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Psychology 105 > Chapter 17 - treatment of psycological disorders > Flashcards

Chapter 17 - treatment of psycological disorders Flashcards

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1
Q

The Helping Relationship

• Goal of Treatment:

A

• Help change maladaptive thoughts, feelings, behaviours

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2
Q

Two elements in all of psychotherapy

A

Therapeutic relationship and therapy techniques

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3
Q

Therapies found in psychodynamic

A
  • Psychoanalysis (Freud)

- Brief psychodynamic therapies

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4
Q

Therapies found in humanistic

A
  • client centred therapy (roger)

- Gastalt therapy

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5
Q

Therapies found in cognitive

A
  • rational emotive therapy (Ellis)
  • cognitive therapy (beck)
  • mindfulness based behavioural treatments
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6
Q

Therapies found in behavioural

A
  • classical conditioning
  • operant conditioning
  • modelling
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7
Q

Therapies found in biological

A
  • drug therapy
  • electroconvulsion therapy
  • psycho surgery
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8
Q

Psychoanalysis
• Based on Freudian principles

• Goal:

A

Help patients achieve insight

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9
Q

Insight =

A

conscious awareness of psychodynamics underlying problems

• Adjust behaviour underlying problems learned in childhood

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10
Q

Free Association

A
  • Uncensored conversation

* Verbal reports of thoughts, feelings, or images that enter awareness without censorship

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11
Q

Dream Interpretation

A

• Therapist helps client understand the symbolic meaning of their dreams

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12
Q

Resistance

A
  • Defensive maneuvers that hinder process of therapy

* Sign that anxiety-arousing material is being approached

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13
Q

Transference

A

• Client responds irrationally to therapist like he/she was important figure from client’s past

• Brings out repressed feelings & maladaptive
behaviours

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14
Q

Two types of transference

A

Positive:
• Feelings of affection, dependency, love

Negative:
• Irrational expressions of anger, hatred, disappointment

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15
Q

Interpretation

A
  • Statements by therapist, Provide client with insight into behaviour
  • Time consuming as client must arrive at ‘insight’
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16
Q

Brief Psychodynamic Therapies

A
  • Briefer, more economical
  • Focus on maladaptive past influences
  • Employ psychoanalytic concept in focused, active fashion
  • interpersonal therapy
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17
Q

Interpersonal Therapy

A

• Focus on client’s current relationships with important people in their lives

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18
Q

Humanistic Psychotherapies

• Focus:

A
  • Conscious control of behaviour
  • Personal responsibility
  • Disordered behaviour caused by lack of awareness and negative self image
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19
Q

Client-Centered Therapy
- Carl rogers

Focus:

A

Focus on therapeutic environment

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20
Q

In client entered therapy, how it the therapeutic environment focused on?

A
  • Unconditional positive regard (no judgement)
  • Empathy
  • genuineness
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21
Q

Gestalt Therapy

• Goal:

A

Bring feelings, wishes, and thoughts into awareness

• Make client “whole” again

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22
Q

Methods of gestalt therapy

A
  • Often carried out in groups
  • More active and dramatic approaches than client-centered approaches
  • Role-play
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23
Q

Cognitive Therapies
• Key Figures: Aaron Beck & Albert Ellis

• Focus

A
  • Role of irrational and self-defeating thought patterns

* Help clients discover & change cognitions that underlie problems

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24
Q

Rational Emotive Therapy

A 
• Activating event 
• Belief system 
• Consequences
• (emotional & behavioural) 
• Disputing or challenging maladaptive
emotions, behaviours
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25
Q

Beck’s Cognitive Therapy

A
  • Irrational beliefs
  • Ideas underlie maladaptive response
  • Point out errors of thinking
  • Help clients identify & reprogram “automated” thought patterns
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26
Q

Behaviour Therapies

A

• Maladaptive behaviours are the problem, not a symptom

  • they are learned, therefore they can be unlearned through CC or OC or modelling
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27
Q

Classical Conditioning Treatments

A
  • Exposure
  • flooding
  • implosion
  • systematic desensitization
  • in-vivo desensitization
  • aversion therapy
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28
Q

Exposure

A
  • Treat phobias through exposure to feared CS in the absence of UCS
  • Response prevention used to keep the operant avoidance response from occurring
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29
Q

Flooding

A

• Exposed to real-life stimuli

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30
Q

Implosion

A

• Imagine scenes involving stimuli

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31
Q

Systematic Desensitization

A
  • Learning-based treatment for anxiety disorders

* Eliminate anxiety through counterconditioning

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32
Q

Steps to Systematic Desensitization

A

1) Train muscle relaxation skills
• Anxiety & relaxation cannot co-exist

2) Stimulus hierarchy
• Low-anxiety to high-anxiety scenes (10-15)

3) Relaxation & progressive association with stimulus hierarchy

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33
Q

In-Vivo desensitization

A

• Controlled exposure to ‘real life’ situations

• Creates more anxiety during treatment than
systematic desensitization

• Anxiety may reduce more quickly though

34
Q

Aversion Therapy

A

• Condition an aversion to a CS
(e.g. alcoholic drink)
• CS paired with noxious UCS

35
Q

Operant Conditioning Treatments

• Aka behaviour modification

A
  • Use positive reinforcement, extinction, negative reinforcement, or punishment
  • Attempt to increase or reduce behaviour
  • token economies
  • punishment
36
Q

Operant conditioning treatment Successful when \

A

traditional therapies are difficult to implement

E.g., Profoundly disturbed children, mentally retarded

37
Q

Token Economies

A
  • System for strengthening desired behaviours through application of positive reinforcement
  • Tokens given for desirable behaviours
  • Tokens exchanged for tangible reinforcers
38
Q

Token economies

Goal:

A
  • Achieve desired behaviours with reinforcers

* Become reinforced with social reinforcers & self-reinforcement processes (e.g., self pride)

39
Q

Use of Punishment:

A
  • only if no alternatives and with consent

- Success with severely disturbed, self-destructive children

40
Q

Modelling

A

• Social Skills Training

41
Q

Social Skills Training

A
  • Modeling approach
  • Learning of new skills by observing and imitating a model who performs a socially skillful behaviour
  • need self efficacy
42
Q

“Third-wave” Cognitive-behavioural Therapies

A

• Concepts of mindfulness

Mindfulness-based approaches
• Acceptance
• Commitment
• Dialectical behaviour therapy

43
Q

Acceptance and commitment therapy

A
  • Focus on mindfulness as vehicle of change

* Exert control over thoughts and feelings

44
Q

Dialectical behaviour therapy

A
  • Borderline personality disorder treatment

* Elements from cognitive, humanistic, behavioural, psychodynamic therapies

45
Q

Culturally Competent Therapists

A
  • Use knowledge about client’s culture to achieve broad understanding of client
  • Attentive to differences from cultural stereotype as well
46
Q

Gender Issues In Psychotherapy • For females

A
  • Focus on changing women’s life circumstances
  • Aware of oppressive environmental conditions
  • Focus on supporting people in choices that meet their needs
47
Q

Evaluating Psychotherapies

• Specificity Question

A
  1. Which types of therapy
  2. Which kinds of therapists
  3. Which kinds of clients
  4. Which kinds of problems
  5. Which kinds of effects
48
Q

Evaluating Psychotherapies

• Difficulties:

A
  • Many variables not controlled
  • Therapist-client interactions varied
  • Measuring therapeutic effects
  • which kind of therapists measure outcomes
49
Q

Spontaneous remission

A

• Symptom reduction in absence of treatment was as high as success rate reported by therapists

50
Q

Randomized Clinical Trials

A

• Random assignment of clients to experimental or control groups

51
Q

In Randomized Clinical Trials

Types of control groups:

A
  • No-treatment
  • Placebo control condition
  • Other effective treatment
52
Q

Meta-Analysis

A

• Researchers combine statistical results of many studies to reach overall conclusion

  • effect size
53
Q

Effect Size

A

• What percentage of clients receiving therapy had a more favourable outcome than average control client

54
Q

Clinical significance

A

• Require that at the end of therapy, clients’ seeking treatment for a particular disorder, falls within the range of those not experiencing the particular problem

55
Q

Factors affecting the outcome of therapy

A
  • client variables
  • therapist variables
  • techniques
56
Q

Client Variables

A
  • Openness: Willingness to invest self in therapy; take risks
  • Self-Relatedness
  • Nature of Problem: Needs to “fit” with therapy being used
57
Q

Self-Relatedness: Ability to:

A
  • Experience & understand internal states
  • Be attuned to processes in relationship with therapist
  • Apply what is learned in therapy to their lives
58
Q

Therapist Variables

A 
Quality of relationship with client: 
• Empathy
• Unconditional acceptance
• Genuineness
• Trust
• Caring
59
Q

Techniques

A
  • Selecting & implementing appropriate techniques for client and situation
  • Dose-response effect
60
Q

Dose-response effect

A

• Amount of treatment & quality of outcome

61
Q

Factors in Effective Therapy

A
  • Faith in therapist: Client’s belief that they’re receiving help
  • Plausible explanation for problems: Alternative way of looking at selves & problems
  • Protective setting & supportive relationship • Opportunity to practice new behaviours
  • Increased optimism & self-efficacy
62
Q

biological factors

A

• Drugs, Electroconvulsive therapy, Psychosurgery

63
Q

Antidepressant Drugs

A
  • Tricyclics
  • Monoamine oxidase (MAO) inhibitors
  • Selective serotonin reuptake inhibitors (SSRIs)
64
Q

Tricyclics

A
  • Increase activity of norepinephrine & serotonin

* Prevent reuptake of excitatory neurotransmitters

65
Q

Monoamine oxidase (MAO) inhibitors

A
  • Increase activity of norepinephrine & serotonin
  • Monamine oxidase breaksdown neurotransmitters
  • severe side effects
66
Q

Selective serotonin reuptake inhibitors (SSRIs)

A
  • Block reuptake of serotonin
  • Milder side effects than other antidepressants
  • Reduce depressive symptoms more rapidly
  • least side effects
67
Q

Antipsychotic drugs

A
  • Decrease action of dopamine
  • Reduce positive symptoms of schizophrenia (e.g. delusions and hallucinations)
  • Little effect on negative symptoms
68
Q

Tardive dyskinesia

A

Uncontrollable motor movements, caused by antipsychotic drugs, permanent

69
Q

clozapine (Clozaril)

A

reduces not only positive symptoms, but also negative ones, and it appears not to produce tardive dyskinesia

70
Q

reserpine (tranquilizers)

A

calmed psychotic patients. Decrease dopamine

71
Q

Electroconvulsive Therapy

A

• Useful in treating severe depression

  • Effects can be immediate
  • 60-70% improve
72
Q

Electroconvulsive Therapy

• Criticisms

A
  • Possibility of relapse is high
  • Possibility of permanent memory loss
  • Possibility of permanent brain damage
73
Q

Electroconvulsive Therapy

Currently

A
  • # of treatments limited

* MRI scans reveal no brain damage

74
Q

Psychosurgery

A
  • Remove or destroy parts of brain
  • Least used of biomedical procedures
  • lobotomy
  • Cingulotomy
75
Q

Lobotomy

A
  • Destroy nerve tracts to frontal lobes

* Psychosis decreased with antipsychotic drugs

76
Q

Cingulotomy

A
  • Cut fibres that connect frontal lobes & limbic system

* Useful in severe depression & OCD

77
Q

PET scans show differences in the following brain regions in response ot psychotherapy and SSRI drugs

A
  • amygdala
  • hippocampus
  • temporal cortex
78
Q

Deinstitutionalization

A 
Deinstitutionalization
• Transfer of treatment to community
• 77.4% treated as in-patients in 1955
• 27.1% in 1990
• Good concept
• Requires availability of mental health care in
community. Otherwise…..
79
Q

Deinstitutionalization

• Revolving door phenomenon

A
  • Repeated rehospitalizations

* Large # of disturbed people who live on streets

80
Q

Preventive Mental Health

A
  • Situation-focused prevention

* Competency-focused prevention

81
Q

Situation-focused prevention

A
  • Reduce or eliminate environmental causes of disorders

* Enhance situational factors that prevent disorders

82
Q

Competency-focused prevention

A

• Designed to increase personal resources & coping skills

Psychology 105 (9 decks)

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