Psychological Therapies treatment therapies Part 1

Question 1

Describe what is psychotherapy

Answer 1

Treatment through communication and relationship factors between an individual and a therapist

How the therapist responds depends on the type of psychotherapy

Usually brief, problem-oriented

Question 2

What is cognitive therapy ?

Answer 2

Therapist promotes the idea that thoughts affect emotions through discussion, therapist identifies patient’s cognitive errors

Patient learns to evaluate(challenge) the validity of the thoughts and replace them with more adaptive thoughts

Question 3

When and what form is cognitive therapy most useful?

Answer 3

• useful for managing mild depression and generalized anxiety
• Most often cognitive therapy is combined with behavioral therapy known as Cognitive-Behavioral therapy ( CBT)

Question 4

What is behavioral therapy?

Answer 4

Therapies that focus on changing behavior by using principles of classical, operant, and vicarious conditioning

Question 5

Describe and list examples of behavioral therapy

Answer 5

Treatment is a fun oriented and directed toward a specific behavior

1. Systemic desensitization
2. Exposure therapy and flooding
3. Token economy
4. Aversion therapy
5. Biofeedback
6. Vicarious Conditioning

Question 6

List the 3 steps to systemic desensitization

Answer 6

Step 1: relaxation training

Step 2: hierarchy construction

Step 3: desensitization

Question 7

Describe all the steps in systemic desensitization

Answer 7

1. Relaxation training:
   - diaphragmatic breathing to lower hyperventilation and anxiety symptoms
   - Progressive muscle relaxation (PMR): systemic contraction and release of muscles to lower tension
2. Hierarchy construction- patient develops a hierarchal list from lowest to highest fear of anxiety provoking situations
3. Desensitization - patient confronts each item on the list starting with the least stressful using relaxation techniques
   - imaginary, in-vivo or virtual exposures are used

Question 8

What is the goal of systemic desensitization?

Answer 8

To associate the anxiety-provoking scene with relaxation rather than anxiety

Question 9

What is the goal of relaxation training in systemic desensitization ?

Answer 9

To train patients in physical states that are incompatible with anxiety

Question 10

What are exposure and flood therapy?

Answer 10

Both techniques, the patient is exposed to the feared stimulus (in vivo, imaginable or virtual) for a prolonged period WITHOUT training in an incompatible response(I.e. no relaxation training )

Question 11

Differentiate exposure and flood therapies

Answer 11

Exposure therapy: gradual exposure to a fearful stimulus

Flooding: non-gradual, prolonged, full-intensity exposure to a fearful stimulus

Question 12

What are token economies ?

Answer 12

A behavioral therapy of a system or reinforcing and punishing specific behaviors by giving or taking away tokens. Tokens are exchanged for rewards

Question 13

What is aversion therapy?

Answer 13

A behavioral therapy that reduces an undesirable behavior by associating the behavior with an actual noxious stimulus/consequence (e.g. pinching oneself when one has an urge to smoke)

Question 14

What is covert sensitization therapy?

Answer 14

Behavioral therapy a type of aversion therapy in which the undesirable behavior is associated with an imagined noxious stimulus/consequence (e.g. imagining a breakup of relationship because of drinking)

Question 15

What is biofeedback?

Answer 15

A behavioral therapy what includes learning to control an involuntary physiological activity through feedback of a bodily state(E.g. Muscle tension)

Question 16

How does biofeedback work?

Answer 16

Physiological activity is translated to a signal(e.g. sound) so that any change in signal reflects a physiological change

Feedback (through reinforcers and punishers) helps person learn to detect and automatically modify one’s bodily state

Question 17

What is vicarious conditioning?

Answer 17

A behavioral therapy that includes learning through observing someone whose behavior has been operantly or classically conditioned (e.g. a boy sees a peer get punished for swearing; now the boy doesn’t swear)

Question 18

What is vicarious conditioning often used to do ?

Answer 18

Often used to develop interpersonal skills (social skills, assertiveness, medical interviewing)

Involves viewing others (live/videotaped) in specific contexts and the consequences of their behaviors

Question 19

What is the main use of behavioral therapy?

Answer 19

Used to develop, modify and manage behaviors in people of all ages and types of problems (beyond mental illness)

Often used as cognitive behavioral therapy

Question 20

What psychodynamic therapy?

Answer 20

A long-term therapy approach in which the patient does most of the talking while the therapist occasion interjects comments, questions and interpretations

Question 21

What does psychodynamic therapy involve?

Answer 21

• analysis of early relationships with parents and significant others and how they relate to a patient’s present-day problems
• analysis of transference (a patient’s emotional reaction to the doctor) and countertransference(the doctor’s emotional reaction to a patient) based on past relationships

Can be both positive and negative forms of transference and countertransference

Both have influence on clinical judgement

Question 22

What specifically does psychodynamic therapy seek to accomplish?

Answer 22

• identification and modification f a patient’s use of defense mechanisms
• the use of techniques to reveal the contents of the unconscious (I.e. repressed thoughts)

Question 23

Why un-repress memories? (Done in psychodynamic therapy)

Answer 23

Rationale: repressed thoughts are believed to cause emotional distress

Objective: to release strong, repressed emotions (the term for this process is called “catharsis”)

Consequence: improved mental health

Question 24

List some techniques of psychodynamic therapy to access the unconscious

Answer 24

1. Hypnosis
2. Free Association tests
3. Interpreting Freudian slips
4. Dream interpretation

Question 25

Describe hypnosis

Answer 25

- Induction of a trance-like state - helps patient relax and focus on past memories - May lead to false memories due to patient’s heightened state of suggestibility

Question 26

Describe free association tests

Answer 26

- Stating the first word that comes to mind when word is spoken - the generated word is thought to reveals one’s thought

Question 27

Describe interpreting Freudian slips

Answer 27

-unintentional speech/writing errors are regarded as revealing one’s true feelings

Question 28

Describe dream interpretation

Answer 28

Symbolism in dreams is thought to reveal one’s true thoughts

Question 29

A major goal of psychodynamic therapy is to promote insight, what is the rationale fir this?

Answer 29

- if a patient understands the reasons for one’s behavior, they are greater likely to change - insight doesn’t always cause a change and this treatment approach is not appropriate for all mental problems

Question 30

What is the goal of humanistic therapy?

Answer 30

To facilitate “self-actualization” (maximizing one’s potential ) by fostering problem-solving in a supportive environment

Question 31

What are the techniques used in humanistic therapy?

Answer 31

Involves therapists: - listening without judging, directing or advising - Displaying genuineness, empathy and acceptance “unconditional positive regard” - Actively listening by reflecting and clarifying what patient expresses - Acting as a “psychological mirror” that helps clients see the necessary course of action more clearly

Question 32

Describe the purpose of group therapies

Answer 32

Therapy provided to more than 1 person com currently using any psychotherapeutic approach

Question 33

Describe traditional group therapy

Answer 33

Groups of people with the same issue, increases self-acceptance, self esteem, self disclosure and feedback from other members - learning through influence of peers - Opportunity for patients to practice new interpersonal skills learned in individual sessions

Question 34

What are the 2 types of group therapies?

Answer 34

1. Traditional group therapy | 2. Family systems therapy and marital therapy

Question 35

Describe family systems therapy and marital therapy

Answer 35

Goal: improve family dynamics by changing any part of the system Technique: the therapist observes family dynamics in a group setting and has the members practice different ways of responding Uses the premise that an individuals problem results from the family system

Question 36

What are self-help groups?

Answer 36

A voluntary organization composed of members who share a common problem and have the mutual goal to help one another deal with the problem

Question 37

How are self-help groups done?

Answer 37

- led By somebody with the same issue, not a mental health professional - provides a source of support and inspiration to its members - considered a vital part of treatment for many disorders, especially drug addiction

Question 38

Why is the effective press of psychotherapy difficult to study ?

Answer 38

Due to heterogeneity of psychotherapy (e.g. patient diagnosis, technique used, therapy duration)

Question 39

Describe the effectiveness psychotherapy

Answer 39

Psychotherapy is better than no treatment On average there is no significant difference in outcome based on psychotherapy type Certain techniques are more effective at treating certain disorders ( CBT for anxiety )

Question 40

Describe the active ingredient in all psychotherapies

Answer 40

The therapeutic alliance: the means by which a doctor and patient engage with each other to try to effect beneficial change in the patient Often the alliance itself is considered more important than the brand of therapy