1. 15.6 to 15.7 - Group therapies
1.1. 15.6 - Types of group therapy
1.1.1. Can use a large variety of styles and take several forms, but person-centered, Gestalt and behavioral seem to work best
1.1.2. Family counseling: a form of group therapy where family members meet with a therapist
1.1.3. Self-help (support) groups: Without a trained therapist, composed of people with similar problems
1.2. 15.7 - Evaluation of group therapy
1.2.1. Cheaper than individual therapy, great deal of social and emotional support from other group members
1.2.2. Has been demonstrated to be very effective for people with social anxiety
1.2.3. Lack of a private setting, therapists time has to be shared, problem with inability of people with severe disorders to tolerate being in a group
2. 15.8 to 15.9 - Does psychotherapy really work?
2.1. 15.8 - Studies of effectiveness
2.1.1. Eysenck's early survey of client improvement seemed to suggest that clients would improve as time passed, with or without therapy, however these results could not be replicated in many studies since
2.1.2. Surveys of people who have received psychotherapy say it is more effective than no treatment at all
2.1.3. 75 - 90% of people who receive therapy report improvements, the longer a person stays in therapy the better the improvement. Psychotherapy works as well alone as with drugs
2.1.4. Some types of psychotherapy are more effective for certain types of problems, but no one psychotherapy method is effective for all problems
2.2. 15.9 - Characteristics of effective therapy
2.2.1. Effectiveness is not easy to study due to different theories, techniques, time frames for success and tendency of therapists to be eclectic
2.2.1.1. Common factors approach: focuses on those factors common to successful outcomes from different forms of therapy
2.2.1.2. Clients benefit through evidence-based practice, or empirically validated treatment
2.2.2. Greater success is often tied to the relationship between the therapist and the client (therapeutic alliance), a sense of safety and longer time in therapy
2.2.3. Cultural, ethnic and gender concerns should also be examined, as there are several potential barriers when the culture of the client and therapist are different: culture-bound values, class-bound values, language, "American" cultural assumptions and communication style
3. 15.10 to 15.12 - Biomedical therapies
3.1. 15.10 - Psychopharmacology
3.1.1. Psychopharmacology involves the use of drugs to control or relieve the symptoms of a psychological disorder. Different types of drugs including:
3.1.1.1. Antipsychotic drugs: used to treat psychotic symptoms such as hallucinations, delusions and bizarre behavior
3.1.1.1.1. Typical antipsychotic: works by blocking certain dopamine receptor, serving as a dopamine antagonist. However, block more pathways in dopamine system then are involved in psychosis, can cause serious problems with prolonged use
3.1.1.1.2. Atypical antipsychotic: May also suppress dopamine, but to a much greater extent in the one dopamine pathway that seems to cause psychotic problems
3.1.1.2. Antianxiety drugs: address anxiety and related disorders, include minor tranquilizers that have a sedative effect (benzodiazepines) and certain antidepressant drugs
3.1.1.3. Mood-stabilizing drugs: These so called antimanic drugs are used to treat bipolar disorder and include lithium and certain anticonvulsant and antipsychotic drugs
3.1.1.4. Antidepressant drugs: are used in the treatment of depression and include the following:
3.1.1.4.1. Monoamine oxidase inhibitors (MAOIs)
3.1.1.4.2. Tricyclic antidepressants
3.1.1.4.3. Selective serotonin reuptake inhibitors (SSRIs)
3.2. 15.11 - ECT and psychosurgery
3.2.1. Electroconvulsive therapy (ECT)
3.2.1.1. Still used to treat severe depression and a few other disorders that have not responded to other forms of treatment
3.2.1.2. Involves application of an electric shock and resulting seizure
3.2.1.3. Traditional side effects have been minimized by lower levels of current and use of both muscle relaxers and anesthesia
3.2.2. Psychosurgery
3.2.2.1. Only used as a last resort, involves cutting into brain and removing or destroying brain tissue
3.2.2.2. Prefrontal lobotomy
3.2.2.2.1. One of the earliest psychosurgeries, front part of the lobe was cut away, this was discontinued when antipsychotic drugs started to be developed
3.2.2.3. Bilateral anterior cingulotomy
3.2.2.3.1. Modern psychosurgery method, primarily used for obsessive compulsive disorder or generally when no other treatments have worked for other severe conditions
3.2.2.3.2. Works by MRI guiding an electrode to the cingulate gyrus, where an electric current destroys a very particular area of brain cells
3.3. 15.12 - Emerging techniques
3.3.1. Emerging technologies for treatment of psychological disorders include repetitive transcranial magnetic stimulation (rTMS), transcranial direct current stimulation (tDCS), and deep brain stimulation (DBS)
4. 15.13 - Lifestyle factors: fostering resilience
4.1. Individuals with and without psychological disorders benefit from proactive, healthy strategies for taking care of their physical and mental health; getting enough sleep, eating a healthy diet, engaging in regular exercise, and spending time in nature can boost resilience
5. 15.1 - Treatment of psychological disorders: past to present
5.1. Mentally ill people began to be confined to asylums in the 1500s, with inhumane treatments, but luckily this changed around 1800
5.2. Psychotherapy involves a person talking to a psychological professional about the person's problems
5.2.1. Insight therapy: gaining understanding into motives and actions
5.2.2. Action therapy: aimed at changing disordered behavior directly
5.3. Biomedical therapy uses a medical procedure to bring about changes in behavior
6. 15.2 to 15.3 - Insight therapies
6.1. 15.2 - Freud's psychoanalysis
6.1.1. Psychoanalysis: Aimed at revealing unconscious conflicts, urges and desires through two main techniques:
6.1.1.1. Dream interpretation: involved deciphering hidden, latent content from the manifest content, which is the actual dream itself
6.1.1.2. Free association: involved patients talking freely about whatever came to mind; believed to reveal hidden, unconscious concerns
6.1.2. Modern psychodynamic approach: more directive and less time consuming than before, focuses on ego and disregards id
6.1.3. Although techniques have been modified, still lacks scientific support for basic premises and requires client to be fairly intelligent and verbally expressive
6.1.4. Interpersonal psychotherapy: eclectic therapy with some theoretical roots in the psychodynamic approach but combines aspects from humanistic and cognitive-behavioral therapies
6.2. 15.3 - Humanistic therapy
6.2.1. Humanistic therapies focus on the conscious mind and subjective experiences to help clients gain insights.
6.2.2. Person-centered therapy
6.2.2.1. Very nondirective, allowing the client to talk through problems and concerns while the therapist provides a supportive background
6.2.2.2. 3 basic elements of person-centered therapy: authenticity, unconditional positive regard and empathy
6.2.3. Gestalt therapy
6.2.3.1. More directive, helping clients become aware of their feelings and take responsibility for their choices in life
6.2.3.2. Gestalt therapists try to help clients deal with things in their past that they have denied and will use body language and other nonverbal cues to understand what clients are really saying
6.2.4. Humanistic therapies are associated with large pre-post client change maintained for a significant period of time. However, they are not based in experimental research and clients are required to be fairly intelligent and verbally expressive
7. 15.4 to 15.5 - Action therapies
7.1. 15.4 - Behavior therapies
7.1.1. Classical conditioning techniques
7.1.1.1. Systematic desensitization
7.1.1.1.1. Consists of 3 step process: 1. client relaxes through deep muscle relaxation training, 2. constructing list from least to most fear, 3. client goes up list to engage with items while remaining in a relaxed state
7.1.1.2. Exposure therapies
7.1.1.2.1. Expose individual to anxiety-provoking stimulus in real or imagined form, in a gradual or sudden (flooding) manner
7.1.1.3. Aversion therapy
7.1.1.3.1. Reduces the frequency of undesirable behavior by teaching the client to pair an unpleasant stimulus with the undesirable behavior
7.1.2. Operant conditioning techniques
7.1.2.1. Modeling
7.1.2.1.1. Therapy based on the observation and imitation of a model
7.1.2.2. Reinforcement
7.1.2.2.1. Strengthens a response by following it with some pleasurable consequence. Examples are:
7.1.2.3. Extinction
7.1.2.3.1. Involves the removal of a reinforcer to reduce the frequency of a particular response
7.1.2.4. Behavioral activation
7.1.2.4.1. Has been successful with depression and involves reintroducing individuals to their regular environments and routines as one way to increase opportunities for positive reinforcement
7.1.3. Virtual reality therapy is a computer-based simulation of environments that can be used to treat disorders such as phobias and PTSD
7.1.4. Behavior therapies can be effective in treating specific problems, such as drug addictions and phobias, and can help to improve some of the more troubling behavioral symptoms associated with more severe disorders
7.2. 15.5 - Cognitive therapies
7.2.1. Beck's cognitive therapy
7.2.1.1. Focused on helping people change their way of thinking by critically and objectively analyzing distorted thoughts
7.2.1.2. Common distortions in thinking:
7.2.1.2.1. Arbitrary inference: jumping to conclusions without any evidence
7.2.1.2.2. Selective thinking: focusing only on one (negative) aspect of a situation
7.2.1.2.3. Overgeneralization: drawing a sweeping conclusion from one incident and applying it to other areas of life
7.2.1.2.4. Magnification and minimization: blowing bad things out of proportion while not emphasizing good things
7.2.1.2.5. Personalization: attributing negative feelings of others to oneself
7.2.2. Cognitive behavioral therapy (CBT)
7.2.2.1. Works at changing a person's illogical or distorted thinking
7.2.2.2. 3 goals of CBT:
7.2.2.2.1. Relieve the symptoms and solve the problems
7.2.2.2.2. Develop strategies for solving future problems
7.2.2.2.3. Change irrational, distorted thinking
7.2.3. Rational emotive behavior therapy (REBT)
7.2.3.1. Therapist challenges clients' irrational beliefs and replaces them with more rational helpful statements, often arguing with clients
7.2.4. Evaluation: shorter and less expensive than insight therapies, treating symptom not cause, effective for many disorders, including depression, anxiety disorders, stress disorders and personality disorders