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MSII - Behavioral Science > Psychotherapy > Flashcards

Psychotherapy Flashcards

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1
Q

what is the definition of psychotherapy?

A

informed and intentional application of clinical methods and interpertional stances derived from established psychological principles for the purpose of assisting people to modify their behaviors, cognitions, emotions, and/or other personal characteristics in directions that participants deem desirable
-so focus on what patients want, not what physician wants

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2
Q

what are the 6 theoretical orientations?

A
  1. psychoanalytic/psychodynamic
  2. interpersonal
  3. family
  4. behavioral
  5. cognitive
  6. cognitive behavioral (combination)
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3
Q

what are the common factors of psychotherapy theories?

A
  1. expectation - by seeking help, one will change (take advantage of optimism)
  2. therapeutic relationship/alliance - important, but varies according to theory
    - behaviorism < cognitive < combo < psychoanalytic
  3. Hawthorne effect - improvement as a result of receiving attention (when being watched, people improve)
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4
Q

generally, what is the psychoanalysis and psychodynamic theory?

A

based on idea that unconscious conflicts are repressed and cause difficulty (insight-oriented)
-aims to make the unconscious conscious, and understand conflicts/behaviors

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5
Q

what are psychoanalysis and psychodynamic techniques?

A
  • free association
  • analysis of transference (how patient reacts to therapist; counter transference is how therapist reacts to patient)
  • analysis of resistance
  • dream interpretation
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6
Q

what is the timeline of psychoanalysis and psychodynamic techniques?

A

long-term therapy (multiple meetings/week, usually over several years)
-shorter, time-limited dynamic therapy focuses on present

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7
Q

what are psychoanalysis and psychodynamic techniques used to treat?

A
  • depression
  • anxiety
  • some personality disorders
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8
Q

what is interpersonal theory generally? it’s aim?

A

based on idea that problematic attachments early in life predispose one to develop disorders that are expressed through troubled interpersonal relationships in present-aims to correct interpersonal problems

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9
Q

what are 4 major interpersonal problems?

A
  1. loss and grief
  2. role disputes
  3. role transitions
  4. interpersonal deficits
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10
Q

how long is interpersonal therapy? the focus? what is it used to treat?

A
  • short term (12-16 sessions)

- focuses on current relationships-used to treat depression and eating disorders

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11
Q

what is the family systems theory of psychotherapy, generally? the aim?

A

based on idea that identified patient reflects a dysfunction in a whole family system

  • entire family is the patient, not just the child or parent
  • aims to improve family’s relational health
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12
Q

what are family system psychotherapy techniques?

A
  • normalizing boundaries (instead of parents living vicariously through children)
  • redefine blame (on self or on other people may not be necessary)
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13
Q

what is family system psychotherapy used to treat mostly?

A
  1. children identified with behavior problems
  2. families dealing with conflict
  3. teenagers with eating disorders or substance abuse
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14
Q

what are group therapies, generally?

A

used to treat people with common experiences, particular disorder, or interpersonal difficulties

  • allows members to learn skills, discuss own feelings, and provide feedback and support to others
  • therapist is the facilitator
  • typically consists of ~8 people, meeting weekly
  • often time-limited
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15
Q

what is behavioral therapy, generally? aim? techniques?

A

based on learning theory

  • aim to relieve symptoms by unlearning maladaptive behaviors
  • techniques based on classical conditioning and operant conditioning
  • -systematic desensitization
  • -aversive conditioning
  • -flooding/implosion
  • -token economy (positive reinforcement)
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16
Q

what is behavioral therapy used to treat? which techniques?

A
  • phobias (systematic desensitization, flooding)
  • depression (behavioral activation)
  • autism spectrum disorders (applied behavior analysis/token economy)
  • psychotic disorders (token economy)
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17
Q

what is classical conditioning generally?

A

learning signals and associations between 2 types of stimuli

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18
Q

what are the phases of classical conditioning? (using Pavlov)

A
  1. before conditioning has occured
    - unconditioned stimulus (meat powder) elicits unconditioned response (salivation)
    - -unconscious reaction-neutral stimulus (bell) elicits orienting response (originally unaware of relation)
  2. process of conditioning
    - NS followed by UCS induces UCR
    - -important that NS is before UCS
  3. after conditioning has occurred
    - now conditioned stimulus (bell) induces conditioned response (salivation)
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19
Q

what are changes over time in the strength of conditioned response? (in terms of Pavolv)

A
  1. acquisition (CS bell and UCS meat paired in learning curve)
  2. extinction (UCS withheld, but CS stays cause decrease in strength of CR until it reaches zero)
  3. time delay
  4. spontaneous recovery (CS is again presented, but will go extinct again if UCS withheld)
    - note that the amount of drool is lower than it was at peak of acquisition
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20
Q

explain stimulus generalization in terms of Pavlov’s bell

A

if the bell was at 1000 Hz, the max drool response occurs at 1000 Hz
-similar Hz (950, 1050) will also cause response, but not as high

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21
Q

explain stimulus discrimination

A

if there are no limits to stimulus generalization (complimentary process)
-organism learns to differentiate among similar stimuli, thus won’t react unless things are exactly the same setting

22
Q

what are applications of classical conditioning?

A
  1. can lead to development of intense, irrational fears of objects or situations (phobias)
    - systematic desensitization uses classical conditioning principles to treat such fears
  2. used in addictions treatments
23
Q

what is instrumental/operant conditioning? what is the basic component/

A

learning the consequences of behavior

  • basic component is reinforcing (positive and negative)
  • also includes punishing
24
Q

what is a reinforcer? difference between positive and negative?

A

basic component of operant conditioning

  • reinforcer: stimulus event that increases probability that operant behavior will occur again
  • -positive: stimulus strengthens response if it follows that response
  • -negative: unpleasant stimulus that (if removed) strengthens response that removes stimulus
25
Q

what are the steps of positive VS negative reinforcement?

A

+
behavior: you put coins in vending machine
presentation of pleasant/positive stimulus: get food
frequency of behavior increases: put coins in vending machines in future

-
behavior: during a boring event, you leave early due to headache
removal of unpleasant stimulus: you get out of boring event
frequency of behavior increases: you do the same thing next time

26
Q

how do delays and size of reinforcement affect behavior?

A
  • effect of reinforcer is stronger if it comes soon after response occurs (reward immediately)
  • the larger the reinforcer, the more vigorous the behavior ($1 VS $100)
27
Q

what are the different schedules of reinforcement?

A
  1. continuous reinforcement schedule - reinforcer delivered every time a particular response occurs
  2. partial or intermittent reinforcement schedule - reinforcement is given only some of the time (used more often)
28
Q

what are the types of partial/intermittent reinforcements?

A
  1. fixed ratio: fixed number of responses required for reinforcement (every 10, you get $1)
  2. variable ratio: number of responses required for reinforcement varies (averages of 10, gets money; casinos)
  3. fixed interval: fixed set of time must elapse before next opportunity for reinforcement (weekly paychecks)
  4. variable interval: time interval that must elapse before next opportunity for reinforcement varies (amount of time varies)
29
Q

what type of schedule has a more immediate effect? which is more longstanding?

A

immediate: fixed or variable ratio

long-term: fixed or variable interval

30
Q

what is punishment?

A

presentation of an aversive stimulus or the removal of a pleasant one following behavior

  • results in a decrease in the behavior of a response
  • two types of punishment (positive and negative)
31
Q

what is the difference between negative reinforcement and punishment?

A

NR: remove negative stimulus, strengthen behavior
P: remove good stimulus or present bad stimulus, weakens behavior

32
Q

what are the types of punishment?

A

+
behavior: touch a hot iron
presentation of unpleasant stimulus: hand is burned
frequency of behavior decreases: no longer touch hot irons

  • (also known as penalty)
    behavior: careless with ice cream cone
    removal of pleasant stimulus: ice cream falls
    frequency of behavior decreases: no longer careless with ice cream
33
Q

what are the drawbacks of punishment?

A
  • doesn’t “erase” undesirable habit, only suppresses it
  • -may produce unwanted side effects
  • can be ineffective unless given immediately after response and each time response was made
  • can become aggression or abuse when given in anger
  • signals what is inappropriate behavior, but doesn’t specify correct alternative behavior
34
Q

what are the clinical applications of learning theory? goals? methods?

A
  • view problems as learned behaviors
  • -these behaviors can be changed without searching for hidden meanings or unconscious causes
  • goal of treatment is to understand learning principles maintaining undesired behaviors and learn new responses in those situations
  • methods:
  • -systematic desensitization
  • -flooding/implosion
  • -positive reinforcement
  • -aversive condition
  • -self monitoring
  • -stimulus control
35
Q

what is systematic desensitization?

A

type of clinical application of learning therapy

-patient visualizes series of anxiety-provoking stimuli while remaining relaxed

36
Q

what is flooding/implosion?

A

type of clinical application of learning therapy

-direct exposure of fear without possibility of avoidance or escape

37
Q

what is positive reinforcement?

A

type of clinical application of learning therapy

-used to alter problematic behavior and teach new skills (token economy)

38
Q

what is aversive condition?

A

type of clinical application of learning therapy

-classical conditioning principles are used to associate physical or psychological discomfort with undesired behaviors

39
Q

what is self monitoring?

A

type of clinical application of learning therapy

  • maintain detailed record of daily activities
  • used to establish antecedents/consequences
  • patient teaches themselves
40
Q

what is stimulus control

A

type of clinical application of learning therapy

-modification of environmental cues that maintain or elicit behaviors

41
Q

what is cognitive therapy? what is it based on? its aim? how does it help?

A

monitoring and modifying; based on idea that problems develop as a result in errors in thinking

  • treatment aims to replace presumed distorted appraisals (driven by schemas) with more adaptive appraisals
  • therapist helps clients to:
  • -monitor thoughts
  • -recognize relations among cognition, behavior, and affect
  • -test validity of automatic thoughts (cure false beliefs)
  • -substitute more realistic cognitions
  • -identify and later alter schemas that predispose people to think in negative ways
42
Q

what are cognitive distortions?

A

errors in logic (corrected via cognitive therapy)

-catastrophizing (end of the world because ___), overgeneralizations, dichotomous thinking (all or none)

43
Q

what are techniques of cognitive therapy?

A
  • psychoeducation

- cognitive restructuring

44
Q

what is the timeframe for cognitive therapy? what is it used to treat?

A 
short term (12-18 sessions)
-treats depression, anxiety and eating disorders
45
Q

what is cognitive behavioral therapy (CBT)? what are its important components?

A

combines both cognitive and behavioral techniques

-all share 3 fundamental propositions, 3 major classes, and 4 elements of case formulation

46
Q

what are the 3 major classes of CBT?

A

all orient themselves toward different amounts of cognitive VS behavior change

  1. coping skills therapy - focus on developing repertoire of skills to manage stressors
  2. cognitive restructuring methods - assume emotional distress is consequence of maladaptive thoughts
  3. problem solving therapies - combination of other two
47
Q

what are the 3 fundamental propositions of CBT

A
  1. congnitive activity affects behavior (mediational model)
  2. cognitive activity may be monitored and altered (cognitive therapy)
  3. desired behavior change may be effected through cognitive change
48
Q

what do all CBTs share in common, other than the mediational nature?

A
  1. emphasize homework and outside-of-session activities
  2. direction of session activity (directive, NOT dictating)
  3. teaching skills to cope with symptoms
  4. focus on patient’s future experiences
  5. providing patient with information about his/her treatment, disorder, or symptoms
  6. focus on patient’s cognitive/intrapersonal experience (specifically illogical or irrational thoughts/beliefs)
49
Q

what is the session framework for CBT?

A

50 minutes: 10-30-10

  • 10: check-in of previous homework, distress rating, bridge from last session, brief discussion of week, agenda setting
  • 30: therapeutic work that helps client change and achieve goals
  • 10: summary, new homework discussion, feedback
50
Q

what are the 4 elements to CBT case formulation

A
  1. assessment - diagnosis yields information that is helpful-nomothetic (science = laws) –> idiographic (distinction)
  2. treatment planning - mechanism change goals of treatment-what psychological mechanisms need to change in order to attain goals
  3. treatment - technical eclecticism or manual driven-fidelity with flexibility (manual is merely a guideline)
  4. continuous monitoring and hypothesis testing-collect data very often and test formulation and monitor progress
51
Q

what are the 4 elements of case-level formulation?

A
  1. disorders and problems - symptoms and impairments, not just symptoms
  2. mechanisms - what is causing and maintaining problems and symptoms
  3. precipitants - diathesis-stress model
  4. origins - how patient acquired mechanisms that cause problems

MSII - Behavioral Science (18 decks)

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