LGD 3 Psychotherapy

Question 1

What is goal of psychotherapy?

Answer 1

increase range of behaviors available to patient and relieve symptoms and alter problematic patters = talking and relationship based

Question 2

What is psychotherapy used for?

Answer 2

• psychiatric symptoms/syndromes
• specific problems/stresses
• gen problems/self esteem
• augment treatment in non-psych conditions

Question 3

How effective is psychotherapy?

Answer 3

75-80% of pts show benefit

Question 4

What is principle of psychodynamic/psychoanalytic psychotherapy?

Answer 4

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

Question 5

What are techniques of psychodynamic/psychoanalytic psychotherapy?

Answer 5

frequent sessions, unstructured therapy, free association, interpretations of transference and defense mech, exploration of fantasy life, therapeutic alliance

Question 6

What pts are indicated for psychoanalytic/dynamic therapy?

Answer 6

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

Question 7

What are goals of psychoanalytic/dynamic therapy?

Answer 7

increase insight/conscious awareness to fix maladaptive patterns beyond symptom remission

understand truth about oneself and motivations

Question 8

What feat distinguish psychodynamic from other therapies?

Answer 8

• focus on affect/expression of emotion
• discussion of past experience
• focus on therapy relationship
• exploration fantasy life
• unstructured
• exploration of defense mech/transference

Question 9

What are goals of CBT [cognitive-behavioral therapy]?

Answer 9

modify current cognitions-behaviors without regard to where they came from = unlearn and relearn adaptive behavior/thinking

typically short term

Question 10

What are indications for CBT?

Answer 10

depression, anxiety

Question 11

What is principle of CBT?

Answer 11

based on learning theory

Question 12

What are techniques of CBT?

Answer 12

structured, psychoeducation, identify automatic thoughts

therapist = active teacher

Question 13

What is dialectical behavior therapy [DBT]?

Answer 13

buddhist meditative practice combined with CBT = emotion regulation, distress tolerance and acceptance, mindfulness

Question 14

What is aversive conditioning?

Answer 14

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

Question 15

What is exposure therapy?

Answer 15

exposure to feared stimulus to elicit pavlovian extinction of conditioned fear

technique = systemic desensitization, [gradual increase in exposure to stimulus], flooding [full exposure]

Question 16

What are indications for exposure therapy?

Answer 16

specific phobias, PTSD, OCD

Question 17

What are indications for DBT?

Answer 17

borderline personality disorder

self injury/suicidal

Question 18

What is exposure with response prevention?

Answer 18

indications = OCD, phobias

exposure to anxiety producing stimulus but can’t perform associated anxiolytic ritual

Question 19

What is token economy for?

Answer 19

increase target behaviors = reinforce the good not punish the bad via operant conditioning

Question 20

What are the 2 levels of dysfunctional cognition targeted by CBT?

Answer 20

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

Question 21

What distinguishes CBT vs psychodynamic therapy?

Answer 21

CBT = short [5-20 sessions wkly], for current problem, agenda driven

psychodynamic = long [mos-yrs 1-4x/wk], for general problem, free association

Question 22

What is supportive psychotherapy?

Answer 22

• 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

Question 23

What are indications for supportive therapy?

Answer 23

fragile pts who have trouble tolerating other therapy, with low insight, low motivation for change