Chapter 17 – Treatment Of Psychological Disorders Flashcards
deep sleep/ depatterning therapy
giving patients a drug-induced coma
Shocking them while they were unconscious
Following the shocks with recorded messages played to the patient
T/F A majority of people with mental health issues first seek help from mental health professionals
false
They first seek help from family members, physicians, acquaintances, self-help groups, members of the clergy
what kind of education does a Counseling/clinical psychologist have
phD
PsyD
five years of training
what kind of education two psychiatrists have
what do psychiatrist do
they are medical doctors who specialize in psychotherapy and bio medical treatments
where do psychiatric social worker’s work
Community agencies
what do you marriage and family counselor’s specialize in
problems arising from family relations
what do pastoral counsellors focus on
spiritual issues
who do abuse counsellors work with
substance/sexual abusers and their victims
The goal of psychoanalysis
to help clients achieve insight
insight
conscious awareness of the psychodynamics that underlie your problems
what are the types of psychodynamic therapies
free association
Dream interpretation
free association
The client just says whatever comes in to mind
what does the analyst expect to gain through free association
clues concerning important themes or issues
T/F The analyst expects that free association directly leads to unconscious material
false
what happens in dream interpretation
analyst helps clients search for unconscious material in the dreams
They help the client to understand what the symbols in the dream really represent
resistance
defensive manoeuvres that hinder the process of therapy
transference
The client response irrationally to the analyst as if they were an important figure from the clients past
what are the two forms of transference
positive transference
Negative transference
positive transference
client transfers feelings of intense affection, dependency, or love to the analyst
negative transference
The client transfers feelings of intense anger, hatred, or disappointment to the analyst
interpretation
any statement made by the therapist intended to give the clients insight into their behavior/dynamics
what is the general rule in psychoanalytic treatment about making interpretations?
only interpret what’s already near the surface and almost in the clients current awareness
Don’t make a deep interpretations of strongly defended unconscious dynamics
similarities between lengthy psychoanalysis and brief psychodynamic therapies
they both emphasize understanding the influences of the past, utilizing insight and interpretation
how are brief psychodynamic therapies different from lengthy psychoanalysis
focused on addressing current life events
therapist and client sit facing each other
Conversation instead of free Association
Clients are seen once a week, not daily
The goal is to help the client with specific life problems, not completely rebuilding the clients personality
interpersonal therapy
A type of brief psychodynamic therapy
Focuses on the clients current interpersonal problems
how do humanistic theorists view humans
capable of consciously controlling their actions and taking responsibility for their choices and behaviour
Everyone possesses into resources for self healing and personal growth
Disordered behaviour reflects a blocking of the natural growth process
Who developed client centred therapy
Carl Rogers
what did Carl Rogers believe was the “active ingredient” in therapy
The relationship that develops between client and therapist
what did Rogers find where the three important and interrelated therapist attributes
1) unconditional positive regard
2) empathy
3) genuineness
define what is meant by unconditional positive regard, when it comes to client centred therapy
therapist cares about and except the clients
Therapist doesn’t judge the clients
Therapist believes in the clients ability to work through their problems
define what is meant by empathy in client centred therapy
The therapist truly senses the feeling/meetings experience by the client
The therapist communicates this understanding to the client by reflecting back to them
define what is meant by genuineness in client centred therapy
there must be consistency between the way therapist feels and the way they behave
Therapist must be able to express both positive and negative feelings
what is the goal of gestalt therapy
bringing important feelings, wishes, and thoughts that are blocked from awareness into awareness so that the client can be “whole” again
empty chair technique
client is asked to imagine a figure from their life in the chair and then carries a conversation, pretending to be both themselves and the other figure
what was the problem of gestalt therapy
it wasn’t very scientific
They couldn’t do systematic research on the effectiveness of their techniques
what do cognitive approaches to psychotherapy focus on. what do the therapists try to do
The role of a rational and self-defeating thought patterns
Therapist tries to help clients discover and change the cognitions that underlie their problems
Ellis’ rational – emotive therapy
irrational thoughts are the cause of self-defeating emotions
ABCD model
what does each letter in the ABCD model stand for
activating event that triggers the emotion
belief system that underlies the way someone appraisers the event
consequences of that appraisal
disputing/challenging the belief system
what happens in Becks cognitive therapy
helping clients identify and reprogram their “automatic” thought patterns
which disorders have responded most favourably to Becks cognitive therapy
depression Anger disorder's Anxiety disorders Personality disorders Eating disorders
what did behaviour therapist believe
inner dynamics or not important
Behavior disorders are learned behaviors
The maladaptive behaviours can be unlearned through classical and operant conditioning
what are classical conditioning treatments included in behaviour therapy
exposure
Systematic desensitization
aversion therapy
exposure
clients are exposed to the stimuli, but the unconditioned stimulus (the adverse event) does not happen
Plus the anxiety response will be extinguished
flooding
exposing the client to real life stimuli
implosion therapy
having the client imagine scenes involving the stimuli
what disorder is exposure effective for
PTSD
phobias
systematic desensitization
using counterconditioning to eliminate anxiety
counterconditioning
I need a response that is incompatible with anxiety is conditioned to the anxiety arousing condition stimulus
what is the first step in systematic desensitization
training the client in the skill of voluntary muscle relaxation
what is the second step of systematic desensitization
helping the client to make a stimulus hierarchy of 10 to 15 scenes relating to the fear, arranging the scenes from low anxiety to high anxiety
what does the therapist do in the desensitization sessions
deeply relaxed the client and ask them to physically imagine the first scene in the hierarchy for several seconds
The deep relaxation will replace anxiety as the conditioned response to that stimulus
in vevo desensitization
client is carefully exposed to a hierarchy of real life situations, instead of imagining the scenes
what disorders is desensitization useful for
anxiety
aversion therapy
therapist pairs a stimulus that stimulates deviant/self-defeating behaviour (CS) with an adversive UCS in order to condition an aversion for the CS
what kind of disorders are aversion therapies useful for
alcoholics
Pedophiles
behaviour modification
using operant conditioning as a treatment, in order to increase/decrease a specific behaviour
what are types of operant conditioning
positive reinforcement
Negative reinforcement
Punishment
Extinction
token economy
A system for strengthening desired behaviours
They give tokens as positive reinforcement
what groups of people and environments has the use of the token economy been useful in
schizophrenics Businesses Schools Prisons Home environments
what two questions must therapists ask themselves before deciding to use punishment as a therapeutic technique
1) are there effective, less painful alternative approaches
2) is the behaviour we’re trying to get rid of harmful enough to the individual/society to justify the severity of the punishment
social skills training
A model performs a socially skilful behavior, while the client observes and then imitates
with what groups of people is social skills training useful for
individuals who have minor deficits in social skills
Delinquents we need to learn how to resist negative peer pressure’s
Hospitalized schizophrenics who need to learn social skills in order to function outside the hospital
third wave cognitive behavioural therapy’s
therapies that incorporate the concept of mindfulness as a central objective to behaviour change
They represent the addition of humanistic concepts and eastern methods of behaviour therapy
what is included in third wave cognitive behavioural therapies
acceptance and commitment therapy
Dialectical behaviour therapy
mindfulness
A mental state of awareness, focus, openness, addict’s actives of immediate experience
It involves nonjudgmental appraisal
what types of conditions and disorders is mindfulness meditation being used to treat
stress related conditions and disorders
Like anxiety and depression
Also helps prevent relapse and helps neutralize self blame following a lapse
acceptance and commitment therapy
using mindfulness as a vehicle for change
Instead of teaching clients to control their thoughts/feelings, clients are taught to just notice, accept, and embrace their thoughts/feelings
dialectical behaviour therapy
treatment for BPD
This therapy includes elements from cognitive, behavioral, humanistic, and psychodynamic therapies
describe the behavioural element of DBT
behavioural techniques are used to help the clients learn interpersonal, problem-solving, and emotion control skills
describe the cognitive element of DBT
cognitive approaches are used to help client learn more adaptive thinking about the world, relationships, and of themselves
describe the psychodynamic aspect of DBT
psychodynamic element to traces the history of early deprivation and projection that created many of the problems
describe the humanistic aspect of DBT
humanistic emphasis on acceptance of thoughts and feelings helps clients better tolerate negative emotions
which group of people are more likely to utilize mental health services: white population’s or minority groups
White populations
what factors serve as barriers to therapy for ethnic minorities
1) cultural norm against turning to professionals outside your own culture for help
2) many minority members have a history of bad experiences with white bureaucracies
3) language barriers
4) poverty is a bigger issue for minority groups, maybe they can’t afford/get to therapy
5) not many counsellors can provide culturally responsive forms of treatment
what do we mean when we say most therapists can’t provide culturally responsive forms of treatment
sometimes they operate on the basis of inaccurate stereotypes
what can we do to increase the access of culturally diverse groups to psychological treatment
1) set up mental health services in minority population areas, staffed by culturally skilled counsellors
2) cultural congruence
3) train more therapists from minority ethnic groups
cultural congruence
treatment that is consistent with cultural beliefs and expectations
T/F for clients to choose to stay in therapy, it hasn’t been shown that the outcomes are better when they are seen by therapist from their own ethnic group
true
cultural competence
therapist with knowledge about the clients culture can achieve a broad understanding of the client, while also understanding how the client may differ from the cultural stereotype
they can introduce culture specific elements into the therapy
T/F it is possible to train therapists to be more culturally sensitive
true
what specific stressors do women face that could be the reason behind anxiety and depression occurring more frequently amongst women in western cultures
1) there are more women in poverty
2) less available opportunities
3) there are strains created by the demand of multiple roles (mother, worker, spouse)
4) many women have been subjected to violence and abuse
T/F it is necessary that women be treated by female therapists
false
what’s important is that the therapist is sensitive to gender issues
specificity question
what kind of effects are produced by a certain combination of therapy, therapist, clients, and problems?
spontaneous remission
symptom reduction in the absence of any treatment
randomized clinical trial’s
participants who have well-defined psychological disorders and are similar and other variables are randomly assigned to an experimental or control condition
what could the control condition in an RCT be
no treatment
or
Placebo
T/F researchers should collect follow up data
true
meta-analysis
combining the results of many studies to arrive at an overall conclusion
effect size statistic
A common measure of treatment effectiveness
It tells researchers what percentage of clients who have received therapy had a more favourable outcome than those who didn’t receive the treatment
T/F psychodynamic, client centered, gestalt and behavioural approaches were quite similar in their effectiveness
false
Client centered, psychodynamic, and behavioural are quite similar
gestalt yielded less positive effects
dodo bird verdict
widely different therapies have similar efficacy
differential effectiveness
specific therapies may be highly effective for treating some clinical disorders but not others
clinical significance
at the end of therapy, a clients depression scores should fall within the range for nondepressed people
what clients variables are important to treatment outcome
Openness
Self relatedness
Nature of the problem
openness
The clients general willingness to invest themselves in therapy and take the risks required to change themselves
self relatedness
The clients ability to experience/understand internal states like thoughts/emotions
The clients ability to be attuned to the processes that go on in the relationship with her therapist
The clients ability to apply what they learned in therapy to their lives outside of treatment
why is the nature of the problem and important client factor
The type of therapy being used should fit the nature of the problem
deterioration effect
hostile interchanges between therapist and client can negatively impact the outcome of treatment
does – response affect
The relation between the amount of treatment received and the quality of the outcome
psycho pharmacology
The study of how drugs affect cognitions, emotions, and behaviours
what types of drugs are Valium, Xanax, and BuSpar
anti-anxiety/tranquilizing drugs
what is the drawback of anti-anxiety drugs
psychological and physical dependence can develop
They can experience with drawl symptoms when they stop taking them
Anxiety symptoms often return when people stop taking the drugs
what is different about BuSpar
has fewer tiring side effects
Less potential for abuse
how do anti-anxiety drugs work
increasing GABA, which is inhibitory
what are the three major categories of antidepressant drugs
tricyclics
Monoamine oxidase inhibitor’s
selective serotonin reuptake inhibitor’s
how do tricyclics work
prevent re-uptake of excitatory transmitters
how do MAO inhibitor’s work
reduce activity of monoamine oxidase, which breaks down neurotransmitters
Side effects of MAO inhibitors
increase blood pressure if taken with certain food
how do SSRI’s work
increase activity of serotonin
Side effects of SSRIs
nervousness, insomnia, sweating, joint pain, sexual disfunction
why are SSRIs replacing tricyclics
they have mild or side effects, and reduce depressive symptoms along with anxiety symptoms
compare the recovery rates for psychotherapy and for drug therapy
higher for psychotherapy
compare the recovery rates for psychotherapy and for combined treatments
they were the same
compare the recovery rates for combined treatments and for drug therapy
combined treatments was higher
major tranquilizers
synthetic antipsychotic drugs
what is the primary effect of the major tranquilizers
decrease the action of dopamine
what affects do antipsychotic drugs have on the symptoms of schizophrenia
they reduce positive symptoms
They have a little effect on negative symptoms
Tardive dyskinesia
uncontrollable and grotesque movements of the face and tongue
Irreversible once it develops
Side effects of antipsychotic drugs
Tardive dyskinesia
pros of clozapine/clozaril
reduces positive and negative symptoms
Doesnt produce tardive dyskinesia
cons of clozapine
produces a fatal blood disease in some people who take it
electro convulsive therapy
attaching electrodes to the school, administering an electric current to the brain in order to induce a seizure
T/F ECT is used to relieve anxiety disorders
false
it can’t relieve anxiety disorders
which disorders respond favourably to ECT
major depression
psychosurgery
surgical procedures that removes or destroys brain tissue to change disordered behaviour
describe the first lobotomy performed by Walter Freeman
insert ice pick through edges of eyesocket into the brain
Wiggle it back-and-forth to sever the nerve tracts
Side affects of lobotomies
seizures
Stupor
Memory/reasoning impairment
Listlessness
cingulotomy
what is it
cutting a small fibre bundle near the corpus callosum that connects the frontal lobe’s with the limbic system
cingulotomy
what does it treat
severe depressive disorder
Obsessive compulsive disorder
cingulotomy
side effects
seizures
what was the problem of early mental health institutions
overcrowded
Understaffed
Underfinanced
People admitted lost the skills needed to re-enter the outside world
deinstitutionalization
transfer in the primary focus of treatment from the mental institution to the community
what are the two major approaches to preventing mental disorders
situation focussed prevention
Competency focussed prevention
situation focussed prevention
reducing the environmental causes of behaviour disorders
Enhancing situational factors that prevent the development of disorders
competency focus prevention
increase personal resources and coping skills
battlemind
an intervention used on returned soldiers
debriefing phase, teaching them to adapt the combat skills they learned to the home environment
