5.5 Treatment of Psychological Disorders
- Syllabus
- 2025
- Topic
- 5.5
- Level
- —
Learning objectives
5.5A—Describe research and trends in the treatment of psychological disordersDescribe research and trends in the treatment of psychological disorders.• Many researchers who have conducted metaanalytic studies of psychotherapy conclude that psychotherapies are generally effective. Many psychologists use evidence-based interventions to develop treatment plans. Therapists should exhibit cultural humility and establish a therapeutic alliance with the client to deliver therapy successfully.5.5B—Describe research and trends in the treatment of psychological disordersDescribe research and trends in the treatment of psychological disorders.• Due to the increased use and effectiveness of psychotropic medication therapy, hospitals and asylums deinstitutionalized massive numbers of people in the late 20th century. Therapists now prefer to treat in decentralized ways, often with a combination of medication and psychological therapies.5.5C—Describe ethical principles in the treatment of psychological disordersDescribe ethical principles in the treatment of psychological disorders.• Psychologists in clinical or therapeutic situations must follow certain ethical principles as established by the APA, including nonmaleficence, fidelity, integrity, and respect for people’s rights and dignity.5.5D—Describe techniques used with psychological therapiesDescribe techniques used with psychological therapies.• Psychodynamic therapies employ free association and dream interpretation to uncover the unconscious mind.• Cognitive therapies may employ cognitive restructuring or fear hierarchies to combat maladaptive thinking. Cognitive therapy proposes that people should focus on the cognitive triad—negative thoughts about oneself, the world, and the future.• Applied behavior analysis involves applying principles of conditioning to address mental disorders and developmental disabilities. Exposure therapies (such as systematic desensitization), aversion therapies, and token economies all employ principles of applied behavior analysis. Biofeedback uses principles of conditioning to help clients regulate body systems (such as the sympathetic and parasympathetic nervous systems) that contribute to feelings of anxiety or depression.• Cognitive-behavioral therapies, such as dialectical behavior therapy and rationalemotive behavior therapy, combine techniques from the cognitive and behavioral perspectives to treat mental and behavioral disorders.• Therapy from the humanistic perspective, commonly referred to as person-centered therapy, employs active listening and unconditional positive regard.5.5E—Explain how group therapy is different from individual therapyExplain how group therapy is different from individual therapy.5.5F—Describe effective uses of hypnosisDescribe effective uses of hypnosis.• Hypnosis has shown effectiveness in treating pain and anxiety. Research does not support the use of hypnosis to retrieve accurate memories or regress in age. IVE5.5G—Describe interventions derived from the biological perspectiveDescribe interventions derived from the biological perspective.• Psychoactive medications, such as antidepressants, antianxiety drugs, lithium, or antipsychotic medications, interact with specific neurotransmitters in the central nervous system to address possible biochemical causes of mental disorders. Psychoactive medications can have side effects such as tardive dyskinesia (a movement disorder related to the regulation of dopamine in the nervous system).• Surgical or invasive interventions include psychosurgery (which may involve lesioning), TMS (transcranial magnetic stimulation), or electroconvulsive therapy. The lobotomy is a form of psychosurgery that was popular in the mid-20th century but is rarely, if ever, performed today. 127
Effective Therapy Combines Evidence and Relationship
Meta-analytic studies combine findings across many psychotherapy studies. Many researchers using this approach conclude that psychotherapies are generally effective. This supports a broad trend, not a claim that every therapy works equally well for every client or disorder.
| Treatment element | Role |
|---|---|
| Meta-analytic evidence | Estimates overall patterns across studies |
| Evidence-based intervention | Uses research evidence to help build a treatment plan |
| Cultural humility | Keeps the therapist attentive to the client's cultural context and limits of the therapist's assumptions |
| Therapeutic alliance | Establishes a collaborative working relationship needed to deliver therapy successfully |
A sound treatment plan therefore needs more than a technique name: it connects an evidence-supported intervention with the client's needs and context, while the therapeutic alliance supports successful delivery.
General effectiveness does not prove that one approach is best in every case. An evidence-based technique and a strong alliance serve complementary rather than interchangeable functions.
Treatment Shifted from Institutions to Decentralized Care
As psychotropic medication therapy became more widely used and effective, hospitals and asylums deinstitutionalized large numbers of people in the late twentieth century. Treatment increasingly moved away from long-term centralized institutions toward decentralized settings.
| Trend | Meaning |
|---|---|
| Deinstitutionalization | Large-scale movement of people out of hospitals and asylums |
| Decentralized treatment | Care delivered outside one large long-term institution |
| Combined treatment | Medication used together with psychological therapy |
The modern preference described by the CED is often a combination of medication and psychological therapies. Each component targets different aspects of a disorder, so combination does not mean they are the same intervention.
The historical trend does not show that medication alone addresses every psychological or social need. It explains a change in treatment setting and practice, not a universal outcome for every person.
Four Ethical Duties Guide Psychological Treatment
| APA principle | Treatment duty |
|---|---|
| Nonmaleficence | Avoid causing harm |
| Fidelity | Maintain trust and professional responsibility |
| Integrity | Act honestly and accurately |
| Respect for people's rights and dignity | Protect autonomy, privacy, and human worth |
The principles work together. A therapist considering an intervention must weigh possible harm, preserve a trustworthy professional relationship, describe the treatment honestly, and respect the client's rights and dignity.
A helpful intention does not remove ethical duties. Clinical and therapeutic situations require psychologists to follow the principles throughout assessment, planning, delivery, and communication.
Therapy Techniques Follow Different Change Mechanisms
| Approach | CED techniques | Intended change |
|---|---|---|
| Psychodynamic | Free association, dream interpretation | Uncover unconscious material |
| Cognitive | Cognitive restructuring, fear hierarchies; examine the cognitive triad of negative thoughts about self, world, and future | Change maladaptive thinking |
| Applied behavior analysis | Exposure or systematic desensitization, aversion therapy, token economies | Apply conditioning principles to behavior |
| Biofeedback | Condition regulation of body systems such as sympathetic and parasympathetic activity | Improve control of bodily responses linked with anxiety or depression |
| Cognitive-behavioral | Dialectical behavior therapy, rational-emotive behavior therapy | Combine cognitive and behavioral techniques |
| Humanistic/person-centered | Active listening, unconditional positive regard | Provide a client-centered relationship |
Identify a technique by its mechanism. Changing a maladaptive interpretation is cognitive; changing learned behavior through conditioning is behavioral; using both is cognitive-behavioral. Active listening and unconditional positive regard indicate a person-centered approach.
A fear hierarchy is listed with cognitive therapies in this CED, while systematic desensitization is an exposure method using behavioral principles. Similar topics do not make their mechanisms identical.
Group and Individual Therapy Differ in Who Participates
| Format | Participants in the therapeutic session | Distinct interaction source |
|---|---|---|
| Individual therapy | One client works with a therapist | Therapist–client interaction |
| Group therapy | Multiple clients participate with a therapist or therapists | Therapist interaction plus interaction among group members |
The difference is the treatment format, not necessarily the theoretical perspective. A cognitive, behavioral, or other technique can be delivered in a format whose participants and interactions differ.
The CED Objective asks for the distinction but supplies no claim that one format is always more effective. Do not infer superiority, confidentiality practices, or outcomes not provided by evidence.
Hypnosis Has Supported Uses—and Clear Limits
| Claim about hypnosis | Research status in the CED |
|---|---|
| Treating pain | Has shown effectiveness |
| Treating anxiety | Has shown effectiveness |
| Retrieving accurate memories | Not supported |
| Regressing a person in age | Not supported |
An evidence-based use must match the supported outcome. Data showing reduced chronic pain after hypnosis can support a treatment claim about pain; it cannot be repurposed as evidence that hypnosis recovers accurate memories.
A vivid or confident recollection produced under hypnosis is not evidence of accuracy. Effectiveness for pain or anxiety does not validate unrelated claims about memory or age regression.
Biological Interventions Target Brain and Body Processes
| Medication class or example | Biological principle |
|---|---|
| Antidepressants | Interact with specific central nervous system neurotransmitters |
| Antianxiety drugs | Interact with specific central nervous system neurotransmitters |
| Lithium | Addresses a possible biochemical cause through biological action |
| Antipsychotic medication | Interacts with neurotransmitter systems to treat psychotic symptoms |
Psychoactive medications can cause side effects. Tardive dyskinesia is a movement disorder related to dopamine regulation in the nervous system and is an important risk associated with some medication use.
| Surgical or invasive intervention | CED scope |
|---|---|
| Psychosurgery | May involve lesioning |
| TMS | Transcranial magnetic stimulation |
| Electroconvulsive therapy | Listed biological intervention |
| Lobotomy | Historical psychosurgery, popular in the mid-twentieth century and rarely, if ever, performed today |
Biological interventions are not interchangeable: medications act through biochemical systems, while procedures intervene differently. The CED describes categories and risks, not instructions for choosing or administering treatment.