Best Treatments for Mental Disorders

A quick overview of best practice treatments for mental disorders. Great for personal study, as flashcards, for study for the NCMHCE or similar exams, or as a presentation.

1. Best Treatments for Mental Disorders

2. Clinician Characteristics Ethnicity Culture Empathy Congruence Positive Regard

3. Treatment Location Considerations Danger of client Severity of symptoms Objectives of treatment Cost L east restrictive environment S ufficient resources Levels of Care Hospitalization P artial hospitalization D ay treatment (outpatient therapy)

4. Objectives of Treatment Examples: Crisis intervention Safety Alleviation of symptoms Self growth Recovery

5. Appropriate Use of Certain Therapies

6. Appropriate Uses for Humanistic Psychotherapy Depression Anxiety Alcohol misuse Personality disorders Interpersonal relationship problems Coping with cancer Trauma

7. Appropriate Uses for Behavior Therapy OCD conduct disorder ODD Some sleep disorders Anxiety Mood disorders For people motivated to change and follow through with homework assignments, and supportive people to help them

8. Appropriate Uses for Psychodynamic Psychotherapy Motivated to change, Committed to therapy Psychologically minded Smart Good verbal skills Flexible and mature defenses Have a focal issue Had one meaningful relationship in their childhood Not for: Severe Personality Disorders Severe Depression Psychosis

9. Best Treatments & Tests for Common Disorders

10. Treatment of Choice For Histrionic Personality Disorder Treatment: Long term individual psychotherapy Cognitive-behavioral Therapy Group therapy can be helpful (feedback ) Assessment instrument :

11. Treatment of Choice For Narcissistic Personality Disorder Treatment: Psychoanalytic (anger, envy, self-sufficiency ) Cognitive-Behavioral Assessment instrument :

12. Treatment of Choice For OCD Personality Disorder Treatment: Individual therapy, with a structured and active approach R eality based approach A nger management Substance use disorders S ocial skills training Assessment instrument : Dysfunctional Thought Record (active log)

13. Assessments for Dissociative Identity Disorder Assessments: Cambridge Depersonalization Scale Structured Clinical Interview for Depersonalization and Derealization Spectrum

14. Treatment of Choice For Borderline Personality Disorder Treatment: Group therapy better than individual therapy Dialectical Behavior Therapy Mentalization -based Therapy Transference-focused Therapy Schema-focused CBT Supportive psychotherapy STEPP group therapy Assessment instrument :

15. Treatment of Choice For Antisocial PD Treatment: Individual therapy, with a structured and active approach R eality based approach A nger management Substance use disorders S ocial skills training Assessment instrument :

16. Treatment of Choice For Schizotypical PD Treatment: Supportive, lengthy and slow Cognitive Therapy behavior therapy for speech patterns Assessment instrument :

17. Treatment of Choice For Schizoid PD Treatment: Schema therapy Behavioral techniques such as social and communication skills Assessment instrument :

18. Treatment of Choice For Paranoid Personality Disorder Treatment: individualized treatment preferred not good candidates for group therapy Not cognitive therapy Assessment instrument : Millon Clinical Multiaxial Inventory MMPI Structured Clinical Interview

19. Treatment of Choice for Delirium 1. Check for metabolic problem 2. Check for a worsening, chronic physical disorder such as a cardiovascular or respiratory problem 3. Check for prescription drug effects 4. Check for which cognitive impairments Treatment: Psychotherapy M edication (slow the process ) Shelter from excessive stimulation and surround with familiar things Psychoeducation Assessment instrument : Delirium Symptom Interview (DSI ) Confusion Assessment Method (CAM ) Mental Status Examination and Neurology

20. Treatment of Choice for Somatization Disorders Treatment: Assessment instrument : Anxiety Disorders Interview Schedule (ADIS-IV-L)

21. Treatment of Choice for Sleep Disorders Treatment: Behavioral treatment Relaxation therapy, including progressive relaxation Biofeedback C ognitive thought stopping Assessment instrument : Yale-Brown Obsessive Compulsive Scale (Y-BOCS) Obsessive-Compulsive Inventory-Revised

22. Treatment of Choice For Paraphilias Treatment: Medication Group therapy Sex Addicts Anonymous 12 Step program Sexual Compulsives Anonymous Sex and Love Addicts Assessment instrument : The Sexual Interest and Desire Inventory-Female (SIDI-F ) The Sexual Opinion Survey (SOS ) Sexual Dysfunction Scale Sexual Desire Inventory Early Sexual Experiences Checklist used to detect unwanted sexual experiences before age 16 Interview for Sexual Functioning (DISF)

23. Treatment of Choice For Alcohol Disorders Treatment: Assessment instrument : Rapid Alcohol Problems Screen (RAPS4 ) Michigan Alcoholism Screening Test (MAST ) CAGE (Screening for Alcohol Abuse ) Alcohol Use Disorders Identification Test (AUDIT)

24. Treatment of Choice For Bulimia Nervosa Treatment: Manual based CBT Assessment instrument :

25. Treatment for Cyclothymic Disorder Therapy: Interpersonal and Social Rhythm Therapy (IPSRT ) Family Focused Therapy ( FFT) Cognitive Behavioral Therapy Also Career counseling Interpersonal skill Group counseling Assessment: Family history

26. Treatment of Choice for Dysthymic Disorder Therapy: Cognitive-behavioral interpersonal therapy social skills training Assertiveness decision-making skill-building Instrument: Beck Depression Inventory Steen Happiness Index

27. Treatment of Choice For Intellectual Disability In Children Treatment: (SIB ) Behavior modification is treatment of choice (for self-injury) Parent Training, Community Based Treatment Individual Psychotherapy Assessment instrument: Weschler's and Standford-Binet's Intelligence tests

28. Treatment of Choice For Autism Spectrum Disorders Treatment: Behavioral therapy, although no best treatment Floor Technique Pervasive Development Pivotal Response Training (PRI ) Group therapy Social skills training, Psychoeducation Assessment instrument : Childhood Autism Rating Scale The Social Communication Questionnaire Taylor and Jasper’s Social Skills Inventory (eye contact, empathy, answering social questions, etc )

29. Treatment of Choice For ADHD Treatment: Stimulant Medications Parent Training Counseling Behavioral Targeted Classroom Intervention Social Skills Assessment instrument : Achenbach Child Behavior Checklist Behavior Assessment System for Children, 2nd edition Conners ’ Teacher Rating Scales-Revised

30. Treatment of Choice For Conduct Disorder Treatment: Problem-Solving Skill (PSST ) Dysregulation Impulsivity Social Skills, Anger Management Parent Management Assessment instrument : Achenbach Child Behavior Checklist Behavior Assessment System for Children, 2nd edition Conners ’ Teacher Rating Scales-Revised

31. Treatment of Choice For ODD Treatment: Problem-solving Skills Training (PSST) Cognitive Behavioral Therapy Individual Therapy Assessment instrument: Achenbach Child Behavior Checklist Behavior Assessment System for Children, 2nd edition Conners ’ Teacher Rating Scales-Revised

32. Treatment of Choice For Separation Anxiety in Children Treatment: Cognitive-Behavioral most effective Exposure therapy useful, Coping Cat model ( manual) Assessment instrument : Child’s Depression Inventory (ages 7-17

33. Treatment of Choice For Depression & Bipolar Disorder in Children Treatment: CBT Interpersonal Therapy Combination Family Focused and CBT Psychoeducation DBT has some support For children, Instruments used : Assessment instrument : Child’s Depression Inventory (ages 7-17 ), The Washington University Schedule for Affective Disorders and Schizophrenia (for school age children) Young Mania Rating Scale ( YMRS) (distinguishes between bipolar and other disorders)

34. Treatment of Choice For PTSD in Children Treatment: CBT Emotion Focused Cognitive-behavioral, Trauma Focused CBT ( sexually abused children) Assessment instrument : Trauma Symptom Checklist for Children, Beck Anxiety Inventory

35. Treatment of Choice For PTSD in Adults Treatment: Prolonged Exposure Therapy is best Cognitive Processing Therapy (CPT) for sexual assault Anxiety Management Training Also EMDR Group and family therapy Stress Inoculation Training Assessment instrument : Beck Anxiety Inventory The Clinician-Administered PTSD Scale ( CAPS) PTSD Checklist DAP

36. Treatment of Choice For Adjustment Disorder in Children & Adults Treatment: No best practice Crisis-intervention model, relieving acute symptoms B rief psychodynamic psychotherapy Assessment instrument : None specific

37. Treatment of Choice For Major Depressive Disorder Treatment: CBT Interpersonal Psychotherapy (best for low level of social functioning) Mindfulness Practice Exercise Assessment instrument : Beck Depression Inventory Hamilton Rating Scale SCID

38. Treatment of Choice For Bipolar Disorders Treatment: Medication First Family Focused Psycho-educational Treatment, Interpersonal Therapy (IPT) Cognitive-Behavioral Therapy Group Therapy during recovery Also Day treatment group therapy self-help groups Assessment instrument : Beck Depression Inventory Hamilton Rating Scale SCID

39. Treatment of Choice For Anxiety Disorders Treatment: Cognitive-behavioral therapy Exposure therapy Acceptance-Based therapy ( interoceptive ) Exposure Mindfulness meditation SIT DBT ACT Assessment instrument : Beck Anxiety Inventory Anxiety Disorders Interview Schedule

40. Treatment of Choice For Panic Disorder Treatment: Cognitive-Behavioral therapy is best Panic Control Therapy ( PCT) Also ACT SFIT Family Therapy Group Therapy Graduated and Pacing Exposure Assessment instrument : ADVIS (Brown et al.,1994) measures avoidance, severity of panic and panic related symptoms

41. Treatment of Choice For Phobias Treatment: Exposure-based are best May include exposure as relaxation training, breathing retraining and paradoxical intention Assessment instrument : Beck Anxiety Inventory, for differences in phobias and delusional fears

42. Treatments

43. Stress Inoculation Training ( SIT) Combination of cognitive restructuring with training in verbal self-instruction and behavioral self-management techniques Clients apply these skills to a series of increasingly stressful situations as therapy progresses

44. Interpersonal Psychotherapy IPP Interpersonal Psychotherapy is effective treatment for : Depression Bipolar disorder Bulimia nervosa post-partum depression Major depressive disorder Cyclothymia Various other disorder Focuses on relationships Time-limited Employs homework, structured interviews, and assessment tools Related to CBT