DYSFUNCITONAL BEHAVIOR: TREATMENTS
Biological therapies
Antianxiety drugs: reduce anxiety, make patient less excitable. Examples: Benzodiazepines, nonbenzodiazepines
Antidepressant drugs: Treat gen. anxiety disorder, panic disorder, OCD, social phobia, PTSD, some eating disorders. Lithium is used to treat bipolar disorder.
Tricyclics- increase level of certain neurotransmitters; Monoamine oxidase (MAO) inhibitors- not as widely used, more toxic; Selective serotonin reuptake inhibitor (SSRI)- interfere with reabsorption of serotonin to increase it in brain.
Antipsychotic drugs: Diminish agitated behavior, reduce tension, decrease hallucinations, improve social behavior, improve sleep. Neuroleptics- most widely used, block dopamine system’s action in brain, used to treat symptoms of schizophrenia.
Electroconvulsive therapy (ECT): Shock therapy, used on severely depressed patients, causes brain seizure (electric current through brain briefly). Effectiveness: just as effective as cognitive therapy/ antidep. drugs, but with more severe side effects if any at all (i.e. memory loss, cognitive impairments).
Psychosurgery: Removal/ destruction of brain tissue. Prefrontal lobotomy- at first it was done by inserting a surgical instrument in the brain and rotating it to sever fibers that connect frontal lobe with thalamus. In modern times, this is used only as a last resort; now they make a small lesion in limbic system.
Psychodynamic therapies
Stress importance of unconscious mind, interpretations, childhood; goal: patient to realize maladaptive ways and their origins.
Psychoanalysis- Freud’s therapeutic technique for analyzing person’s unconscious thoughts.
Free association- encouraging person to say whatever comes to mind.
Catharsis- the release of emotional tension experienced when reliving emotionally charged experience.
Interpretation- person’s statements/ behavior are not taken at face value, interpretations of “hidden” meanings behind these.
Dream analysis- manifest content (conscious, remembered aspects) vs. latent content (unconscious, unremembered, symbolic aspects).
Transference- when person relates to analyst in ways that reproduce/ relive important relationships in person’s life.
Resistance- person’s unconscious defense strategies to prevent analyst from understanding person’s problems.
Contemporary psychodynamic therapies: accord more power to consciousness and current relationships, emphasize dev. of self in social contexts.
Humanistic therapies
Client-Centered therapy (Rogers) Accepting client’s feelings openly; more emphasis on self-reflection; personal client-therapist relationship.
Conditional positive regard- sense of worth we receive from others (with strings attached).
Nondirective role of therapist.
2 techniques: genuineness a.k.a. congruence, active listening.
Gestalt therapy (Fritz Perls) Therapist challenges person to face problems.
Dream int. is important, conflicts brought to surface.
Techniques: set examples, encourage congruence between verbal/ nonverb. behavior, use role playing, openly confront client, be more directive than client-centered therapy would.
Behavior therapies
Assume that overt symptoms are the problem (tries to remove symptoms themselves); now includes concepts of social cognition/ observation, as well.
Classical conditioning Techniques: systematic desensitization/ flooding: making person confront his/her fear (phobia). Second technique: aversive conditioning- repeated pairings of unwanted behavior with aversive stimuli (electric shocks, insults, etc.) to reduce person’s rewards.
Operant conditioning Changing consequences of behavior.
Behavior modification; reinforcement is used.
Token economy- tokens that later are exchanged for money or candy are given to reinforce behavior.
Disadvantage: some stop expressing positive behavior when tokens are no longer being given.
Cognitive therapies
Cognitive restructuring, focus of more overt symptoms (like behavioral), less concerned about past, more structure than humanistic techniques.
Rational-Emotive behavior therapy (REBT) Based on idea that ppl. develop psych. disorders because of irrational/ self-defeating beliefs (proposed by Albert Ellis).
Therapist must rationally examine client, who is then shown how to rationalize beliefs).
Beck’s cognitive therapy Aaron Beck said that psych. probs. (depression) occur when ppl. think illogically about themselves, their env., and the future.
Cognitive-Behavioral therapy Emphasis of reducing self-defeating thoughts plus on changing behavior.
Self-efficacy, self-instructional methods, person is influenced by culture/ society.
Sociocultural approaches and issues in treatment
Group therapy, family/couples therapy, self-help support groups
Cultural perspectives
The above therapies are geared toward individualistic societies of the West, not necessarily towards collectivist societies.
Ethnicity: Researchers have found that clients are less likely to drop out of therapy early and are more likely to have better outcomes if his/her ethnicity is the same as the therapist’s.
Gender: Many new, nontraditional therapies emphasize the significance of helping ppl. break free from traditional gender roles/ stereotypes
The effectiveness of psychotherapy
It’s been seen that insight and behavior therapies work equally effective (and both are better than no treatment at all).
Therapy integrations
Integrative therapy (many therapists use multiple techniques of therapy).