22. Psychotherapy

Question 1

Medical therapeutics include what?

Answer 1

medications, psychological treatments, procedures (surgery, ECT, etc).

Question 2

what do psychiatric interventions include?

Answer 2

medications and psychological treatments.

Question 3

for what illnesses is medication the foundation of therapy? for what illnesses is psychological treatment the foundation?

Answer 3

meds: psychotic disorders

both/psycho: major depression, panic

Question 4

most counseling focuses on what?

Answer 4

some aspect of change

Question 5

what are cahracteristics of a helpful counselor?

Answer 5

• demonstrates empathy
• consistently supportive
• provides explanations
• provides coping strategies
• confidentiality
• maintains boundaries

Question 6

Supportive Therapy: what is emphasis?

Answer 6

support and strengthen existing behaviors, incl coping mechanisms. includes crisis intervention, support groups, individual support

Question 7

Expressive Therapy: what is emphasis?

Answer 7

more exploratory, focus on developing insight. includes psychoanalysis, psychodynamic therapy

Question 8

Behavior Therapy: what is emphasis?

Answer 8

focus on changing behaviors rather than understanding the problem. relaxation training, social skills, exposure therapy

Question 9

Cognitive Therapy: what is emphasis?

Answer 9

focus on changing cognitions that contribute to problems. relies on linkage between cognitions, behaviors, emotions.

Question 10

how does therapy help?

Answer 10

thought to harness neuroplasticity, change abnormal brain structures and functions.

Question 11

what are the concepts that drive Behavior Therapy?

Answer 11

classical and operant conditioning.

Question 12

classical conditioning?

Answer 12

stimulus pairing. can explain development of pathology.

Question 13

operant conditioning?

Answer 13

behavior shaped by reinforcement, positive or negative.

Question 14

what is a cornerstone of behavioral change techniques?

Answer 14

self-monitoring in a systematic manner.

Question 15

several effective types of behavioral techniques?

Answer 15

• relaxation training
• social skills training
• contingency management
• exposure

Question 16

Theory behind CBT?

Answer 16

cognitive factors are related to dysfunctional behaviors and uncomfortable emotions. modifying thoughts will lead to changes in behavior and emotion.

Question 17

what is the sequence of events in CBT?

Answer 17

identify automatic thoughts, replace maladaptive thoughts with more realistic ones. same with schemata that are maladaptive.

Question 18

types of dysfunctional thinking?

Answer 18

• all or none
• overgeneralization
• catastrophizing
• emotional reasoning
• fortune telling
• labeling

Question 19

ways to challenge the thoughts?

Answer 19

-identify the distortion
-examine the evidence
-think in shades of grey
-double standard (would you say it to a friend)
-experimental technique (test the thought)
-semantic method (be extremely specific and exact)
-

Question 20

Which brain areas change in response to therapy?

Answer 20

Prefrontal cortex: with therapy, should increase activity.

amygdala: with therapy, should decr activity or be moderated by PFC.

Question 21

what area of the brain handles problem solving?

Answer 21

dorsolateral prefrontal cortex. can inc executive functioning, incl working memory and cognitive flexibility.

Question 22

what area of the brain handles perspective on self and others?

Answer 22

anterior cingulate cortex, precuneus.

Question 23

what area of the brain regulates distressing affective states/do emotional processing?

Answer 23

insular cortex, amygdala, many areas of cortex.

Question 24

what is a behavior that will increase future anxiety? decrease future anxiety?

Answer 24

inc: avoidance
decr: exposure

Question 25

define transference

Answer 25

our expectation of how we should be treated by others is based on how we were treated as children

Question 26

what are Behavior Therapies particularly useful for?

Answer 26

illnesses where behavior is the primary problem: eating disorders, OCD

Question 27

why does Behavioral Therapy include social skills training?

Answer 27

social skills are necessary for reinforcing activities that help in recovery from mood, anxiety, schizophrenia

Question 28

what is contingency management? example?

Answer 28

positive reward for a behavior that is incompatible with the problem behavior. example: drug free urine sample.

Question 29

What is Exposure therapy useful for?

Answer 29

Phobias, PTSD

Question 30

Behavior therapy causes lasting brain changes where?

Answer 30

normalized overactivity in amygdala, lateral orbitofrontal cortex as emotion-related learning takes place.

Question 31

what are the ABCs of CBT?

Answer 31

actual event/antecedent
behavior/automatic thought
consequences (may be depressed mood, tension)

Question 32

what is cognitive restructuring?

Answer 32

replacing maladaptive thoughts with more realistic one

Question 33

in depressed patients, what does the amygdala do?

Answer 33

increased/unregulated activity. processes emptional aspect of information, generates emotional reactions. projects to cortical/subcortical regions including hippocampus

Question 34

in depressed patients, what does the prefrontal cortex do?

Answer 34

decreased activity during emotion-information processing tasks. usually inhibits limbic system, dampens emotional reactivity.