Psychotherapy

Question 1

3 main approaches fro treatment and the methods they contain?

Answer 1

1) INSIGHT - psychoanalysis, client centred, cognitive

2) BEHAVIOURAL - Cognitive behavioural approaches - Classical Conditioning, Systematic Desensitization

3) BIOMEDICAL - drug therapy > anti anxiety, antidepressants, antipsychotics.

Question 2

Most important part of treatment?

Answer 2

People who can support and help individual to change.

Question 3

Goal of Insight therapies?

Answer 3

• Guide client toward an understanding that their unrealistic thought patterns are incorrect
• Help clients achieve conscious awareness of the psychodynamics that underlie their problems.
• free association, dream interpretation, Transference

Question 4

What is Free Association?

Answer 4

Insight therapy
- Psychoanalysis
- lie on couch
- Speak out load any thoughts, feelings, images that entered awareness

Question 5

What is Resistance?

Answer 5

Avoidance patterns that hinder therapy

Question 6

What is Transference?

Answer 6

The client begins talking to analysts as if they were the person that their thoughts and feelings were directed to

Question 7

Psychodynamic therapy success?

Answer 7

Too expensive/ time consuming
- Interpersonal Therapy can be successful in talking through and adapting to struggles/ changes in relationships

Question 8

Goal of Behaviour Therapy?

Answer 8

• If maladaptive behaviour is learned, so too can it be unlearned

Question 9

When is behaviour therapy effective ve ineffective?

Answer 9

Very helpful for phobias and social anxiety and OCD

Not helpful for genetic DOs (schizophrenia, major mood DOs)

Question 10

Client Centred Therapy?

Answer 10

Insight Therapy - Carl Rogers
- Most important active ingredient in therapy is the relationship b/w client and therapist

Question 11

3 important attributes of CCT?

Answer 11

Unconditional Positive Regard
Empathy
Genuineness

Question 12

What is Gestalt Psych?

Answer 12

Bring together the whole of our experiences into immediate awareness to gain full understanding of how thoughts, feelings, memories control us

Question 13

What is Rational Emotive Therapy?

Answer 13

Cognitive (Insight) therapy
- Irrational thoughts, not unconscious dynamics were the main cause of self-defeating emotions
- Uses the ABCD model

Question 14

Beck’s Cognitive Therapy?

Answer 14

Show clients that their thoughts/ logic, not their situation, cause their maladaptive emotional reaction

• Most helpful w/ depression - treatment of choice

Question 15

Classical Conditioning techniques?

Answer 15

Used for Behavioural therapies
Exposure

Systematic Desensitization

Question 16

What is Exposure therapy?

Answer 16

Behavioural
Used for Phobias
- Expose the client to the fear creating conditioned stimulus w/o the unconditioned stimulus while using Response Prevention Techniques

• Believe that the anxiety will extinguish over time w/ prolonged exposure
• Treatment of choice for PTSD

Question 17

What is Systematic Desensitization?

Answer 17

Behavioural
> Learning based treatment for anxiety DOs

> Uses Counter-conditioning
- produce a new response that is incompatible with anxiety to be conditioned to the anxiety-arousing stimulus

> Be very relaxed and construct a stimulus hierarchy
- Create low anxiety response to those stimuli as one talks through them one by one = desensitization

Question 18

What is AVERSION THERAPY?

Answer 18

Behavioural
Pair an attractive (but maladaptive stimulus) w/ a noxious unconditioned stimuli to condition an aversion to the conditioned (attractive) stimuli

For substance abuse - inject client with nausea inducing drug and have them drink alcohol

Question 19

What is Behaviour Modification?

Answer 19

Treatment techniques that use operant conditioning to increase or decrease a behaviour
- Helpful for those w/ Schizophrenia
- Positive reinforcement with the Token Economy has been successful in encouraging behaviour change in schizophrenic mental hospital patients

Question 20

Dialectical Behaviour Therapy (DBT)

Answer 20

> Developed specifically for Borderline Personality DO (BPDO)
- these people are very difficult to treat because they…
- struggle having relationships
- low emotional control
- self-destructive behaviours
- Often suicidal

Consists of a package of elements from many different techniques
> Behaviour techniques to learn interpersonal/ emotional control skills
> Cog. Techniques to learn more adaptive thinking about life
> Psychodynamics to trace the early development of DO and its causes
> Humanistic emphasis on tolerating negative emotions better

Goal is to stop self-destructive behaviours!

Question 21

Important Cultural Factors in Therapy?

Answer 21

Cultural congruence
Cultural Competence
Need more diverse therapists
Use culture specific elements in therapy

Question 22

What is the Specificity Question?

Answer 22

Which therapy, given by which therapists, to which DO, produces what effects?

Question 23

What is Biomedical Psychotherapy?

Answer 23

The use of drugs in biological interventions of psych DOs
Drug therapies are the most common therapy
3 common drugs classes

Question 23

3 Factors affecting the outcome of Therapy?

Answer 23

> Therapist Variables (empathy, genuineness, experience)

> Client Variables (opens, self-relatedness, nature of the problem)

> Techniques (timing, specific ones used)

Also the quality of relationship b/w therapist and client

Question 24

Anti-Anxiety Drugs (prevalence, usefulness, concerns, names)?

Answer 24

Used by 15% of those 18-74
- XANAX is the most popular
- Can help clients deal w/ anxiety producing situations more effectively if combined w/ other therapies
- People can become dependant after long-term use - withdrawal symptoms
- BuSpar drug is very effective in treating GAD and PTSD

Side effects = tired, light-headedness, slurred speech, addictive

Question 25

Anti-Depressant Drug categories?

Answer 25

3 major categories
- Tricyclics (Elavil)
- Monamine Oxidase (MAO) Inhibitors (Nardil)
- Selective Serotonin Reuptake Inhibitors (SSRIs - Prozac)

Question 26

Tricyclic drugs function?

Answer 26

> Increase the activity of excitatory NTs norepinephrine and serotonin
Prevent reuptake of these NTs to allow prolonged excitatory stimulation of postsynaptic neuron

• Side effects = dizziness, sweating, weight gain

Question 27

MAO inhibitor drugs function?

Answer 27

Reduces the activity of MAO enzymes that break down NTs in the synaptic cleft
- Lots of side effects (worse that tricyclics) > high blood pressure

Question 28

Function of AntiPsychotic Drugs?

Answer 28

Drug = Chlorpromazine
> Major focus in for schizophrenia
> Major tranquilizers - decrease the action of Dopamine to prevent overactivity which is thought to cause schizophrenia
> Decrease hallucinations/ delusions but not apathy/ withdrawal.

> Must remain on drugs for them to help - relapses happen very quickly if patients come off them - common

Question 28

Selective Serotonin Reuptake Inhibitors Function?

Answer 28

Blocks serotonin reuptake mechanism on presynaptic neuron to increase Serotonin concentration and its stimulation of the postsynaptic neuron

> Some side effects for Prozac but less bad than the other 2
- Insomnia, joint pain, nervousness, drowsiness, increased anxiety

Question 29

Side Effects of Antipsychotic drugs?

Answer 29

Severe Movement DO
- Tardive Dyskinesia
- Cause uncontrolled, grotesque movements of face/ tongue and flailing of limbs
- In 20-30% of patients

New Drug = Clozaril - reduces + and - Symptoms as well as TDK but it produces a fail blood disease in 1-2% of patients

Question 30

Best use of Antipsychotic drugs?

Answer 30

Best used w/ psychotherapy involving skills training, and family/ group training

Question 31

What is Electroconvulsive Therapy?

Answer 31

The inducing of seizures to help w/ schizophrenia - not very helpful actually

> Helps more w/ severe depression for those w/ high suicide risk where drugs would take too long

Question 32

What is Psychosurgery?

Answer 32

Procedure to remove/ destroy brain tissue in order to change disordered behaviour - Lobotomy - not very helpful

Small surgery called Cingulotomy is successful at treating severe depression and OCD - Cut a small bundle of fibre that connect the frontal lobe and the limbic system

Question 33

Issues w/ Drug treatments?

Answer 33

They modify DO but don’t cure it
Don’t teach coping/ problem solving skills

Question 34

Causes of relapse for mental hospital patients?

Answer 34

Low funding for hospitals means that they cannot give people help once they leave and there isn’t enough funding for community programs/ treatment which help people reenter social life.

This means communities can’t meet/ care for the needs of the institutionalized and people come off their meds and end right back in the hospital = Revolving Door Phenomenon

50-65% stop taking meds after leaving hospital b/c of side effects or they feel better

Question 35

2 Forms of Preventative Mental Health

Answer 35

Situational Focused Prevention
- reduce/ eliminate environmental causes of BDOs
- Reduce stress in family, work, community
- better education, socioeconomic equality

Competency Focused Prevention
- Increase personal resources and Coping skills
- Group programs

Question 36

Issues w/ Psychoanalysis?

Answer 36

> Gaging effectiveness of different therapies
Measurement/ diagnoses b/w therapists varies
No agreed upon definition fro abnormality
Different DOs affect the type of treatment
Therapy depends on client choice to participate

Question 37

3 Commonalities b/w Psychotherapies?

Answer 37

Interpersonal relationship of trust/ warmth

Getting reassurance and support

Achieving understanding/ insight

Question 38

What is Catharsis?

Answer 38

Re-experiencing something to the full emotional extent and in that you release those thoughts and emotions that were dragging you down and you have more energy to direct to positive thoughts/ emotions/ the present reality, instead of the past weighing you down