Chapter 17: Treatment of Psychological Disorders Flashcards
Psychodynamic therapies
Based on Freudian Principles
Goal is to help patients achieve insight (conscious awareness of psychodynamic underlying problems)
Psychoanalysis: Free Association, Dream Interpretation, Resistance, Transference
free association: uncensored conversation, verbal reports of thoughts, feelings, or images that enter awareness without censorship
dream interpretation: understanding symbolic meaning of dreams
resistance: defense maneuvers hindering process of therapy, is a sign that anxiety arousing material is being approached
transference: client views the therapist as a important figure in client’s past
- positive; feelings of affection dependency, love
- negative; irrational expressions of anger, hatred and disappointment
Humanistic Psychotherapies
- goal is to achieve self actualization
- focus on fixing the present and not a past relationship compared to psychodynamic
- client- centered therapy
- CARL ROGERS
What is Client Centered Therapy?
- use of unconditional positive regard, accepting clients without judgement or evaluation
- empathy, view the world through client’s eyes
- genuieness- consistency between therapist’s feelings and behaviors
- “to have a friend, you must be a friend”
Gestalt Therapy
- goal is to bring feelings, wishes and thoughts into awareness
- to make client “whole” again without dissonance
- method: often in groups, more active and dramatic approaches than client centered approaches
Cognitive Therapies
- key figures: AARON BECK and ALBERT ELLIS
- focus is to help clients discover and change conditions that underlie problems, changing distorted thoughts
- role of irrational and self-defeating thought patterns
Cognitive Therapies: Rational Emotive Therapy
activating event activates a belief system that leads to consequences (emotional and behavioural) then you dispute or challenge the maladaptive emotions and behaviours caused by the activating event
Cognitive Therapies: Beck’s Cognitive Therapy
- Irrational Beliefs
- ideas underlie maladaptive response, point out errors of thinking, help clients identify and reprogram “automated” though patterns
Behavior Therapies
where maladaptive behaviours are the problem and not the symptom
- aims to counteract unwanted behaviors
Behaviour Therapies: Exposure, Flooding, Implosion
- Exposure: treat phobias through exposure to feared CS in the absence of UCS
- Flooding: exposed to real-life stimuli
- Implosion: Imagine scenes involving stimuli
Behaviour Therapies: Systematic Desensitization
- learning - based treatment for anxiety disorders, eliminate anxiety through counterconditioning
eg. for fear of snakes
start of small by trying to relax with a picture of a snake, then to a deal irl snake, then irk snake in enclosure, then snake on u - stimulus hierarchy - low anxiety to high anxiety
Behaviour Therapies: In-Vivo desensitization
- controlled exposure to ‘real life’ situations
- creates more anxiety during treatment than systematic desensitization
- anxiety may reduce more quickly though
Behaviour Therapies: Aversion Therapy
- CS paired with noxious UCS
eg. CS: alcohol UCS: electric shock
so when patient sees alcohol, but is shocked, it produces an emotional response with is a condition anxiety response for the desired outcome to be reduced wanting of alcohol
Behaviour Therapies: Operant Conditioning (Behaviour Modification) Treatments
- use positive reinforcement, extinction, negative reinforcement, or punishment
- attempt to increase or reduce behaviour
- successful when traditional therapies are difficult to implement
Social Skills Training
- modeling approach
Key factor: increased self-efficacy, believing you can succeed
Cognitive-behavioral Therapies: Mindfulness-base approaches
- concepts of mindfulness
- humanistic and eastern methods
- acceptance
- commitment
- dialectical behaviour therapy
Acceptance and Commitment Therapy and Dialectical Behaviour Therapy
- focus on mindfulness as vehicle of change
- exert control over thoughts and feelings
Dialectical behaviour therapy
- borderline personality disorder
- elements from cognitive, humanistic, behavioural, psychodynamic therapies
Cultural and Gender Issues in Psychotherapy
- North American and Western European Assumptions
- not shared by all cultures
- cultural norms- not seeking help outside one’s culture, language barrier, lack of culturally responsive treatments
Cultural Issues: Culturally Competent Therapists
- use knowledge about client’s culture to achieve broad understanding of client
- understand cultural background
- attentive to differences from cultural stereotype as well, understand both individual and cultural differences
Psychotherapy Research Methods
Spontaneous remission: symptom reduction in absence of treatment was as high as success rate reported by therapists
Drug Therapies: Anti-anxiety drugs
- newer drug: Buspirone (Buspar)
- Anti-anxiety drugs: reduce anxiety without affecting alertness, slow down excitatory synaptic activity
– side effects: drowsiness, lethargy, dependence
Drug Therapies: Antidepressants Drugs
Tricyclics- increase activity of norepinephrine and serotonin, prevent reuptake of excitatory neurotransmitters
Monoamine oxidase (MAO) inhibitors: increase activity of norepinephrine and serotonin, breakdown neurotransmitters
Selective serotonin reuptake inhibitors (SSRIs): block reuptake of serotonin, this put on first cause its more specific and less side effects
- serotonin activity is low in many depressed clients
Drug Therapies: Antipsychotic drugs
- decrease action of dopamine, reduce positive symptoms of schizophrenia, little effect on negative symptoms
TARDIVE DYSKINESIA: severe movement disorder
Electroconvulsive Therapy
- began with observation that schizophrenia and epilepsy rarely occur together
- useful in treating severe depression, effects can be immediate
- procedure: patient given sedative and muscle relaxant, shock less than 1 second, causing seizure of CNS
