Chapter 12 Flashcards
What is Psychoanalysis?
an Insight-Oriented Therapy
First use of a “talking cure”
Developed by Sigmund Freud
- anna o, starts talking about symptoms/issues and they suddently go away
Identify unconscious motivations—why is it that we do the things that we do??
what are key characteristics in Psychoanalysis?
Free association - patient lies down and away from the dr. has them tell them the first thing that pops into their head
Dream analysis—freud says that all dreams have meaning
- the royal road to the unconscious
- Wish fulfillment
- Unveiling the defense mechanisms
- Resistance—patient refuses to cooperate
- Interpretation
- Transference - ie repressed sexual urges for father transferred onto freud
freud says that dreams are our way of fullfilling our dangerous wishes (affair or killing someone)
in dream interpretation what does nakedness tell us?
Shame about a behavior or trait
in dream interpretation what do snakes tell us?
Represents the unconscious
Period of transition in life
Phallic
in dream interpretation what do tunnels tell us?
Need for security and nurturing
Represents the vagina, birth or the womb
in dream interpretation what do nightmares tell us?
Too much indulgence and need to slow down and heal
in dream interpretation what does being chased tell us?
A setback toward your goal
Threatening
Running away from rather than confronting a problem
The “chaser” may represent the self
in dream interpretation what does flying tell us?
Personal sense of power or control
Problems with flight means lack of control
what is psychodynamic therapy?
Similar to psychoanalytic therapy
Less frequent sessions
- Psychoanalysis—4-5 times/week for 4 years or more
- Psychodynamic—1 or 2 visits / week for as little as 12 visits
Less emphasis on sexual and aggressive drives
what is humanistic therapy?
Carl Rogers developed this therapy
also called Client-centered therapy
Incongruence
help to identify the patients
-Real self (ego)
-Ideal self (super ego)
what are Client-centered therapy techniques?
Reflection
Empathy means to put yourself in someone elses shoes)
Unconditional positive regard
what are some assessments of Insight-Oriented Therapies?
Difficult to evaluate
Who benefits from them?
Healthy
Articulate
Interested in motives
what is behavior therapy?
A type of therapy based on learning (both classical- and operant-conditioning principles) that focuses on changing observable, measurable behaviors
what are the ABC’s of behavior therapy?
Antecedents—what precedes or triggers a behavior (I am afraid I won’t be able to do calculus)
Behavior—the maladaptive reaction to the trigger (skip calculus because cannot do inferential calculus)
Consequences—fail calculus
Counter-conditioning—pairs the trigger with a new response (get a tutor, study harder, visit professor)
what are the classical conditional based behavior therapy techniques?
Exposure (often used for anxiety disorders)
- Imaginable exposure—imagine a spider crawling on your hand
- In vivo exposure—actually have a spider crawl on your hand
- Virtual reality exposure (people with fear of flight put into simulation)
Stimulus control—one beer instead of 20
Systematic desensitization—cannot be fearful
and relaxed at the same time
-Progressive muscle relaxation (common in yoga practices (lie down and relax all muscles)
-Then contact with the feared object
what are the operant conditional based behavior therapy techniques?
Behavior modification
-Reinforcement, extinction and punishment (drugs for alcohol aversion)
Token economies
- Used with mentally handicapped
- Coprophagia in institutions
Self-monitoring techniques
what other behavior therapy techniques are there other than operant and classical conditional based techniques?
Observational learning
what is cognitive therapy?
Beck
A type of therapy that focuses on realistic and rational thoughts rather than on their feelings or behaviors
what are cognitive distortions that are common in cognitive therapy?
Dichotomous thinking - black and white only ,either you are great or awful nothing in the middle
Mental filter - only think about bad and filter out good
Mind reading - they know what the other person is thinking (about them)
Catastrophic exaggeration - if I don’t “x” my world will end
Control beliefs - either everything is out of your control of that you must control your life completely or lose control forever
what is pyschoeducation as it relates to cognitive therapy?
teach patient to act more rationally
what is Albert Ellis’s rational emotive behavior therapy (REBT)?
Healthy function interrupted by
- self-downing
- Hostility and rage toward others’ poor -performance
- Low frustration tolerance—blaming everything and everyone for problems
what is are the ABC’s of REBT?
it’s actually ABCDEF!
Activating event + Beliefs = Consequences (anxiety, for example) Dispute of the irrational belief causes Effect of a new philosophy, and with Further action the new, rational belief takes hold
what are beck’s cognitive therapy techniques?
Cognitive restructuring—shifts away from automatic thinking to more rational thinking
Daily record of dysfunctional beliefs
Identify automatic thoughts
Identify rational rather than irrational responses
when cognitive therapy is used to treat depression what result does it have?
cognitive training patients are much less depressed
what is the focus, goal and techniques associated with behavioral therapy?
focus: Maladaptive behavior
goal: Change the behavior, its antecedents or its consequences
techniques:Progressive relaxation; systematic desensitization;
Exposure techniques;
Stimulus control;
Behavior modification
what is the focus, goal and techniques associated with Cognitive Therapy?
focus: Automatic thinking; cognitive distortions;
Faulty beliefs and irrational thoughts
goal:Change dysfunctional and unrealistic thinking to more rational thinking;
Recognize the continuum of relationships in thinking, behaviors and feelings
techniques:Use of the ABCDEF technique;
Psycho-education;
Role-playing
what are the different types of Biomedical Therapies used to treat psychological conditions?
Psychopharmacology
- Antipsychotic or neuroleptic drugs
- good for treating bipolar disorder
Electroconvulsive therapy (also known as electroshock therapy)
Transcranial magnetic stimulation
what are the different types of Psychopharmacology used to treat Schizophrenia?
Antipsychotic (neuroleptic) medications—thorazine (first generation antipsychotics)
- Target positive symptoms
- Tardive dyskinesia a consequence (uncontrollable shaking)
Atypical antipsychotics (second generation antipsychotics like Risperdal)
- Newer
- Target both the positive and the negative symptoms
- Reduces amount of dopamine in the brain
Early treatment (men 17-25 are the most common group, typically they live in urban/poor areas)
introduction of drugs to treat Schizophrenia created a rapid decline in state and county mental hospital populations
what are the different types of Psychopharmacology used to treat Mood Disorders?
Tricyclic antidepressants (TCAs)—the first effective treatment for depression
Monoamine oxidase inhibitors (MAOIs)
interactions with tyramine (in cheeses and wine)
Selective serotonin reuptake inhibitors (SSRIs)
- Prozac, Zoloft, Paxil
- side effects - insomnia, sexual disfunction (less or more)
Serotonin (SSRIs) /norepinephrine reuptake
inhibitors (SNRIs)
-Serzone, Effexor
- helps by blocking of reuptake
St. John’s wort—as effective as SSRIs in studies
- homeopathic (not FDA approved or monitored)
Lithium
- used for bipolar disorder,
- treats positive/manic symptoms
what are the positive and negative symptoms of Schizophrenia?
positive - delusions, hallucinations (auditory),
negative - catatonia
what are the different types of Psychopharmacology used to treat anxiety disorders?
Benzodiazepines
- Xanax, Valium
- Often for short periods because it’s very addictive
- Can have fatal reaction when taken with alcohol
Antidepressants
- TCAs
- SSRIs
- SNRIs
what are some characteristics of Electroconvulsive Therapy (ECT)?
Used when medication and therapy are ineffective
Effective treatment for MDD (Depression)
Fell out of favor in 1940;s because it was overused/abused, used to keep people docile.
Abuse
Regaining popularity
Memory loss - anterior grade amnesia
used to help treat major depresive disorder
don’t really know why it works. thought is that it’s like restarting a computer
- stimulates cell growth - increase in neurons
what are some characteristics of Transcranial Magnetic Stimulation (TMS)?
Relatively new technique
100- to 200- (microsecond is 10-6 s) microsecond bursts of high-intensity magnetism
May replace ECT
- it’s available in dr office
used for depression and addictions
rearranges molefules in cortex - can specify a very specific part of the brain to treat
what type of training does a counselor have?
marriage and family counselor
specialize in problems arising from family relations
pastoral counselors provide counseling to countless people
abusers and spouse and child abusers and their victims
what type of training does a clinical or psychiatric social worker have?
2 year master of social work graduate program plus post graduate supervision prepares some social workers to offer psychotheraphy, mostly to people with everyday personal and family problems. about half have earned the national association of social workers designation of clinical social worker
what type of training does a clinical psychologist have?
most psychologists with a PHD or PsyD and expertise in research, assessment and therapy, supplemented by a supervised internship and often post-doctoral training. About half work in agencies and institutions, half in private practice.
what type of training does a psychiatrist have?
psychiatrists are physicians who specialize in the treatment of psychological disorders. not all psychiatrists have had extensive training in psychotherapy but as an MD they can prescribe medications. this they tend to see those with the most serious problems. many have their own private practice.
what are some other modalities we learned in treatment of psychological disorders?
Individual therapy
Group therapy
Family therapy
- Systems therapy
- -Reframing—new way of conceptualizing a problem
- -Validation—therapist acknowledges the clients’ feelings
Self-help therapies
- Support groups
- -Alcoholics Anonymous
- -No clinically trained group leader
- Bibliotherapy (self help books)
what are some of the innovations in psychotherapy?
Psychotherapy integration
-Technical eclecticism
Managed care
-Financial concerns (psychoanalysis takes 4 yrs min to treat)
Therapy protocols
- Guidelines for each session
- Addresses common disorders systematically
Brief therapy (12 to 20 sessions start to finish)
Cybertherapy
how can we prevent psychological disorders?
Universal preventive interventions
-Target all members of a group (all 17 yrs old high school boys in urban areas)
Selective preventive interventions
-Target high-risk subgroups (women for MDD)
Indicated preventive interventions
-Target those with symptoms but not disorder
what are some of the challenges in research of psychotherapy?
Common factors—talking about emotions is cathartic and suggests better health long-term
- but men don’t like to talk about problems
Allegiance effect
- Cognitive Behavioral therapy is well thought of now but new treatments might come out later and psychologists might be stuck in their ways and not try
Control group
Confounds
what types of treatments lead to successful intervention?
biological considerations, psychological considerations, and social-cultural considerations
