Chapter 17 - Therapies Flashcards
What are the serious side effects of ECT?
Disorientation
Memory loss
Broken bones
Death from cardiac failure
What is the current use of ECT?
Briefer currents only to one side of brain
Anesthetics
Muscle relaxants
What is the efficacy of ECT?
Short-term for patients with depression
50%+ relapse
Temporary cognitive impairments
What are psychotropic agents?
Affect individual’s psychological functioning
Discovery of most psychotropic medications occur _________.
Serendipitously
What are the 3 antipsychotics that are used?
Phenothiazines
Long-term medication regimen for schizophrenia
Second generation antipsychotics
What do phenothiazines do?
First-generation antipsychotics
Reduce hallucinations
Led to deinstitutionalization
What are the side effects of long-term medication regimen for schizophrenia?
Extrapyramidal effects
Symptoms similar to Parkinson’s (motor problems) and tardive dyskinesia (tics)
What do antipsychotics do?
Stabilize mood
Fewer extrapyramidal effects
What is the guideline to choosing medication?
Based on least # and severity of side effects for patient
What do anxiolytics do?
Alleviate symptoms of anxiety and muscle tension by lowering SNS activity, respiration and heart rate
What are the 2 classes of anxiolytics?
First class: barbiturates
Second class: benzodiazepines
What are the factors of barbiturates?
Addictive
Large doses toxic
What are the factors of benzodiazepines?
Less toxic, still addictive
Withdrawal and convulsions
Needs to be gradually reduced
What are the guidelines for using anxiolytics?
Should only be used for brief periods
What are the 4 antidepressants?
MAOIs
TCAs
SSRIs
SNRIs
What are the downsides to MAOIs?
Severe dietary restrictions
Can cause increase in blood pressure
What are the downsides to TCAs?
Unpleasant side effects such as…
Dry mouth
Blurry vision
Constipation
Light headedness
SSRIs and SNRIs are __________ than TCAs.
Better tolerated
What are the side effects of SSRIs and SNRIs?
Nausea
Diarrhea
Headache
Tremors
Sleeplessness
SSRIs and SNRIs take ______ weeks to demonstrate improvement, and optimal response by ______ weeks.
1-2; 3-4
What are the guidelines for SSRIs and SNRIs?
First-line medication options
What are the suicidal risks for antidepressant medications?
TCAs toxic in overdose
SSRIs could increase suicidal behaviour/ideation
What are 3 mood stabilizers?
Lithium
Anticonvulsives
Antipsychotics
What are the side effects of lithium?
Nausea/dizziness
Weight gain
Mild diarrhea
Narrow window of effectiveness
What are 3 factors of stimulants?
Short-acting
Peak efficacy 1-5 hours after administration
Mild improvements in executive functioning
What are the differences in stimulant effects for children and adults?
Children: improved ADHD symptoms, general behaviour, and quality of life
Adults: mild improvement in symptoms
What are the side effects of stimulants?
Appetite suppression
Sleep disturbance
Mood disturbance
Headaches
Abdominal discomfort
Fatigue
What are the guidelines for using stimulants?
Should be first-line for both children and adults with ADHD
What are the 3 summaries of pharmacological treatments?
No medication for treating everyone with particular disorder
Difficult to predict favorable response
Does not lead to new skills/coping mechanisms, which may lead to relapse
What is the definition for psychotherapy?
Process where professionally trained therapist systematically uses techniques from principles to relieve person’s psychological distress/facilitate growth
What are the 4 theoretical orientations of psychotherapy?
Psychodynamic
Cognitive-behavioural
Humanistic-experiential
Integrative/eclectic
What is the goal of psychoanalysis?
Help patients understand unconscious factors controlling behaviour
What are the 5 psychoanalytic techniques?
Free association
Dream interpretation
Interpretation
Analysis of resistance
Analysis of transference
What is analysis of resistance?
Analyze when client becomes unwilling to discuss certain topics
What are the 2 types of psychodynamic therapies?
Brief
Interpersonal
What is the difference between the two psychodynamic therapies?
Brief: Freudian techniques, short term, goals and interpretations of life events
Interpersonal: interaction of patient and social environment, problematic interpersonal styles
What are 3 factors of humanistic-experiential approaches?
Focus on subjective and current experiences
Free will and responsibility
Genuine and accepting therapist
What are 4 examples of humanistic-experimental therapies?
Client-centered
Existential (meaning to life)
Gestalt (distortions)
Emotion-focused
What is the empty chair technique of gestalt therapy?
Help to make client more aware of genuine feelings as if speaking to person in conflict
What is third wave CBT?
Accepting thoughts/emotions and way person experiences/reacts
What are the 9 CBT interventions?
Reinforcement
Response shaping
Behavioural activation
Relaxation training
Exposure
Assertiveness training
Problem solving
Cognitive restructuring
Mindfulness
What is reinforcement?
Reinforce desirable behaviours, ignore undesirable behaviours
What is behavioural activation?
Increase overall activity to increase natural reinforcers and ultimately decrease depressive symptoms
What is assertiveness training?
Rehearse and practice in therapy sessions before applying to real life
What are integrative approaches?
Draws on selected aspects of various schools of therapy
What is eclectic vs integrative?
Eclectic: select certain techniques
Integrative: combine techniques
What are the 3 “common ingredients” of therapy?
Hope for change
Alternative explanation to understand problem
Change way of thinking, feelings or acting
What are the 4 treatment modalities?
Individual
Couples
Family
Group
Who provides psychotherapy?
Clinical psychologists
After making an appointment, only ____% show up to first appointment, and majority attend fewer than ______ sessions, terminating before gaining optimal benefit.
50; 10
What is treatment efficacy?
Evidence of treatment effects when delivered in context of controlled study
What is treatment effectiveness?
Evidence of effects when treatment evaluated in “real world” context
What is meta-analysis?
Method of quantitatively summarizing results of multiple research studies
Objective and generalizable
According to Smith, Glass, and Miller, average person receiving therapy was ________ than people who did not.
Better off
For anxiety disorders, a(n) ________ element is required.
Exposure
For depressive disorders, __________, _________ and ___________ therapies are efficacious in treating depression, and suggests the active component of CBT is _________.
Interpersonal; CBT; psychodynamic
Behavioural activation
For sleep-wake disorders, the best psychotherapies are _______ interventions such as ________, ___________, _________ and ___________.
CBT
Relaxation training; sleep restriction; stimulus control; thought challenging
For personality disorders, _______ and ______ are used to treat BPD.
DBT; psychodynamic
What are the best treatments for bipolar disorder?
Combo of psychological interventions and medications
What are the best treatments for early psychosis?
CBT and family-based services
What are the best treatments for schizophrenia?
CBT
When combined with ___________, psychotherapies can yield beneficial effects in functioning.
Medication
What are issues with generalizing of clinical settings?
Limitations of research evidence (controlled environment)
Very different from real world
What are the 3 criterion developed by APA for the “empirically supported therapy”?
Repeated demonstration of efficacy
Use of treatment manuals
Clear description of participants
What are the clinical practice guidelines?
Use available research evidence for assessment, diagnosis, treatment
Offer authoritative recommendations on treatment
What are the 3 foundations of good treatment?
Early detection
Sound assessment
Person-centered care
