Clinical Psychology: Treatment of psychological disorders (CH15) Flashcards
Psychotherapy
Interaction between a therapist and someone suffering from a psychological problem, with the goal of providing support or relief from the problem
Eclectic psychotherapy
A form of psychotherapy that involves drawing on techniques from different forms of therapy, depending on the client and the problem
Psychodynamic psychotherapies
Explore childhood events and encourage individuals to use this understanding to develop insight into their psychological problems
- Unconsious conflicts
- Interpretations of transferences (feelings of 1 person transferred to others) and defense mechanisms (what is the underlying cause?)
- Insight (awareness of reason so we can deal with it)
Psychoanalysis
Assumes humans are born with aggressive and sexual urges that are repressed during childhood development through the use of defense mechanisms
Resistance
A reluctance to cooperate with treatment for fear of confronting unpleasant unconsious material
Transference
Analyst begins to assume major significance in client’s life and the client reacts to the analyst based on unconscious childhood fantasies
Interpersonal psychotherapy (IPT)
Form of psychotherapy that focuses on helping clients improve current relationships
Behaviour therapy
Type of therapy that assumes that disordered behaviour is learned and that symptom relief is achieved through changing overt maladaptive behaviours into more constructive behaviours
- Behavioural modification: importance of conditioning (reverse bad behaviour)
- Contingency management: focus on what people do so we can stop those actions
- Systemic desensitization: numb/remove emotional bond
- Social training skills
Token economy
Form of behaviour therapy in which clients are given “tokens” for desired behaviours, which they can later trade of rewards
Exposure therapy
Involves confronting an emotion-arousing stimulus directly and repeatedly, ultimately leading to a decrease in emotional response
Systematic desensitization
Procedure in which a client relaxes all muscles of his/her body while imagining being in increasingly frightening situations
Cognitive therapy
Aaron Beck
Focuses on helping a client identify and correct any distorted thinking about self, others or the world
ex. dog phobia due to association of the dog with pain due to a dog bite
ex. depressed student think he/she will not pass college courses because he/she thinks that he/she is stupid
- Cognitive modifications: evaluating and modifying one’s belief set and the way one perceives the world
- Collaborative empiricism: work with therapist to find better way to look at world
- Guided discovery
- Socratic questioning: have patient think and see ways of improvement
Mindfulness meditation
Teaches an individual to be fully present in each moment; to be aware of his or her thoughts, feelings and sensations; detect symptoms before they become a problem
Cognitive behavioural therapy (CBT)
Blend of cognitive and behavioural therapeutic strategies
- Acknowledges that there are ways of helping people think more rationally when thought does play a role
- Problem focused (specific problems)
ex. reducing the frequency of panic attacks or returning to work after a bout of depression - Action oriented (assist the client in selecting specific strategies to help address those problem; client is expected to DO things such as practice relaxation exercises or use a diary to monitor relevant symptoms
ex. severity of depressed moods, panic attack symptoms
Generalized anxiety disorder (GAD)
Drug treatments:
- Buspar (serotonin antagonist -anxiety)
- Effexor, Paxil, Lexapro (serotonin/NE reuptake inhibitors [SNRI’s] -depression)
Behavioural therapy:
-Awareness and elimination
Cognitive therapy:
-Meditation, self-monitoring and problem-solving
Phobias
Drug treatments:
- Valium (GABA agonist) *tranquilizer (antianxiety for calming)
- Various SSRI’s (serotonin agonists) *increase serotonin neurotransmitters
Behavioural therapy:
- Exposure therapy (gradual increase of exposure)
- Social modelling
Cognitive therapy:
-Similar to GAD approach
Antidepressants
Class of drugs that help lift people’s mood
- Iproniazid: type of monoamine oxidase inhibitor (MAOI) that prevents enzyme monoamine oxidase from breaking down neurotransmitters such as NE, serotonin, dopamine
- Tricyclic antidepressants: block reuptake of NE and serotonin thus increasing amount of neurotransmitter in synaptic space between neurons
ex. Tofranil, Elavil - Selective serotonin reuptake inhibitors (SSRI’s): blocks reuptake of serotonin in brain which makes more serotonin available in synaptic space between neurons thus increase chance of “recognizing” and using this neurotransmitter in sending desired signal
ex. Prozac, Celexa, Paxil - Serotonin and NE reuptake inhibitor (SNRI’s): acts on both serotonin and NE
ex. Effexor, Wellbutrin
Antianxiety medications
Drugs that help reduce person’s experience of fear or anxiety
- Benzodiazepines (type of tranquilizer by facilitating action of neurotransmitter GABA that inhibits certain neurons in brain thus produces calming effect)
ex. Valium, Ativan, Xanax
Agonist vs. antagonist
Agonist: drug that has an affinity for and stimulates physiologic activity at cell receptors normally stimulated by naturally occurring substances
Antagonist: have affinity but no efficacy for their receptors, and binding will disrupt the interaction and inhibit the function of an agonist at receptors
Panic disorder
Drug treatments:
- Xanax or Klonapin (benzodiazepines) *tranquilizer (antianxiety for calming)
- Clomipramine (tricyclic antidepressant) *increase in both serotonin and NE at synaptic spaces
Behavioural therapy: cross between GAD (awareness and elimination) and phobia (exposure therapy)
Cognitive therapy: Psychoeducation and cognitive restructuring (what is causing bodily reaction to generate decrease reaction)
OCD
Drug treatments
- Paxil, Zoloft, Prozac, Luvox, Celexa (SSRIs, increase serotonin in synaptic space)
- Clomipramine (tricyclic antidepressant, increase serotonin and NE)
Behavioural therapy: response prevention (limit ability to compulsive behaviour by increasing time intervals)
Cognitive therapy: cognitive restructuring (become okay with waiting)
Depression
Drug treatment
- Prozac, Paxil, Zoloft (SSRIs, increase in serotonin)
- Elavil (tricyclic antidepressant, increase in serotonin + NE)
- Nardil (MAOI)
- Reverse effect: increase in suicide tendencies if drug does not work due to pessimism, increase E to carry out action
Behavioural therapy: behavioural activation (engage in more positive behavious)
Cognitive therapy: correct depressive ways of though (reteach, world is not gray, not as bas as one thinks)
CBT: efficacy, persistance
Electroconvulsive therapy (ECT)
Transcranial magnetic stimulation (TMS)
Electroconvulsive therapy (ECT)
“Shock therapy”; a treatment that involves inducing mild seizure by delivering an electrical shock to the brain
-for severe depression or mania
Transcranial magnetic stimulation (TMS)
A treatment that involves placing a powerful pulsed magnet over a person’s scalp, which alters neuronal activity in the brain
-Depression, magnet place above right or left eyebrow to stimulate prefrontal cortex to either decrease right frontal activity or increase left frontal activity
Bipolar disorder
Drug treatment:
-Lithium (mood stabilizer)
CBT: medication schedules, strategies; recognition of early signs (recognize when swing is happening)
Mood stabilizers
Medication used to suppress swings between mania and depression
ex. Lithium
- very powerful and may lead to longterm kidney/thyroid problems
Frontal lobotomies (leucotomies)
Cutting off part of frontal lobe leading to worsened conditions
-motivation for better treatments
Schizophrenia
Drug treatments (antipsychotics):
- Thorazine (neuroleptic) -but have nasty permanent side effects (unstoppable movements)
- Seroquel, Risperdal (atypical antipsychotics) to treat positive and negative symptoms
Behavioural therapy: social skill training (new employment)
Cognitive rehabilitation: attention, reasoning and flexibility
CBT:
- recognizing reality
- medication management
- improbe coping strategies
ECT
Transcranial magnetic stimulation
DID
No evidence of any successful treatments of medication, CBT
Psychodynamic theory: integrate personalities, memories, etc.
