psychological treatment Flashcards
Explain the basic goal of all psychotherapy:
the basic goal of phychotherapy, whatever the approach is to help people change their thoughts, feelings and behaviour patterns so that they can live happier and more productive lives. The relationship between th client and the person providing help is an important ingredient in psychotherapeutic sucess.
Analyse the therapeutic techniques based on different perspectives of human behaviour
Psychodynamic, believe behaviour as a product of unconscious processes.
humanistic-
theorists view humans as capable of humanistic consciously controlling their actions and taking responsibility for their choices and behaviour.
-they believe that everyone possesses inner resources for self-healing and personal growth and that disordered behaviour reflect a blocking if the natural growth process. this blocking is brought about by distorted perceptions, lack of awareness about feelings or a negative self-image.
focus on the role of irrational and self defeating thought patterns and therapist who employ this approach try to help clients discover and change the cognitions that underlie their problems.
they denied the importance of inner dynamics. they purposed that:
- maladaptive behaviours are not merely symptoms fo underlying problems, rather they are the problem
- problem behaviours are learned in the same ways normal behaviours are
- maladaptive behaviours can be unlearned by applying principles derived from research on classical conditioning, operant conditioning and modelling.
mindfulness- as a mental state is often-defined as a state of awareness, focus, openness and acceptance of immediate experience.
techniques have been used to treat psychological disorders including anxiety and depression.
Recognise how principles of therapy are applied to families and groups
group approaches offer clients opportunities to gain insight into how they interact with others and to observe how others approach problems
- family therapy is based on the notion that individuals problems are often reflections of dysfunctional family systems
- couple therapies help couples improve their communication patterns and resolve difficulties in their relationships. the addition of acceptance training to behavioural couples therapies has improved outcomes.
Evaluate how cultural and gender issues affect access to and issues dealt with in therapy
members of minority groups underuse mental health services
- culturally competent therapists take into account both cultural and individual factors in understanding the client and are willing to introduce culture-specific element into therapy
- awareness of oppressive conditions that adversely affect women and a willingness to support life goals that so not necessarily conform to gender expectations can increase therapeutic outcomes for women
Determine how biological approaches are applied to the treatment of disorders
drug therapies are the most commonly used biological interventions.
-drugs that affect mood, thought and behaviour are now among the most frequently prescribed medications in Australia.
- most common are antidepressants, antianxiety and antipsychotic
- the specific drug control neurotransmitters help control feelings such as anxiety and depression. eg. antidepressant drugs, increase the activity of the excitatory neurotransmitters norepinephrine (noradrenaline) and serotonin, these are involved with positive emotion and motivation.
Electroconvulsive therapy:
- used originally on schizophrenic patients
- the electrodes are placed on the side of their head and shock current is sent through.
- it has been seen to be useful to treat severe depression (people at high risk of suicide) no one knows why it works. high relapse is considered however.
psychosurgery; refers to surgical procedures that remove or destroy brain tissue in an attempt to change disordered behaviour.
-now only used as a last resort in specific situations.
- all changes, whether produced by psychotherapy, a biological therapy or a combination of the two, results in structural changes in brain circuitry and synaptic networks
- changes in neurotransmitter, autonomic or hormonal factors underlie positive changes in response to treatments
- research on current drugs and the development of new ones are an important focus of current research
Recognise the factors that impact on the outcome of therapy
specificity question; which types of therapy administered by which kinds of therapist to which kinds of clients having which kinds of problem produce which kinds of effects. this question is not answered or straightforward.
- client variables, three important variables, client’s openness, involves clients general willingness to invest themselves in therapy and take the risks required to change themselves, self-relatedness refers to their ability to experience and understand internal states such as thought and emotions, to be attuned to the processes that go on in their relationships with their therapists and to apply what they learn in therapy to their lives outside of treatment. Also the nature of the problem and its degree of fit with the therapy being used.
therapist;
the relationship that the therapist is able to establish with the client. As noted by carl Roger’s emphasis on the importance of therapist qualities such as empathy, unconditional acceptance and genuineness. the quality of the therapeutic relationship accounts for about 30 per cent of the variance in treatment outcomes.
-note when a therapist does manifest the behaviours, the effects of therapy are not simple null, clients actually can get worse.
techniques; the techniques for specific patients, the psychologist needs to have knowledge to apply accurate techniques
common factors:
- clients faith in the therapist and belief that they are receiving help
- a plausible explanation for clients problems and an alternative way of helping them look at themselves and their problems
- a protective setting in which clients can experience and express their deepest feelings within a supportive relationship
- an opportunity for clients to practise new behaviours
- clients achieving increased optimism and self efficacy.
Explain what factors have impacted on how mental disorders are treated from a community perspective
mental hospitals and asylums have decreased a lot since the 50s but many hospital bed have opened because of this. the only way not to have institutions fill with people is to have good quality mental health care. so that people can get help outside hopefully before their mental health deteriorates.
money into healthcare services specifically mental health.
note SSRIs have side effects that can also be negative.
Detail how the different approaches of preventative mental health care work to reduce the incidence of mental disorders
treating disorders early, in some cases treating the disorder in childhood in attempt to prevent their continuation into adulthood.
two main approaches:
situation-focused prevention; is directed at either reducing or eliminating the environmental causes of behaviour disorders or enhancing situational factors the help prevent the development of disorders. eg. enhancing functioning of families, reduce stress within organisations, provide better educational opportunities for children.
NOTE; children in a randomly assigned experimental study (3-5yrs) the experimental group had an intensive nutritional, physical-exercise and educational program and at 17 had lower scores on measures of antisocial personality disorder and at 23 had lower criminal records.
competency-focused prevention,
-designed to increase personal resources and coping skills. eg strengthening resistance to stress, improving social and vocational competencies, enhancing self-esteem and helping people gain the skills needed to build stronger social support systems.
Psychodynamic perspective-
psychodynamic:
believe behaviour as a product of unconscious processes.
-historical roots (Sigmund Freud) psychoanalytic theory.
-Sigmund’s original theory modified but essentially it is about internal conflicts and unconscious factors that underlie maladaptive behaviour.
-psychoanalysis refers to Freud’s theory, with a goal to help clients achieve insight, the conscious awareness of the psychodynamic that underlie their problems. this awareness helps change maladaptive behaviour. use free association, where clients report with censorship any thoughts, feelings or images that enter their awareness. these random thoughts providing clues into the unconscious. they also believe dreams express impulses, fantasies and wishes, the client keeps bottled up in waking hours.
- other aspects of Frauds theory is the idea of resistance, people naturally wanting to maintain their ego and status quo so resistance (defensive manoeuvres that hinder the process of therapy). transference, is another element where clients begin to project onto the ‘blank screen’ of the therapist important perceptions and feelings related to their underlying conflicts, (occurs when the client responds irrationally to the analyst as id she or he were an important figure from the client’s past). finally interpretation, which is any statement by the therapist that is intended to provide the client with insight into his or her behaviour or dynamic.
-A general rule the psychoanalytic treatment is to interpret what is already near the surface and just beyond the client’s current awareness.
IMPORTANT- Offering “deep” interpretations of strongly defended unconscious dynamics is considered poor technique because the clients awareness is so far removed it cannot be helpful. there is very little empirical evidence for this therapy, and therefore practices decreased significantly in the 70s.
Psychodynamic and interpersonal therapies:
has changes a lot and now just use concepts from the original theory, as originally to much time and money was used (5 times a week).
- now they use the concepts such as using brief psychodynamic psychotherapies that focus on understanding the maladaptive influences of the past and relating them to current patterns of self-defeating behaviou. they also use concepts of importance on insight and interpretation. but don’t use free association.
- now they focus more on current life event instead of truing to re-build a personality.
so. .
- research has shown that deinstitutionalisation can work when adequate community treatment is provided. unfortunately, any people receive inadequate mental health services in the community.
- prevention programs may be directed at changing environmental conditions or personal factors.
Humanistic psychotherapies
theorists view humans as capable of humanistic consciously controlling their actions and taking responsibility for their choices and behaviour.
- they believe that everyone possesses inner resources for self-healing and personal growth and that disordered behaviour reflect a blocking if the natural growth process. this blocking is brought about by distorted perceptions, lack of awareness about feelings or a negative self-image.
- they purpose that barriers often result from childhood experiences that foster unrealistic or maladaptive standards for self-worth.
- they focus primarily on the present and future instead of the past
- therapy is directed at helping clients to become aware of feelings as they occur.
person-centred therapy:
-best known and most widely used humanistic therapy
Rodgers- believed that when therapists can express unconditional positive regard, empathy and genuineness, they create a climate in which the client feels accepted.
- creating a constructive therapeutic relationship, they exhibit increased self-acceptance, greater self-awareness, enhanced self-reliance.
- popular in counselling psychology
Gestalt therapy;
the idea is that whatever we perceive, whether external stimuli,ideas or emotions, we concentrate on only part of our whole experience (the figure) while largely ignoring the background against which the figure appears.
-people which psychological difficulties, that background includes important feelings, wishes and thoughts that are blocked from ordinary awareness because they would evoke anxiety.
-often used in groups and they used the ‘empty chair technique’ where the person discovers unresolved feelings having a conversation which someone in their life in the empty chair.
-with the goal being to help clients become more aware of their feeling and the ways in whcih they interact with others.
cognitive therapies perspectives
focus on the role of irrational and self defeating thought patterns and therapist who employ this approach try to help clients discover and change the cognitions that underlie their problems.
- they do not emphasise the importance of unconscious psychodynamic processes, but they do point out that because our habitual thought patterns are do well-practised and ingrained they tenr to run off almost automatically so that we may be only minimally aware of them and may simply accept them as reflecting reality. therefore clients often need mhelp identifying the beliefs,ideas and self-statements that trigger maladaptive emotions and behaviours. once identified these cognitions can be challenged and with practice and effort, changed.
Ellis`s rational- emotive therapy
A-ctivating the event that seems to trigger the emotion
B-elief system that underlies the way in which a person appraises the event
C-onsequences (emotional and behavioural) of that appraisal
D-isputing, or challenging maladaptive emotions and behaviours
-you have an irrational belief then find the rational alternative.
Becks cognitive therapy
- the goal of his cognitive approach is to point out errors of thinking and logic that underlie emotional disturbance and to help clients identify and reprogram their overlearned automatic thought patterns
-in treating depressed clientsm a first step is to help clients realise that their thought, and not the situation, cause their maladaptive emotional reactions, this sets the stage for identifying and changing the self-defeating thoughts.
RATIONALITY
- Becks contribution to understanding and treating depression have made his cognitive therapy a psychological treatment of choice for that disorder.
changing beliefs and thinking that underlie maladaptive emotions and behaviours
behaviour therapies, perspective;
they denied the importance of inner dynamics. they purposed that:
- maladaptive behaviours are not merely symptoms fo underlying problems, rather they are the problem
- problem behaviours are learned in the same ways normal behaviours are
- maladaptive behaviours can be unlearned by applying principles derived from research on classical conditioning, operant conditioning and modelling.
applying these principles can address a range of behaviours and disorders.
classical conditioning procedures have been used in two major ways. first, they have been used to reduce, or decondition, anxiety responses. second they have been used in attempts to condition aversive emotional responses to a particular stimuli, such as alcohol or inappropriate sexual objects. most commonly used, exposure therapies, systematic desensitisation and aversion therapy.
exposure therapy; the most direct way to reduce the fear is through a process of extinction of the enxiety. this requires exposure to the feared CS in the absence of the UCS while using response prevention, to keep the operant avoidance response from occurring. expose to dog, experience anxiety, but anxiety will extinguish in time if the person remain tin the presence of the CS (dog and the UCS (attack) does not occur.
- considered a very effective technique
- (plasic bag with horses) is what is it really
- use virtual reality
Systematic desensitisation: a counterconditioning approach.
- Joseph Wolpe, launched this learning-based treatment for anxiety disorders.
- the counterbalancing approach involves, a new response that is incompatible with anxiety is conditioned to the anxiety-arousing CS. the difference is that this method uses substitute responses not just the CS, to counter the anxiety response.
- got people into a very relax state and then got them to image different but relevant scenarios of the CS. the scenes are ranked from least to most anxiety provoking, when a patient can imagine the scene for increasingly longer period without experience anxiety then they go to the next scene. this can be come in real life scenarios too.
Aversion therapy;
the therapist pairs a stimulus that is attractive to the client (the CS) with a noxious UCS in an attempt to condition an aversion to the CS. so Paedophiles have undergone treatment which strong electric shocks are paired with slides showing children. though their is no evidence for the effectiveness of aversion treatment for paedophilia.
operant conditioning treatments;
behaviour modification- refers to treatment techniques that apply operant conditioning procedures in an attempt to increase or decrease a specific behaviour. using positive reinforcement, extinction, negative reinforcement or punishment.
positive reinforcement;
token economy- involves the systematic application of positive reinforcement to strengthen desires behaviours.
schizophrenic patients were given tokens when they displayed appropriate behaviour, once they got enough tokens they got privileges.
punishments;
though they can immediately a behaviour psychologist regard it as the least prefered.
only used when their is no other way.
behavioural activation, is a behavioural treatment for depression that increases positively reinforcing behaviours . so instead of changing cognition like is cognitive behavioural therapy for depression, the behavioural activation therapist work with the client to change behaviours that will increase reinforcement and thereby reduce depression.
modelling and social skills training
- clients learn new skills by observing and then imitating a model who performs a socially skilful behaviour.
- patients practice skills in therapy that they can use in the real world
the ‘third wave’ of cognitive behavioural therapies
mindfulness- as a mental state is often-defined as a state of awareness, focus, openness and acceptance of immediate experience.
techniques have been used to treat psychological disorders including anxiety and depression.
-helps to increase awareness of thoughts and emotions
Dialectical behaviour therapy; is a multimodal intervention program developed specifically for the treatment of borderline personality disorder.
key notes for third wave CBT
- they have adopted mindfulness as a central tool for therapeutic change
- two main mindfulness-based approaches are mindfulness-based stress reduction and mindfulness-based cognitive therapy.
