Characteristics of treatment for psychopathology include:
- Provide relief from the distress caused by symptoms
- Provide the client with self-awareness and insight into their problems
- Enable the client to acquire coping and problem-solving skills to prevent similar problems in the
future
- Attempt to identify and resolve the causes of psychopathology and problematic ways of behavior /
thinking / dealing.
The treatment depends on at least 2 factors:
- The theoretical orientation and training of the therapist
- The nature of psychopathology
The therapist should demonstrate that s/he is engaged in continuing professional development (CPD).
That is, they must regularly update their knowledge of recent developments in treatment techniques.
Theoretical approaches to treatment
Psychodynamic approaches
- The aim is to reveal unconscious conflicts that may be causing the symptoms.
- Most psychodynamic approaches assume that unconscious conflicts develop early in life and the
therapy is designed to identify life events that may have caused these conflicts.
- The therapist helps the client acknowledge these conflicts, bring them to consciousness and work
for strategies for change.
- Examples: Free association, transference, dream analysis, interpretation
Behavior therapy
- Overall includes all interventions that attempt to change the client’s behavior
- Conditioning: form of associative learning in behavior therapy
- They believed that many disorders were a result of faulty learning and that symptoms were
acquired through simple conditioning.
- The first set of therapies is based on classical conditioning, this is known as behavior therapy in
general. Examples are:
o Extinction: disrupting the association between the anxiety-provoking cues/situations and
the traumatic outcomes
o Exposure therapy: Flooding, Counterconditioning, Systematic desensitization
o Reciprocal inhibition: fixes the relationship between anxiety-provoking cue and threatening
consequence and also attaches a response to the cue that is incompatible with anxiety
o Aversion therapy: conditions aversive outcome to a stimulus
- The second set of therapies is based on operant conditioning, this is known as behavior
modification / behavior analysis. Examples are:
o Functional analysis: identifying the consistencies between problematic behavior and
consequences that may be reinforcing them
o Response shaping: encourages new behaviors
o Behavioral self-control: personal use of operant conditioning principles to control your own
behavior
, Cognitive therapies
- Overall, it is based on the belief that psychological problems are products of faulty ways of thinking
- Rational emotive therapy (RET): by Albert Ellis. He believed people carry around a set of
assumptions which determines how they judge themselves and others and many of these
assumptions are irrational and cause emotional distress. RET challenges these irrational beliefs and
persuades the person to set more attainable goals.
- Beck’s cognitive therapy: depression is maintained by negative schemas and the therapy engages
the patients in an objective assessment of their beliefs.
- Cognitive behavior therapy (CBT): intervention to change both thoughts and behaviors
o the client is encouraged to keep a diary about significant events, moods, feelings
o the client is urged to identify and challenge irrational or biased thoughts
o clients are given homework of ‘behavioral experiments’ to test whether their assumptions
are rational and accurate
o clients are trained in new ways of thinking, behaving and reacting
- Mindfulness-based cognitive therapy (MBCT): emphasized a mental state of present-moment
focus and nonjudgmental awareness.
- Acceptance and commitment therapy (ACT): rather than changing the way clients think, it teaches
them to notice, accept and embrace them by increasing psychological flexibility.
Humanistic therapies
- Holistic therapies: considers the ‘whole’ person and not just the individual symptoms of
psychopathology
- Supports a more personal relationship between the client and therapist that genuine, empathetic,
and has unconditional positive regard.
- Therapy allows the clients to make their own decisions and solve their own problems
Family and systemic therapies
- Family therapy: helps improve communication between family members, resolves specific conflicts
and applies systems theory: attempts to understand the family as a social system that has complex
relationships and remold these relationships into well-functioning ones.
Drug treatments
- Many drug treatments have a palliative effect: reduce the severity of symptoms and alleviate
distress but they rarely provide the client insight into their problems.
- most commonly used ones are antidepressant drugs, anxiolytic drugs and antipsychotic drugs.
Treatments for Mood Disorders (MDD and Bipolar) – Hooley and Butcher
- With the wide variety of treatment available and public awareness, more and more people are
seeking treatment. However still, only 40% of people with mood disorders receive minimally
adequate treatment. The probability of receiving treatment is higher for people with severe mood
disorders. Even without formal therapy, majority of patients with mania and depression recover in
less than a year.
Pharmacotherapy
- Antidepressants, mood-stabilizing and antipsychotic drugs are all used to treat mood disorders.
MDD
- The first category of antidepressant medication developed in the 1950s is the monoamine oxidase
inhibitors (MAOIs). They inhibit the action of monoamine oxidase, the enzyme responsible for the
breakdown of norepinephrine and serotonin once released.
- The MAOIs are quite effective but they have potentially dangerous side effects if certain food rich
in tyramine amino acid are consumed (red wine, beer, salami etc.).
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