Module 52-3: psychological, biomedical therapies Flashcards
psychotherapy
an interactive experience with a trained professional, working on understanding and changing behavior, thinking, relationships, and emotions
Cognitive behavioral therapy (CBT)
- focuses on how what you think and feel influence your behavior
- restructure maladaptive thoughts, increase adaptive behaviors
CHANGE oriented
cognitive behavioral therapy sessions
- vrey structured, skills-based therapy
- typically only lasts 10-14 wks
- equal collaboration between client and therapist: therapist serves as a teacher of skills and is actively involved during the session
- start with psychoeducation, hw every week
cognitive behavioral cycle
thoughts, behavior, feelings all influence each other
if you fail a test and decide to watch netflix – only makes you feel worse rather than running
if you get the highest grade, you go out and do more things yay
biomedical therapy
the use of medications and other procedures acting directly on the body to reduce the symptoms of mental disorders
eclectic approach (combining therapies)
uses techniques from various forms of therapy to fit the client’s problems, strengths, and preferences
- medication and psychotherapy can be used together, and may help the each other achieve better reduction in symptoms
cognitive restructuring process (CBT)
- track thoughts, identify maladaptive thoughts normally you’re not even cognizant of what you’re feeling
cognitive distortions (CBT)
- catastrophizing
- neg filter
- overgeneralizing
- labeling
- discounting positives
- mind reading
cognitive restructuring interventions (CBT)
identify alternative, helpful thoughts
- how can you make this thought more accurate, complete balanced?
- silver lining?
- what would you say to a friend in your situation?
- your alternative thought must feel true to you
- pos. event scheduling
- problem solving
practice practice practice
CBT behavioral activation/pleasant events scheduling (part of CBT intervention)
ex: go running, go for a walk, call a friend, cook, eat a piece of cake, rate mood before and after
CBT: problem solving (intervention CBT)
- identify obstacles in doing cbt hw, brainstorm possible solutions, pick one to try, continue down list until you find a soln that works
CBT coping skills (intervention)
- breathing training
- progressive muscle relaxation
- mindful practice
CBT exposure (CBT intervention)
goal: reduce behavioral avoidance
psychoed - anxiety curve
create fear hierarchy and situational exposure diary
1) picture of needle
4) touching a needle
5) getting a shot
habituate yourself to reduce anxiety over time
CBT evidence based treatment
- determining treatment through evaluating effectiveness of treatment through research
- research has indicated that CBT is one of the most efficacious treatments for anxiety disorders and depression
schools of psychotherapy
cognitive behavioral therapy (CBT) - Skinner, Pavlov, Beck
acceptance and commitment therapy - Hayes
dialectical behavioral therapy - Marsha Linehan (U Wash)
psychodynamic therapy - Freud’s legacy
Aceptance and Commitment Therapy (ACT)
- acceptance –> change
- change perspective on these thoughts, know that suffering is normal
- accept negative thoughts and emotions, commit to taking behaviors that are aligned with your values
ACT treatment structure
10-14 sessions
- integrates common CBT practices
- begins with brief mindfulness exercise (focus on breath)
- weaves didactic info into experiential practice
- utilizes several metaphors (eg. passengers on a bus)
ACT planning interventions
- what valued direction does the patient want to move in?
- identify barriers to values-aligned living
cognitive fusion, experiential avoidance, unworkable action?
cognitive fusion (ACT)
what problematic rules, judgments, self-descriptions, etc is the patient fused with (accepting as true?)
experiential avoidance (ACT)
what emotions sensations memories is the patient trying to avoid?
unworkable action (ACT)
what is the patient doing that keeps them stuck?
values (ACT)
what give you a sense of meaning in your life (ongoing)
ex: be a loving spouse
cognitive defusion (ACT)
- say milk repeatedly for 30 seconds – it literally becomes just a word
- sing your negative thoughts or say them as a news reporter
ACT interventions: mindfulness
breathing, the present etc
ACT goals
can be completed
ex: get married
ACT get thinking:
what would you want someone to say about you at your funeral? 75th bday party, kids – identify values in difff domains, use your values as a compass
Dialectical Behavioral Therapy (DBT)
- developed to treat borderline personality disorder
ACT/CBT effectiveness
- shown to be most efficacious therapy for anxiety and depression
- ACT is also effective at treating and preventing depression and chronic pain
- ACT, CBT equally effective for anxiety disorders
Borderline personality disorder
- frantic efforts to avoid abandonment (real or imagined)
- pattern unstable and intense interpersonal relationships
- unstable self image
- impulsivity
- suicidality
- emotional instability
- feeligns of emptiness
- paranoid
- uncontrollable anger
Dialectical Behavioral Therapy (DBT) - 4 core skills
regulate emotions rather than problematic behaviors by:
1) mindfulness
2) interpersonal effectiveness (working on interactions)
3) emotion regulation
4) distress tolerance
DBT Hierarchy
1) suicide and self harm
2) therapy interfering behaviors
3) quality of life behaviors
components of DBT
- indiv therapy
- skill group
- phone coaching
- consultation team
DBT effective for
- Borderline personality disorder
- eating disorders
- elderly patients with depression and personality disorders
psychoanalysis
Freud’s techniques for the unconscious
free association
interpretation of free association, dreams
psychodynamic therapy (updated psychoanalysis)
- fewer sessions but can last for years – not skills based
- less id ego superego theory
- identifies maladaptive relationship patterns with the therapist that might generalize to the person’s real life
- uses therapist patient interaction to identify patterns of thinking and relating to others (any potential problem areas for change)
- good for only maladaptive behaviors not for anxiety or others
psychopharmacology
study of drug effects on behavior, mood, and the mind
antipsychotic
blocks dopamine receptors
- treatment of positive schizo symptoms
- side effects tardive dyskinesia (facial tongue body movements), diabetes, movement problems including sluggishness
antianxiety
- slows nervous system activity in the body and brain could be used for ptsd
- temporarily reduces worried thinking and physical agitation
- side effects slowed thnking reduced learnign, dependence, withdrawal
antidepressant
- increasing levels of serotonin sometimes norepinephrine at synapses by inhibiting reuptake
- improves mood and control over depressing/anxious thoughts
- side effects: dry mouth, constipation, reduced sexual desire and or response
mood stabilizers
unsure how they work
- reduces mania highs and depressive lows (lithium)
- blood levels must be monitored
ADHD “stimulants”
- blocking reuptake of dopamine from synapses
- help control impulses, reduce distractibility and need for stimulation including fidgeting
- decreases appetite
Electroconvulsive therapy (ECT)
- induces mild seizure that disrupts severe depression for some people
- might allow neural re-wiring and boost neurogenesis
- neg. effect: memory loss
therapeutic lifestyle change
- exercise
- changing neg thoughts to improve mood and maybe rewire brain
- meetin basic needs for sleep, nutrition, ligth meaningful activity, social connection
