22. Psychotherapy Flashcards
Medical therapeutics include what?
medications, psychological treatments, procedures (surgery, ECT, etc).
what do psychiatric interventions include?
medications and psychological treatments.
for what illnesses is medication the foundation of therapy? for what illnesses is psychological treatment the foundation?
meds: psychotic disorders
both/psycho: major depression, panic
most counseling focuses on what?
some aspect of change
what are cahracteristics of a helpful counselor?
- demonstrates empathy
- consistently supportive
- provides explanations
- provides coping strategies
- confidentiality
- maintains boundaries
Supportive Therapy: what is emphasis?
support and strengthen existing behaviors, incl coping mechanisms. includes crisis intervention, support groups, individual support
Expressive Therapy: what is emphasis?
more exploratory, focus on developing insight. includes psychoanalysis, psychodynamic therapy
Behavior Therapy: what is emphasis?
focus on changing behaviors rather than understanding the problem. relaxation training, social skills, exposure therapy
Cognitive Therapy: what is emphasis?
focus on changing cognitions that contribute to problems. relies on linkage between cognitions, behaviors, emotions.
how does therapy help?
thought to harness neuroplasticity, change abnormal brain structures and functions.
what are the concepts that drive Behavior Therapy?
classical and operant conditioning.
classical conditioning?
stimulus pairing. can explain development of pathology.
operant conditioning?
behavior shaped by reinforcement, positive or negative.
what is a cornerstone of behavioral change techniques?
self-monitoring in a systematic manner.
several effective types of behavioral techniques?
- relaxation training
- social skills training
- contingency management
- exposure
Theory behind CBT?
cognitive factors are related to dysfunctional behaviors and uncomfortable emotions. modifying thoughts will lead to changes in behavior and emotion.
what is the sequence of events in CBT?
identify automatic thoughts, replace maladaptive thoughts with more realistic ones. same with schemata that are maladaptive.
types of dysfunctional thinking?
- all or none
- overgeneralization
- catastrophizing
- emotional reasoning
- fortune telling
- labeling
ways to challenge the thoughts?
-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)
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Which brain areas change in response to therapy?
Prefrontal cortex: with therapy, should increase activity.
amygdala: with therapy, should decr activity or be moderated by PFC.
what area of the brain handles problem solving?
dorsolateral prefrontal cortex. can inc executive functioning, incl working memory and cognitive flexibility.
what area of the brain handles perspective on self and others?
anterior cingulate cortex, precuneus.
what area of the brain regulates distressing affective states/do emotional processing?
insular cortex, amygdala, many areas of cortex.
what is a behavior that will increase future anxiety? decrease future anxiety?
inc: avoidance
decr: exposure
define transference
our expectation of how we should be treated by others is based on how we were treated as children
what are Behavior Therapies particularly useful for?
illnesses where behavior is the primary problem: eating disorders, OCD
why does Behavioral Therapy include social skills training?
social skills are necessary for reinforcing activities that help in recovery from mood, anxiety, schizophrenia
what is contingency management? example?
positive reward for a behavior that is incompatible with the problem behavior. example: drug free urine sample.
What is Exposure therapy useful for?
Phobias, PTSD
Behavior therapy causes lasting brain changes where?
normalized overactivity in amygdala, lateral orbitofrontal cortex as emotion-related learning takes place.
what are the ABCs of CBT?
actual event/antecedent
behavior/automatic thought
consequences (may be depressed mood, tension)
what is cognitive restructuring?
replacing maladaptive thoughts with more realistic one
in depressed patients, what does the amygdala do?
increased/unregulated activity. processes emptional aspect of information, generates emotional reactions. projects to cortical/subcortical regions including hippocampus
in depressed patients, what does the prefrontal cortex do?
decreased activity during emotion-information processing tasks. usually inhibits limbic system, dampens emotional reactivity.
