Chapter 16 Flashcards
Biological treatments
Involve use of drugs, electroconvulsive therapy (ECT), brain surgery or other methods that affect body or brain chemistry
Can be effective, because many disorders have a biological basis
Placebo
a substance with no chemical effects given to a patient instead of a drug
Biological Treatments - Concerns
Increasing off-label prescription
Side effects may feel worse than the disorder symptoms
Especially bad with Lithium and antipsychotics, leading to high relapse and dropout rates
Long-term effects
Addiction
Diabetes
Tardive dyskinesia
Psychosurgery
Any surgical procedure that destroys selected areas of the brain believed to be involved in emotional disorders or violent, impulsive behavior
Frontal lobotomy
Destroys or separates parts of the frontal lobes
Stops strong emotional reactions, leads to flat affect
Also can interfere with other frontal lobe functions – planning, socially appropriate behavior
18,000 conducted 1939-51
Antonio Moniz’ method
Moniz’s hypothesis was that, in mentally ill patients, the presence of abnormal neural connections originate from the frontal lobes. Working at the University of Lisbon, Moniz believed that certain obsessive and melancholic persons could be helped if their frontal lobes were cut out.
Moniz received the 1949 Nobel Prize in Physiology or Medicine.
Walter Freeman’s method
transorbital lobotomy which cuts out parts of the frontal cortex where he claimed he no longer needed a drill, sterile field nor surgical scrubs.
Electroconvulsive Therapy (ECT)
Used in cases of severe major depression
Ineffective for other conditions
Initiated by Ugo Cerletti in 1937
Produces retrograde amnesia for the procedure itself
Widely used today (100,000+ / year)
Criticized as a tool more of control than treatment
Antipsychotic Drugs
Block or reduce sensitivity of brain receptors that respond to dopamine
Some increase levels of serotonin, a neurotransmitter that inhibits dopamine activity
Can relieve positive symptoms of schizophrenia but are ineffective for or even worsen negative symptoms
Side effects include weight gain, diabetes
Increasingly prescribed off-label (e.g. Seroquel)
Antidepressants
Monoamine oxidase inhibitors (Nardil, Parnate)
Elevate norepinephrine / serotonin in brain by blocking an enzyme that deactivates them
Tricyclic antidepressants (Elavil, Tofranil)
Boost norepinephrine and serotonin in brain by preventing normal reuptake of these substances
Selective serotonin reuptake inhibitors (SSRIs)
Also inhibit re-uptake of serotonin to boost levels
Examples – Prozac, Zoloft, Paxil
Anti-Anxiety (Tranquilizers)
Increase levels of gamma-aminobutyric acid (GABA), an inhibitory neurotransmitter
Developed for shorter-term use, with high relapse rates when people stop taking them
Often overprescribed by general physicians for patients who complain of any mood problems
Overprescription or long-term use can lead to addiction
Examples – valium, xanax
Psychodynamic Therapy
Uses various techniques to explore the unconscious as a route to identifying and solving problems
Behavioral Methods
Apply principles and techniques of classical and operant conditioning to help people change self defeating or problematic behaviors
Free Association
A method of uncovering unconscious conflicts by saying freely whatever comes to mind
Transference
A critical step in which the client transfers unconscious emotions or reactions onto therapist (e.g. conflicts about parents)
Dream analysis
the investigation of repressed feelings that can be expressed in our dreams.
Systematic desensitization
a treatment for phobias in which the patient is exposed to progressively more anxiety-provoking stimuli and taught relaxation techniques.
Behavioral self-monitoring
a form of data-gathering in which clients are asked to systematically observe and record specific targets such as their own thoughts, emotions, body feelings, and behaviors.
Aversive conditioning
used to help a person give up a behavior or habit by having them associate it with something unpleasant.
Cognitive Therapy
Aim is to have people identify and understand maladaptive thought patterns, then change them to improve their life
Albert Ellis’s Rational-Emotive Behavioral Therapy (REBT)
focuses mostly on the present time to help you understand how unhealthy thoughts and beliefs create emotional distress which, in turn, leads to unhealthy actions and behaviors that interfere with your life and goals.
therapist and client actively challenge existing beliefs
Aaron Beck’s Cognitive Therapy
examines interconnection of thoughts, feelings and behaviors
Humanistic Therapy
Humanistic therapy emphasizes people’s free will to change
Client- / Person-Centered Therapy (Carl Rogers)
Emphasizes empathy with client, seeing the world as client does
Family Therapy
Many problems develop in the context of family, or are perpetuated by the dynamics of the family
Any changes made will affect all members of the family.
Family-System Perspective
Therapy with individuals or families that focuses on how each member forms part of a larger interacting system
Group Therapies Advantages
Can be led by a professional to show people that they are not alone in their problems
People can learn from the growth of others
Less expensive than one-on-one
Most common type is that used in AA, NA, etc.
Group Therapies Disadvantages
Lack of confidentiality
Requires a skilled facilitator to avoid social issues such as groupthink
Evaluating Therapies
Success hinges on:
Getting the person into the most compatible type of therapy for their disorder and personality.
Client and therapist working together in a therapeutic alliance.
Therapist being culturally competent for client population.
Client being motivated to change.
Scientist-Practitioner Gap
A substantial, serious disconnect between scientists who research and those who practice.
Practitioners often disregard scientific evidence as not relevant to their personalized approaches
This leads to perpetuation of misdiagnoses and useless or harmful treatment methods
Scientists may undervalue the individual human elements of therapy, overemphasize one-size-fits-all approaches
comorbid disorder
individual who has two or more diagnoses, which often includes a substance abuse
diagnosis and another psychiatric diagnosis, such as depression, bipolar disorder, or schizophrenia
counterconditioning
classical conditioning therapeutic technique in which a client learns a new response to
a stimulus that has previously elicited an undesirable behavior
nondirective therapy
therapeutic approach in which the therapist does not give advice or provide
interpretations but helps the person identify conflicts and understand feelings
play therapy
therapeutic process, often used with children, that employs toys to help them resolve
psychological problems
transference
process in psychoanalysis in which the patient transfers all of the positive or negative emotions
associated with the patient’s other relationships to the psychoanalyst
unconditional positive regard
fundamental acceptance of a person regardless of what they say or do; term
associated with humanistic psychology
virtual reality exposure therapy
uses a simulation rather than the actual feared object or situation to help
people conquer their fears
