Foto: UR/Katrin Groß Below you will find helpful information on common psychological disorders and their psychotheraputic treatment options, such as cognitive behavioural therapy.
Common psychological disorders and their treatment
Anxiety disorders
In anxiety disorders, clients avoid fearful situations or objects, experience panic attacks or worry excessively about everyday situations. Anxiety disorders are treated in behavioural therapy after intensive preparation using confrontation techniques. Patients confront the anxious object or situation with the support of their psychotherapist until the anxiety has subsided, negative expectations have been corrected and new, more positive experiences can be made with the object or situation.the confrontation with the anxiety-provoking conditions can take place in reality, in the imagination or in virtual realities. If indicated, confrontation procedures are supplemented by techniques for changing problematic thoughts. Confrontation therapy carried out professionally by a psychotheraputic has a very high success rate, so that although the therapy can be exhausting and stressful in the short term, fears can be overcome sustainably in the medium and long term.
Specific phobia
Specific phobias include the fear of certain animals (e.g. spiders), situations (e.g. heights), forces of nature (e.g. thunderstorms), blood and syringes, or other conditions (e.g. vomiting or swallowing). Specific phobias are mainly treated with exposure in vivo or in virtual reality. Patients, accompanied by their therapist, confront themselves with real or virtual spiders, for example, or climb a real or virtual tower.
Social anxiety disorder
Social anxiety disorder is characterised by a fear of being judged negatively by other people, e.g. when speaking or eating in front of other people. This is often accompanied by strong physical reactions such as sweating, trembling or blushing. Social phobia is treated by means of behavioural experiments and cognitive restructuring. As part of the behavioural experiments, patients and their therapists recreate social situations in therapy in order to explore their own effect on other people in more detail and to be able to correct negative beliefs in this regard. In our university outpatient clinic, we also use virtual realities in this context, in which patients can, for example, give lectures in front of a virtual audience or address virtual people. The new experiences are then gradually transferred to reality outside the therapy setting.
Agoraphobia
Agoraphobia is a fear or avoidance of situations from which escape is difficult or where help is hard to come by (e.g. alone at home, public transport, crowds, flights, etc.). Agoraphobia can occur with or without panic attacks.in the treatment of agoraphobia, interoceptive exposure is combined with exposure in vivo or in virtual reality. As part of interoceptive exposure, patients confront themselves with typical physical symptoms of a panic attack in the company of their therapist. Exposure in vivo or in virtual reality involves confrontation with typical, anxiety-inducing situations (e.g. travelling on public transport), which are also accompanied by the psychotherapist.
Panic disorder
In panic disorder, sudden attacks of anxiety occur regardless of the situation, which are accompanied by sometimes severe physical symptoms (e.g. palpitations, sweating, trembling, dizziness, hot and cold shivers, tingling in the hands, shortness of breath, etc.) and are often accompanied by the fear of fainting or dying. Panic disorder is mainly treated with interoceptive exposure. With the support of their therapist, patients confront themselves with the typical physical symptoms of a panic attack.
Generalised anxiety disorder
In generalised anxiety disorder, patients worry excessively about everyday issues, e.g. a possible accident or illness of relatives or themselves. These worries are often associated with increased muscle tension, sleep problems or other physical symptoms. In the case of generalised anxiety disorder, worry confrontation is carried out alongside a reduction in reassurance behaviour. This involves the patient confronting their worries with the support of their therapist until they gradually "lose their terror".
Depressive disorders
Depressive disorders are characterised by a depressed mood, rapid exhaustion, lack of drive and loss of pleasure and interest. The most important treatment techniques of cognitive behavioural therapy for depressive disorders are building up positive activities, changing problematic thoughts and improving social relationships.
Post-traumatic stress disorders
Post-traumatic stress disorder can develop in people who have experienced stress of extraordinary threat or catastrophic proportions. Complaints include recurring memories, nightmares, overexcitement and avoidance behaviour. Most psychotherapy methods base the treatment plan for post-traumatic stress disorder on a four-stage model: 1) building safety, 2) stabilisation, 3) protected confrontation, 4) reintegration.
Personality disorders
Personality disorders are interactional disorders that usually have their origins in the client's childhood. The main problems become apparent in close relationships. Schema therapy, a further development of cognitive behavioural therapy for personality disorders, is useful for treating personality disorders. Dialectical behavioural therapy (DBT) is the treatment method of choice for borderline personality disorder. DBT comprises several therapy modules (e.g. mindfulness, stress tolerance, dealing with feelings, interpersonal skills). The focus of DBT is on skills training, i.e. the development of behaviours that are effective in the short term and not harmful in the long term.
Somatoform disorders
Physical complaints without sufficient organic medical findings are referred to as somatoform disorders. As physical functions (primarily through the autonomic nervous system) are influenced by the psychological state, cognitive behavioural therapy addresses the psychological part of the physical complaints. There are various ways to improve the psychological influence on physical complaints (e.g. relaxation techniques, mindfulness, changing problematic thoughts).
Addictive disorders
Addictions can be substance-related or non-substance-related. Common substance-related addictions are alcohol and nicotine abuse or dependence. Non-substance-related addictions include gambling and shopping addiction. Addictions are typically characterised by cravings, withdrawal symptoms and social impairment caused by the addiction. In the case of addictions, outpatient psychotherapy usually only makes sense following successful detoxification and / or withdrawal treatment.
Obsessive-compulsive disorders
Obsessive-compulsive disorders can be obsessive thoughts and / or compulsive behaviour. Frequent obsessive thoughts are, for example, incessant thoughts about aggressive, religious or sexual topics. Compulsive behaviours can include compulsive checking or washing. Obsessive personality traits that have a problematic effect on quality of life (e.g. perfectionism, rigidity) can also be an indication for psychotheraputic treatment.
Eating disorders
Psychotherapy is particularly indicated for anorexia (anorexia nervosa) and bulimia (binge eating disorder). Anorexia is present if the BMI (body mass index) is below 17.5 and other diagnostic criteria are met (e.g. self-induced weight loss, body image disorder). If the BMI is less than 15, inpatient treatment should always take place. Important characteristics of bulimia are, for example, recurring binge eating and measures to counteract the fattening effect of food (e.g. vomiting, starvation). As part of psychotherapy, the focus is on establishing a healthy food intake and changing problematic thoughts about food and one's own body.
Behavioural therapy in general
Alongside psychodynamic and analytical psychotherapy as well as systemic psychotherapy, behavioural therapy is one of four scientifically recognised guideline psychotherapy methods. Cognitive behavioural therapy starts with problematic behavioural and thought patterns, which are identified during therapy and their connection to the psychological problem is worked out. The second step is to work specifically on changing them.
According to Margraf (2009), behavioural therapy is characterised by the following principles:
Principle 1: Behavioural therapy is based on empirical psychology
Behavioural therapy strives to concretise its theoretical concepts and therapeutic methods and make them accessible to empirical testing. This means that the methods of behavioural therapy are scientifically tested for effectiveness in practice.
Principle 2: Behavioural therapy is problem-oriented
Behavioural therapy focuses on the current individual problem. Problematic behaviours and thoughts are changed in order to alleviate the problem. The aim is also to improve general problem-solving skills.
Principle 3: Behavioural therapy addresses the predisposing, triggering and perpetuating problem conditions
In behavioural therapy treatment, predisposing (susceptible), triggering and maintaining conditions for the current problem are taken into account. As the maintaining conditions in particular can be changed in the present, they play a central role in solving the problem in behavioural therapy.
Principle 4: Behavioural therapy is goal-oriented
The therapist and client define the therapy goals to be achieved at the beginning of treatment. This is intended to prevent therapist and client from pursuing different goals or unrealistic goals.
Principle 5: Behavioural therapy is action-oriented
Active participation by the client is a requirement for successful behavioural therapy. Behavioural therapy does not only consist of discussing and reflecting on problems, but clients actively practice new behaviours and experiences.
Principle 6: Behavioural therapy is not limited to the therapeutic setting
In order for the problem to change in everyday life over the course of psychotherapy, it is necessary for the client to regularly try out and practice the strategies acquired in the protected therapeutic setting between sessions.
Principle 7: Behavioural therapy is transparent
In the context of behavioural therapy, the individual explanatory model for the disorder at hand and the therapeutic approach between therapist and client are discussed transparently at all times.
Principle 8: Behavioural therapy should be "help for self-help"
In behavioural therapy, clients should learn skills for independent analysis and coping with future problems. This should strengthen the client's self-help potential: In the medium term, they should be enabled to counteract new problems and relapses without therapeutic help.
Principle 9: Behavioural therapy strives for continuous further development
As behavioural therapy empirically evaluates its theoretical concepts and treatment methods, behavioural therapy is in a constant process of differentiation and further development.
____________________________________________________________________________________
Margraf, J. (2009). Background and development. In: J. Margraf & S. Schneider (Eds.), Textbook of Behaviour Therapy (3rd ed., pp. 3-45). Heidelberg: Springer.
Links to further helpful information
Links CBT
Note: The links provided lead to external third-party websites over whose content we have no influence. Therefore, we cannot accept any liability for this external content. The respective provider or operator of the pages is always responsible for the content of the linked pages. The linked pages were checked for possible legal violations at the time of linking. Illegal contents were not recognisable at the time of linking.
However, permanent monitoring of the content of the linked pages is not reasonable without concrete evidence of an infringement. If we become aware of any legal infringements, we will remove such links immediately
Under the following link you will find detailed information on the topics "Am I mentally ill?" and various psychotheraputic treatment offers:
BPtK patient brochure "Paths to psychotherapy" (opens in a new window). (This PDF is not accessible)
Under the following links you can download leaflets and patient information on various psychological disorders in adults:
DPtV patient information leaflets on psychological disorders (external link, opens in a new window)
Under the following link you can download patient information on various psychological disorders in children:
The following link will provide you with information on the four guideline psychotherapy procedures that are reimbursed by the health insurance funds:
Reimbursable psychotherapy procedures (external link, opens in a new window)
Under the following link you will find a brochure on frequently asked questions about psychotherapy: