INTRODUCTION

As we know, clinical psychology plays an important role in our daily lives. Clinical
psychology is a broad approach to human, individual and interpersonal issues ranging from
assessment, diagnosis, consultation, treatment, development, administration and research
programs, taking into account a large number of populations including children, adolescents,
adults, parents, families, groups and less fortunate people. There is also an overlap between
several fields of clinical psychology and other fields of professional psychology such as
counseling psychology and clinical neuropsychology as well as some professional fields
beyond psychology

In other words, clinical psychology is a branch of psychology associated with the assessment
and treatment of mental illness, abnormal behavior and psychiatric problems. This field also
integrates psychological sciences with the treatment of complex human problems as well as
making it an attractive career option for those looking for a challenging and rewarding field

The first American psychologist, Lightner Witmer, introduced the term in 1907. Witmer, who
is also a former Wilhelm Wundt student, defined clinical psychology as "an individual study
by observation or experiment with the aim of promoting change". Today, clinical psychology
is seen as one of the most popular sub-fields in psychology.

And in this assignment, I will elaborate on two intentional treatments namely in biological
and psychosocial as well as the role of psychiatrists in mental health services.

. BIOLOGICAL INTERVENTIONS

2.1.Psychopharmacotherapy (Psychopharmacotherapy)

For information, psychopharmacotherapy is the use of medicines in the treatment of

psychiatric disorders. These medicines are often referred to as psychoactive or psychotropic
drugs. Medicines used in psychopharmacotherapy are usually prescription drugs.
Psychopharmacotherapy can be used alone or in conjunction with psychotherapy to help
reduce personal symptoms of anxiety, depression, psychosis and other psychiatric disorders.
Psychiatric drugs used in the treatment of psychological disorders can be categorized into
five main groups: Antidepressants, Anxiolytic, Antipsychotic Drugs, Antimanic and
Psychostimulants
2.1.1.Antidression

Antidepressants are medications for depression. It is often used to treat a variety of conditions
such as anxiety disorders, outrageous compulsive disorders, eating disorders, chronic pain,
neuropathic pain and some mediocre ersonal disorders such asp ersonality and for snoring,
ersonal, hyperactivity disorders (ADHD), drug abuse and sometimes insomnia or sleep
disorders.

Antidepressants can be used alone or combined with other medicines. Most antidepressants
have a slow start that lasts for 2 to 6 weeks but for those who respond well to the drug given,
some levels of efficacy are often seen after 1 week. Examples of medicines are Prozac.

Classification

There are many antidepressant drugs available in the market. The key role is played by the
time that might be required for a particular outcome of the drug on the individual i.e. the
response time of a drug can be known in the due course. The commonly used antidepressants
are

• Selective serotonin re-uptake inhibitors (SSRIs)

• Serotonin and norepinephrine re-uptake inhibitors (SNRIs)

• Monoamine oxidase inhibitors (MAOIs)

• Tricyclic antidepressants (TCAs)

• Tetracyclic antidepressants

• Serotonin receptor modulators (SRMs) • Lithium Salts

2.1.2.Anxiolytic

Anxiolytic is also known as antipanic or antianxiety which is a drug to prevent anxiety.

Anxiolytic is a drug used to treat anxiety and psychological and physical-related symptoms.
In other words, anxiolytic is useful in treating anxiety disorders. In addition, beta blockers
receptors such as propranolol and oxprenolol can be used to combat anxiety symptoms even
without anxiolytic. In the meantime, anxiolytic is also known as a small sedation where the
term is less used in the modern context and originally from the primary sedative which is also
known as the neurolepticsor antipsychotic

Examples of common anxiety disorders include general anxiety disorders and phobic
disorders. Almost 25% of the population will suffer anxiety disorders at a certain time during
their lifetime. Until the 1990s, these medicines were the backbone of pharmacologic
treatments for associated anxiety disorders

The Administration of Drug Enforcement (DEA) classifies anxiolytic as a controlled

substance because sometimes these drugs are being misused or used for recreational and
pleasure purposes. In addition, physical dependence occurs when these medicines are used at
high doses or for a prolonged period of time.

This means that if someone who is experiencing symptoms is unpleasant this is because they
suddenly stop in taking their medicines. Common symptoms include anxiety, insomnia,
anxiety, anxiety, muscle tension and irritability as well as seizuresand depression

2.1.4.Antimanic drug,

Any drug that stabilizes mood by controlling symptoms of mania, the abnormal

psychological state of excitement.

Mania is a severe form of emotional disturbance in which a person is progressively and

inappropriately euphoric and simultaneously hyperactive in speech and locomotor behaviour.
This is often accompanied by significant insomnia (inability to sleep), excessive talking,
extreme confidence, and increased appetite. As the episode builds, the person experiences
racing thoughts, extreme agitation, and incoherence, frequently replaced
with delusions, hallucinations, and paranoia, and ultimately may become hostile and violent
and may finally collapse. In some persons, periods of depression and mania alternate, giving
rise to bipolar disorder.
The most effective antimanic medications, which are used primarily for bipolar disorder, are
the simple salts lithium chloride or lithium carbonate. Although some serious side effects can
occur with large doses of lithium, the ability to monitor blood levels and keep the doses
within modest ranges makes it an effective treatment for manic episodes, and it can also
stabilize the mood swings of the patient with bipolar disorder. Lithium has a gradual onset of
action, taking effect several weeks following initiation of treatment. The precise mechanism
of its action is not known.
If patients take an overdose of lithium, or if their normal salt and water metabolism becomes
unbalanced by intervening infections that cause anorexia or fluid loss, then loss of
coordination, drowsiness, weakness, slurred speech, and blurred vision, as well as more
serious chaotic cardiac rhythm and brain-wave activity with seizures may occur. Because
lithium is generally excreted along with sodium in the urine, rehydration and supportive
therapy are all that is required for treatment. Prolonged use of lithium, however, can in fact
damage the body’s ability to respond properly to the hormonevasopressin, which stimulates
the reabsorption of water, thus causing the emergence of diabetes insipidus, a disorder
characterized by extreme thirst and excessive production of very dilute urine. Lithium can
also interfere with the response of the thyroid gland to the thyroxin-stimulating hormone
produced in the pituitary gland.
Other compounds used in the treatment of mania include valproic acid, carbamazepine,
gabapentin, benzodiazepines (e.g., clonazepam and lorazepam), haloperidol, and
chloropromazine. These substances reduce the transmission of nerve impulses in
the brain and thereby lessen the severity of manic episodes. They are important
antimanic alternatives to lithium in instances when lithium does not provide adequate
symptom control, and, with some exceptions, they may be used in combination with lithium,
particularly when rapid control of acute mania is needed to bridge the delay to onset of action
of lithium therapy.

2.1.5.Psychostimulants

Psychostimulants, also called stimulants, mainly consist of amphetamines (Dexedrine) and

methylphenidates (Ritalin, Concerta, Metadate and Methylin), which are very similar in
chemical structure to amphetamines. A stimulant refers to any mind-altering chemical or
substance that affects the central nervous system by speeding up the body’s functions,
including the heart and breathing rates. In children, however, stimulants appear to act as
suppressants, but psychiatrists and doctors state they have no idea why.3 One thing parents
must know, however, is that methylphenidate, the generic name for Ritalin, is classified by
the US Drug Enforcement Administration as a Schedule II* narcotic in the same abuse
category as morphine, opium and cocaine. It is also classified by the International Convention
on Psychotropic Substances in the same abuse category as amphetamine, PCP
(hallucinogenic drugs such as angel dust) and methamphetamine. Psychiatrists claim that
psychostimulants can improve a child’s academic performance by helping him to focus.

2.2 Electroconvulsive Therapy

Electroconvulsive therapy (ECT) is a procedure, done under general anesthesia, in which
small electric currents are passed through the brain, intentionally triggering a brief seizure.
ECT seems to cause changes in brain chemistry that can quickly reverse symptoms of certain
mental health conditions.

ECT often works when other treatments are unsuccessful and when the full course of
treatment is completed, but it may not work for everyone.

Much of the stigma attached to ECT is based on early treatments in which high doses of
electricity were administered without anesthesia, leading to memory loss, fractured bones and
other serious side effects.

ECT is much safer today. Although ECT may still cause some side effects, it now uses
electric currents given in a controlled setting to achieve the most benefit with the fewest
possible risks.

Why it's done

Electroconvulsive therapy (ECT) can provide rapid, significant improvements in severe

symptoms of several mental health conditions. ECT is used to treat:

 Severe depression, particularly when accompanied by detachment from reality

(psychosis), a desire to commit suicide or refusal to eat.
  Treatment-resistant depression, a severe depression that doesn't improve with
medications or other treatments.

 Severe mania, a state of intense euphoria, agitation or hyperactivity that occurs as

part of bipolar disorder. Other signs of mania include impaired decision-making,
impulsive or risky behavior, substance abuse, and psychosis.

 Catatonia, characterized by lack of movement, fast or strange movements, lack of

speech, and other symptoms. It's associated with schizophrenia and certain other
psychiatric disorders. In some cases, catatonia is caused by a medical illness.

 Agitation and aggression in people with dementia, which can be difficult to treat

and negatively affect quality of life.

ECT may be a good treatment option when medications aren't tolerated or other forms of
therapy haven't worked. In some cases ECT is used:

 During pregnancy, when medications can't be taken because they might harm the
developing fetus

 In older adults who can't tolerate drug side effects

 In people who prefer ECT treatments over taking medications

 When ECT has been successful in the past

Psychotherapy (Psychotherapy)
Psychotherapy is a general term that refers to therapeutic interaction or contraction between
trained personality and patient, patient, family, spouse, or group. Psychotherapy aims to
improve the sense and wellbeing. Psychotherapy practitioners use a variety of techniques
based on experience building relationships, dialogues, communication and behavioral
changes created to improve the mental health of the client or patient and to improve the
relationship of the group as in a family.

Psychotherapy is a process that focuses on helping someone to heal and learn more
constructive ways to deal with problems or issues in his life. It can also be a supportive
process when going through difficult or under stress such as starting a new career or through
a divorce process.

In general, psychotherapy is recommended when a person struggles with issues of life,

relationships, work, certain mental health concerns and issues that cause an individual to
experience pain or disappointment for more than a few days.

Most psychotherapists tend to focus on problem solving and goal orientation. This means that
at the onset of treatment, therapists will help you make the desired decision in your life. This
goal will often be broken down into smaller objectives to be achieved and incorporated into a
formal treatment plan.

Most psychotherapy practitioners today work and focus on helping you achieve that goal.
This is done only through a conversation session and discusses therapeutic techniques that
can better assist you in overcoming difficult times in your life.

Successful psychotherapy is seen when an individual enters the therapy and has a strong
desire to change. If one does not want to change then, the change will be very slow. A
meaningful change is changing the aspects of your life that are not beneficial and hence stop
them from going on
Psycho educations (Psychoeducation)
Education psychology refers to education offered to individuals with mental health
conditions. Regular training in educational psychics involves schizophrenic patients, clinical
depression, anxiety disorders, psychotic illness, eating disorders and personality disorders as
well as patient-specific treatments in the context of physical illness. The goal is for patients to
better understand and be able to cope with the disease.

In a broader sense, educational psychics refer to education given to individuals living with
emotional disturbances. The core principle in the educational psychology is that education
has a role in emotional and behavioral change. With a better understanding of the causes and
effects of the problem, educational psychology broadens the individual's view of influencing
their emotions and behaviors. Education psychology also teaches public about mental health
issues. We can determine mental health not only when we have no problem but know what
the person can expect from others and ourselves and know what to do when something comes
to a problem.

From a clinical point of view, educational psychics target both the mentally ill and the family
members. Knowledge of this problem is very important in helping the patient's family
understand what is actually happening to the patient and indirectly, training them on how to
help in the patient's mental health.

Social Skills Training (SST)

Social Skills Training (SST ) helps individuals to learn the right behaviors and how to
interpret social signals so they know how to behave appropriately in dealing with other
individuals in different situations. The goal of SST is to teach individuals about oral and not
just the behaviors involved in social interaction but also improve their ability to function in
daily social situations. It is assumed that when an individual improves their social skills or
alter their chosen behavior will indirectly increase their self-esteem and have better
interpersonal relationships. This is because, there are many who have never been taught about
the right ways to interact in a social environment and have difficulties relating to others. In
addition, SST is also found to be effective in the treatment of patients with various emotional
problems, including shyness or social phobia, management disorders, drug addiction,
marriage problems and family conflicts, anxiety disorders, depression, lack of confidence and
so on. In the meantime, treating patients who are addicted to alcohol, the patient will directly
learn ways to deal with their own desires as well as social signals associated with the
personality SST can also help patients who suffer from shyness or social phobia to improve
communication and social skills so they can get along with others with more confidence and
ease. Additionally, SST has been used to aid schizophrenic patients by increasing their
overall firmness and skill in their conversation

3. PSYOSOSIAL INTERVENTIONS
3.1.Psychotherapy (Psychotherapy)
Psychotherapy is a general term that refers to therapeutic interaction or contraction between
trained ersonality and patient, patient, family, spouse, or group. Psychotherapy aims to
improve the sense and wellbeing. Psychotherapy practitioners use a variety of techniques
based on experience building relationships, dialogues, communication and behavioral
changes created to improve the mental health of the client or patient and to improve the
relationship of the group as in a family.

Psychotherapy is a process that focuses on helping someone to heal and learn more
constructive ways to deal with problems or issues in his life. It can also be a supportive
process when going through difficult or under stress such as starting a new career or through
a divorce process.

In general, psychotherapy is recommended when a person struggles with issues of life,

relationships, work, certain mental health concerns and issues that cause an individual to
experience pain or disappointment for more than a few days.

Most psychotherapists tend to focus on problem solving and goal orientation. This means that
at the onset of treatment, therapists will help you make the desired decision in your life. This
goal will often be broken down into smaller objectives to be achieved and incorporated into a
formal treatment plan.

Most psychotherapy practitioners today work and focus on helping you achieve that goal.
This is done only through a conversation session and discusses therapeutic techniques that
can better assist you in overcoming difficult times in your life.

Successful psychotherapy is seen when an individual enters the therapy and has a strong
desire to change. If one does not want to change then, the change will be very slow. A
meaningful change is changing the aspects of your life that are not beneficial and hence stop
them from going on.

3.2.Psycho educations (Psychoeducation)

Education psychology refers to education offered to individuals with mental health
conditions. Regular training in psychopendology involves schizophrenic patients, clinical
depression, anxiety disorders, psychotic illness, eating disorders and ersonality disorders as
well as patient-specific treatments in the context of physical illness. The goal is for patients to
better understand and be able to cope with the disease.
In a broader sense, Education psychology refers to education given to individuals living with
emotional disturbances. The core principle in psychopendidikan is that education has a role in
emotional and behavioral change. With a better understanding of the causes and effects of the
problem, educational psychics broaden the individual's views in influencing their emotions
and behaviors. Education psychology also teaches public about mental health issues. We can
determine mental health not only when we have no problem but know what the person can
expect from others and ourselves and know what to do when something comes to a problem.

From a clinical point of view, educational psychics target both the mentally ill and the family
members. Knowledge of this problem is very important in helping the patient's family
understand what is actually happening to the patient and indirectly, training them on how to
help in the patient's mental health

3.3.Teaching Social Skills

Social Skills Training (SST) training helps individuals learn appropriate behavior and how to
interpret social signals so they know how to behave appropriately in dealing with other
individuals in different situations. The goal of SST is to teach individuals about oral and not
just the behaviors involved in social interaction but also improve their ability to function in
daily social situations. It is assumed that when an individual improves their social skills or
alter their chosen behavior will indirectly increase their self-esteem and have better
interpersonal relationships.
This is because, there are many who have never been taught about the right ways to interact
in a social environment and have difficulties relating to others.

In addition, SST is also found to be effective in the treatment of patients with various
emotional problems, including shyness or social phobia, management disorders, drug
addiction, marriage problems and family conflicts, anxiety disorders, depression, lack of
confidence and so on. In the meantime, treating patients who are addicted to alcohol, the
patient will directly learn ways to deal with their own desires as well as social signals
associated with the ersona.
SST can also help patients who suffer from shyness or social phobia to improve
communication and social skills so they can get along with others with more confidence and
ease. Additionally, SST has been used to aid schizophrenic patients by increasing their
overall firmness and skill in their conversations.
4. Clark & Wells (1995) and Clark (2001) have developed a cognitive model for the
maintenance of social phobia (Fig. 1). Most of the material for the rest of this article is
derived from their approach. The aim of the model is to answer the question of why the
fears of someone with social phobia are maintained despite frequent exposure to social
or public situations and the non-occurrence of the feared catastrophes. Recent research
from controlled trials supports the efficacy of the approach (Clark et al, 2003). The
model suggests that when patients enter a social situation, certain rules (e.g. ‘I must
always appear witty and intelligent’), assumptions (e.g. ‘If a woman really gets to know
me then she will think I am worthless’) or unconditional beliefs (e.g. ‘I’m weird and
boring’) are activated. When individuals believe that they are in danger of negative
evaluation, an attentional shift occurs towards detailed self-observation, and monitoring
of sensations and images. Socially anxious individuals thus use internal information to
infer how others are evaluating them (in Fig. 1 this is ‘processing of self as a social
object’). The internal information is associated with feeling anxious, and vivid or
distorted images are imagined from an observer perspective (Hackmann et al, 2000).
These images are mostly visual, but they might also include bodily sensations and
auditory or olfactory perspectives. This is not, of course, what an observer actually
‘sees’. Recurrent images can be elicited by asking patients to recall a social situation
associated with extreme anxiety. The images are usually linked to early memories. The
therapist asks the patient when he or she remembers first having the experience
encapsulated in the recurrent image and to recall the sensory features and meaning that
these had. For example, someone who had an image of being fat remembered being
teased during adolescence, which resulted at the time in feelings of humiliation and
rejection. A second factor that maintains symptoms of social phobia are safety
behaviours. These are actions taken in feared situations which are designed to prevent
feared catastrophes (Salkovskis, 1991). Safety behaviours in social phobia include: using
alcohol; avoiding eye contact; gripping a glass too tightly; excessive rehearsing of a
presentation; reluctance to reveal personal information; and asking many questions.
Safety behaviours are often problematic: they prevent disconfirmation of the feared
catastrophe; they can heighten self-focused attention and monitoring to determine if the
behaviour is ‘working’; they increase the feared symptoms (e.g., keeping arms close to
the body to stop others seeing one sweat will increase sweating); they have an effect on
others (e.g. the individual may appear cold and unfriendly, so that a feared catastrophe
becomes a self-fulfilling prophecy); and they can draw attention to feared symptoms
(e.g. speaking quietly and slowly will lead others to focus on the individual even more).
It is hypothesised that a third factor that maintains symptoms of social phobia is
anticipatory and post-event processing. Such processing focuses on the feelings and
constructed images of the
Psychotherapy: Humanistic Therapy

Figure 1. The quality of the relationship between therapist and patient is of great importance in person-
centered therapy.

Humanistic psychology focuses on helping people achieve their potential. So it

makes sense that the goal of humanistic therapy is to help people become more self-
aware and accepting of themselves. In contrast to psychoanalysis, humanistic
therapists focus on conscious rather than unconscious thoughts. They also
emphasize the patient’s present and future, as opposed to exploring the patient’s
past.

Psychologist Carl Rogers developed a therapeutic orientation known as Rogerian,

or client-centered therapy (also sometimes called person-centered therapy or
PCT). Note the change from patients to clients. Rogers (1951) felt that the term
patient suggested the person seeking help was sick and looking for a cure. Since
this is a form of nondirective therapy, a therapeutic approach in which the therapist
does not give advice or provide interpretations but helps the person to identify
conflicts and understand feelings, Rogers (1951) emphasized the importance of the
person taking control of his own life to overcome life’s challenges.

In client-centered therapy, the therapist uses the technique of active listening. In

active listening, the therapist acknowledges, restates, and clarifies what the client
expresses. Therapists also practice what Rogers called unconditional positive
regard, which involves not judging clients and simply accepting them for who they
are. Rogers (1951) also felt that therapists should demonstrate genuineness,
empathy, and acceptance toward their clients because this helps people become
more accepting of themselves, which results in personal growth.