Treatment for psychological disorders can be categorized into
insight therapies, behavior therapies, and
All psychotherapies offer hope, new perspectives on a
problem, and an empathic relationship with a therapist.
Many types of professionals provide psychological treatment.
All psychodynamic therapies are based on Sigmund Freud’s
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
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
Humanistic therapists believe that it is important to be genuine and
empathic and provide unconditional positive regard.
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
In group therapy, a therapist meets with several people at
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
Self-help groups are similar to therapy groups, except that
they do not have a therapist.
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
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
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
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.
People who seek psychotherapy are more likely to be women,
to be more educated, and to have medical
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
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.