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Treatment of
Psychological Disorders

Explore the major therapeutic approaches used to treat mental health conditions: from psychotherapy to biomedical interventions and beyond.

AP Psychology

What Is Psychotherapy?

Psychotherapy is a broad term for treating psychological disorders through verbal and psychological techniques. A trained therapist helps the client work through thoughts, feelings, and behaviors that cause distress or impair functioning.

Talk Therapy
Uses conversation to explore the root of distress and develop coping strategies
Goal-Oriented
Aims to reduce symptoms, improve functioning, and increase well-being

A Brief History of Treatment

Treatment of mental illness has evolved dramatically over centuries: from trephination and asylums to evidence-based therapies and the deinstitutionalization movement of the 1960s.

1
Ancient Era: Spiritual explanations: exorcisms, trephination (drilling holes in skull)
2
Asylum Era (1700s-1800s): Institutionalization; Pinel and Dix advocated humane treatment
3
Modern Era (1950s+): Psychotropic drugs, deinstitutionalization, community mental health

Two Major Categories of Treatment

Treatment Approaches Psychotherapy Biomedical Therapy Psychodynamic Humanistic Behavioral/ CBT Drug Therapy Brain Stimulation Insight + Action Oriented Biological Interventions

Psychoanalytic and Psychodynamic Therapy

Founded by Sigmund Freud, psychoanalysis aims to bring unconscious conflicts into conscious awareness. Modern psychodynamic therapy is shorter and less intensive but shares the same core ideas.

Free Association
Patient says whatever comes to mind, revealing unconscious thoughts
Dream Analysis
Interpreting the latent (hidden) content of dreams for symbolic meaning
Transference
Patient projects feelings about important figures onto the therapist

Humanistic Therapy: Rogers' Approach

Carl Rogers developed client-centered therapy (also called person-centered therapy), which emphasizes the therapist creating a supportive environment for self-exploration and growth.

1
Unconditional Positive Regard: Accepting the client without judgment, no matter what they express
2
Genuineness (Congruence): The therapist is authentic and transparent in the relationship
3
Empathic Understanding: The therapist mirrors and reflects the client's feelings accurately
4
Active Listening: Paraphrasing, reflecting, and clarifying to show deep engagement

Behavioral Therapies

Behavioral therapies apply learning principles (classical and operant conditioning) to directly change problematic behaviors, without focusing on unconscious processes.

Systematic Desensitization
Pairs relaxation with gradually increasing exposure to a feared stimulus (counterconditioning)
Aversive Conditioning
Pairs an unpleasant stimulus with an unwanted behavior to reduce it
Token Economy
Operant conditioning: rewards (tokens) reinforce desired behaviors in a structured setting

Cognitive-Behavioral Therapy (CBT)

Thoughts Feelings Behaviors influence influence influence

Aaron Beck developed CBT, which combines cognitive restructuring (challenging irrational thoughts) with behavioral techniques. Albert Ellis' Rational Emotive Behavior Therapy (REBT) is a closely related approach.

Insight vs. Action Therapies

Insight Therapies Action Therapies
Goal Understand root causes Change behavior directly
Focus Unconscious, past experiences Present symptoms, learning
Examples Psychoanalysis, Humanistic Behavioral, CBT
Duration Often long-term Often short-term, structured
Therapist Role Interpreter / facilitator Coach / instructor

Biomedical Therapies: Drug Classes

Antidepressants
SSRIs (e.g., Prozac, Zoloft) increase serotonin availability. Treat depression and anxiety.
Antipsychotics
Block dopamine receptors. Treat schizophrenia and psychotic symptoms. Typical vs. atypical.
Anxiolytics
Benzodiazepines (e.g., Xanax) enhance GABA. Treat anxiety disorders. Risk of dependence.
Mood Stabilizers
Lithium is the classic example. Treats bipolar disorder by reducing mania.

Brain Stimulation Therapies

ECT
Electroconvulsive therapy: brief electrical current to the brain. Used for severe, treatment-resistant depression.
TMS
Transcranial magnetic stimulation: magnetic pulses to specific brain regions. Non-invasive, fewer side effects.
DBS
Deep brain stimulation: implanted electrodes in specific areas. Experimental for severe OCD and depression.

How to Match Treatment to Disorder

1
Identify the disorder: Determine the specific diagnosis (e.g., GAD, MDD, schizophrenia)
2
Consider evidence-based treatments: Which approach has the strongest research support for this disorder?
3
Evaluate severity: Mild cases may respond to psychotherapy alone; severe cases may need medication or combination
4
Consider the eclectic approach: Most modern therapists integrate techniques from multiple orientations
5
Monitor and adjust: Treatment is a process: reassess and modify the plan as needed

Example: Treating a Specific Phobia

Low Moderate High Anxiety Hierarchy Step 1 Imagine spider → Step 2 Look at photo → Step 3 Hold real spider + Deep relaxation at each step Systematic Desensitization (Wolpe)

Example: Treating Major Depression

A patient with major depressive disorder (MDD) might receive a combination approach: CBT to address cognitive distortions plus an SSRI to correct serotonin imbalances.

CBT Component
Identify automatic negative thoughts (e.g., "I'm worthless"). Challenge and replace with balanced thoughts.
SSRI Component
Blocks serotonin reuptake, increasing availability. Takes 4-6 weeks for full effect.

Example: Treating Schizophrenia

Schizophrenia typically requires antipsychotic medication as the primary treatment, often supplemented by psychosocial interventions.

1
First-generation (typical) antipsychotics: Chlorpromazine, haloperidol. Block dopamine \(D_2\) receptors. Risk of tardive dyskinesia
2
Second-generation (atypical) antipsychotics: Clozapine, risperidone. Block dopamine and serotonin. Fewer movement side effects
3
Psychosocial support: Social skills training, family therapy, and supported employment help with daily functioning

Common Mistakes on the AP Exam

✕ Confusing CBT with Psychoanalysis
CBT focuses on present thoughts and behaviors; psychoanalysis explores unconscious past conflicts. They are fundamentally different.
✕ Mixing Up Drug Classes
SSRIs treat depression (serotonin), not schizophrenia. Antipsychotics target dopamine. Know which drug treats which disorder.
✕ Forgetting Systematic Desensitization Steps
It requires both an anxiety hierarchy AND relaxation training. Flooding uses exposure without relaxation: they are different techniques.

Summary Comparison Table

Approach Focus Key Technique Best For
Psychoanalytic Unconscious conflicts Free association Long-term insight
Humanistic Self-actualization Active listening, UPR Personal growth
Behavioral Learned behaviors Desensitization Phobias, habits
CBT Thoughts + behaviors Cognitive restructuring Depression, anxiety
Biomedical Brain chemistry Medication, ECT Severe disorders

Question 1 of 5

A therapist asks her client to say whatever comes to mind without censoring any thoughts. This technique is called:

Question 2 of 5

Which class of drugs blocks dopamine receptors and is primarily used to treat schizophrenia?

Question 3 of 5

Carl Rogers' client-centered therapy emphasizes all of the following EXCEPT:

Question 4 of 5

In systematic desensitization, the client is trained to:

Question 5 of 5

A psychiatrist prescribes an SSRI for a patient with major depressive disorder. This medication works primarily by: