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MODULE 4

BIOLOGICAL THERAPY AND OTHER ECLECTIC THERAPIES

Lesson 1: Electroconvulsive Therapy

Lesson 2: Psychopharmacology

Lesson 3: Group Therapy

Lesson 4: Marriage Counseling

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Module 4

Biological Therapy and Other Eclectic Therapy

INTRODUCTION

This module presents the biological therapies which involve some actual
somatic or bodily treatment for psychological disorders – the most widely used
electroconvulsive therapy and chemotherapy. This module also includes an
introduction on group therapy and marriage counseling.

OBJECTIVES

After studying this module, you should be able to:

1. Discuss what ECT is and when is it used in clinical practice

2. Identify and explain the different psychopharmacological intervention in
the clinical practice
3. Understand the overview of group therapy and marriage counseling.

DIRECTIONS/ MODULE ORGANIZER

There are four lessons in the module. Read each lesson carefully then
answer the exercises/activities to find out how much you have learned.
Work on these exercises carefully and submit your output to your tutor or to
the Psychology Department Faculty room.

In case you encounter difficulty, discuss this to your tutor during the face-
to-face meeting. If not contact your tutor at the College of Arts and
Sciences office.

Good luck and happy reading!!!

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Lesson 1

 Electro-convulsive Therapy

A. History

Early asylum keepers recognized that the symptoms of psychotic patients

who also suffered from epilepsy seemed to improve after having a seizure.
The Portuguese psychiatrist Ladislas Meduna began experimenting with
different ways to induce seizures, and in 1934 discovered that Metrazol,
a stimulant drug, produced seizures if given in high enough doses.
Amazingly, Meduna noted that his patients' psychotic symptoms did, in fact,
diminish after a Metrazol-induced seizure. This novel treatment quickly
became known as convulsive therapy.

In 1937, it was realized that there were a few problems associated with
this treatment, most notably, the fact that Metrazol produced violent
thrashing convulsions which would commonly result in vertebral fractures.
Additionally, the drug would produce a feeling of morbid apprehension
before the convulsions began. For these reasons, psychiatrists began
searching for alternative ways to induce seizures.

Around the same time, Italian neurologist Ugo Cerletti was

experimenting with seizure induction in dogs by delivering electrical shocks
directly to their heads. Psychiatric legend holds that Cerletti was shopping
at a butcher shop one day in Italy and noticed that the butcher would
deliver an electrical shock to the heads of pigs before slaughtering them.
The electricity caused the animal to enter an anesthetized coma-like state.
Cerletti wondered whether electricity applied to the heads of human
patients would similarly produce anesthesia before provoking
convulsions. Electroconvulsive therapy was born.

The treatment is now used primarily in general hospital psychiatric units

and in psychiatry hospitals. Although ECT has been used for more than 50
years, there is continuing controversy concerning the mental disorders for
which it is indicated, its efficacy in their treatment, the optimal methods of
administration, possible complications, and the extent of its usage in
various settings. These issues have contributed to concerns about the
potential for misuse and abuse of ECT and to desires to ensure the
protection of patients’ rights. At the same time, there is concern that the
curtailment of ECT used in response to public opinion and regulation may
deprive certain patients of a potentially effective treatment.

In recent decades, researchers intensified efforts to establish the

effectiveness of ECT and its indications, understand its mechanism of
action, clarify the extent of adverse effects, and determine optimum
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treatment technique. Despite recent research efforts yielding substantial

information, permitting professional and public evaluation of the safety and
efficacy of ECT, the investigation of ECT has not generally been in the
mainstream of mental health research.

B. Apparatus

 110 volt – 60 cycle – alternating current

 The “dosis” consists of a combination of voltage and time.
 Applications range from 70 to 130 volts continuing for 0.1 to 0.5 of a
second
 Usually one starts with 80 volts for 0.2 seconds.
 If no convulsion is produced, the voltage and the time are increased.
Only generalized seizures are productive of desired results.
 Individuals have different “convulsive threshold”.
 Females have higher thresholds than males
 Middle-aged have higher threshold than younger patients.

C. Technique

Once the patient and the physician have decided that ECT may be
indicated, the patients should undergo a pretreatment medical examination
that includes a history, physical, neurologic examination, EKG, and
laboratory tests. Medications that affect the seizure threshold should be
noted and decreased or discontinued when clinically feasible. MAO
inhibitors should be discontinued two weeks before treatment, and patients
should be essentially lithium free.

An area should be designated for the administration of ECT and for

supervised medically recovery from the treatment period this area should
have appropriate health care professionals available and should include
equipment and medications that could be used in the event of
cardiopulmonary or other complications from the procedure. A health
professional specifically trained and certified in the use of brief anesthetic
procedures should administered anesthesia. The treatment team should
include nursing personnel trained in ECT and recovery

No food intake during 2 hours before act period patient should go to

comfort room beforehand period dentures are removed. Treatment is given
on the bed which is well supported by a board. Patient lies on his back.
Shoulders, arms, size are held by a nurse to prevent extreme movements.
But the control should not be too rigid or type. Mouth gag is placed between
the teeth. Tongue is depressed to prevent biting. Patience shin is firmly
held so that the jaw cannot open 24 and become dislocated. Electrodes are
placed on both sides of the forehead. When button is pressed, the patient
becomes instantly unconscious even if no seizure follows fade, he will have
no memory of a shock period the convulsion is accompanied by apnea

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The convulsion has a tonic fee for more or less 10 seconds, followed
by a clonic phase somewhat longer duration. Following the clonic phase
comma there is a phase of muscular relaxation with stertorous respiration.
It is advised to roll the patient on his side to prevent inhalation of saliva.
The patient remains unconscious for about five minutes. For the next five to
ten minutes, he slowly rises to consciousness. After that, there is a period
of confusion during which the patient has to be watch. He may fall out of
bed. The patient should be permitted to lie for 1 hour. If left on disturbed,
he may sleep for one hour or more

Typically, ECT is administered as follows the treatment is given in the

early morning after an 82 12-hour period of fasting. Atropine or other
anticholinergic agent is given prior to the treatment. An intravenous line is
placed in a peripheral vein, and access to this vehicle the patient is fully
recovered. The anesthetic methohexital is given first comma followed by
succinylcholine for muscle relaxation. Ventilatory assistance is provided
with a positive pressure bag using 100% oxygen. The EKG, blood pressure,
and pulse rate is monitored throughout the procedure. Stimulus electrodes
are placed either bifrontotemporally or with one electrode placed
frontotemporally and the second electrode placed on the ipsilateral side.
Bilateral ECT may be more effective in certain patients or conditions. It has
been established, however, that unilaterally city, particularly on the
nondominant side, is associated with a shorter confessional period and
fewer memory deficits. Also, a brief pulse stimulus is associated with fewer
cognitive defects than the traditional sine waves stimulus. Seizure threshold
varies greatly among patients and may be difficult to determine comma
nevertheless the lowest amount of electrical energy to induce an adequate
seizure is used. Seizure monitoring is necessary and may be accomplished by
an EEG or by the “cuff” technique. In this technique, a blood pressure cuff
is placed on an arm or leg and is inflated above systolic pressure prior to the
injection of a muscle relaxing agent. In unilateral ECT, the cuff should be on
the same side as the electrodes to ensure that a bilateral seizure occurred.

D. Frequency

The number of treatments in a course of therapy varies. six to twelve

treatments are usually effective. The usual frequency is 2 to 3 times weekly
week for a total of 12 to 20 ECT’s depending up on results obtained. For
depressive patients and also for acutely disturb patients who are threatened
by a psychotic exhaustion, to ease it is may be given in one day for two or
three successive days. This leads to greater confusion, which will clear up
later. Following ECT, most depressed patients should be continued on
antidepressant medication or lithium to reduce relapse.

E. Indications

Efficacy for ECT has been established for mood disorders;

schizophrenia and other psychotic disorders; and a small number of non-
psychiatric medical conditions.

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 Mood disorders

1. Major Depressive Disorder (MDD)

ECT is the most effective and rapid acting treatment for unipolar
depression; therefore, for depressed persons at high risk for suicide,
it can be the treatment of choice.

In MDD with Psychotic Features, antidepressants alone are less likely

to provide amelioration of either mood or psychotic symptoms; thus,
treatment should be with combined antidepressant and antipsychotic
medications or ECT.

In depression in ambulatory patients where antidepressants from

different classes have failed (e.g., a selective serotonin reuptake
inhibitor or SSRI; a tricyclic antidepressant of TCA; and a monoamine
oxidase inhibitor or MAOI), ECT should be discussed as an alternative
to yet another medication trial.

Finally, there are co-morbid conditions which shift the risk/benefit

ratio in favor of ECT over medication, including patients with
depression who are elderly, physically debilitated, or pregnant,

2. Bipolar Disorder

Acute depression in bipolar disorder does not generally respond

(rapidly or adequately) to mood stabilizers, with the possible
exception of lithium, lamotrigine and quetiapine, or to
antidepressants (some of which can carry risk of precipitating the
manic phase of the illness, called switching).  Therefore, ECT should
be considered for a patient with bipolar disorder in the depressive
phase, particularly if unresponsive to even one medication trial of an
antidepressant or mood stabilizer.

Unlike antidepressants, ECT does not lead to switching. In

fact, ECT treats mania as well as depression, and, for mania either
unresponsive to antidepressants or requiring rapid resolution due to
potential danger to life or limb, ECT may be the treatment of choice
for mania.

Finally, for persons with bipolar disorder and co-morbid medical

conditions as well as some elderly patients, ECT may—contrary to
common misconception—be a safer alternative than medication.

 Schizophrenia

The first use of ECT in psychiatry was in the treatment of schizophrenia,

based on clinical observation that persons with epilepsy and schizophrenia

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often had an improvement in symptom severity following a spontaneous

seizure. 

Its efficacy in treating persons with schizophrenia and schizoaffective

disorder has been well established, although its use decreased with the
introduction of neuroleptics in the 1950s.  ECT remains an effective
treatment for persons with schizophrenia, and should be considered for
persons with schizophrenia who have failed to respond to several
antipsychotics, including clozapine, as well as in those whose co-morbid
medical status makes ECT a safer option; in the case of persons with
schizophrenia, this could include a history of neuroleptic malignant
syndrome (NMS), particularly if this has occurred on more than one
occasion.

 Non-psychiatric medical conditions

ECT, including maintenance ECT, has been helpful for patients with

Parkinsonism where pharmacotherapy with dopamine agonists or precursors
is either of limited efficacy and/or precipitates psychosis or other severe
behavioral changes.

As noted above, NMS may require avoiding antipsychotic medication and

favor the use of ECT. ECT does not cause NMS and has been shown to be a
rapid and effective treatment for NMS.

F. Results

Many people begin to notice an improvement in their symptoms after

about six treatments with electroconvulsive therapy. Full improvement may
take longer, though ECT may not work for everyone. Response to
antidepressant medications, in comparison, can take several weeks or more.
No one knows for certain how ECT helps treat severe depression and other
mental illnesses. What is known, though, is that many chemical aspects of
brain function are changed during and after seizure activity. These chemical
changes may build upon one another, somehow reducing symptoms of
severe depression or other mental illnesses. That's why ECT is most effective
in people who receive a full course of multiple treatments.
Even after your symptoms improve, you'll still need ongoing depression
treatment to prevent a recurrence. Ongoing treatment may be ECT with less
frequency, but more often, it includes antidepressants or other
medications, or psychological counseling (psychotherapy).

G. Complications

Electroconvulsive therapy (ECT) is a safe and effective treatment for

severe mood disorders. Rarely there can be serious complications, such as
postictal agitation, cardiovascular compromise, prolonged seizures, and
status epilepticus, all of which are important for the clinician to recognize
and treat. Postictal agitation can be severe, requiring emergent

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intervention and subsequent prophylactic measures to avoid premature ECT

discontinuation. Cardiovascular responses to ECT include significant
hemodynamic changes that may result in complications, even in patients
without preexisting cardiovascular conditions. However, preexisting
cardiovascular conditions per se are not contraindications to ECT in patients
with disabling psychiatric disease. Recognizing and treating prolonged
seizures is essential to prevent progression to status epilepticus. Failure to
recognize and treat any of these events may result in increased mortality
and morbidity. Understanding such complications and their management
strategies avoids unnecessary treatment discontinuation due to manageable
ECT complications.

THINK!
When should you consider ECT as a mode of treatment? What are its
When should you consider ECT as a mode of treatment? What are its
pros and cons? Is ECT effective?
pros and cons? Is ECT effective?

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Lesson 2

 Psychopharmacology

Facts to know:
1. Psychopharmacology is the use of medications to treat mental health
conditions.
2. Medications are most effective when combined with psychotherapy.
3. Psychiatric medications should be monitored by a licensed physician.

What is Psychopharmacology?
Psychopharmacology refers to the use of medication in treating mental
health conditions. Medications can play a role in improving most mental health
conditions. Some patients are treated with medication alone, while others are
treated in combination with therapy or other treatments.
These agents have the capacity to modify affective states without seriously
impairing cognitive functions, although, they differ from sedative and hypnotic
drugs.

A. Types of Psychiatric Medications

1. NEUROLEPTIC drugs
- used for psychotic disorder
- have effect on the emotional and impulsive stability beyond control of
the patient.
- a.k.a anti-psychotic drug
- affect psychotic behavior i.e. paranoid, schizophrenic, manic or caused
by organic brain dysfunction

1.1. 3 classes of neuroleptic drugs:

 Rauwolfia alkaloids-chemical synthesis in the form of resperine
and serpasil.
 Tricyclics -
 Butyrophenones with haloperidol (Haldol) – directed for paranoid
delusions

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1.2. Clinical Indications

- Used for psychotic behavior characterized by tension, agitation
aggressive outburst, destructiveness, antagonistic and paranoid
reactions, impulsiveness.
- In two weeks, the hallucinations and delusions disappear.
- The more affected the patient is, better response to the drug. The
longer the postponement of the beginning of therapy, the less
effective the drug,
- Indicated for schizophrenia, manic depression – manic phase acute,
organic brain syndromes, and delusional depression.

1.3. Mode of treatment

- Restores perceptual filter to turn off environmental bombardment
- Hallucination and delusions are reduced and perception, attention,
and communication are improved.
- Reduction of patients in mental hospitals
- Neuroleptic drugs open the way for psychotherapy
- Major effect: reduce psychotic thinking and behavior.

1.4. Duration of therapy

- The dose required to achieve full symptom remission should be
continued for two to four weeks and then gradually reduced to a
maintenance level.
- Patients who were chronically affected with the disorder prior to
initiation of drug therapy as in process of schizophrenia should
receive longer courses from six to eight months of treatment.

2. ANTI-ANXIETY Drugs
- Drugs that helps calm and relax the anxious person, reduce anxiety,
and remove troubling symptoms.
- Sedative, central muscle relaxant, anti-convulsant effect

2.1. Types of anxiolytic drugs

 Meprobamate – aka as Milltown, Equanil in 1955. Of value in
anxiety and tension states, phobias, psychosomatic disorders,
insomnia, pre-menstrual tensions. Has poorly defined action.
 Benzodiazepines – less sedative and habit forming. Eliminates
fixated behavior. Most commonly used benzodiazepines are
alprazolam (Xanax) and diazepam (Valium), followed by
chlordiazepoxide (Librium, Librax, Libritabs). Benzodiazepines are
fast acting medications. Must be taken daily for 2 or 3 weeks prior
to exerting its antianxiety effect, most take effect within hours,
some even less time. Benzodiazepines differ in duration of action
in different individuals; they may be taken 3 times a day or once a
day. Dosage is generally started at a low level and gradually raised
until symptoms are diminished or removed. The dosage will vary
depending on the symptoms and the individual’s body chemistry.

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 Buspirone (BuSpar) – used for generalized anxiety disorders.

Although benzodiazepines, tricyclic antidepressants, buspirone, or

SSRIs are the preferred medications for most anxiety disorders,
occasionally, for specific reasons, one of the following medications
may be prescribed: antipsychotic medications, antihistamines (Atarax
and Vistaril) barbiturates such as phenobarbital; and beta-blockers
such as propranolol (Inderal, Inderide). Propanediols such as
meprobamate were commonly prescribed prior to the introduction of
the benzodiazepine, but today rarely are used.

2.2. Clinical Indications

- Indicated for: generalized anxiety, acute anxiety in anxiety neurosis,
conversion reactions.
- Indicated for chronic anxiety states in different neurotic conditions as
in phobias, dissociative reactions, OCD, PTSD, and neurotic
depressive reactions.
- Alcoholic hallucinosis and delirium tremens as a result of alcohol
withdrawal.

3. ANTIDEPRESSANT drugs

3.1. Biochemical hypothesis

- catecholamine theory of depression – a state of “well-being” is
maintained by a continuous adrenergic stimulation of certain
receptors in the brain. The stimulation is done by catecholamines
(hormones produced in the brain).
- a normal level of concentration of the brain-hormones leads to a
state of “well-being”. Decrease in concentration produced
depression.
- catecholamine level can be reduced through:
 Enzymatic destruction – process of monoamine oxidase (MAO)
 Reabsorption of catecholamines in the neurons.

3.2. 2 main categories of ANTIDEPRESSANTS

 Thymetrics – represented mainly by MAO inhibitors. MAO
inhibitors prevent the monoamine oxidase process.
 Thymoleptics – consists of tricyclic drugs. Tricyclic drugs can
be Iminodibenzyl derivatives like tryptizol, and
dibenzodiazepine derivatives. Tricyclic drugs block the re-
uptake process. As a result, there is a normalization of mood,
without leading to euphoria. Psychomotor inhibitions are
reduced. Monoideation disappears. Overdose of tricyclics may
result to delirium.
Note: stimulants like amphetamines facilitate the release of
neurotransmitter compounds and cause therefore a temporary

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increase in the sense of well-being without any anti-psychotic

action.

Antidepressant medications take from one to two weeks to

produce their antidepressant effects.

3.3. Clinical indications

 Thymoleptic drugs give the best result in psychotic depression
 MAO-inhibitors are indicated for patients who show severe
neurotic symptoms combined with depression or anxiety while
there is no diagnosis of one of the major psychoses.
Obsessional patients with multiple neurotic symptoms and
anxiety can benefit MAO inhibitors.

4. ANTI-MANIC drugs
- Bipolar disorder is characterized by cycling mood changes: severe
high and lows. These highs and lows may vary in intensity and
severity.

4.1. Clinical indications

- Anti-manic drugs are indicated for manic “high”

4.2. Anti-manic drug types

 Lithium – evens out mood swings in both directions. Lithium
diminish severe manic symptoms in about 5 to 14 days, but it
may be anywhere from days to several months until the
condition is fully controlled.
 Anti-convulsant – usually used to treat epilepsy.
Carbamazepine (Tegretol) is the anti-convulsant that is widely
used. Rapid cycles of manic-depressive patients respond well
to carbamazepine.

THINK!
Discuss how the different psychopharmacological drugs work in the
Discuss how the different psychopharmacological drugs work in the
brain and thus affecting an individual’s behavior, perception, and
brain and thus affecting an individual’s behavior, perception, and
thinking.
thinking.

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Lesson 3

 Group Therapy

All of the individual therapies can also be used with groups. People may
choose group therapy for several reasons. First, group therapy is usually less
expensive than individual therapy, because group members share the cost. Group
therapy also allows a therapist to provide treatment to more people than would be
possible otherwise. Aside from cost and efficiency advantages, group therapy
allows people to hear and see how others deal with their problems. In addition,
group members receive vital support and encouragement from others in the group.
They can try out new ways of behaving in a safe, supportive environment and learn
how others perceive them.
Groups also have disadvantages. Individuals spend less time talking about their
own problems than they would in one-on-one therapy. Also, certain group
members may interact with other group members in hurtful ways, such as by
yelling at them or criticizing them harshly.

Generally, therapists try to intercede when group members act in

destructive ways. Another disadvantage of group therapy involves confidentiality.
Although group members usually promise to treat all therapy discussions as
confidential, some group members may worry that other members will share their
secrets outside of the group. Group members who believe this may be less willing
to disclose all of their problems, lessening the effectiveness of therapy for
them.

Format of Group Therapy

Groups vary widely in how they work. The typical group size is from six to
ten people with one or two therapists. Often two therapists prefer to work
together in a group so that they can respond not only to one person’s issues, but
also to discussions between group members that may be occurring quickly. Some
groups are open or drop-in groups—new clients may join at any time and members
may attend or skip whatever sessions they desire. Other groups are closed and
admit new members only when all members agree. Regular attendance is usually
required in these groups. In closed groups, both the therapist and group members
will ask a member to provide an explanation for missing a meeting.

When forming a group, therapists try to make clear to potential participants

the goals of the group and for whom it is appropriate. Therapists will often screen
potential participants to learn about their problems and decide whether the group
is right for them. Sometimes therapists prefer diversity among group members in
terms of age, gender, and problem.

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In other cases, therapists may limit membership in a group to individuals with

similar problems and backgrounds. For example, some groups may form specifically
for individuals who are grieving the loss of a loved one, individuals who abuse
drugs or alcohol, people with eating disorders, people suffering from depression,
or troubled elderly individuals.

The techniques used in group therapy depend largely on the theoretical

orientation of the therapist. Humanistic therapists tend to respond to the feelings
and experiences of other members. They may also interpret or comment on social
interactions between group members.

In cognitive-behavioral groups, group members try to change their own

thoughts and behaviors and support and encourage other members to do the same.
Psychoanalytic groups focus on childhood experiences and their impact on
participants’ current behaviors, thoughts, and feelings.

Psychodrama

Psychodrama, the first form of group therapy, was developed in the 1920s
by Jacob L. Moreno, an Austrian psychiatrist. Moreno brought his method to the
United States in 1925, and its use spread to other parts of the world. Participants
in psychodrama act out their problems—often one real stage and with props—as a
means of heightening their awareness of them. The therapist serves as the
director, suggesting how participants might act out problems and assigning roles to
other group members. For example, a woman might reenact a scene from her
childhood with other group members playing her father, mother, brother, or sister.
Groups who use psychodrama may do so weekly or simply as a one-time
demonstration.

Self-Help Groups

A self-help group or support group involves people with a common problem

who meet regularly to share their experiences, support each other emotionally,
and encourage change or recovery. They are usually free of charge to interested
participants. Self-help groups are not strictly considered psychotherapy because
they are not led by a licensed mental health professional. However, they can serve
as an important source of help for people in emotional distress.

There are thousands of self-help and support groups in the United States
and Canada. The oldest and best known is Alcoholics Anonymous, which uses a 12-
step program to treat alcoholism. Other groups have formed for cancer patients,
parents whose children have been murdered, compulsive gamblers, battered
women, obese people, and many other types of people.

THINK!
What are the pros and cons in using group therapy as an
What are the pros and cons in using group therapy as an
intervention?
intervention?
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Lesson 4

 Marriage Counseling

Couples therapy, also called marital therapy or marriage counseling, is

designed to help intimate partners improve their relationship. Therapists treat
married couples as well as unmarried couples of the opposite or same sex.
Therapists normally hold sessions with both partners present. At certain times
during therapy, however, the therapist may choose to see the partners
individually.

Couples may seek therapy for a variety of problems, many of which concern
a breakdown of communication or trust between the partners. For example, an
extramarital affair by one partner may cause the other partner to feel emotional
pain, anger, and distrust. Some partners may feel distant from one another or
experience sexual problems. In other cases, one or both partners may have
psychological problems or alcohol or drug problems that negatively affect their
relationship.

The techniques used in therapy vary depending on the theoretical

orientation of the therapist and the nature of the couple’s problem. Most often,
therapists focus on improving communication between partners and on helping
them learn to manage conflict. By observing the partners as they talk to each
other, the therapist can learn about their communication patterns and the roles
they assume in their relationship. The therapist may then teach the partners new
ways of expressing their feelings verbally, how to listen to each other, and how to
work together to solve problems. The therapist may also suggest that they try out
new roles. For example, if one partner makes all of the decisions in the
relationship, the therapist may encourage the couple to try sharing decision-
making power.

Because most couples therapists also have training in family therapy, they
often examine the influence of the couple’s relationships with parents, children,
and siblings. Psychoanalytically oriented therapists may focus on how the partners’
childhood experiences affect their current relationship with each other. For
couples who cannot work through their differences or reestablish trust and
intimacy, separation or divorce may be the best choice. Therapists can help such
partners separate in constructive ways.

THINK!
What is the goal of marriage counseling? Why is marriage counseling
What is the goal of marriage counseling? Why is marriage counseling
important?
important?
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LEARNING ACTIVITY

Make a hypothetical case dialogue during a session

between the clinician and the client/s to depict what
occurs during group therapy and marriage counseling.

 MODULE SUMMARY

In module 2, you have learned about the biological therapy and other
eclectic therapy. You understand how they work and their clinical indications, as
well as some of their limitations in the practice of psychotherapy.
There are four lessons in module 2. Lesson 1 consists of the
electroconvulsive therapy, its historical background and its contribution in dealing
with psychopathology.
Lesson 2 discussed about psychopharmacology where different drugs in
treating psychopathology and their mode of action in influencing behavior and
thinking.
Lesson 3 was about group therapy. In this lesson you learned about how
group therapy works and why people choose group therapy.
Lesson 4 discussed about marriage counseling and its role in improving
relationships.
Congratulations! You have just studied Module 2. now you are ready to
evaluate how much you have benefited from your reading by answering the
summative test. Good Luck!!!

SUMMATIVE TEST
1. Should psychologists be allowed to prescribe medications and treatment like
ECT to their clients? Give a distinction between the role of a psychologist
and psychiatrist.
2. What possible ethical issues do you think are involved in conducting group
therapy and marriage counseling?

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Module 4