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Psychology study materials
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Psychology: Treatment and intervention (psychotherapy, psychopharmacology, prevention)

Psychology · Work through your exam, one topic at a time.

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Treatment and intervention (psychotherapy, psychopharmacology, prevention)

This domain tests treatment matching: which intervention has the best evidence for a specific presentation, plus the safety rules that govern medication. Expect items that contrast two plausible treatments.

Psychotherapy

  • Psychodynamic: insight, transference interpretation, defense analysis; short-term variants exist.
  • Behavioral: systematic desensitization (Wolpe) pairs a fear hierarchy with relaxation; exposure with response prevention (ERP) is first-line for OCD; token economies use reinforcement; aversion therapy is rarely ethical.
  • Cognitive: Beck's CBT targets distorted thoughts and the cognitive triad; behavioral activation targets avoidance in depression.
  • DBT (Linehan) blends acceptance and change for borderline personality: distress tolerance, mindfulness, interpersonal effectiveness, emotion regulation.
  • Humanistic and client-centered: unconditional positive regard, empathy, congruence; the therapeutic alliance is a strong common factor.
  • Third wave: acceptance and commitment therapy, mindfulness-based approaches.

Biological treatments

  • Antidepressants: SSRIs and SNRIs are first-line; tricyclics carry anticholinergic and cardiac risks; MAOIs require a low-tyramine diet to avoid hypertensive crisis. Response takes 2 to 6 weeks and CBT addition improves relapse prevention.
  • Benzodiazepines act quickly at GABA-A but risk dependence; not long-term monotherapy for anxiety.
  • Lithium stabilizes mood with a narrow window (roughly 0.6 to 1.2 mEq/L) requiring blood monitoring.
  • Antipsychotics: typical agents block D2 and cause extrapyramidal symptoms and tardive dyskinesia; atypicals cause fewer motor effects but more metabolic syndrome, and clozapine risks agranulocytosis needing white-cell monitoring.
  • Stimulants for ADHD increase dopamine and norepinephrine availability.
  • Neurostimulation: ECT is highly effective for severe or refractory depression and catatonia; TMS is noninvasive and needs no anesthesia; psychosurgery is a last resort.

Ethics and prevention

  • Informed consent, competence, confidentiality and its legal limits (duty to warn under Tarasoff), mandated reporting.
  • Prevention: primary reduces incidence, secondary is early detection, tertiary reduces disability.

Worked example

A patient with OCD and no depression asks for the best first-line treatment. Reasoning: ERP specifically exposes the patient to triggers while blocking rituals, allowing habituation and belief disconfirmation, so it is the evidence-based psychological answer. An SSRI is a reasonable addition for moderate to severe cases; generic CBT without exposure work is a weaker response.

Traps

Confusing TMS with ECT; recommending benzodiazepines long-term for panic; forgetting lithium monitoring; mixing secondary and tertiary prevention.