LGD 3 Psychotherapy Flashcards
What is goal of psychotherapy?
increase range of behaviors available to patient and relieve symptoms and alter problematic patters = talking and relationship based
What is psychotherapy used for?
- psychiatric symptoms/syndromes
- specific problems/stresses
- gen problems/self esteem
- augment treatment in non-psych conditions
How effective is psychotherapy?
75-80% of pts show benefit
What is principle of psychodynamic/psychoanalytic psychotherapy?
range of treatments based on freuds theories
use self-reflection on past experiences and unconscious to figure out how they inform current relationships = past is alive in the present
What are techniques of psychodynamic/psychoanalytic psychotherapy?
frequent sessions, unstructured therapy, free association, interpretations of transference and defense mech, exploration of fantasy life, therapeutic alliance
What pts are indicated for psychoanalytic/dynamic therapy?
pts with
- inquisitiveness
- ability to tolerate neg emotions
- ability to delineate reality vs sessions
- maintain therapeutic alliance despite transference ebb and flow
- capacity to self reflect
- enough money to do multiple sessions/wk
What are goals of psychoanalytic/dynamic therapy?
increase insight/conscious awareness to fix maladaptive patterns beyond symptom remission
understand truth about oneself and motivations
What feat distinguish psychodynamic from other therapies?
- focus on affect/expression of emotion
- discussion of past experience
- focus on therapy relationship
- exploration fantasy life
- unstructured
- exploration of defense mech/transference
What are goals of CBT [cognitive-behavioral therapy]?
modify current cognitions-behaviors without regard to where they came from = unlearn and relearn adaptive behavior/thinking
typically short term
What are indications for CBT?
depression, anxiety
What is principle of CBT?
based on learning theory
What are techniques of CBT?
structured, psychoeducation, identify automatic thoughts
therapist = active teacher
What is dialectical behavior therapy [DBT]?
buddhist meditative practice combined with CBT = emotion regulation, distress tolerance and acceptance, mindfulness
What is aversive conditioning?
reduce appeal of undesired behaviors = associate behaviors with physical or psychological discomfort –> expose to unpleasant stimulus while engaging in targeted behavior
goal = create aversion to the behavior
use in: nail biting, sex addiction
What is exposure therapy?
exposure to feared stimulus to elicit pavlovian extinction of conditioned fear
technique = systemic desensitization, [gradual increase in exposure to stimulus], flooding [full exposure]
What are indications for exposure therapy?
specific phobias, PTSD, OCD
What are indications for DBT?
borderline personality disorder
self injury/suicidal
What is exposure with response prevention?
indications = OCD, phobias
exposure to anxiety producing stimulus but can’t perform associated anxiolytic ritual
What is token economy for?
increase target behaviors = reinforce the good not punish the bad via operant conditioning
What are the 2 levels of dysfunctional cognition targeted by CBT?
automatic thoughts = occur rapidly, often based on erroneous logic, accessible through therapist questioning [arbitrary inference, all-or-none thinking, magnification/minimization, personalization]
cognitive schema = deeper cognitive structs with basic rules for filtering info from environment
What distinguishes CBT vs psychodynamic therapy?
CBT = short [5-20 sessions wkly], for current problem, agenda driven
psychodynamic = long [mos-yrs 1-4x/wk], for general problem, free association
What is supportive psychotherapy?
- ameliorate symptoms while improving self-esteem and adaptive coping skills –> increase resilience, strengthen adaptive defenses
via therapeutic modeling, self-disclosure, reassurance, encouragement, advice, empathetic listening
What are indications for supportive therapy?
fragile pts who have trouble tolerating other therapy, with low insight, low motivation for change
