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Chapter 16.docx

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Wilfrid Laurier University
Todd Ferretti

Chapter 16 - Approaches to Treatment and Therapy Biological Treatments  Contemporary view alternatives between mental disorders as diseases (medical treatments) and emotional problems (psychological treatments)  Drug treatments on the rise with growing recognition of biological and genetic components to disorders o Medications that alter the production of or response to neurotransmitters in the brain Antipsychotic Drugs  Drugs used primarily in the treatment of schizophrenia and other psychotic disorders  Most designed to block or deduce the sensitivity of brain receptors that respond to dopamine  As affects all dopamine in the brain, can have negative side effects  Reduce agitation, delusions, and hallucinations  Side effects such as muscular rigidity, tremors, and involuntary muscle movements (tardive dyskinesia)--> can be severe Antidepressant Drugs  Drugs used primarily in the treatment of mood disorders, especially depressions and anxiety  Produce unpleasant physical reactions o Can range from dry mouth, overall dryness, to more severe impacts (i.e. increase likelihood of suicide, affect other mental aspects) o Although some of these effects not proven, fact that drug companies try to hide these negative results give them some validity Three Classes of Antidepressants  Monoamine oxidase inhibitors (MAOI's)  Tricyclic Antidepressants  Selective serotonin reuptake inhibitors (SSRI's) o Stops serotonin from being reabsorbed, blocks re-uptake mechanism o Prevents serotonin from being sucked back into neurons, makes brain feel like it has more normal level of serotonin, makes brain feel less depressed o Most prevalent used antidepressant Tranquilizers and Lithium  Anti-Anxiety Drugs (Tranquilizers) o Drugs commonly, but often inappropriately, prescribed for patients who complain of unhappiness, anxiety, or worry o Useful as short-term treatment of panic disorder o Increase activity of GABA  Lithium Carbonate o Drug frequently given to people suffering from bipolar disorder (moderates norepinephrine and stops overstimulation from glutamate) Drug Treatments Cautions About Drug Treatments  Limitations to Drug Treatments: 1. The Placebo Effect  The apparent success of a medication or treatment due to the patient's expectations of hope rather than to the drug itself 2. High Relapse and Dropout Rates  Many participants drop out, and fall back into problem over course of study 3. Dosage Problem  Therapeutic Window: The amount of medication that is enough but not too much 4. Disregard for effective, possibly better, non-medical treatments 5. Unknown long term risks  As test on animals and don't have an extensive time frame to study drug, can miss effects that can take years to happen 6. Untested off-label uses  Drugs are sometimes prescribed for conditions outside their intended use Direct Brain Interventions  Psychosurgery o Any surgical procedure that destroys selected areas of the brain believed to be involved in emotional disorders or violent, impulsive behaviour (i.e. prefrontal lobotomy)  Electroconvulsive Therapy (ECT) o A procedure used in cases of prolonged and severe major depression, in which a brief brain seizure is induced o Not sure why exactly this helps o Newer alternatives like transcranial magnetic stimulation (TMS) used for milder stimulation Kinds of Psychotherapy Psychodynamic Therapy  Relied on Freud's method of psychoanalysis & traditionally involved free association  Evolved into many psychodynamic or "depth therapies” o Major element is transference process where client transfers unconscious emotions or reactions (e.g., feelings about parents) onto the therapist Behavioural Therapy o Therapy that applies principles of classical and operant conditioning to help people change self defeating or problematic behaviours  Use a variety of methods depending on the problem or situations o Exposure, systematic desensitization, behavioural self monitoring, skills training Behaviour Techniques 1) Exposure o Graduated Exposure: method where a person suffering from a phobia or panic attacks is gradually taken into the feared situation or exposed to a traumatic memory until the fear subsides o Flooding: A form of exposure treatment in which the client is taken directly into the feared situation until his or her anxiety subsides 2) Systematic Desensitization o Systematic Desensitization: step-by-step process of desensitizing a client to a feared client of experience o Based on counter conditioning: process of pairing a conditioned stimulus that elicits a response that is incompatible with an unwanted conditioned response o Very effective for treating a large variety of phobias and anxieties 3) Behavioural Self Monitoring o A method of keeping careful data on the frequency and consequences of the behaviour to be changed 4) Skills Training o An effort to teach the client skills that he or she may lack, as well as new constructive behaviours to replace self-defeating ones Cognitive Therapy  Forms of therapy, designed to identify and change irrational, unproductive ways of thinking and, hence, to reduce negative emotions (i.e. catastrophizing)  Rational Emotive Behaviour Therapy (REBT): designed to challenge client's unrealistic thoughts (e.g. overgeneralizations, catastrophizing) (Ellis)  Other form include cognitive therapy for depression (Beck) and stress inoculation for anxiety (Meichenbaum)  Stress Inoculation: o Used to treat anxiety  Consists of three stages: o Education Phase: individual is taught about anxiety and works to identify situations that generate anxiety o Rehearsal Phase: person is taught how to manage anxiety and practices being exposed to threatening situations o Implementation Phase: Client deals with anxiety-provoking stimulus in real-world situations  Externalize the stimulus and anxiety to help treat it  Ridiculous fears and ideas seem realistic, logical methods to try and help clients do not work Procrastination  Many procrastinators are perfectionists (if you can't do it perfectly, then don't do it at all)  Failure to accept limitations leads to impossible standards and catastrophizng (rather than rational responses) Dr. Cage is a psychiatrist who makes use of electric shock and prescription medications in his treatment of patients. Which term best characterizes this type of therapist? • A. humanistic • B. cognitive • C. behavi
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