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Management of Disorders > Psychological Therapies > Flashcards

Psychological Therapies Flashcards

1
Q

What was the first wave of psychological therapy?

A

Behavioural psychotherapy

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2
Q

Who was the primary influencer of the US tradition?

A

Skinner

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3
Q

What was the main methods used by the US tradition?

A

Operant conditioning - using positive and negative reinforcers

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4
Q

What was the main target of the US tradition?

A

Behaviour modification - reducing unwanted behaviours and encouraging desired ones

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5
Q

In what setting were the US behavioural approaches typically used?

A

Psychiatric and other long-stay institutions

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6
Q

What is the key model in operant and behavioural modification approaches?

A

The ABC model

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7
Q

What are the three parts of the ABC model?

A

Antecedent stimulus (stimulus)
Behaviour (response)
Consequence (reinforcer)

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8
Q

What is functional analysis / applied behavioural analysis?

A

A technique used to examine the purpose of a behaviour to better understand what caused the behaviour, the behaviour itself, and the possible consequences

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9
Q

What are the two broad categories of behaviour types?

A
  1. To obtain or access something positive
  2. To avoid or escape something negative
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10
Q

What are the four main purposes of challenging behaviour?

A
  1. Sensory stimulation/distraction
  2. Escape/avoid situations or tasks
  3. Attention
  4. Tangible reward

(SEAT)

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11
Q

What tools can be used to assess situations, behaviours and reinforcers?

A

Functional Assessment Screen Tool or ABC charts

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12
Q

Give an example of an antecedent based approach to modifying behaviour.

A

Reducing an individual’s exposure to a distressing stimulus

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13
Q

What is the main goal of a behaviour based approach to modifying behaviour?

A

To provide an individual with new skills that can be used to achieve the purpose of the behaviour in a better way (e.g. non-verbal communication aids)

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14
Q

What is the main target of a consequence based approach to modifying behaviour?

A

To identify what reinforcement is maintaining to problem behaviour and how we can break this link

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15
Q

Give an example of a consequence based approach to behaviour modification.

A

Extinction (ignoring the behaviour)

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16
Q

What is the fastest approach to extinction?

A

A continuous reinforcement schedule - immediate and consistent reinforcement for a period of time followed by the complete removal of reinforcement

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17
Q

How is the extinction approach usually applied in practice?

A

Non-contingent reinforcement - ongoing, minimal reinforcement, increased when the behaviour is not occurring to reinforce the positive behaviour

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18
Q

What is TREA?

A

Treatment Routes for Exploring Agitation - a behavioural intervention for agitation in dementia that uses an ABC assessment to determine individualised treatment

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19
Q

What are primary (tangible) reinforcers?

A

Rewards that satisfy basic, biological needs such as water, food, or sleep.

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20
Q

What are secondary reinforcers?

A

Rewards with no intrinsic value that have been conditioned/learned in association with a primary reinforcer (e.g. money, tokens, praise)

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21
Q

What are the advantages of using token economies as reinforcers?

A

▪️Easier to control and manage at the time of behaviour
▪️Scalable (can be something someone can ‘save up’)
▪️Resistant to satiety effects
▪️Can also have a ‘response cost’ (loss tokens in response to problem behaviour)

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22
Q

What is contingency management?

A

A behaviour modification intervention that reinforces positive behaviours through incentives (secondary reinforcers) (e.g. star charts)

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23
Q

What five components are necessary for an effective token system?

A
  1. Token value is explicit and understood
  2. Accurate and transparent token recording
  3. Association with valued tangible reinforcers
  4. Clear rules for earning and losing tokens
  5. Consistent implementation
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24
Q

What disorders most commonly incorporate contingency management and token economies in their therapeutic regime?

A

▪️Learning disability
▪️Neurodevelopmental disorders
▪️Substance misuse

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25
Q

In 2003, LePage et al studied the use of a token economy on an acute psychiatric unit. What were their main findings?

A

▪️Reduction in total injuries on the ward, particularly between patients
▪️Reduction in the severity of staff injuries

26
Q

How have behavioural modification approaches evolved?

A

Focus has shifted from the behaviour to the person, aiming to change behaviours for the person’s own benefit (e.g. improve QoL or reduce harm)

27
Q

Who were the main influencer of the British tradition of behavioural psychotherapy?

A

Watson, Pavlov, Hull, and Cover-Jones

28
Q

What were the main methods used in the British tradition?

A

Classical conditioning, de-conditioning, and extinction to address emotions rather than behaviours

29
Q

What were the main targets of British tradition behavioural therapy?

A

‘Neuroses’, anxiety, and fear (emotions!)

30
Q

Which psychotherapy tradition focused on behaviours more so than emotions?

A

US

31
Q

Which psychotherapy tradition focused on emotions more so than behaviours?

A

British

32
Q

In what settings were the British approaches to psychotherapy typically used?

A

Acute psychiatric settings and outpatient care

33
Q

What was Watson and Rayners influential study?

A

Little Albert - using Pavlovian conditioning to study fear acquisition in a child

34
Q

What is a generalised conditioned response?

A

When a response conditioned to one stimulus is evoked by other similar stimuli (transferred fear)

35
Q

What were Cover-Jones’ key experiments?

A

▪️Reducing Peters fear through exposure
▪️Changing Peters conditioned response to rabbits by presenting positive stimuli at the same time (biscuits)
▪️Measured blood pressure as a sign of physiological arousal

36
Q

What is Joseph Wolpe known for?

A

Developing behaviour therapy by applying early research to the treatment of Neuroses - Systematic Desensitisation

37
Q

What is reciprocal inhibition?

A

Wolpes theory that anxiety or fear is inhibited by a feeling or behaviour that is incompatibke with these emotions (impossible to have both) (e.g. relaxation, eating)

38
Q

What are stimulus hierarchies?

A

A graded list created by the patient of situations from easy to difficult with steps in between to systematically expose them to a feared situation

39
Q

What is response prevention?

A

Inhibition of fear reduction behaviours, such as closing eyes. The idea is to experience the anxiety and learn that it decreases on its own.

40
Q

What is relaxation training?

A

Patients taught skills to reduce anxiety, subjectively and physically, for before and during exposure (thought to enable counter-conditioning)

41
Q

What behavioural treatment approach is Wolpe known for and what are the main components?

A

Systematic Desensitisation

▪️Stimulus hierarchies
▪️Exposure and response prevention
▪️Relaxation training

42
Q

What is Social Learning Theory?

A

We learn important behaviours by observing the behaviours and consequences of others (learning without reinforcement)

43
Q

What was the seminal research for social learning theory?

A

Bandura’s bobo doll experiments

44
Q

What were Bandura’s main observations in the bobo doll experiments?

A

Children who observed aggressive play were more likely to imitate the aggression

45
Q

What is systematic desensitisation now most commonly used for?

A

Common phobias

46
Q

What are the two types of avoidance?

A

Active and passive

47
Q

What is active avoidance?

A

An action to prevent an aversive event that would happen if we did nothing (e.g. finding ourselves Iong grass and leaving immediately)

48
Q

What is passive avoidance?

A

Avoidance of a situation in which the danger could happen (e.g. avoiding long grass)

49
Q

What type of response distances us from an ongoing aversive event?

A

Escape

50
Q

What type of response distances us from an future aversive event?

A

Avoidance

51
Q

What is maladaptive avoidance behaviour?

A

Avoidance of a relatively safe stimulus due to excessive anxiety or fear of a future aversive event, which often perpetuates the anxiety leading to disorder

52
Q

What was the second wave of psychological therapy?

A

Cognitive therapy, considering the role of cognition and not just the behaviour itself

53
Q

What are the three main strands of cognitive therapy/CBT?

A

▪️ Coping skills (instead of maladaptive responses)
▪️ Problem solving
▪️ Restructuring (identify and change maladaptive thinking patterns

54
Q

What are the core premises of Beck and Ellis’s approach to cognitive therapy?

A

▪️ Emotional state is not a direct consequence of our situation, but is mediated by thoughts
▪️ These thoughts are often illogical or irrational

Primary aim to reduce emotional distress!

55
Q

What was Beck’s cognitive triad?

A

Thinking in depression is characterised by schema based on pervasive negative beliefs of:
▪️ Self
▪️ World
▪️ Future

56
Q

What are NATs?

A

Negative Automatic Thoughts - emerge without effort, common in response to particular situations or triggers

57
Q

What are the key characteristics of NATS?

A

▪️ Negative
▪️ Feel bad
▪️ Uninvited
▪️ Unhelpful
▪️ Believable

58
Q

How might NATs link to depression?

A

▪️ Repeated tendency to think negative as a mechanism by which low mood may be maintained
▪️ Low mood is more likely to result in negative thought compared to positive

59
Q

What are the main cognitive distortions/unhelpful thinking patterns seen with increased negative thought?

A

▪️ ‘All or nothing’ thinking
▪️ Mental filtering/selective abstraction - paying more attention to things that support out negative views (confirmatory bias)
▪️ Magnification and minimisation - disqualifying the positive?
▪️ Catastrophising (illogical leaps)
▪️ Personalising (assume personal responsibility for things)
▪️ Overgeneralisation (always, never)
▪️ Emotional reasoning (equating feeling for reality)

60
Q

What is the hot-cross bun model of cognitive therapy?

A

Triggering events leads to dynamic system and vicious circles of:
▪️ Thoughts
▪️ Feelings
▪️ Behaviour
▪️ Physical sensations

61
Q

What did Wolpe use to measure anxiety during exposure and response prevention?

A

Subject Units of Distress or Discomfort (subjective scale from 1-100, has to be sufficiently low to move onto the next exposure)

Management of Disorders (28 decks)

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