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Psychology 385 > Chapter 17/18 - Prevention and treatment > Flashcards

Chapter 17/18 - Prevention and treatment Flashcards

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1
Q

Why do most Canadians with mood disorders take primarily medications to manage their mental health problems?

A
  • Most management of mental health problems is done in primary care settings
  • Only physicians can prescribe psychotropic medications in Canada. Many are not trained in psychotherapy
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2
Q

What are carceral institutions?

A
  • Programs offered by prisons/penitentiaries
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3
Q

What is the most frequent cause of delayed treatment in public agencies?

A
  • Long waiting lists
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4
Q

What disorders may require more extended forms of treatment?

A
  • May include eating disorders and borderline personality disorder, substance abuse disorders as well
  • Bipolar and schizophrenia may involve life-long follow-ups
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5
Q

What regulations regarding mental health practitioners are found among all provinces?

A
  • All provinces require professional registration for psychologists and clinical social workers at the master’s or PhD level
  • ‘Counselors’ are regulated in some provinces, most recently Alberta
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6
Q

What are the different neurostimulation treatments?

A
  • ECT (depression and bipolar)
  • TMS (depression)
  • Vagus nerve stimulation (coil wraps around nerve and stimulates it to help with depression; not commonly done, difficult to remove coil once implanted)
    *ECT and TMS most common
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7
Q

What are the most common psychopharmacological treatments?

A
  • Antidepressants - MAO inhibitors, TCAs, SSRIs, SNRIs, NDRI
  • Anxiolytics - Anxiety/panic attacks (benzodiazepines, some antidepressants)
  • Antipsychotics
  • Mood stabilizers (BPD)
  • Stimulants - ADHD. Adderall
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8
Q

What are the key features of psychodynamic psychotherapies?

A
  • Focus is on current life circumstances, affect and expression of emotion
  • Exploration of attempts to avoid thoughts and feelings (why does this occur)
  • Identification of themes and patterns
  • Focus on interpersonal relations
  • Focus on the therapy relationship (ex. issue transference)
  • Exploration of fantasy life (this is special to psychodynamic therapies)
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9
Q

What is time-limited psychotherapy (TLDP) and supportive-expressive therapy?

A
  • Therapy has a goal
  • Therapist actively directs patient recollections, facilitate the expressions, offer interpretations quickly and directly, and clearly supportive of patients
  • Have individual and group applications
  • Often ‘medium’ term (20-30 sessions)
  • Is outcome oriented
  • TLPD uses some psychoanalytic techniques
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10
Q

What’s the general focus of behavioural and cognitive therapies?

A
  • Focus on behaviour change in the present
  • Is outcome-oriented
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11
Q

What are some of the behavioural techniques based on classical conditioning?

A
  • Systematic desensitization
  • In-vivo desensitization
  • Flooding
  • Aversion therapy
    *All used for anxiety
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12
Q

What are some of the first-wave behavioural therapies?

A

*Many based on classical conditioning and operant conditioning
- Contingency management - used a lot with kids, control over rewards/penalties
- Social skills training

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13
Q

What are some of the ‘second wave’ behavioural therapies and cognitive techniques?

A
  • Problem-solving therapy
  • Self-instruction training
  • Cognitive therapy - challenging negative/distorted beliefs
  • Rational Emotive Therapy (RET) - challenging irrational beliefs through direct disputation
  • Behavioural activation therapy for depression
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14
Q

What are some of the third-wave cognitive therapies?

A
  • Acceptance and commitment therapy (ACT)
  • Mindfulness-based cognitive therapy (MBCT)
  • Dialect behaviour therapy (DBT)
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15
Q

What therapies do ACT, MBCT, and DBT all have in common?

A
  • Emphasize principles such as acceptance, mindfulness, values-based living, and examining one’s thoughts in a dispassionate way
  • Third-wave therapies employ trans-diagnostic techniques that can be applied to many disorders (ex. meditation).
  • Emphasis on wellness ans quality of life
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16
Q

What’s cognitive diffusion?

A
  • Helping people realize that what they think about becomes them, and that this isn’t true
  • Cannot think ideas into real events
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17
Q

What are the general principles of humanistic therapies?

A
  • Psychotherapy is client-centered
  • Therapy is non-directive. Change is largely client-determined. The patient is encouraged to make his choices
  • Empathy, warmth, and genuineness are seen as essential to produce change
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18
Q

What are the different types of humanistic therapies?

A
  • Client-centered therapy
  • Existential therapy
  • Gestalt therapy (relations with others)
  • Emotion-focused therapy
19
Q

What is humanistic therapy most commonly used for?

A
  • Depression, interpersonal issues, distress associated with chronic and life-threatening conditions
20
Q

How is the effectiveness of treatments for mental disorders measured?

A
  • Use randomized clinical trials, which were initially developed for medical studies
  • Can be difficult to replicate methodology since there’s a lot of diversity within types of psychotherapies
21
Q

What are the major benefits of psychotherapy?

A
  • People who receive therapy are better off than 80% of untreated people
  • 2/3 patients improve significantly in therapy; 1/3 of those who don’t seek therapy improve over time
  • Also very economical, may even pay for themselves
22
Q

Why do most people often only attend less than 10 sessions?

A
  • They start to feel better and so they stop going
  • Not good
  • Ideally, for depression, 10-20 sessions are ideal
23
Q

What’s the major controversy concerning psychotherapies?

A
  • Should psychotherapies that have not been shown to be effective be taught or used?
  • Ex. CBTs largely dominate the field of efficacy research, therefore are promoted as most effective
24
Q

What are Jerome Frank’s common factors regarding why psychotherapy works?

A
  • A trained healer in whom the sufferer believes and from whom he/she seeks treatment
  • A structured interaction between the healer and sufferer in which change occurs as a consequence of words, acts or rituals (i.e., corrective experiences)
  • Major ingredients of healing: The instillation of hope, the provision of alternative explanations for problems, the expectation that the client will think, act, or feel differently as a result of the interaction
25
Q

What’s a major factor of success for psychotherapy?

A
  • The therapist-client relationship (‘the therapeutic alliance’)
  • Severity of diagnosis also plays a big role
  • YAVIS - young, attractive, verbal, intelligent, successful
26
Q

What’s your typical psychotherapy client?

A
  • Most likely younger, middle-class, female, with at least some post-secondary education
27
Q

What’s special about the national Institute for Health and Care Excellence (NICE) in the UK?

A
  • They provide guidelines for evidence-based practice, especially with anxiety and mood disorders
28
Q

What’s community intervention and prevention?

A
  • Community psychology provides an ecological perspective which emphasizes the interdependence of individuals, families, and communities, and society
29
Q

What are some general statistics regarding mental disorders in Canada?

A
  • About 20% of Canadians (around 7 million people)
  • It is estimated that at any given time, 14% of Canadian children aged 4 to 17 suffer from a mental disorder
30
Q

Why are young people usually the main targets in public mental health strategies?

A
  • Because approximately 70% of mental health problems start in childhood and/or adolescence
31
Q

What’s the difference between primary, secondary, and tertiary prevention?

A
  • Primary - interventions aimed at preventing the occurrence of the problem (ex. sex education)
  • Secondary - interventions performed after the problem is identified but before it has caused suffering, losses, or disability (ex. adolescents with low SES)
  • Tertiary - interventions aimed at preventing further deterioration once the problem has caused damage 9ex. drug rehab)
32
Q

What is mental health promotion?

A
  • An approach to mental health which emphasizes strengths, resilience, and positive mental health as opposed to reacting to pathology
  • Mental health is more than the absence of disorder
33
Q

What’s universal prevention?

A
  • Includes all individuals in a geographical area or particular setting
34
Q

What’s selective prevention?

A
  • Assumes that there are known factors that affect mental health and an intervention is directed at a population where those factors are most prevalent
  • Ex. schools in a low-income part of the city
35
Q

What’s indicated prevention/early intervention?

A
  • Programs directed at individuals showing early signs of mental health problems
36
Q

What are major principles that contribute to positive mental health?

A
  • The ability to enjoy life
  • The ability to deal with life’s challenges
  • Emotional well-being
  • Spiritual well-being
  • Social connections and respect for culture, equity, social justice and personal dignity
37
Q

What are some current approaches to prevention?

A
  • The identification of risk factors and the issue of cumulative risk
  • The identification of protective factors
  • Wellness enhancement and the promotion of resilience
  • Social justice perspectives
38
Q

What does wellness enhancement and the promotion of resilience involve?

A
  • Fostering secure attachment of children to caregivers
  • Encouraging the development of age-appropriate competencies
  • Creating healthy, safe, and ‘just’ social environments
  • Empowering people psychologically and politically
  • Helping people develop the resources to cope effectively with stressful life events
39
Q

According to Rutter (1987) what are some important risk and protective factors?

A

1) reducing risk impact
2) Interrupting unhealthy chain reactions stemming from stressful events
3) Enhancing self-esteem and self efficacy
4) Creating opportunities for personal growth

40
Q

What’s the general cost-effectiveness of intervention programs?

A
  • In the US, early intervention and prevention programs show that returns range from $1.50 to $17.00 for every dollar invested
  • Savings in sectors such as the criminal justice system, health system, and lifetime savings
41
Q

What’s cultural competence?

A
  • The degree of compatibility between cultural and linguistic characteristics of a community and the manner in which the combined policies, structures, and processes underlying local mental health services seek to make these services available
42
Q

What’s the difference between interactionist and constructionist perspectives?

A
  • Interactionist - understands that risk factors and protective factors do not affect everyone in the same way
  • Constructionist - the nature of resilience is influenced by how people construct meaning from their experiences
43
Q

What does a prevention program’s fidelity mean?

A
  • The extent to which the innovation corresponds to the originally intended program

Psychology 385 (9 decks)

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