Chapter 17 - Therapies Flashcards by Philia Yip

What are the serious side effects of ECT?

Disorientation

Memory loss

Broken bones

Death from cardiac failure

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What is the current use of ECT?

Briefer currents only to one side of brain

Anesthetics

Muscle relaxants

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What is the efficacy of ECT?

Short-term for patients with depression

50%+ relapse

Temporary cognitive impairments

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What are psychotropic agents?

Affect individual’s psychological functioning

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Discovery of most psychotropic medications occur _________.

Serendipitously

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What are the 3 antipsychotics that are used?

Phenothiazines

Long-term medication regimen for schizophrenia

Second generation antipsychotics

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What do phenothiazines do?

First-generation antipsychotics

Reduce hallucinations

Led to deinstitutionalization

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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)

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What do antipsychotics do?

Stabilize mood

Fewer extrapyramidal effects

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What is the guideline to choosing medication?

Based on least # and severity of side effects for patient

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What do anxiolytics do?

Alleviate symptoms of anxiety and muscle tension by lowering SNS activity, respiration and heart rate

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What are the 2 classes of anxiolytics?

First class: barbiturates

Second class: benzodiazepines

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What are the factors of barbiturates?

Addictive

Large doses toxic

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What are the factors of benzodiazepines?

Less toxic, still addictive

Withdrawal and convulsions

Needs to be gradually reduced

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What are the guidelines for using anxiolytics?

Should only be used for brief periods

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What are the 4 antidepressants?

MAOIs

TCAs

SSRIs

SNRIs

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What are the downsides to MAOIs?

Severe dietary restrictions

Can cause increase in blood pressure

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What are the downsides to TCAs?

Unpleasant side effects such as…

Dry mouth
Blurry vision
Constipation
Light headedness

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SSRIs and SNRIs are __________ than TCAs.

Better tolerated

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What are the side effects of SSRIs and SNRIs?

Nausea

Diarrhea

Headache

Tremors

Sleeplessness

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SSRIs and SNRIs take ______ weeks to demonstrate improvement, and optimal response by ______ weeks.

1-2; 3-4

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What are the guidelines for SSRIs and SNRIs?

First-line medication options

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What are the suicidal risks for antidepressant medications?

TCAs toxic in overdose

SSRIs could increase suicidal behaviour/ideation

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What are 3 mood stabilizers?

Lithium

Anticonvulsives

Antipsychotics

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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