o
ANXIETY DISORDERS
Treatment of Anxiety Disorders
 Generalized Anxiety Disorder
- Benzodiazepines
o
Give short term relief
o
Carry risks – impair both cognitive and motor
functioning
o
Associated with falls in older adults, resulting
in hip fractures
o
Produce both psychological and physical
dependence
- Antidepressants (SSRI)
o
Paroxetine (aka Paxil)
o
Escitalopram (aka Lexapro)
o
Duloxetine (aka Cymbalta)
o
Venlafaxine (aka Effexor)
- Psychological treatments
o
Using images to feel (rather than avoid
feeling) anxious
o
Relaxing deeply to combat tension
 Panic Disorder and Agoraphobia
- Gradual exposure exercises, combined with
anxiety-reducing coping mechanisms such as
relaxation or breathing retraining
- Panic Control Treatment (PCT)
o Exposing patients to the cluster of
interoceptive (physical) sensations that
remind them of their panic attack
- Cognitive-behavioral program
o Calm Tools for Living
 Clinician and patient sit side-by-side as
they both view the program on screen
 Helps patient establish a fear hierarchy,
demonstrate breathing skills, or design
exposure assignments
 Specific Phobia
- Structured and consistent exposure-based
exercises
 Social Anxiety Disorder (Social Phobia)
- Cognitive therapy program
o Emphasizes real-life experiences to disprove
automatic perceptions of danger
- Interpersonal Psychotherapy (IPT)
- Family-based treatment
o Better than individual treatment if parents
also have an anxiety disorder
- Drugs
o Paxil (SSRI)
o Zoloft (SSRI)
o Effexor (SSRI)
o D-cycloserine (DCS) + CBT treatments =
enhanced effect of treatment
TRAUMA AND STRESSOR-RELATED DISORDERS
Treatment of Trauma and Stressor-Related Disorders
 Posttraumatic Stress Disorder
- Psychoanalytic therapy
-
-
Catharsis
 Reliving emotional trauma
o
Imaginal exposure
 Content of the trauma and emotions
associated with it are worked through
systematically
Cognitive therapy
o
To correct negative assumptions about the
trauma e.g., blaming oneself, feeling guilty
Drugs
o
Prozac (SSRI)
o
Paxil (SSRI)
OBSESSIVE-COMPULSIVE AND RELATED
DISORDERS
Treatment of Obsessive-Compulsive and Related
Disorders
 Obsessive-Compulsive Disorder
- Drugs (SSRI)
o
Clomipramine (aka Anafranil)
 Relapse occurs when discontinued
- Exposure and Ritual Prevention (ERP)
o
Most effective approach
o
Rituals are actively prevented and patient is
systematically and gradually exposed to the
feared thoughts or situations
- Cognitive treatments
o Focus: overestimation of threat, importance
and control of intrusive thoughts, sense of
inflated responsibility, need for perfectionism
and certainty
- Psychosurgery
o A misnomer that refers to neurosurgery for a
psychological disorder
 Body Dysmorphic Disorder
- Drugs (SSRI)
o Clomipramine (aka Anafranil)
o Fluvoxamine
- Cognitive-Behavioral Therapy (CBT)
o Exposure and response prevention
o Produce better and longer lasting outcomes
than medication alone
- Dermatology (skin) treatment
o Most often received
- Plastic surgery
o Most common procedures: rhinoplasties
(nose jobs), facelifts, eyeshadow elevations,
liposuction, breast augmentation, surgery to
alter the jawline
 Hoarding Disorder
- Teaching people to assign different values to
objects
- Reducing anxiety about throwing away items that
are somewhat less valued
 Trichotillomania and Excoriation
- Habit Reversal Training
o Patients are carefully taught to be more
aware of their repetitive behavior, particularly
-
as it is just about to begin, and to then
substitute a different behavior
SSRIs (for Trichotillomania)
-
Antidepressants
o SSRIs
 Fluoxetine (Prozac) – best known
o Mixed reuptake inhibitors
 Venlafaxine (Effexor) – best known
o Tricyclic antidepressants
 Most widely used treatment before SSRI
 Imipramine (Tofranil) and amitriptyline
(Elavil) – best known
 Side effects: blurred vision, dry mouth,
constipation, difficulty urinating,
drowsiness, weight gain, sexual
dysfunction
 Lethal if taken in excessive doses
o Monoamine oxidase (MOA) inhibitors
 Block the enzyme MAO that breaks down
such neurotransmitters as
norepinephrine and serotonin
 Used far less often because of two
potentially serious consequences:
hypertensive episodes or death, when
eating and drinking foods and beverages
containing tyramine
o Lithium carbonate (Lithium)
 Found in our drinking water
 Side effects: toxicity (poisoning), lowered
thyroid functioning, substantial weight
gain
 Major advantage: effective in preventing
and treating manic episodes
 Most often referred to as a ‘moodstabilizing drug’
-
Biological treatments
o Electroconvulsive Therapy (ECT)
 Most controversial treatment for
psychological disorders after
psychosurgery
 Electric shock is administered directly
through the brain for less than 1 second,
producing a seizure and a series of brief
convulsions that usually lasts for several
minutes
o Transcranial Magnetic Stimulation
 Another method for altering electrical
activity in the brain
Psychological treatments
o Cognitive-Behavioral Therapy (CBT)
SOMATIC SYMPTOM AND RELATED DISORDERS
Treatment of Somatic Symptom and Related
Disorders
 Somatic Symptom Disorder and Illness Anxiety
Disorder
- Reassurance and education
- Reducing the frequency of help-seeking
behaviors (e.g., assigning a gatekeeper
physician to each patient to screen all physical
complaints)
- Cognitive-Behavioral Therapy (CBT)
- Antidepressant (SSRI)
o Paroxetine (aka Paxil)
 Conversion Disorder (Functional Neurological
Symptom Disorder)
- Identify and attend to the traumatic or stressful
life event, if it is still present (either in real life or
memory)
- Reduce any reinforcing or supportive
consequences of the conversion symptoms
(secondary gain)
DISSOCIATIVE DISORDERS
Treatment of Dissociative Disorders
 Depersonalization-Derealization Disorder
- Psychological treatments similar to those for
panic disorder may be helpful
- Stresses associated with onset of disorder
should be addressed
 Dissociative Fugue
- Recalling what happened during the amnesic or
fugue state, often with the help of friends and
family who know what happened, so the patient
can confront the information and integrate it into
their conscious experience
- Hypnosis
- Benzodiazepines (minor tranquilizers)
 Dissociative Identity Disorder
- Patient must identify cues or triggers that
provoke memories of trauma, dissociation, or
both, and to neutralize them
- Patient must confront and relive the early trauma
and gain control over the horrible events
- Therapist must help the patient visualize and
relive aspects of the trauma until it is simply a
terrible memory
- Hypnosis – to access unconscious memories and
bring various alters into awareness
MOOD DISORDERS AND SUICIDE
Treatment of Mood Disorders
 Depression
-

Learn to replace negative depressive
thoughts and attributions with more
positive ones
 Develop more effective coping behaviors
and skills
o Interpersonal Psychotherapy (IPT)
 Focus on the social and interpersonal
triggers for their depression (such as the
loss of a loved one)
 Develop skills to resolve interpersonal
conflicts and build new relationships
 Bipolar Disorder
- Lithium
- Psychological treatments
o Increasing compliance with drug treatments,
as the “pleasures” of a manic state make
refusal to take lithium a major therapeutic
obstacle
o Interpersonal and Social Rhythm Therapy
(IPSRT)
 Regulates circadian rhythm by helping
patients regulate their eating and sleep
cycles
 Seasonal Affective Disorder
- Light therapy
Prevention of Suicide
- Implicit (unconscious) cognition
o To assess implicit suicidal ideation; Stroop
test
- Agreeing to or signing a no-suicide contract
- Limiting access to lethal weapons for anyone at
risk for suicide
- Cognitive-behavioral interventions
EATING DISORDERS
Treatment of Eating Disorders
 Bulimia nervosa
- Drugs
o Fluoxetine (Prozac)
 Effective particularly during the bingeing
and purging cycle
- Psychological treatments
o Short-term cognitive-behavioral treatments
o Cognitive-Behavioral Therapy-Enhanced
(CBT-E)
 Focus is on the distorted evaluation of
body shape and weight, and maladaptive
attempts to control weight
o Interpersonal Psychotherapy (IPT)
 Binge-Eating Disorder
- Cognitive-Behavioral Therapy (CBT)
- Interpersonal Psychotherapy (IPT)
 Anorexia Nervosa
- Most important initial goal: restore the patient’s
weight to a point that is at least within the low
normal range
- Cognitive-Behavioral Therapy (CBT)
-
Cognitive-Behavioral Therapy-Enhanced (CBTE)
- Family-based Treatment (FBT)
 Obesity
- Not formally considered an eating disorder in the
DSM
- Self-directed weight-loss program (e.g., by
buying a popular diet book)
- Diet programs
o Atkins (carbohydrate restriction) diet
o Ornish (fat restriction) diet
o Zone (micronutrients balance) diet
o Weight Watchers (calorie restriction) diet
- Commercial self-help programs
o Weight Watchers
o Jenny Craig
- Bariatric surgery
o A surgical approach to extreme obesity
SLEEP-WAKE DISORDERS
Treatment of Sleep Disorders
 Insomnia
- Medical treatments
o Benzodiazepine
o Triazolam (Halcion)
o Zaleplon (Sonata)
o Zolpidem (Ambien)
o Flurazepam (Dalmane)
 Circadian Rhythm Sleep Disorder
- Environmental treatments
o Phase delays (moving bedtime later)
 Going to bed several hours later each
night until bedtime is at the desired hour
o Phototherapy
 Using bright light to trick the brain into
readjusting the biological clock
- Psychological treatments
o Stimulus control
 Using the bed only for sleeping and for
sex, not for work or other anxietyprovoking activities
o Progressive relaxation or sleep hygiene
 Changing daily habits that may interfere
with sleep
o Sleep restriction
o Confronting unrealistic expectations about
how much sleep is enough for a person
o Cognitive-Behavioral Therapy (CBT)
Treatment of Parasomnias
 Nightmares (or Nightmare Disorder)
- Cognitive-Behavioral Therapy (CBT)
- Pharmacological treatment
o Prazosin
 Sleep Terrors
- Scheduled awakenings
PHYSICAL DISORDERS
Treatment of Physical Disorders
- Psychosocial treatment
o Biofeedback
 Making patients aware of specific
physiological functions that, ordinarily,
thy would not notice consciously
o Relaxation and Meditation
 Progressive muscle relaxation
 Transcendental meditation – attention is
focused solely on a repeated syllable, or
mantra
 Relaxation response
o A Comprehensive Stress-and-PainReduction Program
 Time-management training
 Assertiveness training
o Drugs and Stress-Reduction Programs
o Denial as a Means of Coping
 Shelley Taylor points out that most
individuals who are functioning well deny
the implications of a potentially serious
condition, at least initially
o Modifying Behaviors to Promote Health
 Injury Prevention
 AIDS Prevention
SEXUAL DYSFUNCTION
Treatment of Sexual Dysfunction
- Providing basic education about sexual
functioning, altering deep-seated myths, and
increasing communication
- Psychosocial treatment
o Sensate focus
o Nondemand pleasuring
- Medical treatments
o Sildenafil (Viagra)
o Levitra
o Cialis
o Injection of vasodilating drugs such as
papaverine or prostaglandin directly into the
penis
o Surgery
o Vacuum Device Therapy
 Works by creating a vacuum in a cylinder
placed over the penis
 Premature Ejaculation
- Squeeze technique
PARAPHILIC DISORDERS
Treatment of Paraphilic Disorders
- Psychological treatment
o Covert sensitization
 Carried out entirely in the imagination of
the patient
 Patients associate sexually arousing
images in their imagination with some
reasons why the behavior is harmful or
dangerous
o Orgasmic reconditioning
 Patients are instructed to masturbate to
their usual fantasies but to substitute
more desirable ones just before
ejaculation
o Relapse prevention
- Drugs
o Cyproterone acetate
 An antiandrogen
 “chemical castration” drug
 Eliminates sexual desire and fantasy by
reducing testosterone levels dramatically
o Medroxyprogesterone (Depo-Provera is the
injectable form)
 A hormonal agent that reduces
testosterone
GENDER DYSPHORIA
Treatment of Gender Dysphoria
- Psychological evaluation and education
- Administration of gonadal hormones to bring
about desired secondary sex characteristics
o Partially reversible
- Sex Reassignment Surgery
o Non-reversible
o
o
o
o
Alter anatomy physically to be consistent
with gender identity
Must live in the desired gender for 1-2 years
Must be stable psychologically, financially,
and socially
Gynecomastia
 The growth of breasts (for transwomen)
-
Biological treatments
o Clonidine
 Given to people withdrawing from
opiates
o Sedative drugs (benzodiazepines)
 Help minimize discomfort for people
withdrawing from other drugs, such as
alcohol
-
Agonist substitution
o Providing the person with a safe drug that
has a chemical makeup similar to the
addictive drug (therefore the name agonist)
 Methadone – an opiate agonist often
given as a heroine substitute; originally
called “adolphine”
 Buprenorphine – blocks the effects of
opiate and encourage better compliance
 Nicotine – a cigarette substitute;
provided to smokers in the form of gum,
patch, inhaler, or nasal spray, which lack
the carcinogens included in cigarette
smoke
 Bupropion (Zyban) – medical treatment
for smoking; also serves as an
antidepressant under the trade name
Wellbutrin
Antagonist treatments
o Antagonist drugs block or counteract the
effects of psychoactive drugs
 Naltrexone – has limited success with
individuals who are not simultaneously
participating in a structured treatment
program
 Acomprosate – decrease cravings in
people dependent on alcohol
Treatment of Gender Nonconformity in Children
- Work with the child and caregivers to lessen
gender dysphoria and decrease cross-gender
behaviors on the assumption that these
behaviors are unlikely to persist anyway and the
negative consequences of social rejection could
be avoided, and that avoiding later intrusive
surgery would be desirable
- “watchful waiting”
o Letting expressed gender unfold
naturally
- Actively affirming and encouraging cross-gender
identification, but critics point out that gender
nonconformity usually does not persist
Treatment of Disorders of Sex Development
(Intersexuality)
- Surgery
- Hormonal Replacement Therapy (HRT)
- Psychological treatments to help individuals
adapt to their particular sexual anatomy or their
emerging gender experience
SUBSTANCE-RELATED DISORDERS
Treatment of Substance-Related Disorders
- First step: help someone through the withdrawal
process
- Ultimate goal: abstinence
-
-
-
Aversive treatments
o Disulfiram (Antabuse)
 For people who are alcohol-dependent
 Prevents the breakdown of acetaldehyde,
a by-product of alcohol, and the resulting
build-up of acetaldehyde causes feelings
of illness
 Causes nausea, vomiting, elevated heart
rate, and respiration
o Use of silver nitrate in lozenges or gum
 Combines with saliva to produce a bad
taste in the mouth
Psychosocial treatments
o Inpatient facilities
 Designed to help people get through the
initial withdrawal period and to provide
supportive therapy so they can go back
to their communities
 Can be extremely expensive
o Alcoholics Anonymous (AA) and its
variations
 Twelve Steps program – developed by
AA; the basis of its philosophy
 Foundation of AA is the notion that
alcoholism is a disease and alcoholics
must acknowledge their addiction to
alcohol and its destructive power over
them
-
o Women for Sobriety
o SMART Recovery
Component treatment
o Contingency Management
 Clinician and client together select the
behaviors that the client needs to change
and decide on the reinforcers that will
reward reaching certain goals
o Community Reinforcement Approach
 Several facets of the drug problem are
addressed to help identify and correct
aspects of the person’s life that might
contribute to substance use or interfere
with efforts to abstain
o Motivational Enhancement Therapy (MET)
 Intends to improve the individual’s beliefs
that any changes made (e.g., drinking
less) will have positive outcomes (e.g.,
more family time)
o Cognitive-Behavioral Therapy (CBT)
 Addresses multiple aspects of the
disorder, including a person’s reactions
to cues that lead to substance use (e.g.,
being among certain friends)
 Addresses the problem of relapse
GAMBLING DISORDER
Treatment of Gambling Disorder
- Treatment is often similar to substance
dependence treatment
- Gambler’s Anonymous
o Incorporates the Twelve Step program
- Cognitive-behavioral interventions
o Setting financial limits
o Planning alternative activities
o Preventing relapse
o Imaginal desensitization
IMPULSE-CONTROL DISORDERS
o
o
o
Cocaine Anonymous and Narcotics
Anonymous
Rational Recovery
Moderation Management
Treatment of Impulse-Control Disorders
 Intermittent Explosive Disorder
- Cognitive-behavioral interventions
o
Helping the person identify and avoid
“triggers” for aggressive outbursts
 Kleptomania
- Behavioral interventions
- Antidepressant medication
o
Naltrexone – an opioid antagonist also used
in the treatment of alcoholism
 Pyromania
- Cognitive-behavioral interventions
o
Helping the person identify the signals that
initiate the urges
o
Teaching coping strategies to resist the
temptation to start fires
PERSONALITY DISORDERS
Treatment of Cluster A Personality Disorders
 Paranoid Personality Disorder
- Unlikely to seek professional help
- Therapists provide an atmosphere conducive to
developing a sense of trust
- Cognitive therapy
o To counter the person’s mistaken
assumptions about others, focusing on
changing the person’s beliefs that all people
are malevolent and most people cannot be
trusted
 Schizoid Personality Disorder
- Rare for a person with the disorder to seek
treatment
- Therapists point out the value in social
relationships
- May need to be taught the emotions felt by
others to learn empathy
- Receive social skills training
- Role-playing
o Therapist takes the part of a friend or
significant other and help the patient practice
establishing and maintaining social
relationships
 Schizotypal Personality Disorder
- Treatment includes some of the medical and
psychological treatments for depression
- Teaching social skills to reduce isolation and
suspicion
- Treating younger persons who have symptoms of
the disorder with antipsychotic medication and
CBT in order to avoid the onset of schizophrenia
is proving to be a promising prevention strategy
- Medical treatment
o Haloperidol
 To reduce ideas of reference, odd
communication, and isolation
Treatment of Cluster B Personality Disorders
 Antisocial Personality Disorder
- Rarely identify themselves as needing treatment
- Most clinicians are pessimistic about the
outcome of treatment for adults as they can be
manipulative even with their therapists
- In general, therapists agree with incarcerating
(imprisoning) these people to defer future
antisocial acts
- Clinicians encourage identification of high-risk
children so that treatment can be attempted
before they become adults
- Parent training for children
- Prevention through preschool programs
 Borderline Personality Disorder
- Patients appear quite distressed and are more
likely to seek treatment
- Symptomatic treatment
- Drugs
o
Mood stabilizers
 Anticonvulsive and antipsychotic drugs –
effective for disturbances in affect (e.g.,
anger, sadness)
- Cognitive-Behavioral Therapy (CBT)
o Dialectical Behavior Therapy (DBT)
 Involves helping people cope with the
stressors that seem to trigger suicidal
behaviors
 Histrionic Personality Disorder
- A large part of therapy focuses on the
problematic interpersonal relationships
- People with the disorder need to be shown how
the short-term gains derived from their various
interactional styles (e.g., emotional crises, using
charm, sex, seductiveness, or complaining) result
in long-term costs, and be taught more
appropriate ways of negotiating their wants and
needs
 Narcissistic Personality Disorder
- Therapy focuses on the person’s grandiosity,
their hypersensitivity to evaluation, and their lack
of empathy towards others
- Cognitive therapy
o Strives to replace the person’s fantasies with
a focus on the day-to-day pleasurable
experiences that truly attainable
- Coping strategies such as relaxation training to
help them face and accept criticism
- Helping them focus on the feelings of others
Treatment of Cluster C Personality Disorders
 Avoidant Personality Disorder
- Behavioral intervention techniques for anxiety
and social skills problems
o Systematic desensitization
o Behavioral rehearsal
- Many of the same treatments used for social
phobia
- Therapeutic alliance
o The collaborative connection between
therapist and client
o An important predictor for treatment success
 Dependent Personality Disorder
- People with the disorder can appear to be ideal
patients because of their attentiveness and
eagerness to give responsibility for their
problems to the therapist
- This submissiveness, however, negates one of
the major goals of therapy: make the person
more independent and personally responsible
- Therapy progresses gradually as the patient
develops confidence in their ability to make
decisions independently
 Obsessive-Compulsive Personality Disorder
- Therapy often attacks the fears that seem to
underlie the need for orderliness
-

Therapists help the individual relax or use
distraction techniques to redirect the compulsive
thoughts
SCHIZOPHRENIA
Treatment of Schizophrenia
- In Kenya, Kisii tribal doctors listen to their
patients to find the location of the noises in their
heads (hallucinations), then get them drunk, cut
out a piece of scalp, and scrape the skull in the
area of the voices
- Biological interventions
o Insulin coma therapy
 Was thought for a time to be helpful, but
closer examination showed it carried
great risk of serious illness and death
o Psychosurgery
o Electroconvulsive Therapy (ECT)
o Transcranial Magnetic Stimulation
 Treatment for hallucinations
 Uses wire coils to repeatedly generate
magnetic fields-up to 50 times per
second-that pass though the skull to the
brain
- Antipsychotic medications
o Neuroleptics
 Meaning “taking hold of the nerves”
 Provided the first real hope
 Help people think more clearly and
reduce hallucinations and delusions
 Dopamine antagonists
 Hadol and Thorazine – earliest
neuroleptics drugs; called conventional or
first-generation antipsychotics
 Risperidone and Olanzapine – newer
medications; called atypical or secondgeneration antipsychotics
- Psychosocial interventions
o Clinicians attempt to reattach social skills
such as basic conversation, assertiveness,
and relationship building
o Therapists divide complex social skills into
their component parts, which clients model
o Clients do role-playing and ultimately
practice their new skills in the “real world”
o Programs teach a range of ways people can
adapt to their disorder yet live in the
community
o Virtual assessments and treatments
 Provide clinicians with controllable and
safer environments in which to study and
treat persons with schizophrenia
o Behavioral family therapy
 Resembles classroom education
 Family members are informed about
schizophrenia and its treatment, relieved
of the myth that they caused the disorder
-
-
Family members are taught practical
facts about antipsychotic medications
and their side effects
 Family members are helped with
communication skills so that they can
become more empathic listeners
 Help them learn constructive ways of
expressing negative feelings to replace
the harsh criticism that characterizes
some family interactions
 Help them learn problem-solving skills to
help them resolve conflicts that arise
o Vocational rehabilitation
 Supportive employment – involves
providing coaches who give on-the-job
training
o Assertive Community Treatment (ACT)
Program
 Involves using a multidisciplinary team of
professionals to provide broad-ranging
treatment
Across cultures
o Xhosa people of South Africa
 Report using traditional healers who
sometimes recommend the use of oral
treatments to induce vomiting, enemas,
and the slaughter of cattle to appease
the spirits
o Hispanics
 Family support
o British
 Use more biological, psychological, and
community treatments
o Native Chinese
 Hold more religious beliefs about both
the causes and treatments of
schizophrenia
Prevention
o Identify and treat children who may be at risk
of getting the disorder later in life
o Treatment of persons in the prodromal
stages
NEURODEVELOPMENTAL DISORDERS
Treatment of Neurodevelopmental Disorders
 Attention-Deficit/Hyperactivity Disorder
- Psychosocial interventions
o Improving academic performance
o Decreasing disruptive behavior
o Social skills training
 Teaching the child how to interact
appropriately with peers
o Reinforcement programs
 Rewarding the child for improvements
 Punishing misbehavior with loss of
rewards
o Parent education programs

Teaching families how to respond
constructively to their child’s behaviors
and how to structure the child’s day to
help prevent difficulties
o Cognitive-Behavioral Therapy (CBT)
 For adults with ADHD
 To reduce distractibility and improve
organizational skills
- Biological interventions
o Stimulants
 Methylphenidate (Ritalin, Adderall) and
other non-stimulant medications such as
atomoxetine (Strattera), guanfacine
(Tenex), and clonidine – have proved
helpful in reducing the core symptoms of
hyperactivity and impulsivity, and in
improving concentration on tasks
 Specific Learning Disorder
- Educational intervention
o Specific skills instruction
 Vocabulary
 Finding the main idea
 Finding facts in readings
o Strategy instruction
 Includes efforts to improve cognitive skills
through decision making and critical
thinking
o Direct Instruction
 A program
 Components: systematic instruction
(using highly scripted lesson plans that
place students together in small groups
based on their progress) and teaching for
mastery (teaching students until they
understand all concepts)
- Biological (drug) treatment
o Methylphenidate (Ritalin, Adderall)
o Restricted to individuals who may also have
comorbid ADHD
 Autism Spectrum Disorder
- No completely effective treatment exists
- Psychosocial treatments
o Behavioral approaches that focus on skill
building and behavioral treatment of problem
behaviors
o Communication and socialization
o Naturalistic teaching strategies
 Includes arranging the environment so
that the child initiates an interest (e.g.,
placing a favorite toy just out of reach)
o
Incidental teaching
o
Pivotal response training
o
Milieu teaching
- Biological treatments
o Major tranquilizers and SSRIs
 Most helpful in decreasing agitation
 Unlikely that one drug will work for
everyone
 Intellectual Disability (Intellectual Development
Disorder)
- Treatment of individuals with ID parallels that of
people with more severe form of Autism
Spectrum Disorder
o Teaching individuals the skills they need to
become more productive and independent
- For individuals with mild ID, intervention is similar
to that for people with learning disorders
o Specific learning deficits are identified and
addressed to help the student improve such
skills are reading and writing
- Communication training
o Can be challenging for individuals with the
most severe disabilities because they may
have multiple physical or cognitive deficits
that make spoken communication difficult or
impossible
 Augmentative communication strategies
– alternative system; may use picture
books, teaching the person to make a
request by pointing to a picture (e.g.,
pointing to a picture of a cup to request a
drink)
- Teaching people how to communicate their need
or desire for such thing as attention as an
alternative to punishment that may be equally
effective in reducing behavior problems as
aggression and self-injury
- Biological treatment
o Currently not a viable option
Treatment of Common Communication and Motor
Disorders
 Childhood-Onset Fluency Disorder
- Psychosocial intervention
o Parents are counseled about how to talk to
their children
- Behavioral intervention
o Regulated-breathing method
 Person is instructed to stop speaking
when a stuttering episode occurs and
then to take a deep breath (exhale, then
inhale) before proceeding
o Altered auditory feedback
 Electronically changing speech feedback
to people who stutter
 Can improve speech, as can using forms
of self-monitoring, in which people modify
their own speech for the words they
stutter
 Language Disorder
- May be self-correcting and may not require
special intervention
 Social (Pragmatic) Communication Disorder
- Individualized social skills training (e.g.,
modeling, role playing) with an emphasis on
teaching important rules necessary for carrying
on conversations with others (e.g., what is too
much and too little information)
 Tourette’s Disorder
- Psychological intervention
o Self-monitoring
o Relaxation training
o Habit reversal
NEUROCOGNITIVE DISORDERS
Treatment of Neurocognitive Disorders
 Delirium
- Haloperidol or other antipsychotic medication
o Treatment for delirium brought on by
withdrawal from alcohol
o Can have a calming effect
- Psychosocial intervention
o Recommended first line of treatment
o Goal is to reassure the individual to help
them deal with the agitation, anxiety, and
hallucinations of delirium
o Patient who is included in all treatment
decisions retains a sense of control
 Neurocognitive Disorder due to Alzheimer’s Disease
- No cure so far, but hope lies in genetic research
and amyloid protein
- Management may include lists, maps, and notes
to help maintain orientation
- New medications that prevent acetylcholine
breakdown and vitamin therapy delay but do not
stop progression of decline