1.3 Integrate knowledge of comparative psychotherapy relevant to practice Flashcards
Recognize the major diagnostic categories in current use.
What are the 7 types of mental disorders?
Some of the main groups of mental disorders are:
mood disorders (such as depression or bipolar disorder)
anxiety disorders.
personality disorders.
psychotic disorders (such as schizophrenia)
eating disorders.
trauma-related disorders (such as post-traumatic stress disorder)
substance abuse disorders.
Recognize the major classes of psychoactive drugs & their effects.
Drug Classifications
Drugs are classified according to their common effects and actions on the mind and body. Click on the following links for more information.
Depressants
Hallucinogens
Opiates
Stimulants
Depressants
Depressants slow normal brain function. Because of this effect, depressants are often used to treat anxiety and sleep disorders.
Although the different depressant drugs work uniquely in the brain, it is through their effect on GABA activity that produces a drowsy or calming effect. GABA works to decrease brain activity.
Despite their prescription for treatment of anxiety and sleep disorders, depressants also carry high addictive potential. The withdrawal effects from long-term depressant use can be life-threatening and produce some of the worst consequences of any other drug classifications. Keep in mind: this includes alcohol.
Examples include: alcohol, Valium, Xanax, Librium, and barbiturates.
Hallucinogens
Hallucinogens are drugs which cause altered perception and feeling. Hallucinogens have powerful mind-altering effects and can change how the brain perceives time, everyday reality, and the surrounding environment. They affect regions of the brain that are responsible for coordination, thought processes, hearing, and sight. They can cause people to hear voices, see things, and feel sensations that do not exist.
Hallucinogens change the way the brain works by changing the way nerve cells communicate with one another. Click here for more information about how the brain is impacted by hallucinogen use.
Hallucinogens possess a moderate potential for addiction with very high potential for tolerance, moderate level of psychological dependence, and low potential for physical dependence. Most of the risks associated with hallucinogen use are associated with the risk for personal injury and life-threatening accidents.
Examples include: LSD, PCP, MDMA (Ecstasy), marijuana, mescaline, and psilocybin.
Opiates
Opiates are powerful painkillers. They are made from opium, a white liquid in the poppy plant. Opiates produce a quick, intense feeling of pleasure followed by a sense of well-being and calm.
Long-term opiate use changes the way the brain works by changing the way nerve cells communicate with one another. If opiates are taken away from opiate-dependent brain cells, many of them will become overactive. Eventually, cells will work normally again if the person recovers, but they cause wide range of withdrawal symptoms that affect the mind and the body.
As with many other drugs, opiates possess very high addictive potential.
Examples include: heroin, morphine, codeine, and Oxycontin.
Stimulants Stimulants are a class of drugs that elevate mood, increase feelings of well-being, and increase energy and alertness. Stimulants can cause the heart to beat faster and will also cause blood pressure and breathing to elevate. Repeated use of stimulants can result in paranoia and hostility.
Stimulants change the way the brain works by changing the way nerve cells communicate with one another. Click here for more information about how the brain is impacted by stimulant use.
As with many other drugs, stimulants possess very high addictive potential.
Examples include: cocaine, methamphetamine, amphetamine, MDMA (Ecstasy), nicotine, and caffeine.
Recognize the benefits, limitations & contraindications of differing psychotherapeutic approaches.
Psychologists generally draw on one or more theories of psychotherapy.
A theory of psychotherapy acts as a roadmap for psychologists: It guides them through the process of understanding clients and their problems and developing solutions.
Approaches to psychotherapy fall into five broad categories:
Psychoanalysis and psychodynamic therapies. This approach focuses on changing problematic behaviors, feelings, and thoughts by discovering their unconscious meanings and motivations. Psychoanalytically oriented therapies are characterized by a close working partnership between therapist and patient. Patients learn about themselves by exploring their interactions in the therapeutic relationship. While psychoanalysis is closely identified with Sigmund Freud, it has been extended and modified since his early formulations. Behavior therapy. This approach focuses on learning’s role in developing both normal and abnormal behaviors.
Ivan Pavlov made important contributions to behavior therapy by discovering classical conditioning, or associative learning. Pavlov’s famous dogs, for example, began drooling when they heard their dinner bell, because they associated the sound with food. “Desensitizing” is classical conditioning in action: A therapist might help a client with a phobia through repeated exposure to whatever it is that causes anxiety. Another important thinker was E.L. Thorndike, who discovered operant conditioning. This type of learning relies on rewards and punishments to shape people’s behavior. Several variations have developed since behavior therapy’s emergence in the 1950s. One variation is cognitive-behavioral therapy, which focuses on both thoughts and behaviors.
Cognitive therapy. Cognitive therapy emphasizes what people think rather than what they do.
Cognitive therapists believe that it’s dysfunctional thinking that leads to dysfunctional emotions or behaviors. By changing their thoughts, people can change how they feel and what they do. Major figures in cognitive therapy include Albert Ellis and Aaron Beck.
Humanistic therapy. This approach emphasizes people’s capacity to make rational choices and develop to their maximum potential. Concern and respect for others are also important themes.
Humanistic philosophers like Jean-Paul Sartre, Martin Buber and Søren Kierkegaard influenced this type of therapy. Three types of humanistic therapy are especially influential. Client-centered therapy rejects the idea of therapists as authorities on their clients’ inner experiences. Instead, therapists help clients change by emphasizing their concern, care and interest. Gestalt therapy emphasizes what it calls “organismic holism,” the importance of being aware of the here and now and accepting responsibility for yourself. Existential therapy focuses on free will, self-determination and the search for meaning.
Integrative or holistic therapy. Many therapists don’t tie themselves to any one approach. Instead, they blend elements from different approaches and tailor their treatment according to each client’s needs.
Art therapy
Internalize cognitive changes. Clients may understand on a cognitive level when thoughts are irrational, but not actually feel better because of it. Imagery can help a person accept new, adaptive thoughts on an emotional level.
Decrease uncomfortable emotions. Distressing images may trigger or maintain uncomfortable emotions. Imagery techniques can lessen the intensity of the images and associated emotions.
Decatastrophize. Many images involve worst-case scenarios. Imagery techniques can help clients imagine more likely outcomes.
Increase adaptive behaviors. Imagery allows clients to visualize using adaptive behaviors, such as coping skills, to work through difficult emotions or situations. This increases the likelihood of using these behaviors.
Respond appropriately to a situation. Imagery allows clients to “test out” different behaviors and identify better possible responses to a situation.
When Therapy Does More Harm Than Good
Woody Schuldt, LMHC
Before being used for treatment, medicines undergo years of testing. In the United States, the Food and Drug administration requires several levels of research that investigate the effectiveness and the potential harm of a new drug. Traditionally, therapy has not been held to these same standards. While tests of psychotherapy efficacy are common, studies of the dangers are rare.
Despite the recent push for empirically supported therapies, clinicians still have the ability to apply treatments with little or no scientific basis. Research of psychotherapy rarely examines what doesn’t work, and more importantly, what might hurt. In a 2007 paper, Scott O. Lilienfeld tackled this problem by asking the question: “What psychological treatments cause harm?” Below are some of his findings.
Outcome studies of psychotherapy indicate that 3 to 10% of clients actually fare worse after treatment. In substance abuse treatment, these numbers are as high as 10 to 15%. These harmful effects include the worsening of symptoms, dependency on the therapist, the development of new symptoms, and a reluctance to seek future treatment.
Crisis Counseling (Sometimes) Interventions immediately following a traumatic event frequently do the exact opposite of what is intended–they increase the likelihood of a client developing symptoms of PTSD. During crisis counseling clients are often asked to "process" their emotions, which may result in over-focusing on the negative and dramaticizing the events. Even when clients report that the intervention has been helpful, objective measures indicate a worsening of symptoms.
Recovered Memory Techniques
Hypnosis, guided imagery, and the repeated questioning of memories may result in the development of false memories. In several high-profile cases clients have unintentionally created false memories of traumatic sexual abuse and even alien abductions. Other consequences of these treatments have included significant increases in suicidal ideation and psychiatric hospitalizations.
Dissociative Identity Disorder (DID)-Oriented Psychotherapy
In DID-oriented therapy clients are asked to bring forward their many different personalities. Hypnosis and other techniques are sometimes used to allow each personality to meet, and clients are encouraged to leave messages to be shared between personalities. Unfortunately, research indicates that these techniques may result in the development of additional new personalities. Additionally, some clients experience symptoms such as suicidal ideation and self-harm only when they have taken on alternative personalities.
Grief Counseling for Normal Bereavement
Studies indicate that therapy for grief should be reserved for cases of long lasting grief and grief triggered by sudden or unexpected deaths. In cases of regular grief, therapy has been found to result in negative outcomes for about half of all participants.
Expressive-Experiential Therapies
Treatments that focus on experiencing or releasing powerful emotions can be helpful for some, but harmful for others. This form of emotional catharsis has been found to result in an increase of negative emotion rather than a reduction. These findings are similar to those indicating that catharsis for anger, such as punching a pillow, results in even more anger.
Other Harmful Treatments
DARE Programs: Children are taught by uniformed police officers about the dangers of drugs. Studies indicate that these programs are completely ineffective and may even increase experimentation with alcohol and other drugs.
“Scared Straight” Programs: At-risk youths are exposed to prisons in an attempt to scare them away from committing crimes. Participants in these programs are more likely to offend in the future.
Boot Camps for Conduct Disorder: Adolescents are taught to respect authority in military-style boot camps. Boot camps have been found to have no significant effect on behavior.
Relaxation for Panic-Prone Clients: Because of a heightened focus on bodily sensations, some panic-prone clients can experience panic attacks as a result of relaxation techniques.
