Different treatments work better for different disorders. Psychotherapy is the use of psychological techniques and the therapist-client relationship to produce emotional, cognitive, and behavior change. Most clinical psychologists describe themselves as eclectic, meaning they use various paradigms. Most use evidence based treatments, which is the practical and scientific approach to therapy.
Therapists adhering to the biological paradigm are first like to develop and refine a diagnosis. Next, clues about causes are put together. Third, scientists experiment with various treatment for preventing or curing the disorder until an effective treatment is found. Treatments generally relieve symptoms rather than fix the actual problem.
One such treatment is Electroconvulsive Therapy (ECT). It involves causing seizures by passing electricity through the brain. It was developed by Lucio Bini and Ugo Cerletti in 1938. ECT involves 6 to 12 sessions over the course of a few weeks. Bilateral ECT is more effective, but causes more memory loss. Unilateral ECT is less effective but with the least memory loss.
Psychosurgery is the surgical destruction of specific regions of the brain. It was developed by Egas Monizin 1935. Nearly 10,000–20,000 procedures have been done in the United States. It was eventually discredited. One form, cingulotomy, is used to treat very severe cases of OCD.
Psychopharmacology is the use of medications to treat psychological disturbances. Psychotropic medicationsare chemical substances that affect psychological state. 11% of American women and 5% of men are taking antidepressants. These medicines are often safe and effective and must be taken for long periods of time. However, all medications have side effects. Psychotropic medications do not cure underlying causes, but symptom alleviation is extremely important.
Another possible treatment for mental disorders are psychodynamic psychotherapies. Sigmund Freud developed
psychoanalysis. Psychoanalysis uses free association to reveal aspects of the patient’s unconscious mind. Slips of the tongue or Freudian slips are “windows into the unconscious”. Techniques psychoanalysts employ are Insight, Interpretation, Transference. Freudian psychoanalysis requires substantial amount of time, expense, and self-exploration on the part of the client. Very little research has been conducted on its effectiveness, which hurts it as anevidence based treatment. From the ashes of psychoanalysis, the psychodynamic psychotherapy was born. Psychodynamic therapists are more directive and engaged, and treatment may be brief.
One type of treatment available to those with mental disorders is Cognitive Behavioral Therapy (CBT). Cognitive Behavior Therapy promotes collaborative therapist-client relationships, a focus on the present, and direct efforts to change problems. CBT uses research-based techniques. The roots of CBT can be traced to John B. Watson’s behaviorism. Early behavior therapists relied heavily on classical conditioning. Today, CBT incorporates many learning principles based on cognitive psychology. CBT is a practical approach oriented to changing behavior. It fully embraces empirical evaluation. CBT as a paradigm asks “what works?”
One tool in the CBT workshed is Systematic Desensitization. John Wolpe (1915–1997) developed the technique while researching the elimination of phobias. He assumed that some phobias were learned through classical conditioning. Under this assumption, he developed systematic desensitization for eliminating fears: progressive muscle relaxation, hierarchy of fears, learning process.
Another tool used is Aversion Therapy. It is the use of classical conditioning to create, not eliminate, an unpleasant response. Used primarily in treating substance abuse (antabuse). However, its effectiveness is not clear.
Contingency Management is an operant conditioning technique that changes rewards and punishment for identified behaviors. Social skills training teaches clients new ways of behaving that are both desirable and likely to be rewarded in everyday life. Assertiveness training and social problem-solving are two types of social skills training. Other cognitive techniques are attribution retraining and self-instruction training.
Aaron Beck developed a form of cognitive psychology specifically as a treatment for depression. It looks at depression as being caused by errors in thinking. The therapist challenges cognitive errors by having clients analyze their thoughts more carefully.
Yet another form of CBT is Rational Emotive Therapy. Albert Ellis suggests emotional disorders are caused by irrational beliefs. These beliefs are absolute, unrealistic views of the world. A major difference from CBT challenge client’s beliefs during the therapy. It is more confrontational than Beck’s CBT. “Third-Wave” CBT is a dialectical behavior therapy. Its focus is on acceptance and commitment.
Humanistic therapies serve as a response to psychodynamic and cognitive behavior therapy. It is a “third force” in psychotherapy. Unlike the other therapies, humanists value humans’ ability to make choices and being responsible for one’s own life. They encourage people to recognize and experience their true feelings. The key to the client changing depends on the therapist-client relationship.
One form of humanistic therapy is Client-Centered Therapy developed by Carl Rogers (1902–1987). He Viewed three qualities as essential in a therapist: warmth, genuineness, and empathy. Client centered therapy encourages therapist self-disclosure. Therapists do not act as experts and try to display unconditional positive regard for their clients.
- Treating Psychological Disorders (andrewhoff.com)
- Common Mental Health Disorders (pallantmedical.wordpress.com)
- Debating the dodo verdict: Does one form of psychotherapy work better than another? (slate.com)
- ADHD: The perfect place to begin Focusing on Mental Health (optimalfunctionmd.wordpress.com)