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Types of Treatment
- Treatment for psychological disorders can be categorized into insight therapies, behavior therapies, and biomedical therapies.
- All psychotherapies offer hope, new perspectives on a problem, and an empathic relationship with a therapist.
- Many types of professionals provide psychological treatment.
Psychotherapy
- All psychodynamic therapies are based on Sigmund Freud’s psychoanalytic treatment.
- Psychoanalytic treatment focuses on uncovering unconscious motives, conflicts, and defenses.
- Three techniques used in psychoanalysis are free association, dream analysis, and interpretation.
- The concepts of transference and resistance are important features of psychoanalysis and current psychodynamic therapies.
- Cognitive therapies attempt to identify and change maladaptive thinking patterns.
- Cognitive therapists believe that depression arises from errors in thinking.
- Cognitive therapists help clients to identify and change automatic thoughts and assumptions about the world.
- Albert Ellis’s rational-emotive therapy is based on the idea that people’s feelings are influenced by their catastrophic thoughts and beliefs about events.
- Behavior therapists focus on addressing symptoms rather than the underlying causes. They use learning principles to modify behavior.
- Systematic desensitization is a type of exposure therapy that uses counterconditioning to decrease anxiety. It is effective at treating phobias.
- Flooding is an exposure therapy in which patients are suddenly exposed to a feared object or situation.
- EMDR is an exposure treatment for post-traumatic stress disorder and panic attacks. The eye movements do not appear to add to the effectiveness of the treatment.
- In aversion therapy, a stimulus that evokes an unpleasant response is paired with a stimulus that evokes a maladaptive behavior.
- Social skills training for improving relationships with people uses techniques such as modeling, behavioral rehearsal, and shaping.
- A token economy is a behavior modification program based on operant conditioning principles.
- Humanistic therapists try to help people accept themselves and free themselves from unnecessary limitations.
- In client-centered therapy, therapists provide a supportive emotional environment that helps clients enhance self-acceptance and personal growth.
- Humanistic therapists believe that it is important to be genuine and empathic and provide unconditional positive regard.
Family Therapies
- In family therapy, a therapist sees two or more members of a family at the same time. Family therapies are based on the idea that people live as interconnected members of families.
- In couples therapy, therapists help couples to identify and resolve conflicts.
Group Therapies
- In group therapy, a therapist meets with several people at once.
- Groups may be homogeneous or heterogeneous.
- In group therapy, the therapist screens participants, promotes a supportive environment, sets goals, and protects clients from harm.
- Group members provide each other with acceptance, support, and honest feedback.
- Self-help groups are similar to therapy groups, except that they do not have a therapist.
Biomedical Therapies
- In drug therapy, psychological disorders are treated with medications. These medications are often effective but have many side effects.
- Antianxiety drugs include benzodiazepines, which reduce central nervous system activity.
- Antidepressants include MAOIs, tricyclics, and SSRIs. These drugs affect the levels of the neurotransmitters serotonin and epinephrine.
- Antipsychotic drugs are used to treat schizophrenia and other psychotic drugs. They reduce dopamine activity.
- Unlike the older antipsychotic drugs, the newer atypical antipsychotic drugs help treat the negative symptoms of schizophrenia. These drugs reduce serotonin activity as well as dopamine.
- Lithium is used to treat bipolar disorders.
- Drug therapies have been criticized for several reasons.
- ECT is used to treat severe depression. It is a controversial procedure.
- Lobotomies are performed only rarely to treat psychological disorders, but cingulotomies are sometimes done.
- TMS is a recently developed noninvasive procedure for treating severe depression.
Effectiveness of Treatment
- Client testimonials and providers’ perceptions are not reliable ways of assessing the effectiveness of treatments.
- Empirical research shows that psychotherapy is effective for many problems.
- All approaches to therapy are equally effective, but some approaches are more effective than others for specific problems.
- Effectiveness does not depend on the therapist’s level of training, experience, or education but does depend on therapist skill. Effective therapists are empathic, genuine, and warm.
- Clients who benefit from therapy tend to be people who are motivated, who are active problem solvers, and who have family support.
- Under some conditions, therapy can be harmful to clients, such as if the therapist acts unethically or coerces the client in any way.
Seeking Treatment
- People who seek psychotherapy are more likely to be women, to be more educated, and to have medical insurance.
- People may not seek treatment because of cost concerns, lack of insurance, or fear of stigma.
- Cultural and ethnic minorities often face barriers to receiving psychotherapy.
Treatment Trends
- In managed care systems, consumers pay lower fees to providers and money is not spent on unnecessary medical services. However, critics argue that managed care compromises quality of care in many ways.
- There has been a trend toward deinstitutionalization over the past several decades.
- Deinstitutionalization has both advantages and disadvantages.
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