Treatment of Psychological Disorders Chapter Notes | AP Psychology - Grade 11 PDF Download

Introduction

This chapter explains how psychological disorders are treated using various methods like therapy and medication. It covers different treatment approaches, their effectiveness, and ethical guidelines. Psychological disorders are addressed through a range of treatments, including therapy, medication, and community-based care. These methods aim to reduce symptoms and enhance mental well-being. Understanding their effectiveness and ethical considerations is vital for clinicians and clients alike. Modern trends emphasize evidence-based practices, cultural sensitivity, and integrated approaches to support recovery.

Research and Trends in Treating Psychological Disorder

Psychotherapy

Meta-analytic research has transformed our understanding of psychotherapy by aggregating data from numerous studies, confirming its efficacy for various mental health conditions.

• Psychotherapy significantly improves outcomes compared to no treatment.
• No single approach suits everyone; effectiveness varies by individual and disorder.
• Combining therapy with medication often yields the best results for conditions like depression, anxiety, and schizophrenia.

Evidence-Based Treatment Approaches

Psychologists prioritize interventions backed by scientific evidence, ensuring proven effectiveness. 

Key methods include:

• Cognitive-Behavioral Therapy (CBT): Targets and modifies negative thoughts and behaviors.
• Exposure Therapy: Gradually desensitizes individuals to anxiety triggers in a safe setting.
• Dialectical Behavior Therapy (DBT): Integrates mindfulness and emotional regulation, often for personality disorders.
• Medication-Assisted Treatment: Pairs therapy with medications for disorders like bipolar disorder, schizophrenia, or severe depression.

Importance of Cultural Humility in Therapy

Effective therapy respects clients’ cultural and personal identities, incorporating:

• Cultural Humility: Valuing and understanding clients’ cultural backgrounds and experiences.
• Adapted Approaches: Tailoring treatments to align with cultural and individual values.
• Reducing Stigma: Promoting open mental health conversations in diverse communities.

Deinstitutionalization and Modern Treatment

In the later part of the 20th century, there was a significant change in how mental health conditions were addressed. Deinstitutionalization involved the large-scale release of individuals from psychiatric hospitals and asylums. This change was driven by the development of effective psychiatric medications and a growing preference for care within the community.

Reasons for Deinstitutionalization:

• Greater use of psychiatric medication: Drugs like antipsychotics, antidepressants, and mood stabilizers improved symptom control, making it possible for many people to live outside of institutional settings.
• Issues with institutional care: Extended stays in hospitals were often linked to neglect, abuse, and isolation. The move away from institutions aimed to offer treatment that was more respectful and effective.
• Growth of community-based services: The rise of mental health clinics, therapy services, and outpatient programs reduced the need for long-term stays in hospitals.

Modern Treatment Approaches: Today, mental health care mostly occurs outside of hospital environments.

• Combined use of medication and therapy: Treatment often includes both psychiatric medication and talk therapies, such as cognitive-behavioral therapy (CBT), to help people manage symptoms.
• Care within the community: Services are now available through outpatient centers, private therapists, and even online, making help more accessible.
• Focus on independence: Support programs like assisted living, job training, and life-skills development help individuals participate in society while coping with their mental health challenges.

Ethical Principles in Treatment

Psychologists adhere to ethical standards to make sure therapy and treatment are provided in a respectful and responsible way. These guidelines, set by the American Psychological Association (APA), are designed to safeguard clients’ well-being and uphold professionalism in mental health practice.

Nonmaleficence (must avoid causing harm to their clients):

• Use safe, evidence-based treatments.
• Avoid harmful techniques.
• Refer clients to specialists when needed.

Fidelity and Integrity (focus on trust and honesty in therapy):

• Uphold confidentiality and treatment commitments.
• Be transparent about qualifications and risks.
• Avoid conflicts of interest for unbiased care.

Respect for People’s Rights (recognizing patient rights to privacy, autonomy, and dignity):

• Support informed decision-making.
• Honor cultural differences and personal beliefs.
• Ensure a safe, discrimination-free environment.

Techniques in Psychological Therapies

Psychodynamic Therapies

Psychodynamic therapy explores unconscious emotions and past experiences to address current behaviors and conflicts.

Techniques:

• Free Association: Clients share unfiltered thoughts to reveal hidden emotions or memories.
• Dream Interpretation: Analyzing dreams for symbolic insights into unconscious conflicts.

Goals:

• Identify unresolved issues from the past.
• Recognize patterns causing distress.
• Bring unconscious emotions to awareness for healing.

Cognitive Therapies

Cognitive therapy targets maladaptive thoughts to foster healthier thinking and behavior.

Techniques:

• Cognitive Restructuring: Replacing irrational thoughts with balanced beliefs.
• Fear Hierarchies: Structured exposure to reduce anxiety triggers.

The Cognitive Triad: Negative thoughts about oneself, the world, and the future drive mental health issues.

• Oneself: Feeling inadequate or unworthy.
• The World: Perceiving life as unfair or hostile.
• The Future: Anticipating failure or ongoing hardship.

Applied Behavior Analysis and Conditioning-Based Therapies

Applied Behavior Analysis (ABA) uses reinforcement and conditioning to modify behaviors, often for anxiety, mental disorders, or autism spectrum disorder.

Behavioral Therapies:

• Exposure Therapies: Gradual confrontation of fears in a safe setting.
• Systematic Desensitization: Pairing relaxation with incremental fear exposure.
• Aversion Therapy: Associating unwanted behaviors with negative stimuli (e.g., bitter taste to stop nail-biting).
• Token Economies: Rewarding desired behaviors with tokens exchangeable for privileges.

Biofeedback and Self-Regulation:

• Uses sensors to monitor heart rate, tension, or breathing.
• Teaches relaxation to regulate nervous system responses, reducing anxiety or depression symptoms.

Cognitive-Behavioral Therapies

Cognitive-Behavioral Therapy (CBT) integrates cognitive and behavioral techniques to address mental and behavioral issues, effective for anxiety, depression, and personality disorders.

Types:

1. Dialectical Behavior Therapy (DBT):
   • Developed for borderline personality disorder, now used broadly.
   • Emphasizes mindfulness, emotional regulation, distress tolerance, and interpersonal skills.
   • Balances acceptance of emotions with behavior change.
2. Rational-Emotive Behavior Therapy (REBT):
   • Challenges irrational beliefs causing distress.
   • Replaces exaggerated thoughts with logical ones.
   • Focuses on how interpretations, not events, shape emotions.

How CBT Works:

• Identifies and reframes negative thoughts.
• Uses behavioral strategies like exposure or reinforcement.
• Encourages real-world practice of coping skills.

Group vs. Individual Therapy

Both group therapy and individual therapy are effective methods of psychological treatment, but they vary in format, style, and advantages. Individual therapy offers one-on-one support tailored to the person, while group therapy emphasizes shared experiences and mutual support among peers. Depending on the client's needs, therapists often suggest using both forms together.

Group Therapy:

• Involves multiple participants with one or more therapists.
• Fosters peer support, shared experiences, and communication skills.
• Cost-effective and used for addiction, anxiety, depression, or social skills.

Individual Therapy:

• One-on-one, personalized treatment.
• Ideal for trauma, deep exploration, or sensitive issues.
• Provides a confidential, tailored space.

Hypnosis

Hypnosis is a treatment method that uses concentrated focus, deep relaxation, and increased suggestibility. It can help with pain management, reducing anxiety, and controlling habits, but it is not a dependable tool for recovering memories or revisiting past ages. Its best results are seen when combined with other forms of therapy.

Proven Uses:

• Pain Management: Reduces chronic, surgical, or medical pain (e.g., migraines).
• Anxiety Reduction: Eases phobias, stress, and generalized anxiety.
• Behavioral Change: Supports quitting smoking, overeating, or other habits.

Limitations:

• Memory Retrieval: Unreliable for recovering memories; may create false ones.
• Age Regression: Not supported for revisiting past life stages accurately.

Biological Interventions

The biological approach in psychology emphasizes the role of brain activity, neurotransmitters, and genetic factors in shaping mental health. Treatments following this perspective work to address biological imbalances and enhance how the brain functions.

Medications

Psychoactive drugs are used to manage mental health conditions by altering neurotransmitter activity in the brain. They help control mood, anxiety, and thinking by acting on specific brain chemicals. These medications are typically combined with therapy to provide a more complete treatment approach. Ongoing supervision by medical professionals ensures side effects are managed and dosages are adjusted for optimal results.

Types:

• Antidepressants: Boost serotonin/norepinephrine for depression and anxiety.
• Antianxiety Drugs: Enhance GABA to calm nervous system activity.
• Mood Stabilizers (e.g., Lithium): Regulate glutamate/serotonin for bipolar disorder.
• Antipsychotics: Block dopamine to reduce psychotic symptoms.

Side Effects:

• Antidepressants/antianxiety: Weight gain, drowsiness, dizziness.
• Lithium: Nausea, tremors, kidney issues.
• Antipsychotics: Tardive dyskinesia (movement disorder).

Surgical and Invasive Interventions

For severe mental illnesses that don’t improve with medication or therapy, more direct treatments may be necessary. These include surgical or other invasive methods that alter brain activity to reduce symptoms. Although psychosurgery is rarely used, procedures like electroconvulsive therapy (ECT) and transcranial magnetic stimulation (TMS) are still applied and constantly improved. Such options are typically considered only when all other treatment approaches have failed.

Psychosurgery:

• Alters brain areas for severe OCD or epilepsy.
• Lobotomies (historical) are obsolete due to harmful effects.

Electroconvulsive Therapy (ECT):

• Induces seizures to treat severe depression, bipolar disorder, or psychosis.
• Safe under anesthesia, used when other treatments fail.

Transcranial Magnetic Stimulation (TMS):

• Non-invasive magnetic pulses for depression, anxiety, or OCD.
• Fewer side effects than ECT.