UNIT 2 ABNORMAL PSYCHOLOGYTherapy- Biomedical (drug therapy, ECT, neurosurgery)- Psychotherapy/psychological (psychodynamic, behavior, cognitive, humanistic, marital, family therapy)- EclecticBiomedical Approach:Drug therapy- Psychopharmacology—science of determining which drugs work to work to alleviate which mental disorders and how they do it- People differ in terms of how quickly they metabolize drugs—must determine appropriate dosage level- Psychoactive drugs—major effects operate on the brain (not heart, liver, glands, etc.)o 1. Antipsychotics (Abilify—major depressive disorder, Seroquel, Risperdal): used for both psychotic disorders and mood disorders with psychotic elements. It reduces delusions/hallucinations. Theory: individuals who have a psychotic disorder may have anexcess of dopamine. Antipsychotic meds help to block some dopamine receptors, which reduces amount of dopamine in thesystem and helps to restore biochemical balance.  60% of all schizophrenia patients experience significant improvement within 6 weeks of starting antipsychotic meds.o 2. Anti-depressants (Zoloft, Paxil, Celexa, Prozac, Lexapro): most commonly prescribed psychiatric meds, used to treat depression. Classical antidepressants—first generation antidepressants.  SSRI= selective serotonin reuptake inhibitors. Depressed people are deficient in serotonin because there is an excessive amount of reuptake in that NT.  1989—Prozac most widely prescribed antidepressant in the world, first introduced to US. Second generation antidepressant—less likely to be fatal if overdose than with first generation Can also be used to treat reducing number of binge episodes for treatment for bulimia. o 3. Anti-anxiety drugs /anxiolytics: (Xanax, Klonopin, Valium, Ativan): most widely prescribed class is benzodiazepine—first released in early 1960s, drug of choice for treating people with acute anxiety, agitation.  Problem: one can become dependent on the drugs, also a high relapse rate. Positive: act very quickly, used in acute situations Benzodiazepines work on enhancing and increasing GABA activity reducing symptoms of anxietyo 4. Mood-stabilizing drugs (Lithium—1970s): used to treat bipolar, estimated that 70-80% of people in manic state will show significant improvement within 2-3 weeks after using LithiumECT— Electric Convulsive Therapy- Passing electric current through head with the goal being to alleviate depressive and manic episodes- Thought to be safe, effective, and an important form of treatment available forpeople severely depressed- Anesthesia and muscle relaxants given, electrodes placed  patient has amnesia, memory problems. Typically involves 12 procedures, done 3x a week over the course of a month. Neurosurgery—- Pre-frontal lobotomy (Phineas Gage but intentional). Used 1930s-1950s. Used as last resort. Not very common. Psychotherapy ApproachA. Psychodynamic approach: FREUD assumed that we develop psychological problems because of unconscious feelings, impulses, and conflicts. - Tap into unconscious, bring into conscious awareness, work on it in therapy alleviate psychological symptoms- Psychoanalysis: Free association catharsis, interpretation, resistance, negative transference ((individual displaces negative feelings towards ones parents onto the therapist)) insight personality restructuring, behaviorchangeo Huge commitment, treatment lasts many years, emotionally draining, expensiveo No empirical supportB. Behavior therapy approach: WOLPE assumed that the symptoms that person presents are the problems that you want to treat- Not delving into person’s family history, unconscious mind, you are going totreat the symptoms by using learning principles to replace unwanted behavior with desirable behaviors- Systematic desensitization: patients learn to relax in anxiety-provoking situations. Has become most widely used behavior therapy. o Replaces feelings of anxiety with feelings of relaxationo Learn relaxation techniques + create hierarchy of anxiety-provoking situations  use relaxation techniques while imagining anxiety-provoking situationsC. Cognitive therapy: assumes our feelings and our behavioral responses to events are strongly influenced by our thinking- Goal: to change client’s thoughts- REBT (Rational Emotive Behavior Therapy): type of cognitive therapy by ELLIS in which irrational or unrealistic beliefs about life events are replacedwith more constructive thought processesD. Humanistic therapy: developed after WWII that stresses person’s potential for growth and self-fulfillment- Focuses on what is going on in the person’s life now- People are responsible for their own lives: failures and successes- Person/client-centered therapy: type of humanistic therapy introduced by ROGERS that emphasizes people’s potential for self-fulfillment and facilitates this by helping people grow in self-awareness and acceptanceo Therapists use active listening and restate the client’s wordso Non-directive therapy—the therapist is not very activeE. Marital therapy: focus on improving communication, problem solving, etc.- Traditional Behavioral Couple therapy (TBCT): focused on changing both members of the couple—short term (10-27 sessions), guided by a manual o 2/3 show improvement- Integrative Behavioral Couple therapy (IBCT): focuses on acceptance of partner’s limitations.o 70—80% show improvementF. Family therapy: trying to decrease amount of tension or criticism in a family- Structural Family therapy: by MINUCHIN and focuses on family dynamics. Makes the assumption that what is going on in family session is a microcosm of what is going on at home. Work on clarifying roles- Thought that the child who brings family into therapy is the least pathological member of the familyEclectic therapy—Draw techniques from various forms of therapy depending on the client’s problems. Sometimes incorporates holistic /naturalistic remedies into their approach  50% of therapists say they are eclecticEffectiveness of Therapy - Client testimonials: can be very misleading because clients enter therapy when they are in crisis. Client attributes improvement to therapy when in factit was just the passage of time. Also, clients have a need to believe that the therapy was effective (they justify the time and money spent). Also, clients generally like their therapists. - Ask cliniciano Do you think there was change and do you think you were