Psychotherapy

Question 1

What’s the central strategy of classic psychoanalysis?

Answer 1

slowly uncover experiences that are repressed in the unconscious mind. These patients receive extended treatment often 4-5 sessions weekly over 3-6 yrs.

Question 2

How does “psychoanalytically oriented psychotherapy” differ from psychoanalysis?

Answer 2

briefer and more direct; also patients face therapists whereas psychoanaylsis, patients recline on a couch facing away from therapists

Question 3

What does brief/short-term psychotherapy designed for?

Answer 3

help ppl deal with current life problems or crises, including a lengthy first interview that unlocks unconscious mind to focus on present problem.

Question 4

What is interpersonal therapy?

Answer 4

notion that psych problems result from difficulties in dealing with other people. In 12-16 weekly sessions, pts gain insights into how their interpersonal interactions and patterns of behavior –> self-isolation.

Focus is on present problems rather than past problems

Question 5

What’s the aim of behavioral and cognitive-behavioral therapies? What are the techniques based on?

Answer 5

relieve the person’s symptoms by unlearning maladaptive behavior and altering negative thinking patterns.

Techniques are based on classical and operant conditioning.

Question 6

List the 4 techniques used in psychoanalysis and define them

Answer 6

1) free associations: the pt says whatever comes to mind –> unconscious memories are revealed and interpreted by therapist
2) interpretation of dreams: the pt reports her unedited dreams to the therapist –> therapist interprets dreams to examine pt’s unconscious conflicts and impulses
3) analysis of transference rxns: pt’s unconscious feelings stirred up by physical or behavioral characteristics of the therapist are expressed toward the therapist –> therapist uses these expressions to understand pt’s past relationships
4) analysis of resistance –> pt blocks unconscious thoughts from consciousness (resistance) b/c pt finds them uncomfortable or unacceptable –> therapist evaluates unconscious thought editing

Question 7

List the 4 major interpersonal problems

Answer 7

• loss and grief
• role disputes
• role transitions (e.g going to college, joining workforce)
• interpersonal deficits (no good social skills)

Question 8

Explain Group therapies

Answer 8

• used to treat ppl with common experiences, a particular d/o or interpersonal difficulties
• typically 8 ppl, meet weekly

Question 9

What is the family systems based on in psychotherapy?

Answer 9

• an identified patient reflects a dysfunction in the whole family system
• help improve family’s relational health by 1) normalizing boundaries and 2) redefining blame.

Question 10

Classic conditioning: systematic desensitization -what is it used for and how does it work?

Answer 10

technique used primarily in the treatment of phobias that involves exposure to increasing doses of the fear-provoking stimulus while pairing it with a relaxing stimulus to induce a relaxation response

Question 11

Classic conditioning: aversive conditioning -what is it used for and how does it work?

Answer 11

used mainly in the treatment of unwanted behavior (e.g. addictions). Using classical conditioning, pair the pleasurable but maladaptive behavior with an aversive or painful stimulus (e.g. electric shock).

Question 12

Operant conditioning: flooding and implosion -what is it used for and what does it involve?

Answer 12

used to treat phobias and involve direct exposure (without the possibility of avoidance or escape) to the actual (flooding) or imagined (implosion) feared stimulus.

Question 13

Operant conditioning: token economy -what is it used for and what does it involve?

Answer 13

used to increase positive behavior in persons who are severely disorganized, autistic or mentally retarded. Thru the process of operant conditioning, desirable behavior is reinforced by a reward or positive reinforcement.

Question 14

Operant conditioning: Biofeedback -what is it used for and what does it involve?

Answer 14

treat physiological disorders (HTN, Raynaud’s disease, migraine, tension headaches, chronic pain, fecal incontinence). Giving pt ongoing physiological info and this info acts as a reinforcer. Pt uses reinforcement & relaxation techniques to control visceral changes.

Question 15

60-yr-old hypertensive woman has her BP measured regularly & the readings are projected on her comp screen. She is then instructed to use a relaxing mental technique or image to reduce her BP. By trial and error, pt finds that when she imagines herself at the beach, the screen shows that her BP decreases. The observed BP acts as positive reinforcement. After a few weeks, pt’s beach image reduces her BP when she is not looking at computer. What kind of conditioning is this?

Answer 15

Operant conditioning: Biofeedback

Question 16

What is cognitive-behavioral therapy?

Answer 16

goal is to correct errors in logic (automatic thoughts). Examples of automatic thoughts include catastrophic thinking (believing only the worst can happen) and overgeneralization (“I can’t do anything right”). Therefore, it is used to treat mild-mod depression and anxiety disorders. Weekly meetings for 15-25 weeks involving replacing negative thoughts with positive thoughts.

Question 17

What are dyads in family therapy?

Answer 17

Dyads are subsystems btw 2 family members

e.g. “executive dyads” = only 2 parents

Question 18

What are “triangles” referred to in family therapy?

Answer 18

dysfunctional alliances btw 2 family members against a third member

Question 19

In operant conditioning, define “reinforcer,” “positive reinforcer” and “negative reinforcer”

Answer 19

reinforcer: a stimulus event that increases the probability that the operant behavior will occur again

Positive reinforcer: stimulus that strengthens the response if it follows that response

Negative reinforcer: an unpleasant stimulus that if removed, strengthens the response that removes the stimulus. (e.g. middle of boring date, you say you have a headache –> date ends early; you do it again)

Question 20

In operant conditioning, when is the effect of the reinforcer the strongest?

Answer 20

• the larger the reinforcer, the more vigorous the response
• using partial/intermittent reinforcement schedule (either fixed interval or variable interval most consistent) to continuous reinforcement schedule

Question 21

In partial reinforcement schedules, which is more effective: fixed/variable ratio or fixed/variable interval?

Answer 21

fixed set of time must relapse before reinforcement or time interval must relapse before next reinforcment varies is better than fixed ratio/variable ratio which uses # of responses.

Question 22

Define punishment and how it’s different from negative reinforcement

Answer 22

punishment is using an aversive stimulus or the removal of a pleasant one after some behaviors –> decrease in frequency of response. Major difference is negative reinforcement strengthens behavior whereas punishment weakens behavior

Question 23

What are 2 kinds of punishment?

Answer 23

1) use unpleasant stimulus

2) remove pleasant stimulus

Question 24

Cognitive behavioral therapy has 3 fundamental propositions, which are?

Answer 24

1) cognitive ability affects behavior (mediational model)
2) cognitive activity may be monitored and altered
3) desired behavior change may be effected thru cognitive change

Question 25

What are the 3 major classes of cognitive behavioral therapy?

Answer 25

1) coping skills therapies -focus on developing skills to manage stressors
2) cognitive restructuring methods -assume emotional distress is the consequence of maladaptive thoughts
3) problem solving therapies -combination of the other 2

Question 26

Describe a typical cognitive-behavioral therapy session

Answer 26

• 50 min therapy “10-30-10”
• use first 10 –> check-in, distress rating, bridge from last session, brief discussion of week, and agenda setting
• use 30 min –> doing therapeutic work that helps client change and achieve their goals
• use final 10 min –> summary, HW discussion and feedback

Question 27

What are 4 elements to cognitive behavioral therapy case formulation?

Answer 27

1) assessment
2) treatment planning
3) treatment
4) continuous monitoring and hypothesis testing