Chapter 15

Question 1

Exposure and response prevention (ERP)

Answer 1

people are gradually exposed to the content of their obsessions and prevented from engaging in their compulsions. For OCD.

Question 2

fail to seek treatment

Answer 2

1) People may not realize that they have a mental disorder that could be effectively treated.
2) People’s attitudes may keep them from getting help. (thinking they can handle it themselves or stigma).
3) Structural barriers prevent people from physically getting to treatment. (finding right psychologist or money$$, lack of clinician availability, inconvenience of attending treatment, transportation troubles).

and may still not even get most effective treatment.

Question 3

2 kinds of treatments

Answer 3

1) psychological treatment - ppl interact with clinician in order to use the environment to change their brain & behavior
2) biological treatment - brain is treated directly with drugs, surgery, or some other direct intervention

Question 4

psychotherapy

Answer 4

an interaction between a socially sanctioned clinician and someone suffering from a psychological problem, with the goal of providing support or relief from the problem. 500 different forms.

Question 5

eclectic psychotherapy

Answer 5

1/3 reported using this; a form of psychotherapy that involves drawing on techniques from different forms of therapy, depending on the client and the problem.

Question 6

psychodynamic psychotherapies

Answer 6

therapies that explore childhood events and encourage individuals to use the understanding that results to develop insight into their psychological problems. little evidence these therapies are effective.

Question 7

psychoanalysis (psychotherapy)

Answer 7

(Freud) assumes that people are born with aggressive and sexual urges that are repressed during childhood development through the use of defense mechanisms. Encourages clients to bring these repressed conflicts into consciousness so that clients can understand them and reduce their unwanted influences.

involves 4-5 sessions per week over avg. 3-6 yrs. Stereotypical lying on a couch.

Question 8

free association (psychoanalysis)

Answer 8

client reports every thought that enters the mind and therapist looks for reoccurring themes.

Question 9

resistance (psychoanalysis)

Answer 9

reluctance to cooperate with treatment for fear of confronting unpleasant unconscious material. If a client resists an interpretation, means it could actually be an issue that needs to be confronted.

Question 10

transference (psychoanalysis)

Answer 10

an event that occurs when the analyst begins to assume a major significance in the client’s life and the client reacts to the analyst based on unconscious childhood fantasies.

Question 11

interpersonal psychotherapy (IPT) (psychotherapy)

Answer 11

form of psychotherapy that focuses on helping clients improve current relationships. Focuses on client’s grief, role disputes, role transitions, or interpersonal deficits. If improve interpersonal relationships, symptoms will subside. Sit face-to-face. Once a week for only a few months. More likely to offer support and advice in addition to interpretation. Less likely to interpret as sexual or aggressive impulses.

Question 12

human and existential therapies

Answer 12

assumption that psychological problems stem from feelings of alienation and loneliness, and that those feelings can be traced to failures to reach one’s potential (humanistic approach) or from failures to find meaning in life (existential approach).

Question 13

person centered therapy (or client centered therapy) [humanistic approach]

Answer 13

assumes that all individuals have a tendency toward growth and that this growth can be facilitated by acceptance and genuine reactions from the therapist. Developed by Carl Rogers. Therapist assumes that each person is qualified to determine their goals for therapy (more confident etc) and even frequency/length of therapy. Therapist tends not to provide advice, but rather rephrases the client’s thoughts back to the client.

Question 14

3 basic qualities (person centered therapy)

Answer 14

1) congruence: refers to openness and honesty in their therapeutic relationship (therapist’s words/facial expression/body language must reflect same msg).
2) empathy: refers to understanding the client by seeing the world from the client’s perspective, which enables the therapist to better appreciate the client’s apprehensions, worries, or fears.
3) Unconditional positive regard: entrails providing a nonjudgmental, warm, and accepting environment in which the client can feel safe expressing their thoughts and feelings.

Question 15

gestalt therapy (existential approach)

Answer 15

developed by Frederick Perls. Goal of helping the client become aware of his or her thoughts, behaviors, experiences, and feelings and to “own” or take responsibility for them. Therapists are warm toward their clients and also reflect back their impressions of the client. Emphasizes experiences and behaviors that occurring in that moment – use empty chair technique.

Question 16

behavior therapy

Answer 16

type of therapy that assumes that disordered behavior is learned and that symptom relief is achieved through changing overt maladaptive behaviors into more constructive behaviors.

Question 17

1) Eliminating unwanted behaviors (behavior)

Answer 17

behavior is influenced by consequences so may need less reinforcing and more punishment.

Question 18

2) Promoting desired behaviors

Answer 18

token economy: form of behavior therapy in which clients are given “tokens” for desired behaviors, which they can later trade for rewards.

Question 19

3) Reducing unwanted emotional responses

Answer 19

exposure therapy: approach to treatment that involves confronting an emotion-arousing stimulus directly and repeatedly, ultimately leading to a decrease in the emotional response. Depends on the processes of habituation and response extinction. In vivo (live) exposure is more effective than imaginary exposure.

Question 20

cognitive therapy

Answer 20

focuses on helping a client identify and correct any distorted thinking about self, others, or the world. Emphasizes the interpretation of the event.

Question 21

Cognitive restructuring

Answer 21

a therapeutic approach that teaches clients to question the automatic beliefs, assumptions, and predictions that often lead to negative emotions and to replace negative thinking with more realistic and positive beliefs.

Question 22

mindfulness meditation

Answer 22

teaches an individual to be fully present in each moment, to be aware of his or her thoughts, feelings, and sensations, and to detect symptoms before they become a problem.

Question 23

cognitive behavioral therapy (CBT)

Answer 23

blend of cognitive and behavioral therapeutic strategies. More problem focused, so undertaken for specific problems (reducing panic attacks for ex) and action orientated (therapist tries to assist the client in selecting specific strategies to help address those problems such as thought journal). Very effective (for depression, GAD, panic disorder, etc).

Question 24

couples therapy

Answer 24

married, cohabitating, or dating couple is seen together in therapy to work on problems usually arising within the relationship. Problem is generally seen from arising from their interaction than the people themselves.

Question 25

family therapy

Answer 25

psychotherapy involving members of a family. The problems and solutions are seen as arising from the interaction of the individuals rather than simply from any one individual.

Question 26

group therapy

Answer 26

technique in which multiple participants (who often do not initially know each other) work on their individual problems in a group atmosphere. Shows others they are not alone; model appropriate behavior for one another; share their insights in how they deal w/ their problems. Disadvantages: may be difficult to get a group of similar people or if a member undermines the treatment of another (dominating the discussion), and clients get less attention.

Question 27

self-help and support groups

Answer 27

discussion groups that are often run by peers who have themselves struggled with the same issues. For ex. Alcoholics Anonymous, Gamblers Anonymous, and AI-Anon (group for family and friends of an alcoholic). Eating disorders, depression, anxiety, etc groups too; almost one for every disorder. Realize others just like them; share own personal success strategies. Cons: some members may be aggressive or engage in behaviors countertherapeutic; may become over sensitized to extreme symptoms.

Question 28

AA

Answer 28

2 mill members in US, 185000 meetings around the world. 12 step program to reach complete abstinence from drinking, including believing in a higher power, practicing prayer and meditation, and making amends for harm to others. greater success than not doing AA, but which parts are effective hasn’t been studied.

Question 29

trephining

Answer 29

drilling a hole in the skull, perhaps in the belief that this would release evil spirits that were affecting the mind

Question 30

antipsychotic drugs

Answer 30

medications that are used to treat schizophrenia and related psychotic disorders. ppl with schizophrenia, before these drugs, had to be kept in asylums (now psychiatric hospitals) as their bizarre symptoms were so disruptive and difficult to handle. after, ppl in these hospitals decreased by 2/3.

Question 31

psychopharmacology

Answer 31

study of drug effects on psychological states and symptoms.

Question 32

antipsychotic drugs and schizophrenia

Answer 32

believed to block dopamine receptors (as schizophrenia may be caused by excess dopamine in the brain). research has found that excess dopamine is linked with positive symptoms but an under activity of dopamine in other parts of the brain seem to be linked with negative symptoms, which is why they still seem to persistent even w/ medication.

Question 33

Atypical antipsychotics

Answer 33

newer drugs (include Clozaril, Risperdal, Zyprexa). appear to block both dopamine and serotonin receptors (unlike the older, conventional/typical antipsychotics) and help relieve positive symptoms. both can create involuntary movements so may need other drugs to treat that.

Question 34

antianxiety medication

Answer 34

drugs that help reduce a person’s experience of fear or anxiety. most common is benzodiapine (Valium, Ativan, Xanax), type of tranquilizer that works by facilitating the action of the neurotransmitter gamma-aminobutyric acid (GABA), which can produce a calming effect. take effect in minutes, but highly addictive. cause drowsiness, neg. effects on coordination and movement.

Question 35

antidepressants

Answer 35

class of drugs that help life peoples moods. Two introduced in 1950s: Monoamine oxidase inhibitors (MAOIs) and the tricyclic antidepressants. most common now are selective serotonin reuptake inhibitors (SSRIs). up to a month to take effect and can effectively treat anxiety disorders. not for bipolar, can increase manic episodes.

Question 36

Monoamine oxidase inhibitors (MAOIs)

Answer 36

MAOIs prevent the enzyme monoamine oxidase from breaking down neurotransmitters such as norepinephrine, serotonin, and dopamine; rarely prescribed anymore due to dizziness and loss of sexual interest as well as potentially dangerous interactions with other common medications.

Question 37

tricyclic antidepressants.

Answer 37

sometime still used but have serious side effects of dry mouth, constipation, difficulty urinating, blurred vision, and racing heart.

Question 38

selective serotonin reuptake inhibitors (SSRIs)

Answer 38

includes Prozac, Celexa, Paxil. work by blocking the reuptake of serotonin in the brain, which makes more serotonin available in the synaptic space between neurons. the greater availability gives the neuron a better chance of recognizing and using this neurotransmitter in sending the desired signal. selective because they work specifically on serotonin system.

Question 39

serotonin and norepinephrine reuptake inhibitor (SNRI)

Answer 39

Effexor; act on both serotonin and norepinephrine; fewer side effects that older drugs.

Question 40

norepinephrine and dopamine reuptake inhibitor

Answer 40

Wellbutrin; fewer side effects than older drugs.

Question 41

herbal and natural products

Answer 41

not considered medications by FDA so exempt from rigorous research to establish their safety and effectiveness. some studies have shown that John’s wort is effective in treating depression, others show no effect. Omega-3 has been studied and seen better than treating depression than placebos.

Question 42

Combining medication and psychotherapy

Answer 42

sometimes one or the other is better. sometimes a combination of the two isn’t better than just one method. Studies suggest that both therapy and medication effect the brain in regions associated with a reaction to threat (participants were alerted that they would have to speak to the public; two groups who had either one of the treatments).

Cons: generally administered by two different people so they have to coordinate for best results. debating whether psychologists should be allowed to prescribe medication in all states.

Question 43

Electroconvulsive therapy (ECT)

Answer 43

shock therapy; a treatment that involves inducing a brief seizure by delivering an electrical shock to the brain across frontal cortex. less than 1 sec. primarily used to treat severe depression that has not responded to antidepressant medications, but can be used to treat bipolar disorder. pretreated with muscle relaxants/anticonvulsant and are under general anesthesia so they are not conscious of the procedure.

side effects: impaired short term memory for first few months, headaches, seizures.

Question 44

transcranial magnetic stimulation (TMS)

Answer 44

treatment that involves placing a powerful pulsed magnet over a person’s scalp, which alters neuronal activity in the brain. noninvasive compared to ECT; minimal side effects of mild headaches and small risk of a seizure and no impact on memory or concentration. may be useful in treating depression that is unresponsive to medication. almost no difference between effectiveness in TMS and ECT. possibly treat audible hallucinations in schizophrenia.

Question 45

phototherapy

Answer 45

therapy that involves repreated exposure to bright light, may be helpful to people who have a seasonal pattern to their depression, such as SAD. approx. effective as antidepressant medication for SAD.

Question 46

psychosurgery

Answer 46

the surgical destruction of specific brain areas; rare.

modern psychosurgery involves precise destruction of brain tissues in order to disrupt the brain circuits known to be involved with the symptoms. For OCD, destroy part of the corpus collosum and cingulate gyrus.

Question 47

Moniz

Answer 47

performed lobotomies in 1930s by inserting an instrument into the brain thru the patient’s eye socket or through holes drilled in the side of the head to severe the connections between the frontal loves and inner brain structures such as the thalamus to help stop aggressive. some were successful, others produced lethargy or childlike impulsiveness; not continued.

Question 48

deep brain stimulation (DBS)

Answer 48

combines the use of psychosurgery with the use of electric currents (as in ECT and TMS). small battery powered device is implanted in the body to deliver electrical stimulation to specific areas of the brain known to be involved in the disorder being targeted to help release/inhibit neurotransmitters where needed. effective for OCD, Parkinson’s, depression.

Question 49

Treatment illusions

Answer 49

can be produced by natural improvements, placebo effects, and by reconstructive memory.

Question 50

1. natural improvement

Answer 50

tendency of symptoms to return to their mean or aberage level. illusion happens when you conclude mistakenly that a treatment made you better when you would’ve gotten better anyways. when you’re at rock bottom, the only way you can go is up, with or without treatment. only way to know effectiveness is to conduct studies that have groups w/ treatment and w/o treatment.

Question 51

2. placebo effects

Answer 51

recovery could be produced by nonspecific treatment effects that are not related to the specific mechanisms by which treatment is supposed to be working. for ex. simply knowing that you are getting treatment can be a nonspecific treatment effect. for ex., placebo, an inert substance or procedure that has been applied with the expectation that a healing response will be produced. can be just as effective as actual medication.

Question 52

3. reconstructive memory

Answer 52

when a client’s motivation to get well causes errors in reconstructive memory for the original symptoms. mistakenly believing your symptoms were worse before treatment than they actually were and that treatment is working.

Question 53

Treatment outcome studies

Answer 53

designed to evaluate whether a particular treatment works, often in relation to some other treatment or a control condition. assigning a group who gets treatment and a control group w/o treatment. also use a range of methods to ensure that any observed effects are not due to treatment illusions so treatment/experimental and control groups are randomly assigned to each condition. treatment is usually assessed in a double-blind experiment so groups don’t know if real/placebo.

Question 54

which treatments work?

Answer 54

some psychologists have argued that most psychotherapies work about equally well. others have argued that there are important differences among therapies and that certain treatments are more effective than others, esp. for treating particular types of problems.

Question 55

treatments and minorities

Answer 55

some have questioned whether treatment studies reported in university clinics will apply to the real world as most do not have lrg numbers of particulars who are of ethnic minority status but some data suggests that treatments work just as well as on white clients.

Question 56

harm of treatments

Answer 56

many drugs used for psychological treatment may be addictive, create long term dependency with serious withdrawal symptoms or simply just trade one unwanted symptom for another (depression for sexual disinterest, anxiety for intoxication).

Question 57

Iatrogenic illness

Answer 57

disorder or symptom that occurs as a result of a medical or psychotherapeutic treatment itself. for ex. when a psychotherapist believes a client has a disorder and they don’t. therapist will work to help the client accept that diagnosis and participate in psychotherapy that can cause symptoms and signs of the disorder to appear.

Question 58

some treatments cause harm

Answer 58

DARE for ex, increases drug and alcohol use. to regular the potentially powerful influence of therapies, psychologists hold themselves to s set of ethical standards for the treatment of people with mental disorders. required for membership in the APA. include a) striving to benefit clients and taking care to do no harm b) establishing relationships of trust with clients c) promoting accuracy, honesty, and truthfulness d) seeking fairness in treatment and taking precautions to avoid biases and e) respecting the dignity and worth of all people.

Question 59

mood stabilizers

Answer 59

for bipolar disorder. (treats manic and depressive episodes).