Chapter 6: Integrative and Biopsychosocial Approaches in Contemporary Clinical Psychology

Question 1

Choice of Theoretical Orientation

Answer 1

Depends on Graduate and Post Graduate Training; the Personality of the professional; and the general worldview held of human nature

Question 2

Unidimensional approaches

Answer 2

Found to be lacking and of limited use in their approach to the full spectrum of psychological problems; research has generally failed to demonstrate that one treatment persective is more effective than another; 45% of improvements in psychotherapy may be attribtable to common factors found in all major theories and approaches; Less than 15% of treatment outcome variance can be accounted for by specific techniques

Question 3

Combination of perspectives and techniques

Answer 3

May have powerful and synergistic effects

Question 4

Free Associations/Automatic Thoughts

Answer 4

Immediate and unfiltered thoughts and feelings that come to mind; highly valued and integrated into their understanding and treatment of human behavior

Question 5

Common Denominators among the Different Theoretical Perspectives

Answer 5

Providing the patient with new experiences within and outside of the therapy session
All psychotherapies encourage the patient to engage in corective experiences that they all provide some form of feedback to the patient
A professional office associated with healing and being helped
A trained mental professional who is supportive, thoughtful, professional, and perceived as an expert in human behavior, enhanced hope and thoughts, feelings, and behaviors can change for the better, fees associated with service, and the avoidance of dual relationships

Question 6

James Prochaska

Answer 6

Discussed commonalities among theoretical orientations by examning the process of change across different types of problems and different methods of treatment

Question 7

Jame’s Prochaska’s Theory of Change

Answer 7

Five stages of change; (precontemplation, contemplation, preparation, action, and maintenance), five levels of change (symptoms, maladaptie cognition, current interpersonal conflicts, family/systems conflicts, past interpersonal conflicts); change processes (consciousness raising, catharsis/dramatic relief, self-evaluation, environmental reevaluation, self-liberation, social liberation, counterconditioning, stimulus control, contingency management, and helping relationship)

Question 8

Theory of Change

Answer 8

Has a cognitive-behavioral flavor; atheoretical, not based on any one theoretical perpective and can applied to all perpectives

Question 9

How efforts at Integration tend to occur

Answer 9

Integrating the theories associated with each perspective
Developing an understanding of the common factors associated with each perspective
Using eclectism in a practical way to provide a range of available strategies

Question 10

Paul Wachtel

Answer 10

Significant contributor to the evolving framework of integration between the psychodynamic and behavioral approaches;
Uses the psychodynamic perpective in focusing on early childhood experiences as well as the notion that unconscious conflicts result in problematic feelings and behaiors
Uses the behavioral principal of reinforcement in the present environment to understand various ongoing emotional, psychological, and behavioral problems
Behavioral interventions can improve insight while insight can lead to behavioral change

Question 11

Theories which are compatible

Answer 11

Cognitive-Behavioral & Psychodynamic Theories
Family Systems, Humanistic & Interpersonal Theories
Behavioral Approaches & Family Systems Theory

Question 12

Multimodal Approach

Answer 12

Developed by Arnold Lazarus; Treatment reflects the patient’s needs based on sevel aspects of behavior: Behavior, Affect, Sensation, Imagery, Cognition, Interpersonal Relationships, and Drugs (BASIC ID)

Question 13

Intervention Strategies

Answer 13

Psychodynamic approaches to increase insight and access unconscious anger and resentment
Cognitive-Behavioral Strategies to manage anxiety symptoms and inattentive behavior at school
Referral to a psychiatrist for evaluation of the possible use of medication to address depression
Referral to a pediatrician to evaluate potential medial problems associated with abuse
Social and community support and interventions to address cultural issues as well as legal issues association with victimization
Family systems approaches to help the entire

Question 14

Irving Weiner

Answer 14

Effective psychotherapy is defined not by its brand name, but by how well it meets the needs of the patient

Question 15

Hans Eysenck

Answer 15

Warned that eclecticism can be a mish-mash of theories, a hugger-mugger of procedures, a gallimaufry of therapies; Eclecticism can result in a passing familiarity with many approaches but competence in none, as well as muddled and unfocused thinking

Question 16

Eclectic Approaches

Answer 16

More popular and has been termed multimodal

Question 17

Contemporary Clinical Psychology

Answer 17

Multidimensional and integative approaches that reflect a biopsychosocial synthesis has become a trend

Question 18

Tension Headaches Associated with Stress

Answer 18

Psychologist must be able to appreciate the biological, psychological, and social influences on the patient’s symptoms; Rule out medical possibilities prior to treating headaches with biofeedback, relaxation, training, psychotherapy, or other psychosocial interventions and strategies in conjunction with anhy appropriate medical treatment

Question 19

Genetically Based Chromosomal Dysfunction

Answer 19

Can lead to a number of conditions that involve behavior and learning problems of interest to clinical psychologists

Question 20

Biologically Oriented Factors

Answer 20

Emphasize the influence of the brain, neurochemistry, and genetic influence on behavior; lead to biologically oriented approaches to study, assess, and treat a wide range of emotional, psychological, medical, and behavioral problems

Question 21

Evolutionary Oriented Professionals

Answer 21

Focus on understanding human behavior in the context of our sociobiological roots

Question 22

Social Relationships

Answer 22

Appear influential in protecting individuals from a variety of physical and psychological problems including depression, hypertension, and alcoholism; strong relationship between social support and longevity is strong; powerful that they can lead to death

Question 23

Theories which influenced development of integrative and contemporary biopsychosocial perspective

Answer 23

Diathesis-Stress Perspective
Reciprocal-Gene-Environment Perspective
Psychosocial Influence on Biology Perspective

Question 24

Diathesis Stress Perspective

Answer 24

Causal perspective for illness or problem; suggests that a biological or other type of vlnerability in combination with psychosocial or environmental stress creates the necessary conditions for illness to occur; States that people have a biological, genetic, cognitive, or other tendency toward certain behaviors and problems. A susceptibility emerges such that certain individuals are more prone to developing potential traits, tendencies, or problems

Question 25

Diathesis

Answer 25

Means that someone is susceptible to developing a particular problem due to some inherent vulnerability; when certain stressors emerge or the conditions are right, the problem then becomes manifest

Question 26

The Diathesis-Stress Model

Answer 26

Diathesis (Genetic Vulnerability) + Stress (Psychosocial Stressors) = Problem

Question 27

Reciprocal-Gene-Environment Perspective

Answer 27

Genetic influences might actually increase the likelihood that an individual will experience certain life events. Thus, certain individuals may have the genetic tendency to experience or seek out certain stressful situations; States that there is a close relationship between biological or genetic vulnerability and life events such that each continuously influences the other

Question 28

Psychosocial Influences of Biology

Answer 28

Psychosocial Factors alter biology; psychosocial influences cal alter neurotransmitter and hormonal circuits

Question 29

Biopsychosocial Perspective

Answer 29

Published in George Engel's paper; suggests that all physical and psychological illnesses and problems have psychological illnesses and problems have biological, psychological, and social elements that require attention in any effective intervention; biological, psychological, and social aspects of health and illness influence each other

Question 30

Biopsychosocial Approach

Answer 30

States that the interaction of biological, psychological, and social influences on behavior should be addressed in order to improve the complex lives and functioning of people who seek professional health and mental health services

Question 31

Biopsychosocial Framework

Answer 31

Applies a systems theory perspective to emotional, psychological, physical, and behavioral functioning; assumes that all human problems are biopsychosocial systems problems, each biological problem has psychosocial consequences and each psychosocial problem has biological correlates

Question 32

J. Miller

Answer 32

Discussed 7 levels of systems, each interdependent on the other; these are functioning at the Cellular, Organ, Organism, Group, Organization, Society, and Supernatural Levels

Question 33

Obsessive-Compulsive Disorder

Answer 33

An anxiety disorder involving obsessions (recurrent and persistent thoughts, images, impulses) and compulsions (repetitive behaviors such as hand washing, checking, ordering, or acts)

Question 34

Structural Differences between People with OCD and those without

Answer 34

Hyperactivity in the orbital surface of the frontal lobe, the cingulate gyrus, and the caudate nucleus; serotonin appears to be particularly active in these areas of the brain (Low seratonin levels)

Question 35

Biopsychosocial Approach to OCD

Answer 35

Biological - hyperactivity in certain parts of the brain Psychological - interventions such as CBT techniques of exposure and response prevention cal alter brain circuitry; interaction between biological and psychological influence is likely to create or reduce OCD behavior Social Influences - culture, religious faith, and social support influence the nature, course, and pronosis of OCD

Question 36

Biopsychosocial Treatment of OCD

Answer 36

Drugs such as Prozac that inhibits the reuptake of serotonin Neurosurgery Cognitive-Behavioral Psychotherapy using exposure and response prevention techniques Social support and education through psychoeducational groups Psychotherapy which may include marital and/or family counseling as well as supportive and insight-related approaches

Question 37

Panic Attacks

Answer 37

Characterized by an intense fear that arises quickly and contributes to a variety of symptoms including heart palpitations, sweating, chest pain, shortness of breath, dizziness, and depersonalization

Question 38

How Biopsychosocial Factors Influence the Development, Maintenance, and Prognosis of Panic Behavior

Answer 38

A combination of genetic factors make some people vulnerable to experiencing anxiety or panic attacks Neurotransmitter activity, specifically the influence of gamma amino butyric Acid (GABA), serotonin, and norepinephrine have been associated with people who experience panic Psychological contributions to the development of panic involve learning through modeling as well as emotionally feeling out of control of many important aspects of one's life Cognitive explanations and situational cues also appear to contribute to panic Social Factors such as family and work experiences, relationship conflicts, and cultural expectations may all contribute to the development and resolution of panic Biological Vulnerability coupled with psychological and social factors create the conditions for fear and panic to occur

Question 39

Biopsychosocial Treatment for Panic

Answer 39

Medications that impact the serotonin and norepinephrine neurotransmitter systems Psychological Treatments that involve gradual exposure to the feared situations, relaxation training, breating exercises, cognitive therapy, and both insight-oriented and supportive psychotherapy