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BM: Unit 2 > Intro to Behavioral Health Treatment > Flashcards

Intro to Behavioral Health Treatment Flashcards

1
Q

What is a theoretical orientation?

A

The theory or set of theories on which therapists base their practice.

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2
Q

What are common theoretical orientations ?

A
  1. Psychodynamic
  2. Humanistic
  3. Interpersonal
  4. Cognitive Behavioral
  5. Eclectic
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3
Q

What is evidence based practice (EBP)?

A

treatment that is based directly on scientific evidence suggesting the strongest contributors/risk factors for psychological symptoms

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4
Q

What is empirically supported treatments (ESTs)?

A

Specific psychological treatments that have been tested (and shown to be effective) in randomized clinical trials

The most commonly-used ESTs are types of CBT

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5
Q

What are Anxiety Disorders & Trauma and Stressor-Related Disorders?

A
  1. Specific Phobias
  2. Social Phobia/Social Anxiety Disorder
  3. Panic Disorder
  4. Obsessive Compulsive Disorder
  5. Posttraumatic Stress Disorder
  6. Generalized Anxiety Disorder
  7. Adjustment Disorder with Anxiety
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6
Q

What situations may elicit the fight-flight-freeze response?

A
  1. Meeting new people
  2. Traumatic memories
  3. relationship conflict
  4. Student loans
  5. Spiders
  6. traffic
  7. Final exams
  8. job interview
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7
Q

What is the cognitive-behavioral model?

A
  1. Event triggers thought, feeling, or behavior
  2. Something triggers this cycle, but the cycle is self-perpetuating
  3. In anxiety disorders, the fight-or-flight response is being triggered inappropriately, is reinforced, becomes overgeneralized, and affects the way we think and perceive the world
  4. To treat any anxiety disorder or mood disorder, the goal is to somehow interrupt this cycle
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8
Q

What is psychoeducation?

A

Explanation for symptoms

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9
Q

What are cognitive distortions?

A

overgeneralization, jumping to conclusions, mind-reading, black & white thinking

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10
Q

What are CBT strategies?

A

1, Psychoeducation
2. Identify and challenge unhelpful thoughts called cognitive distortions
3. Plan behavioral experiments to challenge fears
4. Exposure to feared situations
To allow desensitization and new learning to occur
5. Learn relaxation exercises
A. deep breathing, progressive muscle relaxation

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11
Q

What is the structure of a CBT session?

A
  1. Mood Check
  2. Set the Agenda
  3. Bridge from Last Session
    A. What happened last week?
    B. Review homework
  4. New content
  5. Assign Homework
  6. Feedback – how did today’s session go?
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12
Q

How are specific phobias treated?

A
  1. Treatment: Exposure Therapy
    A. Therapist exposes the patient to the feared situation
    -Look at pictures of spiders, sit in the same room as a spider, hold a spider
  2. Patient is gradually desensitized to the feared situation
    A. Body can’t maintain the fight-flight-freeze response for very long
    B. Staying in the situation allows for learning to take place (“this isn’t actually dangerous”)
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13
Q

Define blood-injury phobia

A

Patients get dizzy or pass out (vasovagal response) at the site of blood, when donating blood, getting an injection, or even watching someone else receive medical care

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14
Q

What is the treatment for blood-injury phobia?

A
  1. Applied Tension for Blood-Injury Phobia
    A. Exposure
    -Pictures of needles, videos of surgery, observing blood donation, donating blood
    B. Applied muscle tension
    -Muscle tension can increase BP, helping the patient to stay conscious in order to benefit from the exposure
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15
Q

How is social phobia/social anxiety disorder treated?

A
  1. Exposure to anxiety-provoking social situations
    A. Conversation with a stranger
    B. Public speaking
    C. Singing in an elevator
    D. Ordering pizza at McDonald’s
    E. Asking directions… to a building you’re standing in front of!
  2. Challenge distorted thinking
    A. “Everyone is judging me”
    B. What evidence do you have that this thought is true?
    C. Do you have any evidence that it’s not true?
    D. What does it mean if everyone is judging you? E. What’s the worst thing that could happen?
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16
Q

How are panic disorders treated?

A
  1. Treatment: Panic Induction
    A. Psychoeducation
    -Fight-Flight-Freeze response is not harmful; it’s just your body’s “alarm system”
    -Hyperventilation means your body is getting too much oxygen; not too little

B. Exposure to panic symptoms

  • Run in place while wearing a winter coat to increase heart rate and induce sweating
  • Spin in an office chair to cause dizziness
  • Breath through a straw to induce hyperventilation
  • > learn that these symptoms are normal bodily sensations that won’t kill you
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17
Q

How is OCD treated?

A
  1. Exposure with Response Prevention (ExRP)
    A. Expose patient to their obsessive thought, and prevent them from engaging in the rituals that typically reduce their anxiety
    B. Anxiety will (eventually) decrease naturally
    C. Learn that the feared consequence won’t come true
    -Touch a toilet seat, don’t wash your hands
    -Hold a knife to your husband’s throat
    -Leave the house and don’t return to check that the door is locked, stove is off, etc.
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18
Q

What is the Prolonged Exposure Therapy (PE) treatment for PTSD?

A

A. Exposure to the traumatic memory
B. In session, patients close their eyes and re-live the memory in vivid detail
C.Stay with the memory, despite feeling distress
D. Fight-flight-freeze response will typically diminish within 45 minutes
E. Patient becomes desensitized to the memory
-It’s just a memory. Still upsetting, but patient learns that it’s not physically dangerous.
F. 8-15 90-minute sessions

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19
Q

What is the Cognitive Processing Therapy (CPT) treatment for PTSD?

A
  1. Patient writes about the trauma in vivid detail
  2. Patient and therapist look for “stuck points” – beliefs about the event (or themselves, or the world) that keep them from feeling better
    A. Typically, stuck points are beliefs that changed as a result of the trauma
    B. e.g., “people are generally good” -> “people are generally bad”
  3. Help patients process the emotions they’ve been avoiding (e.g., grief)
  4. Challenge and restructure stuck points
    A. “People are generally good, but some people are bad.” “The world isn’t entirely safe, but it isn’t entirely dangerous, either.” “I wish this event hadn’t happened, but I did the best I could do given the circumstances.”
  5. 12 60-minute sessions
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20
Q

Define GAD

A

Excessive anxiety and worry occurring more days than not

Individual finds it difficult to control the worry

21
Q

What is the treatment for GAD?

A

Treatment: CBT for Anxiety

  1. Identify and challenge distorted thoughts
  2. Exposure and behavioral experiments
  3. Relaxation Strategies
  4. Might be helpful to use anti-depressants or anti-anxiety medication as well
22
Q

What is the treatment for depressive/mood disorders?

A
  1. Treatment: CBT for Depression
    A. Identify and challenge distorted thoughts
    B. Exposure and behavioral experiments
    C. Relaxation Strategies
    (similar to CBT for Anxiety!)
    D. Can be used in conjunction with antidepressants
23
Q

When are meds indicated for depressive/mood disorders?

A
  1. Severe MDD/suicidal ideation
  2. MDD that does not respond to therapy
  3. Recurrent MDD
24
Q

What meds are used for bipolar disorder?

A
  1. “Mood stabilizers,” Lithium, antipsychotics, anticonvulsants, benzodiazepines
  2. Traditional antidepressants are not typically recommended (can trigger mania)
  3. Very Important to refer individuals with bipolar disorder to a psychiatrist
25
Q

What is problem solving therapy?

A
  1. A type of CBT
  2. Problems are viewed as a normal part of life
  3. Anxiety/Depression is the result of ineffective coping with problems
  4. Emotions are viewed as an indicator that there is a problem to be solved
  5. Therapy focuses on learning effective problem-solving strategies, and on addressing barriers to effective problem solving (e.g., emotional overload, cognitive overload, negative thinking)
26
Q

What is acceptance and commitment therapy?

A
  1. Sometimes called “third wave” CBT
  2. The more you try to control your thoughts, the more you have those thoughts
  3. Thoughts are just thoughts – they’re not necessarily true
  4. Instead of trying to reduce your anxiety, focus on trying to live in accordance with your values despite your thoughts
    “I’m anxious, but spending time with friends and family is important to me.”
27
Q

What is psychodynamic therapy?

A
  1. Insight-oriented therapy, based on the ideas of Freud
  2. Was not developed as an evidence-based therapy, though some researchers are now examining it
  3. Idea that current symptoms are due to past experiences/dysfunctional relationships
  4. Help patient gain awareness of these unconscious patterns – insight will lead to symptom relief
  5. Transference – patient will unconsciously transfer feelings from past relationships to the therapist
    A. Provides the opportunity to have a corrective experience in therapy
28
Q

Define insomnia

A
  1. Difficulty falling or staying asleep

2. Frequently co-occurs with anxiety or depression

29
Q

How is insomnia treated?

A
  1. CBT-Insomnia (CBT-I)

2. Much more effective than medication!

30
Q

What is CBT-Insomnia (CBT-I)?

A
  1. Stimulus Control
    A. Bed is only for sleep and sex. Don’t get in bed if you’re not tired.
  2. Sleep Hygiene
    A. Limit exercise, food, alcohol, TV, etc. before bed
  3. Sleep Restriction
    A. Control time in bed to restore the homeostatic drive to sleep.
  4. Relaxation Training
  5. Cognitive Therapy
    A. Target dysfunctional beliefs/attitudes about sleep
31
Q

What are the risk factors for suicide ideation?

A

Hopelessness, history of previous attempts, plan, means

32
Q

What are the warning signs of suicide ideation?

A

Talking about suicide, feeling like a burden, withdrawing, giving away prized possessions, sudden improvement in mood

33
Q

What are the treatments for substance related disorders?

A
  1. Detox
  2. Inpatient Treatment
  3. Johnson Intervention
  4. 12-Step Programs
  5. CBT
  6. Contingency Management
  7. Motivational Enhancement Therapy
  8. Community Reinforcement Approach (CRA)
  9. Community Reinforcement and Family Therapy (CRAFT)
34
Q

What is detox?

A

A. Short-term, medical supervision of acute withdrawal

35
Q

What is inpt treatment for substance abuse?

A

A. Length of treatment determined by insurance companies
B. Limits set by insurance companies (e.g., 90 days) are typically not long enough to achieve lasting results
C. pts may relapse many times before achieving lasting remission

36
Q

What is Johnson intervention?

A

A. Most families (70%) do not go through with the planned intervention, but if they did, its effective

37
Q

What are 12 step programs? Are they effective?

A

A. Very little evidence that the 12-step formula itself is effective
B. May be helpful due to social support and the sense of meaning/purpose it gives

38
Q

What is CBT for substance abuse?

A

A. Identify and correct problematic behaviors
B. Identify and avoid triggers for drug use
C. Learn new strategies to cope with negative emotions
D. Identify incompatible behaviors to replace drug use
E. Recognize and cope with cravings

39
Q

What is contingency management for substance abuse?

A

A. Incentive-based treatment – tangible rewards to reinforce positive behavior
B. Reward individuals with vouchers or prizes based on results of drug testing

40
Q

What is Motivational Enhancement Therapy?

A

Helps individuals resolve their ambivalence about engaging in treatment and stopping substance use

41
Q

What is community reinforcement approach to substance abuse?

A
  1. Intensive, 24-week outpatient treatment
    Familial, social, recreational, vocational, and material incentives to make a non-drug-using lifestyle more rewarding than substance use
    Goal is to help patients maintain abstinence long enough for them to learn new skills to sustain it
42
Q

What is Community Reinforcement and Family Therapy (CRAFT)?

A
  1. Cognitive-behavioral treatment for friends and family members concerned about a substance-using loved one
  2. By changing their own behavior, family members change the overall family dynamic and may
    A. Decrease their loved one’s substance use
    B. Increase the chance that their loved one will seek treatment
    C. Feel better themselves
43
Q

What are the treatments for feeding and eating disorders?

A
  1. Refer to a specialist (not available in all areas)
  2. Bulimia Nervosa & Binge Eating Disorder
    A. CBT
  3. Anorexia Nervosa
    A. The deadliest mental illness
    B. Might need specialty inpatient care – but even the best treatments available are not particularly effective
    C. Patients tend to relapse
  4. Obesity
    A. Motivational Interviewing, specialty CBT-based interventions, referral to dietician
44
Q

Define personality disorders

A
  1. “An enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s culture.”
  2. Difficulty in interpersonal relationships
45
Q

What are the types of personality disorders?

A

Paranoid, Schizoid, Schizotypal, Antisocial, Borderline, Histrionic, Narcissistic, Avoidant, Dependent, Obsessive-Compulsive

46
Q

What is the treatment for personality disorders?

A
  1. Treatment: Dialectical Behavior Therapy (DBT)
  2. A type of CBT that focuses on four types of skills:
    A. Mindfulness
    -Being fully aware and present
    B. Distress tolerance
    -Tolerating pain in difficult situations, instead of trying to change it
    C. Interpersonal Effectiveness
    -How to ask for what you want and say no, while maintaining self-respect and relationships with others
    D. Emotion Regulation
    -How to change emotions that you want to change
47
Q

How is ADHD treated?

A
  1. CBT
    A. Talk about upsetting thoughts/feelings, identify self-defeating behavior patterns, learn new ways to cope with emotions, identify and build on strengths
  2. Behavior Therapy
    A. Organize tasks or schoolwork in a better way, respond to emotionally-charged events, monitor own actions and reward self for good behavior
  3. Social Skills Training
    A. Learn to have conversations, see others’ perspectives, listen, ask questions, maintain eye contact, read body language
  4. Parent Training
    A. Based on CBT principles. Teaches parents to control the environment and reward good behavior.
48
Q

How is autism treated?

A
  1. Applied Behavior Analysis (ABA)
  2. Behavior analyst designs an intensive, individualized treatment plan, based on an understand how the child’s behavior is affected by the environment
    A. Break down behaviors into simplest components
    B. Use positive reinforcement to reward useful behaviors
    C. Don’t reward harmful or inappropriate behaviors
49
Q

What are the goals for autism treatment?

A
  1. Developmentally appropriate, targeting many areas (communication, self-care, play, motor development, academics)
  2. Enable children to become independent

BM: Unit 2 (7 decks)

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