Putting It Together: Treatment and Therapy

In this chapter, you covered a full gamut of treatment methods, including psychotherapy in its many forms as well as biomedical therapies. Put yourself in the shoes of a mental health counselor. Which treatment method or methods would you prefer to study or utilize in your practice? Which type of counseling would you prefer to seek out as a patient? Review the common types of psychotherapy below:

• Psychodynamic Therapy: The primary focus is to reveal the unconscious content of a client’s psyche in an effort to alleviate psychic tension. Although its roots are in psychoanalysis, psychodynamic therapy tends to be briefer and less intensive than traditional psychoanalysis.
• Behavioral Therapy: These methods focus exclusively on behaviors, or on behaviors in combination with thoughts and feelings that might be causing them. Those who practice behavioral therapy tend to look more at specific, learned behaviors and how the environment has an impact on those behaviors. Two primary types include operant conditioning and classical conditioning.
• Cognitive and Cognitive Behavioral Therapy (CBT): Cognitive therapy seeks to identify maladaptive cognitions (thoughts), appraisals, beliefs, and reactions, with the aim of influencing destructive negative emotions. CBT combines cognitive therapy and behavioral therapy to address maladaptive cognitions as well as dysfunctional behaviors.
• Humanistic Therapy: This form is explicitly concerned with the human context of the development of the individual with an emphasis on subjective meaning, a rejection of determinism, and a concern for positive growth rather than pathology. It posits an inherent human capacity to maximize potential.
• Group Therapy: In this type of social therapy, one or more therapists treat a small group of clients together as a group.
• Eclectic Therapy: Recently, many practitioners have begun to take what’s known as an eclectic approach, meaning they combine aspects of multiple types of therapies. This approach can be useful in that is uses the techniques and theories that work best in a specific patient’s scenario, rather than sticking solely to the methods of one discipline.

Biomedical therapies approach psychological disorders as having biological causes and focus on eliminating or alleviating symptoms of psychological disorders. The mind and body are viewed as connected; poor physical health leads to poor mental health, and vice versa.

Biomedical therapies and psychotherapy are often used in conjunction with one another to treat the whole person. Not all individuals will require biomedical therapy; however, for some, biomedical approaches can help enhance the effectiveness of psychotherapeutic approaches. For example, an individual with schizophrenia who is bombarded with visual or auditory hallucinations may find it difficult to focus in psychotherapy; with medication, the individual’s hallucinations can be eliminated or reduced to a level that allows the individual to benefit from psychotherapy.

• Pharmacotherapy: “Pharmacotherapy” refers to the use of medications in biomedical treatment. Medications exist in four classes: antipsychotics, antidepressants, anti-cycling agents, and hypnoanxiolytics. In general, the effectiveness of medications is upwards of 80%, but some of the medications also contain serious side effects. Once the medication is discontinued, symptoms often return; however, prolonged use can lead to other problems. Different types and classes of medications are prescribed for different disorders. A depressed person might be given an antidepressant, a bipolar individual might be given a mood stabilizer, and a schizophrenic individual might be given an antipsychotic. These medications treat the symptoms of a psychological disorder; they can help people feel better so that they can function on a daily basis, but they do not cure the disorder. Some people may only need to take a psychotropic medication for a short period of time. Others, with severe disorders like bipolar disorder or schizophrenia, may need to take psychotropic medication continuously for effective symptom management.
• ECT: Another biologically based treatment that continues to be used, although infrequently, is electroconvulsive therapy (ECT; formerly known by the unscientific name “electroshock therapy”). It involves using an electrical current to induce seizures in the brain in order to help alleviate the effects of certain mental conditions, such as severe forms of depression or bipolar disorder. The exact mechanism is unknown, although it does help alleviate symptoms for people with severe depression who have not responded to traditional drug therapy (Pagnin, de Queiroz, Pini, & Cassano, 2004). About 85% of people treated with ECT improve (Reti, n.d.). However, the memory loss associated with repeated administrations has led to it typically being implemented as a last resort (Donahue, 2000; Prudic, Peyser, & Sackeim, 2000). A more recent alternative to ECT is transcranial magnetic stimulation (TMS), a procedure approved by the FDA in 2008 that uses magnetic fields to stimulate nerve cells in the brain to improve depression symptoms; like ECT, it is used when other treatments have not worked (Mayo Clinic, 2012).