Treatment Of Psychological Disorders

Treatment of Psychological Disorders

Modern Treatment Facilities  

Hospitalization Community Mental Health Centres Advances in psychotropic medication  Deinstitutionalization  Consequences of deinstitutionalization 

Psychotherapy Settings   

Hospitals Community Mental Health Centres Private offices / clinics

Mental Health Professionals   

Psychiatrists Psychoanalysts Psychologists Clinical  Counseling  School 

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Psychiatric social workers Nurses

Training of Professionals 

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Psychiatrists – Trained as doctors and then specialize in psyvchiatry. Can prescribe Psychologists – Trained in graduate school of psychology. Expert in research, teaching, assessment & clinical practice Counselors – Degree in counseling Social Workers – Masters degree in social work Nurses – Trained in nursing and

Biomedical Therapy 

Drug therapy Antianxiety Drugs  Antipsychotic Drugs  Antidepressants  Lithium 

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Electroconvulsive therapy Psychosurgery

Drug Therapy 

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Types of antipsychotic drugs – chlorpromazine, thioridazine, trifluoperazine, fluphenazine Prevent dopamine activity that helps to reduce episodes of delusion & hallicunation Long term use of antipsychotic drug gives side effects known as Tardive Dyskinesia (TD) – movement disorders – eg. lip smacking, stiff

Side Effect of Antipsychotic Drug 

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Happens when patient on ,medication for 6 months or more Develop Tardive Dyskinesia ( TD) Sometimes movement disorders so severe that leads to difficulty in breathing, talking or eating

Tardive Dyskinesia    

One out of four people who take antipsychotic drug develop TD Happen more among senior citizens & women Majority of people who get TD become disabled If take medication for a while, then stops – probability of relapse doubles

New Antipsyshotic Drugs  

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Clozapine, olanzapine – less side effects Clozapine least likely to get TD, but will be more risky for other side effects such as more white blood cells Therefore, need to go for blood transfusion often

Psychiatric Treatment 

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Recommend a course of antidepressant medication, eg. Valium – for panic attack For OCD – Prozac, helps to increase serotonin level in the brain Treatment for anxiety – mild tranquilizers

Basic Features of Psychotherapy 

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Systematic interaction – therapists & clients interact within a structure with plans & purposes that reflect therapist’s theoretical point of view Psychological principles – draw on psychological principles, theory & research in their practice Behaviour, thoughts & feelings – directed at behavioural, cognitive, &b emotional domain to help clients Abnormal behaviour, problem solving, & personal growth – many people benefit from psychotherapy

Techniques of Psychotherapy       

Psychodynamic therapy Behaviour therapy Cognitive therapy Cognitive-behaviour therapy Humanistic therapy Eclecetic therapy Group, Family and Marital Therapy

Psychodynamic Therapy 

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Focus on conflicts arising during childhood Release repression of unconscious or inner conflicts Free association Dream analysis Transference

Behaviour Therapy 

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Principles of learning, conditioning, reinforcement Systematic desensitization – face the source of anxiety In-vivo exposure Selective reinforcement Modeling Behavioural rehearsal Self regulation

Systematic Desensitization  

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Relax on a couch Mentally, work way through fearstimulus hierarchy, step by step Treatment for anxiety, OCD

Exposure Therapy 

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Subject exposed to intense anxietyprovoking situations Use gradual exposure – do step by step to overcome anxiety Use flooding – helps to extinct or wipe out anxiety

Cognitive Therapy 

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Focus on the dysfunctional thoughts that may underlie depression Rational emotive therapy Beck’s emotive therapy

Cognitive-Behaviour Therapy (CBT)  

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Behaviour modification plus a focus on changing reasoning and thinking Uses relaxation techniques, decatastrophizing, substitute rational alternatives for anxiety-inducing thoughts Produces better long-term results after treatment termination, compared to pharmacological approaches for panic atatck Usedf for social phobia, panic, GAD

Applications of CBT     

Anxiety disorders Depression Eating disorders Drug and al;cohol dependence Sexual dysfunction

Humanistic Therapy 

Person-Centred Therapy - Carl Rogers: Explore how one’s anxiety stems from incongruence between his true self and his social façade  Emphasizes individual tendency toward growth and self-actualization  Client centred therapy  Empathy  Warmth 

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Sociocultural Approaches 

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Group therapy – cost efefctive compared to individual therapy Self-help groups Couple therapy Family therapy Community based programs

Eclectic Approaches 

Use a combination of approaches and techniques from different therapies, including religious therapy if necessary

Multicultural Issues in Psychotherapy 

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Need to take cultural factors into account Psychotherapy is Western in origin Some culture may place more value on spiritual or religious intervention rather than psychotherapy

Befrienders 

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NGO that gives emotional support to those who are depressed Befrienders’ Message – “Prevent suicide is everybody’s work” 14th October – National Suicidal Prevention Day KL – 03 - 7956 8144 Penang – 04 - 281 5161 / 1108 Ipoh – 05 – 547 7933 / 55 Melaka – 06 – 284 2500

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Neurotransmitter & Relationship with Pattern of Behavioural Disorder

Acetylcholine – control muscles & develop memory. If deficient, Alzheimer disease Dopamine – control muscles & process mental activity related with learning, memory & emotion. Less dopamine, become schizophrenic

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Norepinephrine – mental process involved with learning & memory. If not balanced, related with mood dosorder such as depression Serotonin – control mood, satisfaction, & sleep. If not regular, causes depression & eating disorder

Nervous System 

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Central Nervous System – brain & spinal cord Peripheral Nervous System – nervous system that receives & sends messages to the brain & spinal cord; & secretion of hormones

Functions of the Brain 

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Central Nervous System – spinal cord meets the brain Medulla – control heart beat & perspiration Pons – Respiration Cerebellum – Coordination & balance Mid Brain – connects between hind brain and fore brain

Functions of the Brain 2 

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Reticular Activating System – comprises all three brain parts – attention, sleep & stimulus Hippothalamus – control body temperature, emotion & motivation Thalamus – send message to the cortex & sleep process & attention

Functions of the Brain 3 

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Cerebral Cortex – Control higher brain function, eg thinking & use of language Corpus Callosum – connects two hemispheres of cerebral cortex