lecture 3: Treatment Flashcards
Lecture themes
- Why & What Kind of treatment
- Types of Treatment
- Cognitive, Behavioural, CBT
- DBT, Systems, MFT
- Humanistic, Psychodynamic,
Eclectic
6.Modern Psychotherapy
Why Do People Seek Treatment?
- Experiencing stressful circumstances
- Referred by their doctor
- Family/loved ones’ request
- Long-term distress
- Personal growth
What Kind of Treatment?
Biological
* Psychopharmacology (medication) > most common
* ECT - electre shock therapy
* TMS - knocks out part of the brain
Psychological
* Psychotherapy (many forms)
-Evidence-based
-Not evidence-based
Evidence-Based Treatment
Efficacy studies found it efficacious(tp works)
* Treatment works to decrease disorder
* Treatment group ≥ comparison group(placebo or other treatment type) - does better
* it has been tested
a non-evidence based therapy is the oposit: hasnt been tested,donts work(it might),the treatment group does worst then the comperason group, a non-evidence might be a theory
Evidence-Based Treatment
Efficacy = if it worksa
Randomized controlled trials (RCTs)
1. Active/Treatment Group
2. Comparison Group:
* Placebo
* Waitlist - is it just the past of time or the therapy it self?
* Other type of therapy (often TAU-what ever people do)
Which is Better?
Medication vs Psychotherapy
Depends on disorder and individual
Common to combine medication & psychotherapy and seem to be a better treatment
Psychopharmacology
Psychosis
Dopamine (& glutamate?) >Antipsychotics
Bipolar mood disorders
Electrolytes? > Lithium (“Carbolith”)
Anxiety
GABA > Benzodiazepines
not best treated with medication (it only solves the symptoms not the actual issue
Depression
Serotonin > SSRIs
Psychotherapy
- HUNDREDS of approaches
- Efficacy not always demonstrated (if its time passing by or if it is the therapy itsef
Widely Practiced Approaches
Evidence-Based
* Cognitive
* Behavioural
* Cognitive-Behavioural (CBT)
* Dialectical Behaviour Therapy (DBT)
* Family Systems (Systems)
* Marriage and Family Therapy (MFT)
* Interpersonal Therapy (IPT)
Other(non-evidence based)
Psychodynamic
* Classic Psychoanalysis
* Contemporary Psychodynamic Therapy (some research now underway)
Measuring Success in Psychotherapy
Objectifying & quantifying change
- Client self-report(scales)
- Clinician ratings
- Family & friends report(more for children)
- Pre- to post-treatment scores on assessments
- Change in client’s behaviour
Would Change Occur Anyway?
- Improvement often occurs without professional intervention
- Psychotherapy can
accelerate improvement - resrtch finding :
-50% make significant changes after 20 apoiments
-75% changes after 40 apoiments
Cognitive Therapy
Thoughts cause feelings and moods that influence behaviour
- Examines distorted patterns of thinking
-
Change person’s behaviour by changing thoughts
Ex. Modifying self-statements
Changing interpretation of events
ex:im no good to ill just try again next time
Behavioural Therapy
Modify behaviour then feelings will follow
Ex.
-Exposure therapy
-Aversion therapy
-Modeling
-Reinforcement approaches
-Behavioural activation
Works really well with children, anxiety disorders (some depression)
Cognitive-Behavioural Therapy (CBT)
Incorporates thoughts and behaviors maintaining disorder
Most widely practiced
Works well with anxiety, mild moderate depression, conduct disorder, bulimia
CBT
3 Component Model: ABC
- Affect(feelings) influence Behviour(actions) will influnece
- Cognitions (thoughts) influnece the affect
the idea is if you intervene any of the three componants there will be a casacade effect
cognitive therapy + behavioural therapy = CBT
Dialectical Behaviour Therapy (DBT)
a form of CBT
- Most effective treatment for suicidal thoughts and behaviors and NSSI
- Designed for patients with multi-problems (BPD, substance abuse, eating disorders, adults, children)
DBT
Acceptance skills
* Distress tolerance
* Mindfulness
Change skills
* Emotion regulation
* Interpersonal effectiveness
Systems & MFT
- Systems Therapy (Multisystemic; Systems)
-used with children
-very effective - Marital and Family Therapy (MFT)
-Change way family members interact
Humanistic Therapy
- Client-centered
- Motivational interviewing
-Good for building commitment to treatment
-Substance use
Gestalt therapy
- ** it tends to belive that individuals will eventually figure it out what is best for them and stop harmful behaviour**
problem: lack of agree precidure /standerlized procedure
it is benefitial maybe not as other forms of therapies but still benefitial
Psychodynamic Therapies
Classical (Freudian) psychoanalysis
* free association, analysis of dreams, transference, resistance
Psychoanalytically oriented psychotherapy
* object-relations, attachment, interpersonal focus
not a ton of reserch
Eclectic
- Very common
Technically, IPT is eclectic (psychodynamic + cognitive-behavioural)
Interpersonal Therapy (IPT)
- Addresses way the client relates to others (using the therapist-client relationship)
Evidence for working with:
Depression, Borderline Personality Disorder
Psychotherapy & Cultural Diversity
People in minority groups:
* Less studied
* Less use of services
* Fewer mental health professionals
-So, client-clinician often of different cultural backgrounds
-What are the disadvantages?
Rebooting Psychotherapy
Modernizing with technology:
* Internet
* Smart phones
Helps to
* Collect real-time (is therapy actually working)
* Use real-time interventions
