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Chapter 15 Therapies
PSYCH WOOOOOOOOOOOOOOOOOOOOOOOOT
71
Psychology
Undergraduate 1
05/01/2012

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Term
Goals of Therapy (4)
Definition
Reaching a diagnosis

Proposing a probable cause
-Etiology

Making an estimate of the course the problem will take

-Prognosis

Prescribing and carrying out some form of treatment
Term
Types of Therapy

Biomedical Therapies (define)
Definition
Attempt to alter brain functioning with chemical or physical interventions
Term
Types of Therapy

Psychotherapy (define)
Definition
Change faulty behaviors people have
learned

-Words, thoughts, interpretations, and feedback that direct daily strategies for living
Term
Types of Therapy

Psychotherapy (4 types)
Definition
Psychodynamic
Behavior
Cognitive
Humanistic
Term
Therapists


Clinical Social Worker
Definition
Trained to consider social contexts of people’s problems
Term
Therapists


Pastoral Counselor
Definition
Member of a religious group who specializes in treatment of psychological disorders
Term
Therapists


Clinical Psychologist
Definition
Broader background in psychology, assessment and research
Term
Therapists


Counseling Psychologist
Definition
Guidance in many areas, often work in community settings related to the problem areas
Term
Therapists


Psychiatrist
Definition
Have an M.D. degree along with postdoctoral training in mental and emotional disorders
Term
Therapist

Psychoanalyst
Definition
Therapist with either an M.D. or a Ph.D. who has completed specialized postdoc training in the Freudian approach
Term
Historical Perspectives

Specialized institutions were first created when and where?

What kind of stuff went on at these facilities?
Definition
in 14th century western Europe


Mental patients typically chained, tortured, and exhibited to an admission-paying public
Term
Historical Perspectives

When did treatment for psychology related stuff actually surface?
Definition
Treatment came around in the 18th century
Term
Historical Perspectives

What happened in relation to asylums in the 19th and 20th centuries?
Definition
19th and 20th centuries moved the asylums to rural areas to ease the stressors of the city…

Overcrowded and understaffed…
Term
Deinstitutionalization
Definition
Practice of moving people from psychiatric hospitals to other venues for treatment
Arose from social forces and advances in treatment
1960s
Term
What is the problem with Deinstitutionalization?
Definition
Problem is, sometimes the patients don’t receive care from another venue
Often become homeless!
Term
Psychodynamic Therapies (general characteristic) (1)
Definition
Assume the problems were caused by tension between unconscious impulses and constraints of life situation
Term
Psychodynamic Therapies

Psychoanalysis (3 characteristics)
Definition
Intensive and prolonged technique for exploring unconscious motives and conflicts

Attempt to reconstruct repressed memories, then work through the painful feelings to an effective resolution

Takes a long time!
Term
Psychoanalysis

Free Associations
Definition
basically letting the mind wander
Term
Psychoanalysis

Catharsis
Definition
an emotional release, typically the letting out of repressed feelings
Term
Psychoanalysis

Resistance
Definition
an inability or unwillingness to discuss certain topics…provides valuable information to the therapist
Term
Psychoanalysis

Dream Analysis
Definition
examination of the content of dreams to discover underlying or disguised motivations, experiences and desires
Term
Psychoanalysis

Transference
Definition
identification of the therapist as the person who has been at the center of an emotional conflict
Term
Psychoanalysis

When is transference positive?
Definition
when feelings attached are those of love or admiration
Term
Psychoanalysis

When is transference negative?
Definition
Negative when feelings consist of hostility or envy
Term
Psychoanalysis

Countertransference
Definition
when a therapist comes to like or dislike a patient because the patient is perceived as similar to significant people in the therapist’s life
Term
Later Psychodynamic theories focused on (4)
Definition
Current social environment

Continuing influence of life experiences

Role of social motivation and interpersonal relations of love

Significance of ego functioning and development of the self-concept
Term
Cognitive Therapies
Definition
Attempts to change feelings and behaviors by changing the way the client thinks about significant life experiences

Belief is that problems arise because of faulty thinking

-Unreasonable attitudes and expectations
-False premises
-Rigid rules that put behavior on “auto pilot”
Term
Cognitive Therapy for Depression

Aaron Beck
Definition
Help the client identify faulty thinking and learn more adaptive/realistic ways to formulate experiences

I.E. . Write down negative thoughts about self, figure out why they are unjustified, then come up with more realistic, less destructive thoughts.
Term
Cognitive Therapy for Depression

Four Tactics
Definition
1.Challenging client’s basic assumptions
about functioning

2.Evaluating evidence for and against
the accuracy of automatic thoughts

3.Reattributing blame to situational
factors, rather than internal factors

4.Discuss alternative solutions to complex tasks
Term
Goal of Cognitive Therapy for Depression?
Definition
to break the cycle of negative automatic thoughts!
Term
Who created Rational-Emotive Therapy?
Definition
Albert Ellis
Term
Rational-Emotive Therapy (Albert Ellis)
Definition
Teaches clients how to recognize the “shoulds”, “oughts”, and “musts” that are controlling actions
Aims to increase sense of self-worth by getting rid of faulty beliefs

Confrontational technique
Term
Cognitive Behavioral Therapy
Definition
Combines cognitive emphasis on changing false beliefs with behavioral focus on reinforcement contingencies in modification of performance
Term
Research supports Cognitive Behavioral Therapy for what? (6)
Definition
Depression

Panic and anxiety disorders

Eating disorders

Child and adolescent disorders

Substance abuse

Coping with disease/chronic pain
Term
Types of Humanistic Therapy (4)
Definition
Existential approaches
Human potential movement
Client-Centered Therapy (Carl Rogers)
Gestalt Therapy
Term
Humanistic Therapies


Existential approaches
Definition
Emphasis on people’s ability to meet or be overwhelmed by everyday challenges
Term
Humanistic Therapies

Human potential movement
Definition
Encompasses methods to enhance the potential of the average person toward greater levels of performance and greater richness in experience
Term
Humanistic Therapies

Client-Centered Therapy. Who came up with this?
Definition
Carl Rogers
Term
Humanistic Therapies

What is the goal of Client-Centered Therapy
Definition
to promote healthy psychological growth in the individual
Term
Humanistic Therapies

Client-Centered Therapy

Begins with what?
Definition
assumption that everyone has the tendency to self-actualize

Since believed = Healthy development hindered by faulty learning patterns
Term
Humanistic Therapies

Client-Centered Therapy

Strategy for it?
Definition
Recognize, accept, and clarify a
client’s feelings

Utilized:
Unconditional positive regard!
Nondirective and empowering
Term
Humanistic Therapies

Gestalt Therapy

Who came up with it?
Definition
Fritz Perls
Term
Humanistic Therapies

Gestalt Therapy
Definition
Focus on ways to unite mind and body to make a person whole


Help clients express pent up feelings and recognize unfinished business from past conflicts
Term
Humanistic Therapies

Gestalt Therapy

Empty Chair Technique
Definition
Imagine a feeling, person, object or situation in an empty chair…then talk to “occupant” and work out feelings
Term
Group Therapy Pros (5)
Definition
Less expensive to participants

Fewer therapists can help more people

Group is less threatening for those who have problems dealing with authority

Group processes can be used to influence individual maladaptive behavior

Provides a representation of the primary family group
Term
Group Therapy Cons (2)
Definition
Can establish a culture in which little progress is made

Members leaving or joining can change effectiveness of group
Term
Group Therapy Premises (2)
Definition
Provides an opportunity to learn how one comes across to others

Provides evidence that one’s problem may not be that unique…others are dealing with something similar
Term
Group Therapy

Couple Therapy
Definition
Seeks to clarify the typical communication patterns of the partners and then to improve the quality of their interaction
Term
Group Therapy

Family therapy (2)
Definition
Client is the whole nuclear family: Each member is a member of the system

Helps them to perceive what is creating problems for one or more of them
-Recognize positive and negative aspects of their relationships
Term
Group Therapies

Community Support Groups (gives people what?)
Definition
Give people a chance to meet others with the same problems who are surviving and even thriving
Term
Group Therapies

Community Support Groups (4 Basic Areas)
Definition
Addictive behaviors

Physical and mental disorders

Life transition or other crises

Traumas experienced by friends or families of those with serious problems
Term
Group Therapies

Community Support Groups Serves these functions for members (3)
Definition
Provide a sense of hope and control

Provide social support for people’s suffering

Provide a forum for dispensing and acquiring information
Term
Biomedical Therapies

Psychopharmacology
Definition
The branch of psychology that investigates the effects of drugs on behaviors
Term
Biomedical Therapies


Antipsychotic Drugs
Definition
Alter symptoms of schizophrenia

Work by reducing the activity of dopamine in the brain
-Early drugs blocked or reduced sensitivity to dopamine receptors
-Major side effect – tardive dyskinesia

Atypical antipsychotics (newer category)
Decreases dopamine activity and increases seretonin activity
More selective, so fewer motor side effects
In general, there are effective drugs, but the side effects are usually so bad patients don’t want to stay on them…
Up to ¾ of patients go off their meds!
Term
Biomedical Therapies

Atypical antipsychotics
Definition
newer category

Decreases dopamine activity and increases seretonin actiy

More selective, so fewer motor side effects
Term
Biomedical Therapies

Antipsychotic drugs (effects on patients)
Definition
In general, there are effective drugs, but the side effects are usually so bad patients don’t want to stay on them…
-Up to ¾ of patients go off their meds!
Term
Biomedical Therapies


Antidepressant drugs (how do they work?)
Definition
Work by increasing the activity of norepinephrine and seretonin

-Tricyclics reduce the uptake (more available for longer)
SSRIs reduce uptake of seretonin

-MAOs limit the action of the substance that breaks down norepi (so more is available)
Term
Biomedical Therapies


Antidepressant drugs (side effects: 6)
Definition
nausea
dry mouth
insomnia
nervousness
memory impairments
sexual dysfunction
Term
Good News about Antidepressant drugs and side effects
Definition
New class (SNRIs) may not have as many side effects
Term
Biomedical Therapies

Antianxiety drugs (3)
Definition
GAD best treated with benzodiazapine
-Increases activity of GABA

Panic disorders treated with antidepressants

OCD responds well to SSRIs
Term
Biomedical Therapies

Psychosurgery: Prefontal Lobotomy
Definition
New personality minus intense emotional arousal

Inability to plan ahead, indifference to opinions of others, childlike actions, intellectual and emotional flatness
Term
Biomedical Therapies

Psychosurgery:
Electroconvulsive therapy (ECT)
Definition
The use of electric shock to the brain to treat psychiatric disorders
-75-100 volts applied to temples for 1/10 – 1 second until a convulsion occurs (typically lasts 45-60 sec.)
-Prepared by sedation with short-acting barbiturate and muscle relaxant

Symptoms of depression alleviated in 3-4 days, but used as a last resort
-Unease comes from lack of understanding, and potential side effects
Term
Biomedical Therapies

Psychosurgery: Repetitive transcranial magnetic stimulation (rTMS)
Definition
Alternative to ECT…seems to be just as effective, not sure why it works
Term
Evaluating Therapeutic Effectiveness

Does it work?
Definition
Honestly, not always clear…
Term
Evaluating Therapeutic Effectiveness


Spontaneous-remission effect
Definition
Some percentage of individuals recover with no professional intervention
Term
Evaluating Therapeutic Effectiveness

Meta-Analysis
Definition
A statistical technique that allows researchers to summarize results from many experiments
Term
(T/F) We are more concerned now about whether psychotherapy works, instead of why it works and which methods would be more effective
Definition
False. Other way around
Term
What is probably the most effective form of treatment concerning therapies?
Definition
Combinations of therapies! Yay!
Term
Prevention Strategies

Primary Prevention
Definition
seeks to prevent a condition before it begins
Ex. Providing coping skills
Term
Prevention Strategies

Secondary prevention
Definition
attempts to limit duration and severity of a disorder once it has begun
Ex. Early identification and treatment
Term
Prevention Strategies

Tertiary prevention
Definition
limits long-term impact by preventing a relapse
Ex. Keeping schizophrenic patients on their medications
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