Transcript Treatment of Psychological Disorders

Treatment of Psychological Disorders
Types of Therapy
• There are 3 Main Types of
Therapies:
• 1. Insight Therapies
» Therapy achieved through
verbal interaction
• 2. Behavioral Therapies
» Learning principles applied
to change maladaptive
behaviors
• 3. Biomedical Therapies
» Physiological intervention to
reduce symptoms
Insight Therapies
• Psychoanalysis
• Recovery of unconscious conflicts
& motives
– Free Association
» patients are invited to relate whatever
comes into their minds during the
analytic session, and not to censor their
thoughts
– Dream Analysis
» the process of explaining the meaning of
the way the unconscious thoughts and
emotions are processed in the mind
during sleep
– Interpretation
» Patient talks – therapist listens &
interprets
Rorschach Inkblot Test
• subjects' perceptions of
inkblots are recorded
and then analyzed &
interpreted
– Sometimes used to
examine a person's
personality characteristics
and emotional
functioning
Insight Therapies
• Dangers of Psychoanalysis
– Dangers?
» Resistance
• Occurs when patients patients block memories
from conscious memory
» Transference
• unconscious redirection of feelings from one
person to another person or object
» Projection
• ascribing internal feelings on to other things or
people
Insight Therapies
• Person (Client) -Centered Therapy
• Carl Rogers
• therapists create a comfortable, non-judgmental
environment using a non-directive approach to aid
patients in finding their own solutions to problems
• Cognitive Therapy
• Aaron Beck
• help the patient overcome difficulties by identifying
and changing dysfunctional thinking, behavior, and
emotional responses
• Group Therapy
• Simultaneous treatment of several clients
• 6 – 10 individuals meet face to face with a trained
therapist
Behavioral Therapies
• Based on 2 Assumptions
• 1. Behavior is a product of learning
• 2. What has been learned can be unlearned
• Types:
• Systematic Desensitization (Counter-conditioning)
• Aversion Therapy
• Social Skills Training
Systematic Desensitization
• Behavior therapy used to
reduce phobic clients’
anxiety responses through
counter-conditioning
• Steps
– 1. Build an Anxiety Hierarchy
– 2. Training in Deep Muscle
Relaxtaion
– 3. Client tries to work through
the hierarchy, learning to remain
relaxed while imagining each
stimulus
– 4. if possible, confront the real
stimulus
Aversion Therapy
• Behavior therapy in which an aversive
stimulus is paired with a stimulus that
elicits an undesirable response
• Example: Emetic Drug, Electric Shock, etc.
Social Skills Training
• operant conditioning procedures for
training social skills followed by
modeling, coaching, and social cognitive
techniques
Biomedical Therapies
• Psychopharmacotherapy
• Treatment of psychological disorders with
medication
• Types of Medication:
» Anti-Anxiety Drugs
» Anti-Psychotic Drugs
» Anti-Depressant Drugs
**Please remember that medication is usually a SHORTTERM solution and does not treat the underlying cause of
the disorder. Medication also comes with side effects &
safety concerns. **
Anti-Anxiety Drugs
• relieve anxiety by
slowing down the
central nervous system
to relax & calm you
• Can also be prescribed
as sleeping pills and
muscle relaxants
• Once you stop taking
the drug, Anxiety
symptoms return full
force
Anti-Anxiety Drugs
• Benzodiazapines/Tranquilizers
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Fast acting – take effect within 30 minutes
Can be taken as needed
Reduction in brain activity
Metabolize slowly - can build up over time causing
oversedation
– Side Effects
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Drowsiness, lack of energy
•Common Names
Clumsiness, slow reflexes
Slurred speech
•Xanax (alprazolam)
Confusion and disorientation
•Klonopin (clonazepam)
Depression
Dizziness, lightheadedness
•Valium (diazepam)
Impaired thinking and judgment
•Ativan (lorazepam)
Memory loss, forgetfulness
Nausea, stomach upset
Blurred or double vision
Anti-Anxiety Drugs
• Anti-Depressant Drugs
» Preferred because dependency is less common
» Take a lot longer to work – up to 4 – 6 weeks
• Buspirone (BuSpar)
» Newer anti-anxiety medication that doesn’t impair
memory & is not as addictive
» Slower acting – takes about 2 weeks
» Increases serotonin & decreases dopamine in the brain
• Beta Blockers
» Traditionally used to tread high blood pressure & heart
problems
» Fight stress hormones like norepinephrine & controls
physical symptoms of anxiety (heart rate, blood pressure,
sweating, etc.)
Anti-Psychotic Drugs
• used to treat psychotic symptoms found in
Schizophrenia (hallucinations, delusion,
paranoia, etc.)
Typical
Atypical
* Discovered in the 1950’s for Schizophrenia • 1990’s – 2nd Generation Anti Psychotics
treatment only
* Risperidone (Risperdal)
* Chlorpromazine (Thorazine)
* Olanzapine (Zyprexa)
* Haloperidol (Haldol)
* Quetiapine (Seroquel)
* Perphenazine (generic only)
* Ziprasidone (Geodon)
* Fluphenazine (generic only)
* Aripiprazole (Abilify)
* Paliperidone (Invega)
Anti-Psychotic Drugs
• Side Effects
– Most side effects go away after a few
days and often can be managed
successfully
Atypical
• Drowsiness
• Major weight gain
• Dizziness when changing positions
• Metabolic changes
• Blurred vision
• Risk of Diabetes & High
Cholesterol
• Rapid heartbeat
Typical
• Sensitivity to the sun
• Rigidity
• Skin rashes
• Persistent muscle spasms
• Menstrual problems for women
• Tremors
• Tardive Dyskinesia (TD)
• Restlessness
– Can get this from prolonged
usage
– Uncontrollable muscle
movement usually around the
mouth
Anti-Depressant Drugs
• 5 Major Types
• Very popular treatment
option for moderate to
severe depression
• There are TONS available
& often specific
combinations are concocted
by doctors based on
individual cases
• SSRI’s
• SNRI’s
• Atypical
Antidepressants
• Tricyclic &
Tetracyclic
• MAOI’s
Anti-Depressant Drugs
• Selective Serotonin Reuptake Inhibitors
(SSRI’s)
– most commonly prescribed antidepressants
– SSRIs block the reabsorption (reuptake) of the
neurotransmitter serotonin in the brain
• seems to help brain cells send and receive chemical messages, which
in turn boosts mood
• called selective because they seem to primarily affect serotonin, not
other neurotransmitters
– Common FDA approved SSRI’s
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Citalopram (Celexa)
Escitalopram (Lexapro)
Fluoxetine (Prozac, Prozac Weekly, Sarafem)
Paroxetine (Paxil, Paxil CR, Pexeva)
Sertraline (Zoloft)
Anti-Depressant Drugs
• Serotonin
Norepinephrine
Reuptake Inhibitors
(SNRI’s)
• block the absorption
(reuptake) of the
neurotransmitters serotonin
and norepinephrine
• called dual reuptake
inhibitors
– Venlafaxine (Effexor XR)
– Desvenlafaxine (Pristiq)
– Duloxetine (Cymbalta)
• Atypical
Antidepressants
• Called “Atypical” because
they don’t really fit into any
other category
• Mostly affect Dopamine,
Serotonin &
Norepinephrine
– Bupropion (Wellbutrin,
Wellbutrin SR, Wellbutrin
XL
– Trazodone (Oleptro
– Mirtazapine (Remeron,
Remeron SolTab)
– Nefazodone
Anti-Depressant Drugs
• Tricyclic & Tetracyclics
• Older versions of
antidepressants that have
mostly been replaced
– Still an effective option for
some patients
• Block reabsorption
(reuptake) of Serotonin &
Norepinephrine
• Names:
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• Monoamine Oxidase Inhibitors
(MAOI’s)
Amitriptyline
Desipramine (Norpramin)
Nortriptyline (Pamelor)
Protriptyline (Vivactil)
Trimipramine (Surmontil)
• 1st type of antidepressant developed
– now considered “last resort”
• Require strict dietary restrictions
– Can cause dangerous high blood
pressure when combined with
certain foods
• The enzyme monoamine oxidase is
involved in removing
norepinephrine, serotonin, and
dopamine from the brain. MAOIs
prevent this.
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Isocarboxazid (Marplan)
Phenelzine (Nardil)
Selegiline (Emsam, Eldepryl, Zelapar)
Tranylcypromine (Parnate)
Electroconvulsive Therapy
• electric currents are passed through the brain,
deliberately triggering a brief seizure
• Used when other treatments are unsuccessful
• Stigma?
• based on past experimental treatments
• Media attention
• Electroconvulsive therapy is much safer today
New Trends in Therapy
• Eclecticism
• Therapy that draws upon multiple theories, styles, or ideas to
gain complementary insights into a subject, or application
different theories in particular cases
• Individualized Psychology
• Positive Psychology
• Martin Seligman (1998)
• the scientific study of positive experiences, positive individual
traits, and the institutions that facilitate their development
• concerned with well-being and optimal functioning, positive
psychology
• aims to broaden the focus of clinical psychology beyond
suffering and its direct alleviation
New Trends in Therapy
• Light Therapy
• The use of bright light to treat depression &
circadian rhythm disorders
• Reverse Psychology
• a technique involving sharing a belief or behavior
that is opposite to the one desired
• Hopefully will encourage what actually is desired:
the opposite of what is suggested
– Mostly used on children & teens