Chapter 15 - Treatment of Psychological Disorders Flashcards
All forms of psychotherapy involve interactions between the practitioner and client
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Biological therapies
Treatment based on medical approaches to illness and disease. These therapies are based on the idea that mental disorders are the result of abnormalities in neural and bodily processes - like an imbalance of neurotransmitters
Types of biological treatments?
Drugs, electrical stimulation of the brain, surgical intervention
Psychopharmacology
The use of medications that affect brain or body function. They are affective in the short term.
Nonbiological treatments are more effective for some disorders in the long term
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For many disorders, the recent focus has been on combining biological therapies with other approaches to find the best treatment for each patient
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Each theory about a mental disorder includes treatment strategies that are based on the theory’s assumptions about the causes of mental disorders
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Treatment is based on what?
What we think are the CAUSES of mental disorders
Etiologies
The causes of mental disorders
Psychotherapy is aimed at what?
Changing patterns of thought or of behavior
Eclectic approach
Using a variety of techniques that seem appropriate for a given client
Free association
Freud came up with this. You basically talk about whatever comes to mind and the therapist looks out for signs of unconscious conflicts, especially when the client seems resistant to talking about certain subjects. Eventually as you talk, unconscious desires and fears will come out
Dream analysis
Freud came up with this. You interpret the hidden meaning of the client’s dream
Insight
The goal of psychoanalysis: a patient’s awareness of his or her own unconscious psychological processes and how these processes affect daily functioning
Psychodynamic therapy
Examining the patient’s needs, defenses, and motives as a way of understanding why the patient is distressed
Most proponents of psychodynamic theory embrace what?
Freud’s talking therapy - however, the talking tends to be more conversational
Some features of psychodynamic therapy?
Examining client’s avoidance in distressing thoughts, looking for recurring themes and patterns in thoughts and feelings, discussing early traumatic experiences, focusing on interpersonal relations and childhood attachments, examining dreams, emphasizing relationship between therapist and client
Weak evidence that psychodynamic therapy works. What’s a problem with it?
It takes many years… It may help people with borderline personality disorder, it’s not effective
A study found that it makes people feel positive to express their emotions and emotional events
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Talking about emotions and emotional events help boost immune function
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Client-centered therapy
An empathetic approach to therapy; it encourages people to fulfill their individual potentials for personal growth through greater self-understanding. The therapist creates a safe and comforting setting, accepts the client with unconditional positive regard, and takes the client’s perspective. Helps people access their true feelings.
Reflective listening
The therapist repeats the client’s concerns to help the person clarify his or her feelings
Motivational interviewing
Uses a client centered approach over a very short period of time (like 1 or 2 interviews) motivational interviewing is helpful for drug and alcohol abusers
Behavior therapy
Treatment based on the premise that behavior is learned and therefore can be unlearned through the use of classical and operant conditioning. Desired behaviors are rewarded. Unwanted behaviors are ignored or punished.
Social skills training
The therapist will model appropriate social behavior and the client is encouraged to imitate the behavior, rehearse it in therapy, and later apply the learned behavior to real world situations
Modeling
The therapist acts out an appropriate behavior. The client is encouraged to imitate the observed behavior, rehearse it in therapy, and later apply the behavior to real world situations. It’s a form of observational learning
Cognitive therapy
Treatment based on the idea that distorted thoughts produce maladaptive behaviors and emotions; treatment strategies attempt to modify these thought patterns
Cognitive restructuring
A therapy that strives to help patients recognize the maladaptive thought patterns and replace them with ways of viewing the world that are more in tune with reality
Rational-emotive therapy
Through this approach, a therapist acts as a teacher, explaining the client’s errors in thinking and demonstrating more adaptive ways to think and behave
Interpersonal therapy
Focuses on circumstances - namely relationships the client attempts to avoid. This approach integrates cognitive therapy with psychodynamic insight therapy. Interpersonal therapy developed out of psychodynamic ideas on how people relate to one another, but it uses cognitive therapy with psychodynamic insight therapy. Involves exploring interpersonal experiences and relationships
Mindfulness based cognitive therapy
Mindfulness based cognitive therapy is based on principles derived from mindfulness meditation; it helps clients be aware of their negative thoughts and feelings and help people disengage from ruminative thinking through meditation. It’s effective for depression sufferers
Cognitive Behavioral Therapy (CBT)
Incorporates techniques from cognitive therapy and behavior therapy to correct faulty thinking and change maladaptive behaviors
Exposure
A cognitive-behavioral therapy that involves repeated exposure to an anxiety producing stimulus or situation… Most cognitive behavioral therapies have people engage in exposure
Exposure and response prevention
If the client is not permitted to avoid the stimulus they fear and have to be exposed to the fear, the client’s avoidance response is eventually extinguished
Systematic desensitization
The therapist exposes the client to increasingly anxiety producing situations by having the client imagine them and then teaching the client to relax at the same time. Exposure and systematic desensitization are reliable treatments for phobias
Group therapy
Less expensive, helps ppl share emotions and learn social skills and learn from each other
How many client’s is ideal in group therapy
About 8
What types of group therapy are best when structured??
Bulimia and OCD
Systems approach
An individual is part of a larger system. Any change in that individual will affect the system they’re part of (especially family)
Recovering alcoholics = family therapy is good because when the alcoholic gives us drinking thy will be irritable and the family should be aware of that
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Family therapy is good for whom?
Schizophrenics
Expressed emotion
A pattern of negative actions by a client’s family members. The pattern includes critical comments, hostility directed towards the client by family members, and emotional overinvolvement
Some cultures like China are less accepting of psychotherapy
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Psychotropic medications
Drugs that affect mental processes. They act by changing brain neurochemistry. They can inhibit action potentials or alter synaptic transmission to increase or decrease the action of particular neurotransmitters
Psychotropic medications fall into what categories?
- Anti-anxiety drugs
- Antidepressants
- Antipsychotics
Anti-anxiety drugs
A class of psychotropic medications used for treatment of anxiety. They are used in the short-term treatment of anxiety and can be highly addictive and make you drowsy. They DO help you feel more relaxed though. This includes Benzodiazepines. These drugs increase the activity of GABA.
Antidepressants
A class of psychotropic medications used for the treatment of depression. They are often used for anxiety disorders too. Some antidepressants are monoamine oxidase inhibitors - they create MORE serotonin and increase dopamine. Tricyclic antidepressants - result in more neurotransmitters. Selective serotonin reuptake inhibitors (SSRIs) - best known is Prozac. They inhibit the reuptake of serotonin - so they INCREASE serotonin
Antidepressants typically do what?
INCREASE SEROTONIN
Criticism of SSRIs
They have side effects
Antipsychotics
Used to treat schizophrenia and other disorders that involve psychosis
What do antipsychotics do?
Reduce hallucinations and delusions
Side effects of antipsychotics?
Tardive diskinesia
Tardive diskinesia
The involuntary twitching of muscles which can be irreversible. Antipsychotics are not good at treating the negative effects of schizophrenia and can actually make them worse
Lithium
Most effective drug for bipolar disorder
Anticonvulsants
Stabilize bipolar disorder
What about people that don’t respond to treatment - not psychotherapy nor medication
They use alternatives like brain surgery, the use of magnetic fields, and electrical stimulation
Trepanning
Making a hole in someone’s head to let spirits out
Psychosurgery was a thing in the early 1900s
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Lobotomy
Removing parts of prefrontal cortex which makes people listless and have flat effect
Electroconvulsive therapy
A procedure that involves administering a strong electrical current to the patients brain to produce a seizure. It is effective in some cases of severe depression.
What is Electroconvulsive therapy helpful for (ECT)?
SEVERE DEPRESSION
Transcranial magnetic stimulation (TMS)
Delivering an electrical current that produces a magnetic field - may be useful for depression
There is single pulse TMS and repeated TMS
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Deep brain stimulation (DBS)
Implanting electrodes surgically into the brain. It’s used to treat Parkinson’s disease and was relatively effective with few complications - we may be able to use this to treat OCD and depression!!
Additional methods of therapy?
Scream therapy, reenacting your own birth, using hypnosis to remember bad memories,
Types of psychologists who provide treatment
Clinical psychologists, psychiatrists, counseling psychologists, physiatrist social workers,
Technology-based treatments
Use minimal contact with therapists and rely on smartphones; computer programs, or the Internet to provide some form of psychological treatment
Specialized practitioners who help with psychological problems?
Clinical psychologists, psychiatrists, counseling psychologists, psychiatric social workers, psychiatric nurses, and paraprofessionals
What disorders are their highly effective treatments for?
Anxiety disorders, mood disorders, and sexual dysfunction
Few treatments for alcoholism are helpful
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People who experience depression after death of a loved one usually can resolve the depression on their own over time without treatment
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Randomized clinical trials
Good research to establish whether a particular treatment is effective
Evidence based treatments
Psychological disorders should always be treated in ways that scientific research has shown effective
What are evidence based treatments vs just any treatment?
Psychological treatments = evidence based treatment
Psychotherapy = any form of therapy
What characterize psychological treatments?
- Treatments vary according to the particular mental disorder and the client’s specific psychological symptoms
- The techniques used in these treatments have been developed in the laboratory by psychologists, especially behavioral, cognitive, and social psychologists.
- No overall grand theory guides treatment.. Instead, treatment is based on evidence of its effectiveness
What kind of therapy is best for anxiety disorders?
Cognitive-behavioral therapy (CBT)
What drugs are useful in anxiety?
Generalized anxiety is treated well with drugs that block reuptake of serotonin (and therefore increase serotonin)
What treatments don’t treat anxiety well??
Anxiety reducing medications only decrease anxiety in the long term - and they make you drowsy and they’re addictive
What’s the best treatment for phobia?
Behavioral therapy
What else helps treat phobias?
Systematic desensitization
Fear hierarchy
When client makes a list of situations in which fear is aroused in ascending order
Exposure to feared objects defeats the phobia rather than relaxation techniques
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Virtual environments
Exposing the client to their phobia virtually thru like a computer
Cognitive therapy for phobia
Help the client realize it’s irrational
Medical treatments for phobia?
Tranquilizers- they only work in short term tho
Panic disorder treatment?
Cognitive therapy helps - it teaches you how to stop anticipating danger
Cognitive behavioral therapy is VERY helpful
Exposure treatment to the trigger also helps panic disorder
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Legit definition of agoraphobia
Being afraid of enclosed spaces OR open spaces
What’s the BEST treatment for panic disorder?
Cognitive behavioral therapy
What are good treatments for OCD?
SSRIs
Cognitive behavioral therapy (especially exposure and response)
Clomipramine (drug of choice for OCD)
* the use of exposure and response cognitive behavioral therapy IS MORE EFFECTIVE Than clonipramine, the drug of choice for OCD
Deep brain stimulation is a possibility of helping people with OCD
What are good treatments for depression??
Iproniazid (a MAO inhibitor) initially a treatment for tuberculosis but ended up increasing energy levels and appetite and gave people an overall sense of well being… Problem with iproniazid is that it can be lethal if you eat or drink something with tyramine in it
Tricyclics - very effective - but they have bad side effects like drowsiness, weight gain, sweating, constipation, heart problems, dry mouth, etc.
Prozac (an SSRI) - it sometimes causes weight loss, sexual dysfunction, headaches, etc.
Prozac and SSRIs are more often prescribed because they don’t have as severe side effects as tricyclics and MAO inhibitors
Bupropion - less side effects
Cognitive behavioral therapy - just as effective as drugs for treating depression… Depression happens because people have automatic, irrational negative thoughts
Why is medical treatment of depression controversial?
People believe it helps treat symptoms of depression without treating the underlying cause of the depression
The issue is not drugs vs psychotherapy.. It’s which treatment is best for the individual!
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seasonal affective disorder (SAD)
They experience bouts of depression during winter
What can treat SAD?
Phototherapy - exposure to a high-intensity light source for part of each day
Aerobic exercise helps depression
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ECT
Effective treatment for severe depression
Electroconvulsive therapy side effects?
A high relapse rate, memory impairments,
TMS vs ECT
TMS is effective even for patients who have not responded to treatment with antidepressants
Deep brain stimulation is good for
Depression and OCD
What’s the most effective for bipolar disorder?
Lithium!!! Side effects include thirst, hand tremors, excessive urination, and memory problems.
Schizophrenia treatments
Reserpine - a toxic herb - effective antipsychotic
Chlorpromazine - major tranquilizer, reduces anxiety, sedated
Haloperidol -
Extx
Social skills training
An effective way to address some deficits in patients with schizophrenia- helps patients recognize social cues and predict the effects of their behavior in social situations
Cognitive behavioral therapy is helpful in schizophrenia
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Schizophrenics get better as they get older
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Most effective treatment for schizophrenia?
The use of both drugs and psychosocial interventions
People with personality disorders are super difficult to treat
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Dialectical Behavior Therapy
A form of therapy used to treat Borderline Personality Disorder - combines elements of the behavioral and cognitive treatments with a mindfulness approach based on Eastern meditative practices
Conduct disorder
A childhood condition known to be a precursor to antisocial personality disorder
SSRIs make increased suicidal thoughts in kids and adolescents
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ADHD is treated by
Methylphenidate or Ritalin
Applied behavioral analysis
An intensive treatment for autism based on operant conditioning
Psychotherapy
The generic name given to formal psychological treatment
