Chapter 17: Treatment of Psychological Disorders

Question 1

Psychodynamic therapies

Answer 1

Based on Freudian Principles
Goal is to help patients achieve insight (conscious awareness of psychodynamic underlying problems)

Question 2

Psychoanalysis: Free Association, Dream Interpretation, Resistance, Transference

Answer 2

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

Question 3

Humanistic Psychotherapies

Answer 3

• goal is to achieve self actualization
• focus on fixing the present and not a past relationship compared to psychodynamic
• client- centered therapy
• CARL ROGERS

Question 4

What is Client Centered Therapy?

Answer 4

• 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”

Question 5

Gestalt Therapy

Answer 5

• 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

Question 6

Cognitive Therapies

Answer 6

• 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

Question 7

Cognitive Therapies: Rational Emotive Therapy

Answer 7

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

Question 8

Cognitive Therapies: Beck’s Cognitive Therapy

Answer 8

• Irrational Beliefs
• ideas underlie maladaptive response, point out errors of thinking, help clients identify and reprogram “automated” though patterns

Question 9

Behavior Therapies

Answer 9

where maladaptive behaviours are the problem and not the symptom
- aims to counteract unwanted behaviors

Question 10

Behaviour Therapies: Exposure, Flooding, Implosion

Answer 10

• Exposure: treat phobias through exposure to feared CS in the absence of UCS
• Flooding: exposed to real-life stimuli
• Implosion: Imagine scenes involving stimuli

Question 11

Behaviour Therapies: Systematic Desensitization

Answer 11

• 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

Question 12

Behaviour Therapies: In-Vivo desensitization

Answer 12

• controlled exposure to ‘real life’ situations
• creates more anxiety during treatment than systematic desensitization
• anxiety may reduce more quickly though

Question 13

Behaviour Therapies: Aversion Therapy

Answer 13

• 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

Question 14

Behaviour Therapies: Operant Conditioning (Behaviour Modification) Treatments

Answer 14

• use positive reinforcement, extinction, negative reinforcement, or punishment
• attempt to increase or reduce behaviour
• successful when traditional therapies are difficult to implement

Question 15

Social Skills Training

Answer 15

• modeling approach
  Key factor: increased self-efficacy, believing you can succeed

Question 16

Cognitive-behavioral Therapies: Mindfulness-base approaches

Answer 16

• concepts of mindfulness
• humanistic and eastern methods
• acceptance
• commitment
• dialectical behaviour therapy

Question 17

Acceptance and Commitment Therapy and Dialectical Behaviour Therapy

Answer 17

• 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

Question 18

Cultural and Gender Issues in Psychotherapy

Answer 18

• 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

Question 19

Cultural Issues: Culturally Competent Therapists

Answer 19

• 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

Question 20

Psychotherapy Research Methods

Answer 20

Spontaneous remission: symptom reduction in absence of treatment was as high as success rate reported by therapists

Question 21

Drug Therapies: Anti-anxiety drugs

Answer 21

• newer drug: Buspirone (Buspar)
• Anti-anxiety drugs: reduce anxiety without affecting alertness, slow down excitatory synaptic activity
  – side effects: drowsiness, lethargy, dependence

Question 22

Drug Therapies: Antidepressants Drugs

Answer 22

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

Question 23

Drug Therapies: Antipsychotic drugs

Answer 23

• decrease action of dopamine, reduce positive symptoms of schizophrenia, little effect on negative symptoms

TARDIVE DYSKINESIA: severe movement disorder

Question 24

Electroconvulsive Therapy

Answer 24

• 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

Question 25

Psychosurgery: Lobotomy

Answer 25

• destroy nerve tracts to frontal lobes, decreased with antipsychotic drugs

Question 26

Psychosurgery: Cingulotomy

Answer 26

• cut fibres that connect frontal lobes and limbic system
• useful in severe depression and OCD