Psychotherapies Flashcards
Types of major evidence-based psychotherapy
- not all of them, but these are the most used categories*
1) cognitive behavioral therapy
2) interpersonal psychotherapy
3) psychodynamic psychotherapy
4) supportive psychotherapy
5) motivational interviewing
6) Eclectic psychotherapy
CBT principles
Thoughts -> emotions -> behavior -> thoughts
makes up a triangle and implies all three are interconnected. Also intervening at any point in this triangle can help treat the patient
CBT history and evidence
Developed in the 1960s by Aaron beck
Focuses on maladaptive information processing
- often this is “black and white” thinking that is seen in psychiatric disorders (one thing is the worst thing ever and everything else is good)
Uses experimental behaviorist theories from Pavlov and skinner
Has extensive research showing the robust efficacy for CBT in many psychiatric diagnosis
Behavioral activation therapy
Is a 1st line therapy for MDD specifically
Focuses on
- increasing pleasure or mastery
- increasing approach behaviors and decreasing avoidance behaviors
- establishing routines
- structuring and scheduling
- teach skills for prescribed activities
- practicing new activities in session
- teaching alternative behaviors to decrease rumination (maladaptive looping of behavior)
MDD maladaptive practices specifically
Selective abstraction
- drawing conclusions on the basis of just one element rather than all of the elements of a situation
Minimization
- downplaying the importance of a positive thought emotion or event
Personalization
- attributing personal responsibility for events which aren’t under a persons control
Arbitrary inference
- drawing conclusions when there is little or no evidence
Magnification
- “making a mountain out a mole hill”
Overgeneralization
Dialectical behavioral therapies
Specific type of CBT that is used for borderline personality disorder
- 1st line for borderline personality disorders
CBT-i
CBT used specifically for insomnia
CANT EVER use in bipolar patients, its contraindicated
Interpersonal psychotherapy
Addresses interpersonal difficulties that lead to symptoms
Focuses on the following four area of the patients life and relationships
- grief over loss
- interpersonal disputes
- role transitions
- interpersonal skill deficits
best used for DEPRESSION, but can be used for other aspects also
Motivational interviewing stages
Precontemplation
Contemplation
Decision
Action
maintenance
very good in order to get a patient to actually do something you want them to do that they were originally resistant
Psychodynamic psychotherapy
“Insight-oriented psychotherapy”
Effectiveness is hard to test and doesn’t really have a direct indication for psychiatric disorders
- however patients do well with this therapy in general and is usually with patients with behavioral disorders
Evidence generally shows non-inferiorly to more rigorous studied methods
Focuses on relationships and patterns
Transference vs countertransference
Transference = feeling the patient has towards the physician/therapist
Countertransference = feeling the therapies has towards the patient
important to understand both and dont let them disrupt your ways of thinking and treatment you provide
Psychoanalysis
Is a very rare form of behavioral theory since it is so expensive and takes forever to get trained in.
12 step facilitation therapy
12 step programs used for substance abuse
- is very black and white with how patients respond to it.
Art therapy
A type of inpatient therapy that can be used for a variety of psychiatric disorders
- increases sense of self and pleasure that may be missing
- is very good
Hypnosis
Type of therapy that is really only used for drug abuse disorders and sleep disorders.
- can be used for other disorders also but these two have the most evidence
Eclectic psychotherapy
A giant conglomerate of individual psychotherapy.
- is super interchangeable is often what psychiatrists use
Mindfulness and meditation
Evidence is high but is poor quality so its tough to say if its actually affect by itself.
- because of this, it cant hurt to recommend it persay, but it is never 1st line ever and is also never ever a solo therapy (needs to be used as an augmentative therapy)
Group therapies
Is useful in multiple therapies but is defiantly effective for
- substance use disorders
- chronic illness
- bereavement
Mindfulness-based cognitive therapy (MBCT)
Is a type of group therapy that is very useful for mild-moderate or maintenance phases of MDD
- is poor in severe or noval/untreated depression
Contraindications:
- active suicidal ideation
- untreated trauma
- severe instability
- severe unattention or concentration
can be an augmented therapy for refractory depression
What apps/websites are COVID-19 provisioned to be used for telehealth?
Apple FaceTime
Facebook messenger
Google hangouts
Zoom
Skype
are not HIPPA compliant, however are used currently due to COVID-19 demand for telehealth
How do you find a therapist for your patient?
The easiest way is use psychology today.com
Boundaries in psychotherapy
Therapists should generally avoid disclosing information to patients unless that information is directly relevant or helpful
THERE IS NEVER ANY CIRCUMSTANCE WHERE SEXUAL/ROMANTIC RELATIONSHIP WITH A PATIENT (PAST OR CURRENT)
Exceptions to confidentiality in psychotherapy
Mandated reported situations
Threat to imminent harm to self or to others
If doing so is needed to facilitate continuity of care with other current providers
if none of these exceptions are present, MUST KEEP PATIENT INFORMATION PRIVATE VIA PATIENT-PHYSICIAN RELATIONSHIP
