Types of Therapy

treated more humanely and some were allowed to eventually leave the asylum. Mental asylums in the late 1800s were developed in the US, which were more humane.

Electroshock therapy was first used in the middle of the 1900s and was initially not very humane. People were not anesthetized and the treatment was often painful. Electroshock therapy remains in use today but it is done with anesthesia and better safety measures. Antipsychotic drugs were first used in the 1950s and were often very helpful. Asylums were closed in the 1960s and patients were treated in a community setting.

Nowadays, many people are treated at community mental health centers. Most people are seen as outpatients. The downside is that some patients with severe psychotic disorders do not seek this type of treatment and are left homeless with a lack of mental health services. In fact, the incidence of mental illness among the homeless is about 25 percent. There is also a high percentage of people in prison who have mental health disorders. State psychiatric hospitals do exist but focus on short-term care of patients who have psychiatric crises. Other patients are treated because they are required to do so by the criminal justice system.

While treatment exists for mental disorders, it is not always accessible. Some patients, particularly those who live in rural or poverty-stricken areas, cannot find quality treatment. In some places, mental health treatment is not acceptable or not accessible to people who need it. There has been legislation in recent years to improve the accessibility and insurability for mental health problems.

TYPES OF THERAPY

The two main types of treatment for mental health disorders are psychotherapy and biomedical therapy. Psychotherapy involves several treatments used to help individuals with emotional issues. Biomedical treatment involves the use of medications or procedures used to manage psychiatric issues from a more biological perspective.

There are several types of psychotherapy you should know about. These include the following:

• Psychodynamic psychotherapy—this is talk therapy that deals with past childhood issues and how they affect a person’s behavior.

• Play therapy—this is used in children using toys and interactions to deal with a child’s issues.

• Behavior therapy—this uses things like relaxation and learning theory to change a person’ behaviors.

• Cognitive therapy—this is therapy designed at changing patterns of thinking that lead to a person’s distress.

• Cognitive-behavioral therapy—this combines behavior modification and thought processes to change self-defeating behaviors.

• Humanistic therapy—this look at conscious thoughts in order to improve selfawareness and personal acceptance.

Psychoanalysis is not commonly used but was primarily used in the early part of the twentieth century. It was based on Freud s work and covers issues like repressed memories and unconscious impulses. Dream interpretation is a big part of this type of therapy as well as free association, which was said to uncover one s deepest thoughts and emotions. This treatment is based on the patient-therapist relationship and involves transference, which is the putting of emotions and connections onto the therapist. The psychodynamic approach is loosely based on psychoanalysis.

Play therapy, as mentioned, is usually done with children to help them deal with their psychological issues. Children use play in order to work out their fantasies, hopes, and traumatic experiences in a setting that doesn t involve dreams or talk therapy approaches. Some children are allowed to play freely, while others are directed or structured to talk about certain problems in their life.

In behavior therapy, the focus is on things like phobias and other behaviors that need to be changed because they are dysfunctional. Both operant conditioning and classical conditioning are used specifically to alter behavior. Problems such as bedwetting can be improved through the use of the different learning theory approaches.

Other treatments include aversive conditioning, which pairs a negative stimulus with a specific behavior in order to change or stop the behavior. This is the type of treatment sometimes used for things like nail biting, smoking, and alcohol abuse. People learn to associate the aversive stimulus with the behavior and the behavior stops, theoretically.

Exposure therapy is used to treat phobias and anxieties. The patient is gradually exposed to approximations of what they fear until they become conditioned to the stimulus they ultimately fear. Things that are particularly improved with exposure therapy are specific phobias. The type of exposure therapy used today is systematic desensitization, which decreases anxiety related to an exposure to something that is feared. Virtual reality techniques can be used in many of these cases.

A token economy is used in some psychiatric hospitals in order to improve behaviors. This makes use of operant conditioning or rewards and punishments in order to reinforce desired responses. Points or tokens are given that can be exchanged for things the patient desires.

Cognitive therapy focuses on the patient s thoughts that ultimately lead to distressful feelings. Patients are exposed to their own cognitive distortions so they can talk through them and reduce distress. Irrational beliefs are challenged and replaced by rational thoughts and logical thinking. It was first developed by Dr. Aaron Beck in the 1960s.

Cognitive-behavioral therapy also focuses on present-day issues. The patient learns how thoughts affect behaviors. This is a popular form of therapy that is used for many different things. It has been found to be effective in treating psychological disorders, such as bipolar disorder, PTSD, depression, and eating disorders. It has also been used to decrease suicidality by changing patterns of thinking.

Humanistic therapy helps people achieve their goals and maximal potential. It increases self-awareness and sense of personal acceptance. This is called client-centered therapy, because the therapist does not give advice but helps the patient identify feelings and conflicts. The patient takes control over their own life and learns to overcome challenges. The therapist does not judge the person but listens actively with unconditional but positive regard for the patient.

Biomedical therapy is mostly based on the use of medications, called psychotropic drugs. These are described by psychiatrists who monitor the effectiveness of the medications. Some of the different medications include antidepressants, mood stabilizers, and antipsychotics. Anxious patients are often treated with anxiolytic drugs. Mood stabilizers are used for bipolar disorder and stimulants are used for ADHD and sometimes for severe depression.

Electroconvulsive or ECT therapy is what electroshock therapy is now called. The purpose is to cause a generalized seizure in order to reduce symptoms of severe unrelenting depression. The patient experiences some degree of memory loss as part of the side effects, but the majority of patients do improve with this treatment. A form of this is called transcranial magnetic stimulation; it uses a strong magnetic field to reduce depressive symptoms over a period of time.

Patients can be involved in individual therapy with a single clinician. The therapy extends for a variable period of time, in which the patient is treated once a week or twice a month. Group therapy involves people working together in a group setting with the main goal of decreasing isolation and increasing social support. There is less confidentiality in this setting and a risk of personality clashes. Some groups are more educational, while others are more therapeutic in nature.

Couples therapy involves two people who are in an intimate relationship. They work with a therapist in order to better deal with interpersonal conflict. Family therapy works with families using a family systems approach. It is used when one family member has a problem that affects the whole family or when there are family relationship problems to work out.