Chapter 16 Flashcards
1400s-1900s
Mentally ill patients were sent to asylums, segregated from general public
Deinstitutionalization (mid 1900s)
Movement of large number of psychiatric inpatients from care facilities back to society
Made possible by development of effective treatment of some disorders, management of symptoms
Residential Treatment Centers
-Housing facilities where residents receive psychological therapy and life skills training with goal to reintegrate residents into society
-When required, patients’ freedom restricted
-many previously hospitalized patients had no family/social supports to return to
Community Psychology
Focuses on identifying how an individual’s mental health is influenced by their community
Emphasizes community-level variables like social programs, support networks and community resource centers
Research may involve environmental and neighbourhood factors that contribute to stress, anxiety, depression…
Barriers to Psychological Treatment
40% of adults with high anxiety or depression receive therapy
2/3 of people with mental health issues don’t get help
2/3 people diagnosed with mood/anxiety disorders wait 1+ years to seek/receive diagnosis
Avoidance of Help
-Difficulty defining or recognizing disorder
-Stigma around mental illness and therapy
-Skepticism surrounding treatment, psychological/psychiatric professionals
-Gender roles
-Cultural barriers
-Geographical barriers
-Financial barriers
Insight Therapies:
General term referring to therapy involving dialogue between patient and therapist to gain awareness and understanding of psychological problems and conflicts
Began with Freud’s psychoanalysis evolving to:
Psychodynamic therapies>Form of insight therapy that emphasizes need to discover and resolve unconscious conflicts
Psychoanalysis
Intended to help patients become aware of unconscious urges
Modern Psychodynamic Therapies
Focused more on patient’s conscious experience than unconscious experience
Objects Relations Therapy
Variation of psychodynamic theory that focuses on how early childhood experiences and emotional attachments influence later psychological functioning
Focuses on “objects” >Clients’ mental representation of themselves and others
Early relationships between child and “objects” lead to development of mental models that influence future relationships
Humanistic-Existential Psychotherapy
Human nature is fundamentally positive
Focus on conscious experience
Phenomenological Approach: Address clients’ feelings and thoughts as they unfold in present moment rather than looking for unconscious motives or focusing on past events
Humanistic-Existential Psychotherapy cont.
Considers behaviours to be freely chosen by individual
Emphasizes peoples’ strengths
Tries to clarify patients’ issues
Unconditional positive regard toward patients’ healing
Client-Centered Therapy
‘Person-centered therapy’
Focuses on individuals’ abilities to solve their own problems and reach full potential with encouragement of therapist
Dealing with ‘conditions of worth’
Emotion-focused Therapy (EFT): Helps clients face and accept difficult emotions
Behavioural Therapies
Attempt to directly address problem behaviours and the environmental factors that trigger them
Use principles of classical and operant conditioning to change behaviour
eg.aversive conditioning
Aversive Conditioning
Behavioural technique that involves replacing a positive response to a stimulus with a negative response
Systematic Desensitization
Gradual exposure to feared stimulus or situation is couple with relaxation technique
-can involve building an ‘anxiety hierarchy’: list of fearful stimuli ranging from least to most fearful
-flooding: exposing client to most challenging, anxiety inducing aspect of behaviour/situation
Cognitive Behavioural Therapies (CBT)
Consists of procedures like cognitive restructuring, stress inoculation training and exposure to experiences client may tend to avoid
Focused on helping clients recognize their thoughts, emotions and behavioural patterns to build more functional cognitive and behavioural habits
Group Therapy
Grouping people together based on similar issues
Participants benefit from bonding and support provided by other group members
Cost effective, accessible
Family Therapy
Helpful when client difficulties reinforced by unhealthy family dynamics
May help families with specific members with disruptive or dysfunctional behavioural issues
Systems Approach: Views an individual’s symptoms as being influenced by multiple interacting systems (friends, family…) and influences
Biomedical Approach
Use of drugs, surgery, or other medical procedures to alter central nervous system functioning to correct problems thought to be biological in nature
Psychopharmacotherapy
Use of drugs to manage or reduce symptoms
Usually paired with other form of therapy (ex CBT)
Psychotropic Drugs: Medications to alter psychological functioning
Monoamine Oxidase Inhibitors (MAOIs)
Deactivates monoamine oxidase (MAO), enzyme that breaks down serotonin, dopamine and norepinephrine in the synapse>results in increased amount of neurotransmitter
Can cause dangerous side effects (not widely used)
Selective Serotonin Reuptake Inhibitor (SSRI)
Ex Fluoxetine (Prozac)
Block reuptake of serotonin, leaving larger amount in synapse
Most common antidepressant since 1980s
Can change sleep patterns and sex drive
Mood Stabilizers
Prevent or reduce severity of mood swings for bipolar people
Ex Lithium
Side effects: toxicity (kidneys, endocrine system)>no longer popular
Antianxiety Drugs
Influence GABA activity (inhibitory neurotransmitter that reduces neural activity)
ex. Xanax, Valium, Ativan
Side effects: Drowsiness, impaired attention, memory impairments, depression, decreased sex drive, potential for abuse and withdrawal
Antipsychotic Drugs
Treat symptoms of psychosis (delusions, hallucinations, disturbed/disorganized thoughts)
First gen severe side effects: seizures, anxiety, nausea, impotence
Tardive Dyskinesia: Movement disorder characterized by involuntary movements and facial tics
Second gen (Atypical Antipsychotics)
Target dopamine and serotonin transmission
Less likely to produce side effects of first gen, but only work for 50%, less effective over time, compromises white blood cells (immune system)
Surgery
Early techniques involved surgically destroying brain tissues in prefrontal cortex
-ex leucotomy (lobotomy)
>for psychoses and other disorders in 1900s
Modern Focal Lesioning Surgery
-small areas of brain tissue destroyed
-only used in extreme cases
ex. Anterior Cingulotomy
>brain imaging used to target and guide precise location of lesion
Electroconvulsive Therapy (ECT)
Passing electrical current through brain to induce temporary seizure
Only used in extreme cases
May alter activity of certain networks in brain
Promotes neurogenesis in hippocampus
Repetitive Transcranial Magnetic Stimulation (rTMS)
Expose particular area of brain to powerful magnetic field to stimulate or inhibit brain activity in that region
10-25 sessions
Stimulation of left prefrontal cortex (positive emotion) and inhibition of right prefrontal cortex (negative emotion) associated with improvement of depressive symptoms
Deep Brain Stimulation (DBS)
Electrical stimulation of specific brain region using thin electrodes inserted in brain
Results immediate
Risk with surgical insertion of electrodes
May produce unexpected temporary behaviours
