySocial skills trainingTraining in specific cognitive skillsBehavioral training in basic life skills (grooming, financial management, etc)Prognosis for schizophreniaThe majority of schizophrenic patients improve as they get olderThe reason for improvement with age is unknownPrognosis depends on several factors:Age of onset (older onset is better)Gender (women have better prognosis)Culture (more severe in developed
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