6. Chapter 16- Treatment and Therapy

Question 1

What are the 4 classes of drugs used for mental disorders?

Answer 1

1. Antipsychotic drugs- used for schizophrenia and other psychoses, increasingly being used to treat non psychotic disorders (severe depression, bipolar, ADD) and are ineffective for these disorders (mostly used off label and inappropriately)
2. Antidepressant drugs- used for depression, anxiety, phobias, and obsessive-compulsive disorder. Monoamine oxidase inhibitors (MOIs) lift levels of norepinephrine and serotonin (block enzyme that deactivates them)
   Tricyclic antidepressants boost norepinephrine and serotonin levels (prevent reabsorption)
   Selective serotonin reuptake inhibitors (SSRIs) target serotonin
3. Anti-anxiety drugs (tranquilizers)- increase activity of neurotransmitter gamma-aminobutyric acid (GABA), also over prescribed for mood disorders, can help with panic disorders and acute anxiety attacks but do not treat over long period of time
4. Lithium Carbonate- special category of drug that often helps people who suffer from bipolar disorder, moderates levels of norepinephrine or protects brain cells from being over stimulated by glutamate

Question 2

What is the placebo effect?

Answer 2

The apparent success of a medication or treatment due to the patients expectations or hopes than rather to the drug or treatment itself
People responding positively to a new drug just because of the enthusiasm behind it

Question 3

What is the therapeutic window?

Answer 3

The amount of a drug that is enough but not too much
Taking into account the fact that the same dose of a drug may be metabolized differently in men and women, old people and young people, and different ethnic groups

Question 4

What a re the 6 things you dont hear about drug usage for disorders?

Answer 4

1. Placebo effect
2. High relapse and dropout rates- person Amy have short term success with an antipsychotic or antidepressant
3. Dosage problems- therapeutic index
4. Disregard for effective, possibly better, non medical treatments- ads can make you think medical methods are much more powerful than non medical methods
5. Unknown long term risks- drugs aren’t tested for years and years before release
6. Untested off-label uses

Question 5

What is psychosurgery?

Answer 5

Any surgical procedure that destroys selected areas of the brain believed to be involved in emotional disorders or violent, impulsive behaviour

Question 6

What is electroconvulsive therapy (ECT)?

What is transcranial magnetic stimulation (TMS)?

Answer 6

“Shock therapy”
A procedure used in cases of prolonged and severe major depression, in which a brief brain seizure is induced

TMS is the use of a pulsing magnetic coil held to a persons skull over the left prefrontal cortex, this part of brain is less active with people with depression and repeated TMS seems to give it a boost

Question 7

What is free association?

What is depth therapies?

Answer 7

Free association is where the client lies on a sofa, with he analyst sitting out of view and says whatever comes to mind without censoring
The analyst rarely comments, no rush to solve the problem, could take years

Depth therapies are therapies that delve into the deep, unconscious processes believed to be the source of the patients problems
Rather than concentrate on superficial symptoms and conscious beliefs
Psychodynamic therapy

Question 8

What is transference? (In psychodynamic therapies)

Answer 8

A critical process in psychodynamic therapies in which the client transfers unconscious emotions or reactions, such as emotional feelings about his or her parents, onto the therapist

When you realized you like or dislike someone really fast cause they remind you of someone in your life

Question 9

What is behaviour therapy?

What are its 4 methods?

Answer 9

A fork of therapy that applies principles of classical and operant conditioning to help people change self-defeating or problematic behaviours
1. Exposure- gradual exposure to a fear someone Amy have to help fix it instead of them avoiding it and making it worse
Flooding takes client directly into the fear situation and stay there until the stress and anxiety decline
2. Systematic desensitization- olde behavioural method in which a clients conditioned associations with a feared object or experience are broken down, stimulus (dog) for an unwanted response (fear) is paired with some other stimulus or situation that elicits a response incompatible with an undesired one (relaxation)
3. Behavioural self-monitoring- client keeps record of the behaviour that he or she wishes to change, once unwanted behaviour is identified with reinforcers that maintain it, a treatment can be developed
4. Skills training- teaching parents how to discipline their children, impulsive adults how to manage anger, and people with schizophrenia how to get along in the world

Question 10

What is cognitive therapy?

Answer 10

A form of therapy designed to identify and change irrational, unproductive, ways of thinking and to reduce negative emotions
Therapists help identify the beliefs and expectations that might be unnecessarily prolonging their unhappiness, conflicts and other problems

Question 11

What is rational emotive behaviour therapy (REBT)?

Answer 11

A form of cognitive therapy devised by Albert Ellis, designed to challenge the clients unrealistic thoughts
Uses rational arguments to directly challenge a clients unrealistic beliefs or expectations

Question 12

What is overgeneralizing and catastrophizing?

Answer 12

Overgeneralizing- decide that one annoying act by someone means that person is totally bad in every way, or that a normal mistake they made is evidence that they are rotten to the core
Catastrophizing- transforming a small problem into a disaster
“I failed this test, and now I’ll link out of school, and no one will ever like me, and my cat will hate me” etc.

Question 13

What are the 3 phases of the stress inoculation training?

Answer 13

1. Education phase- individual is taught about the nature of anxiety, and client and therapist work together to identify situations that generate anxiety for the client
2. Rehearsal phase- the person is taught how to better manage anxiety, and practices being exposed to threatening situations
3. Implementation phase- client delays with anxiety-provoking stimuli in real-world situations

Question 14

What is humanist therapy?

Answer 14

A form of psychotherapy based on the philosophy of humanism, which emphasizes the clients free will to change rather than past conflicts
Starts from assumption that human nature is basically good and people behave badly or develop problems when they are warped by self-imposed limits

Question 15

What is client-centred (nondirective) therapy?

Answer 15

A humanist approach, devised by Carl Rogers, which emphasizes the therapists empathy with the client and the use of unconditional positive regard
Listens to clients needs in an accepting, non judgemental way

Question 16

What is existential therapy?

Answer 16

A form of therapy designed to help clients explore the meaning of existence and face the great questions of life: such as death, freedom, alienation, and loneliness
Believe we have the power to choose our own destinies

Question 17

What is family systems perspective?

Answer 17

An approach to doing therapy with individuals or families by identifying how each family member forms part of a larger interacting system
If one family members changes, the whole family changes too

Question 18

What is therapeutic alliance?

Answer 18

The bond of confidence and mutual understanding established between therapist and client, which allows them to work together to solve the clients problems

Question 19

What is eye movement desensitization and reprocessing (EDMR)?

Answer 19

Clients move their eyes from side to side, following the therapists moving finger, while concentrating on the memory to be desensitized
Built on the tried-and-true behavioural techniques of desensitization and exposure for treating anxiety

Question 20

What are randomized controlled trials?

Answer 20

Research designed to determine the effectiveness of a new medication or form of therapy in which people with a given problem or disorder are randomly assigned to one or more treatment groups or to a control group

Question 21

What is critical incident stress debriefing (CISD)?

Answer 21

Survivors gather in a group for “debriefing”
Lasts 1-3 hours
Participants are expected to disclose their thoughts and emotions about the traumatic experience

*Shown to make recovering longer and doesn’t help survivors

Question 22

What are the methods of therapy for:
Depression
Prevention of suicide
Anxiety disorders
Anger and impulsive violence
Health problems
Childhood and adolescent behaviour problems
Relapse prevention

Answer 22

Depression- cognitive therapy big success
Prevention of suicide- those who had cognitive therapy were half as likely to attempt suicide again
Anxiety disorders- exposure techniques are most effective for post traumatic stress disorder, etc. Cognitive-behaviour therapy is often more effective than meds for panic disorder, generalized anxiety, etc
Anger and impulsive violence- cognitive therapy reduces anger and abusiveness
Health problems- cognitive and behavioural therapies are highly successful in coping with pain, headaches, etc
Childhood and adolescent behaviour- behaviour therapy is most successful from be whetting to impulsive anger
Relapse prevention- cognitive-behaviour approaches are highly effective in reducing rate of relapse

Question 23

What is multisystemic therapy (MST)?

Answer 23

Believes that because aggressiveness and drug abuse are often reinforced or caused by the adolescents family, classroom, peers, you can’t successfully treat the adolescents without also treating their environment
Highly successful in reducing teenage violence, criminal activity, drug abuse and school problems

Question 24

What are the 4 situations in which the clients risks increase?

Answer 24

1. The use of empirically unsupported, potentially dangerous techniques
2. Inappropriately coercive influence, which can create new problems for the client
3. Prejudice or cultural ignorance on the part of the therapist- some therapists may subconsciously try to convert the client to their values and beliefs
4. Sexual intimacies or other unethical behaviour on the part of the therapist

Question 25

What are the 3 things you should consider when thinking about psychotherapy?

Answer 25

1. Choosing a therapist- appropriate credentials and training
2. Choosing a therapy- not all therapies are equally effective for all problems
   Ex: don’t spend 4 years in psychodynamic therapy for panic attacks when a few sessions of cognitive-behaviour therapy will fix
3. Deciding when to leave- for common emotional problems in life, short-term treatment is sufficient