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Psych Treatments - Coggle Diagram
Psych Treatments
Psychopharmacology
Antianxiety
- Tranquiliser - reduce central nervous system (anxiety, emotional arousal, not alertness)
- For anxiety, OCD, PTSD, panic, social phobia
- e.g. Xanax, Valium
Antipsychotic
- Tranquiliser - decrease dopamine (& serotonin in newer)
- For schizophrenia (mostly +ve)
- e.g. Risperdal
Antidepressant
- Tricyclics, MAO inhibitors, SNRI - increase norepinephrine & serotonin
- SSRI - increase serotonin
- e.g. Zoloft, Prozac
- For depression (& anxiety)
-
Psychostimulants
- For ADHD
- Improves focus & attention
- e.g. Ritalin
Other Biological (for depression)
- ECT (electroconvulsive therapy) - use current to induce seizures
- TMS (transcranial magnetic stimulation): use magnetic fields to stimulate nerve cells
- Psychosurgery
Psychodynamic
Tools:
- Psychoanalysis: In depth talk
- Free association
- Dream analysis
- Interpretation
- Transference
- Resistance
- Play therapy: directed or self-directed
Key ideas:
- Insight: understand unconscious cause
- In-depth talk
- Focus on past
- Strong therapist-client relationship
-
Cause of symptoms:
- Maladaptive view of self
- Maladaptive dealing with emotions
- Unconscious conflicts
Cons:
- Many sessions / $$$
- Interpret beyond situation
- Conflict not internal
Behavioural
What is it: based on learning - classical & operant conditioning, observational learning
Tools:
- Behavioural analysis
- Classical - counterconditioning (learn new response)
** Exposure therapy - flooding, systematic desensitisation
** Aversion therapy (e.g. nail biting / taste, Antabuse)
- Operant
** Rewards/reinforcements or punishments, e.g. ABA (Applied Behavioural Therapy), token economy
** Behavioural activation
- Observational learning / Modelling
** Social skills training
Key ideas:
- Replace maladaptive behaviour with adaptive
- Focus on current behaviour
- Many uses - anxiety, autism, OCD, PTSD, phobia, schizo
-
Humanistic
-
Key ideas
- Promote growth, responsibility, life goals, potential
- Focus on present & future
- Focus on conscious
- Through relationship quality
- People choose & change
Therapeutic alliance - nurturing relationship with:
- Genuineness
- Unconditional positive regard (accept all)
- Empathy (not sympathy)
Tools:
- Person-centred therapy (Rogers)
- Gestalt therapy (Perls)
- Active listening, non-directive
Cause of symptoms:
- Burden of limits / expectations
Cognitive
-
Tools:
- RET (Ellis) (Rational-Emotive Therapy): challenge irrational thoughts, modify them
- Cognitive therapy (Beck): depression, test negative beliefs, cognitive restructuring
Key ideas:
- Change thoughts -> emotions -> behaviour
- ABCDE: Activating - Belief - Consequence (emotional/behavioural) - Dispute - Effective belief
- Change cognitive distortions: all-or-nothing thinking, overgeneralisation, jumping to conclusions
Cause of symptoms:
- 'Irrational' / negative thoughts -
catastrophic, black & white, selective perception
- Schemas (from childhood)
- Core beliefs -> intermediate (attitudes, assumptions, expectations)-> belief system
- Negative thinking / behaviour cycle
CBT &
Third wave
CBT
Key ideas:
- Gold standard, strong research
- Focus on symptoms
- Problem-solving, action, responsibility
-
-
Third wave
Tools:
- CBT + mindfulness
- DBT (Dialetctical Behaviour Therapy): cognitive + help of patient - for borderline personality disorder
- ACT (Acceptance & Commitment Therapy)
- Other: metacognitive, exercise
Key ideas:
- Focus on practical outcomes - reduce stress
- Encourage acceptance
-
-
Biopsychosocial
Biological
- Brain changes
- Neurotransmitters / hormones
- Drugs
Social
- Social skills
- Relationship with therapist
- Culture
Group therapy
-
Key characteristics:
- 4-10 with therapist guiding
- Learning, social support, modelling
- Cheaper, as effective
Types:
- Group (e.g. life altering illness)
- Couples
- Family
Community mental health
-
Key characteristics:
- Delivered by various people, various places
- Goal is to prevent / maintain disorders
- Support in childhood & early adolescence
- Easier for people to live normal life
Types:
- Primary: all receive it
- Secondary: those with risk factors
- Tertiary: those diagnosed (chronic, disability)
Evaluating effectiveness
When providing treatment
- Appropriate (type, severity), evidence based
- Clinical expertise
- Client characteristics
- Dose response (how long / often)?
- Efficacy
** Does it work?
** Compared to others?
** How much has it improved?
Research
Evidence-based
- Research + clinical expertise
- Best practice -> operationalised -> manuals
Outcome based - differentiate effectiveness from:
- Natural improvement (no treatment)
- Non specific treatment (any treatment)
- Placebo effect (expectation of getting better)
Types
- Randomised controlled trials
- Meta-analysis
- Compare with control, placebo (ethical?), another therapy, length of treatments
Effectiveness
- Psychotherapy: better at reducing not preventing,
mostly due to non-specific
- Biomedical: effective short term, but don't treat cause;
best for ADHD
- Social-community: effective but most are modest;
best for prevention (health of babies)
Self-help groups
What is it: voluntary association with others with common desire to overcome issues or improve wellbeing
Key characteristics:
- With trained leader
- Many types of disorders
- May have associations (religious, workplace)
Types:
- Addiction (AA)
- e.g. Parent support groups
Telehealth
Advantages
- Efficacy, alliance, client satisfaction equivalent
- Accessibility: rural / regional, specialists
- Better for some clients (e.g. agoraphobia, less intimidating)
- Practical (e.g. less time away, more flexibility, less wait)
- Covered by Medicare, more after COVID
- Improved resources / PD / guidelines
Disadvantages
- Negative therapist view of efficacy, alliance
- Ethics / guideline uncertainty
- Practical burden
- Lack of training