Chapter 16: Therapies Flashcards
what are some barriers to get treatment?
Uncertainty
whether one
qualifies for help
Stigma about
mental illness
Gender roles- women more likely to be diagnosed with depression (stereotypes)
Men under-report
mental health
problems- men suicide rates are way higher
expense and availability of treatment- not everything is covered under universal healthcare (low income and remote communities at a disadvantage)
________: address
common problems such as stress,
coping, and mild forms of anxiety and
depression
counseling psychologists, masters degree (dealing with fairly healthy people)
_______:
mental health
professionals with
doctoral degrees who
diagnose and treat
problems ranging from
the everyday to the
chronic and severe
Clinical psychologists, phD (deal with healthy to chronically ill people)
________: physicians who specialize in mental health, and
who diagnose and treat mental disorders primarily through
prescribing medications that influence brain chemistry
Psychiatrists, MD
psychiatrists work with psychologists to provide biopsychosocial
________
interventions
______: Provide psychotherapy
and life skills training
so that the residents
can reintegrate into
society to the greatest
extent possible, treat for longer periods of time
range from low to high centers with varying restrictions
residential treatment centers
________: Focuses on how mental
health is influenced by the
neighborhood, economics,
social groups, and other
community-based variables
community psychology, first line of defense (try to avoid large issues!)
how do community psychologists provide help?
Public awareness
campaigns
Educational programs, work out of schools
Subsidized therapy (low-cost)
T/F: Most psychological
interventions have been
tested and evaluated using
sound research designs
true!!
what are some of the limitations to the testing of psychological interventions
no double-blind procedures (therapist always knows what they’re trying to treat)
ethical considerations for control groups (can’t not just treat people that are suffering)
- use “best available therapy”, give someone a technique they know works, but hope your treatment will show better results than the standard control!
cannot standardize therapeutic alliance
______: The use of self-help
books and other
reading materials as
a form of therapy
bibliotherapy
more convenient, cheaper
______: Dialogue between client
and therapist for the
purposes of gaining
awareness and
understanding of
psychological problems
insight therapy
_______ therapies:
forms of insight therapy
that emphasize the
need to discover and
resolve unconscious
conflicts
Psychodynamic
use free association, dream analysis, hypnosis (since Freud thought everything in our unconscious mind needed to be addressed)
what is the history of a freudian slip?
Freud thought the language mistakes we made had significance to our mind (saying mother when trying to say another)- he thought this revealed some insight into the fact that this person had issues with their mother
_______: therapist
listens empathetically
and addresses the
clients’ subjective
feelings and thoughts as
they unfold in the
present moment
Phenomenological
approach
unconditional positive regard, assure the client knows there are no strings attached to the therapists beliefs
humanistic-existential psychotherapy believes…
emphasize that psychological issues arise from a lack of fulfillment in our lives, also that we are empowered to change- we can self-actualize and change!
Carl Rogers’ famous quote explains…
often obstacles to growth are those we impose on ourselves, once we accept ourselves- we can move on!
“the curious paradox is that when I accept myself just as I am, then I can change”
________: a variation of
psychodynamic therapy
that focuses on how
childhood experiences
and emotional
attachments influence
later psychology
Object relations
therapy
________:
a variation of humanistic-
existential psychotherapy
based on the belief that it
is better to face and
accept difficult emotions
and thoughts rather than
to ignore them
Emotion-focused therapy
what are the two modern insight therapies?
object relations therapy
emotion-focused therapy
T/F: Relationship
between therapist
and client is the best
predictor of therapy
success regardless
of the type of insight
therapy used
true!!
ex: schizophrenics cant use object relations therapy as they can’t be super introspective- but works great for people suffering from anxiety
what are the pros to using group and family therapies?
less expensive
organized groups to fit needs
provides social support and practice
gives therapists a more realistic account of patient’s behaviour in real social environments
_______: an orientation toward family therapy that
involves identifying and understanding what each individual
family member contributed to the entire family dynamic
Systems approach
can promote better ways of interacting together when you can understand everyone’s roles in the group
______: Address problem
behaviours and
thoughts, and the
environmental factors
that trigger them,
through conditioning
behavioural therapies
________:
involves replacing a
positive response to a
stimulus with a
negative response,
typically by using
punishment
Aversive conditioning
take Antabuse (drug) then when you drink, it makes you throw up- the hope is that people develop a taste-aversion to alcohol because of this
what are the two forms of exposure therapy?
systemic desensitization
flooding
_______: gradually exposing an individual to
stressful stimuli such that the aversive response extinguishes
Systematic desensitization
-measuring their physiological measures to measure stress responses throughout
______: an individual is immersed in stress-inducing situations
Flooding
- instead of building up, you start with the hardest one! once you learn you can survive the hardest, you should be able to do the rest pretty easily!
what do therapists teach clients before using exposure therapy?
they teach them coping techniques, then put the client in situations where they must use the techniques they have been taught
T/F: Virtual reality technology can enhance exposure therapies by
generating immersive environments that would not otherwise
be possible to reproduce
true!!! can build whatever reality you want!
what is one of the main ways we use virtual reality exposure?
PTSD treatment for soldiers
allows them to control their responses to stress/trauma in a healthier way- allowing them to be less affected on an everyday basis
_____: Not only addresses problematic behaviours, but also
the distorted cognitions underlying them
cognitive-behavioural therapy (CBT)
________:
changing negative cognition
into more realistic and
rational thought patterns
Cognitive restructuring
- consciously restructuring our thoughts
_______:
helps client put
traumatic memories into
perspective
Stress inoculation training
- incorporate exposure therapies (can practice self-restraint skills!)
T/F: CBT requires commitment from therapist and client
true!! takes work to break mental habits
need multiple sessions, with lots of home at work day-to-day basis
_______: Combines mindfulness
meditation with standard
cognitive-behavioural therapy
mindfulness-based cognitive therapy
________: occurs
when one is able to
‘step back’ from one’s
normal consciousness
and observe one’s
thoughts more
objectively
Decentering
_______:
the process of treating
psychological disorders
with drugs
Psychopharmacotherapy
treats cognition, emotion, behaviour
T/F: psychotropic drugs must cross through BBB, need a mechanism for this
true!! makes these drugs difficult to develop!
_______: a
network of tightly
packed cells that only
allow specific types of
substances to move
from the bloodstream
to the brain
Blood-brain barrier
_______: Drugs that prevent or reduce the manic side of
bipolar disorder
mood stabilizers
side effects: nausea, weight gain, fatigue
we use lithium sometimes now- being replaced by anti-convulsant drugs (which target GABA behaviour)
doesn’t eliminate manic phases- just diminishes the intensity
______: salt compound, reduces severity/frequency of manic phases
Lithium
Treatment compliance often a problem during mania, why?
when people feel good, they go off tehir meds, meaning lots of people will enter mania while unmedicated
_______: Alleviate nervousness and
tension, and to prevent
and reduce panic attacks
antianxiety drugs
_______ Promote activity of
GABA, an inhibitory
neurotransmitter,
thereby reducing neural
activity, has short-term effects and high potential for abuse (since we need to constantly take them, in increasing dosages)
- impairs attention, concentration, drowsiness are some side effects
antianxiety drugs
T/F: Early evidence that
MDMA (ecstasy) may
facilitate therapy for
individuals with PTSD
true!!
how does MDMA work?
Increases
norepinephrine (regulates levels of arousal),
serotonin, and
dopamine
Facilitates
concentration and trust
during therapy so as to
better contextualize
traumatic memories
- can stimulate oxytocin (help build bonds with therapist!)
________: Prescribed for disorders such
as schizophrenia and severe
mood disorders
antipsychotic drugs
what was the first generation of antipsychotic drugs, what did they do?
blocked dopamine receptors, almost too well- lots of side effects like…
Tardive Dyskinesia:
Parkinsonian-like symptoms
marked by involuntary
movements and facial tics (really affected quality of life of patients)
_________:
Parkinsonian-like symptoms
marked by involuntary
movements and facial tics
Tardive Dyskinesia
because of the link to Parkinsons and schizophrenia, what has this led researchers to believe?
that they are on two ends of a disorder spectrum, schizo, = too much dopamine
parkinsons= not enough
________
(second-generation): reduces
dopamine and serotonin (sometimes glutamate)
Atypical antipsychotics- more modern form (don’t have the same potency as 1st gen, less side effects)
_______ theory of
depression: underactivity
at serotonin and
norepinephrine synapses
Monoamine
(monoamines are serotonin, norepinephrine)
Upregulation of
serotonin/
norepinephrine
receptors in
_______ studies, because there’s not enough transmitters (makes it more likely to generate signal)
post-mortem way to determine if someone was suffering from depression
autopsies
T/F: the most effective depression drugs target monoamines
true!!
__________ (MAOIs): deactivates
monoamine oxidase, an enzyme that breaks down
serotonin, dopamine, norepinephrine
- oldest antidepressant- deadly side effects, leaves more neurotransmitters able to interact
Monoamine oxidase inhibitors
________: block reuptake of serotonin/norepinephrine (more interaction), older version has deadly side effects
Tricyclic antidepressants
what are the most common depression drugs that we use now?
SSRI’s- do everything selectively! specifically targets serotonin (not as many side effects!)
- doesn’t CREATE happiness, just brings people back to their baseline mood
T/F: Antidepressant drugs take weeks to months before
producing a clinical effect
true!! not only do we need more availability of serotonin, we also need down-regulation of 5HT1A receptor (serotonin receptor)
SSRIs stimulate
release of _____ which
promotes neurogenesis
in the hippocampus
BDNF- important for creating new neurons
_______ helps
regulate HPA axis and
reward circuitry,
involved in
contextualizing fear
memories, and
supports new learning
and memories
Hippocampus
T/F: drugs are a cure-all
false
how do we compare therapies?
response vs. remission
response: do people respond to treatment?
remission: whether people are maintaining their health
T/F: Similar efficacy
between CBT and
antidepressants
true
which therapy has a lower relapse rate?
Cognitive behavioural therapy
(compared to drug therapy!)- gives CBT an added benefit since they’re more long-lasting
T/F: Exercise as a treatment
can be as effective as
SSRIs for some
true!!
how does exercise act as a treatment for depression?
stimulates release of endorphins and BDNF (new learning patterns), positive side effects (look better, feel better, getting outside!)!
drugs are most effective when….
combined with other forms of therapy (like CBT!)
therapeutic approach needs to be tailored ________
to each person, everyone needs different things!
T/F: Neurologists in
1800s and 1900s
experimented with
removing regions of the brain
true!!!
_____: Wire
loop to destroy
frontal lobe
Leucotomy
standardized by prefrontal lobotomy with ‘ice pick’- inspired by initial treatment
Eliminated in U.S. by
1970s
what are the modern surgical method?
focal lesions- very precise
______: small,
specific damage
applied to a cluster of
nerve cells
Focal lesions
For severe psychiatric
problems when all
other methods failed- a drastic step! severe, severe cases where nothing else works
side effects are similar to pharmaceutical alternatives
_______: Treatment in which an electrical current is passed through
the brain to induce a temporary seizure
electroconvulsive therapy (ECT)
when is ECT used?
in severe cases unresponsive to other treatments
works in about half of cases where they’ve been historically unresponsive! suppresses activity of nervous system- and promotes neurogenesis in hippocampus (people can be more adaptive in their thinking/behaviour)
what are the mild side effects of ECT?
Mild side effects such as temporary confusions and amnesia for events around time of treatment
_______: A technique in which a
powerful magnetic field is
used to either stimulate or
inhibit brain activity
Repetitive Transcranial Magnetic
Stimulation (rTMS)
_______: doesn’t use anesthesia or seizure
reduces symptoms in treatment resistance depression
requires multiple sessions, not immediate changes
Repetitive Transcranial Magnetic
Stimulation (rTMS)
______: A technique that
involves electrically
stimulating highly
specific regions of
the brain
deep brain stimulation (DBS)
______: thin electrode-tipped wires inserted into brain
instantaneous results
used for Parkinson’s- recent research for OCD and depression!
DBS
