Psychological and Biological Treatments Flashcards
What is psychotherapy?
• Psychological interventions designed to help people resolve emotional, behavioural, and interpersonal problems and improve the quality of their lives
Who is more/less likely to seek treatment?
- Women are more likely to seek treatment
* Asians and Hispanics are less likely
Who gets the most out of treatments?
- Those motivated to change
- Experiencing anxiety
- Temporary or situational issues
What is a paraprofessional?
• Person with no professional training who provides mental health services
Who practices psychotherapy?
- Both professionals and paraprofessionals
- Provide hope, empathy, advice, support and learning experiences
- Little to no difference in effectiveness based on experience
What are some qualities of an effective therapist?
- Warm and direct
- Selects important topics for focus
- Matches treatments to needs
What are insight therapies?
• Psychotherapies, including psychodynamic, humanistic, and group approaches, with the goal of expanding awareness or insight
What type of insight therapy was influenced by Freud?
Psychoanalytic and Psychodynamic Therapies
What were the 3 approaches/beliefs used by those that practiced psychoanalytic and psychodynamic therapies?
o Cause of abnormal behaviour stem from traumatic or other adverse childhood experience
o Analyze distressing thoughts and feelings that clients avoid, wishes and fantasies, recurring themes and life patterns, significant past events, and the therapeutic relationship
o When clients achieve insight into previously unconscious material, causes and significance of symptoms become evident, often causing symptoms to disappear
What is psychoanalysis? What are the 6 approaches that were used?
- Developed by Freud and one of the first forms of psychotherapy
- Goal was to make people aware of unconscious repressed impulses
Free Association
• Technique in which clients express themselves without censorship of any sort
• Basically, lie on a couch and just say whatever comes to mind
Interpretation
• As therapeutic relationship evolves, analyst gives interpretations for the unconscious bases for what the patient says during free association
• Timing was believed to be key, too early caused anxiety
Dream Analysis
• Therapist interprets what is experienced in the dreams (manifest content) to what it means (latent content)
Resistance
• Attempts to avoid confrontation and anxiety associated with uncovering previously repressed thoughts, emotions, and impulses
Transference
• Projecting intense, unrealistic feelings from their past onto their therapist
• Helped people understand their irrational expectations and demands of others
Working Through
• Helps clients work through their problems
• Clients confront ineffective coping response as they re-emerge in everyday life
What is free association used during psychoanalysis?
- Technique in which clients express themselves without censorship of any sort
- Basically, lie on a couch and just say whatever comes to mind
What is interpretation used during psychoanalysis?
- As therapeutic relationship evolves, analyst gives interpretations for the unconscious bases for what the patient says during free association
- Timing was believed to be key, too early caused anxiety
What is dream analysis used during psychoanalysis?
• Therapist interprets what is experienced in the dreams (manifest content) to what it means (latent content)
What is resistance used during psychoanalysis?
• Attempts to avoid confrontation and anxiety associated with uncovering previously repressed thoughts, emotions, and impulses
What is transference used during psychoanalysis?
- Projecting intense, unrealistic feelings from their past onto their therapist
- Helped people understand their irrational expectations and demands of others
What is working through used during psychoanalysis?
- Helps clients work through their problems
* Clients confront ineffective coping response as they re-emerge in everyday life
What is Neo-Freudian psychoanalysis?
- Therapists more concerned with conscious aspects of functioning
- Emphasize impact of cultural and interpersonal past experiences
- Acknowledge needs more than just sex
What is individualism?
- Carl Jung
- Neo-Freudian psychoanalysis
- Integration of opposing aspects of personality into a whole self
Describe interpersonal therapy (IPT)
- Harry Stack Sullivan
- Neo-Freudian psychoanalysis
- Short term, 12-16 sessions
- Treatment that strengthens social skills and targets interpersonal problems, conflicts, and life transitions
- Therapist is a participant observer who shows clients unrealistic behaviours in everyday life
- Shown effective for treating depression, substance abuse, and eating disorders
Is insight necessary for effective treatment?
- Research shows understanding emotional history is gratifying but not necessary to relieve psychological stress
- Clients need to practice more adaptive behaviours in everyday life, such as working through
- Psychoanalysis difficult to falsify
How does Neo-Freudian psychoanalysis stand up to scientific evaluation?
- Samples were of upper-class people
- No rigorously controlled research
- Research indicates some therapy better than no therapy
- Not really effective for psychotic disorders
What are humanistic therapies?
- Therapies that emphasize the development of human potential and the belief that human nature is basically positive
- Focuses on insight and self-actualization
Describe person-centered therapy
• Carl Rogers
• Humanistic therapy
• Therapy centering on the client’s goals and ways of solving problems
• Therapist must
o Be authentic, genuine person who reveals his or her own reactions to what the client is communicating
o Express unconditional positive regard
Nonjudgmental acceptance of all feelings of client
o Relate to clients with empathetic understanding
What is person-centered interviewing?
- One- to two-session procedure
- Recognizes that many clients are ambivalent about changing long-standing behaviours
- Geared to clarify reasons to change and not change their lives
- Been shown to help treat alcoholism and other health related behaviours
Describe Gestalt therapy
• Fritz Perls
• Humanistic therapy
• Based on Gestalt psychology
o Rules governing how we perceive objects as wholes within their overall context
o Help explain why we see our world as unified forms rather than jumbles of lines and curves
• Believed psychological difficulties were “incomplete gestalts” because they excluded experiences that trigger anxiety from their awareness
• Aim is to integrate differing aspects of client’s personality into unified sense of self
• Recognized awareness, acceptance, and expression of feelings
• Would have the person act out 2 parts of personality with 2 chairs so they could converse with themselves
How do humanistic therapies stand up to scientific evaluation?
- Difficult to measure and falsify
- Therapeutic relationship is a strong predictor of therapy success but is not necessary for improvement
- Causal arrow unsure, does client first improve and therefore so does their relationship?
- Person-centered therapy better than no therapy but findings are inconsistent
What are group therapies? What are some benefits?
• Jacob Moreno
• Therapy that treats more than one person at a time
• Benefits include
o Efficient, time saving, and less costly than individual therapy
o Provide and receive support
o Exchange information and feedback
o Model effective behaviours
o Practice new skills
o Recognition they are not alone
• Are effective for a wide range of issues
• About as helpful as individual treatments
Describe alcoholics anonymous
• 12 step, self-help program that provides social support for achieving sobriety
o Self-help as they often don’t include a professional mental illness specialist
• Treat alcoholism as a physical disease
• Focus is on never drinking again
• No evidence it is any more effective than other treatment options
• Up to 68% drop out within 3 months
What is the abstinence violation effect?
• Negative feelings about a relapse can lead to continued drinking
Describe controlled drinking
- Treat alcoholism as a learned behaviour
- Focus is controlled drinking, not total abstinence
- Teach healthy coping skills and tolerating negative emotions
- As effective as the 12 step AA method
- Total abstinence likely best for those with severe dependence on alcohol or when controlled drinking fails
What is relapse prevention (RP)?
- Teaches not to be ashamed or discouraged when they relapse
* Helps to prevent abstinence violation effect
What are family therapies?
- See most psychological problems as rooted in a dysfunctional family system
- Focus of treatment is the whole family unit
Describe strategic family therapy
• Approach designed to remove barriers to effective communication
• Identified patient
o Scapegoat that family identifies as the one with the problem
• Therapist identifies unhealthy communication patterns and unsuccessful approaches to problem solving
• Give family directives to shift how family members solve problems and interact
• Often uses paradoxical requests, close to reverse psychology
Describe structural family therapy
- Therapists deeply involve themselves in family activities to change how family members arrange and organize interactions
- More effective than no therapy, at least as effective as individual therapy
What are behavioural therapists?
- Therapists who focus on specific problem behaviours and on current variables that maintain problematic thoughts, feelings, and behaviours
- Assume behavioural change results from basic principles of learning
What is exposure therapy?
o Therapy confronting patients with what they fear with the foal of reducing the fear
Describe systematic desensitization (SD)
- Joseph Wolpe
- Patients taught to relax as they are gradually exposed to what they fear in a stepwise manner
- Earliest form of exposure therapy
- Used for phobias, insomnia, speech disorders, and some problem drinking
Reciprocal Inhibition
• You cannot experience two conflicting responses simultaneously
• Principle SD is based on
• I.e., relaxation inhibits anxiety
Counterconditioning
• A form of classical condition as described by Wolpe
What is the anxiety hierarchy and how was it used during systematic desensitization?
- A list of progressively increasing anxiety provoking images
- Pt is to relax first imagine the first anxiety provoking scene
- Once they relax again, they are asked to imagine the second anxiety provoking scene that is closer to the actual fear
- Progresses until they are relaxed and imagining their fear
- Can be done in vivo which is in real life rather than just using imagination
What is dismantling?
o Research procedure for examining the effectiveness of isolated components of a larger treatment
What is flooding exposure therapy?
• Believe that fears are a result of negative reinforcement
• Treatment aims to provoke anxiety repeatedly in absence of actual negative consequences to reach extinction of fear
• Jumps right to the stop of the anxiety hierarchy
• Can also be done in vivo
• Can take an hour or longer
• Successful in treatments of many anxiety disorders including
o Specific phobias
o OCD
o Social phobia
o PTSD
o Agoraphobia
Response Prevention
• Also called ritual prevention in the case of OCD
• Technique in which therapist prevents client from performing their typical avoidance (or ritualistic) behaviours
What is virtual reality exposure therapy?
Virtual Reality Exposure Therapy
• Uses virtual reality to provide experience of fear-provoking situations
• Rivals’ effectiveness of in vivo exposure
• Allows repeated exposure to situations often not feasible in real life (like flying in airplanes)
What is modelling in therapy?
• A form of observational learning • Helpful in treating (not curing) o Schizophrenia o Autism o Depression o ADHD o Social anxiety
What is participant modelling?
- Albert Bandura
- Technique in which the therapist first models a problematic situation and then guides the client through steps to cope with it unassisted
What is assertion training?
- Aiming to train client to express thoughts and feelings in upfront and socially appropriate manner and ensure they aren’t taken advantage of
- Modelling is an important component in this training
What is behavioural reversal?
- Client engages in role play with therapist to learn and practice new skills
- Part of assertion and modelling therapy
What are operant procedure therapy?
• Uses operant conditioning, such as using tokens to reward good behaviour