Psychotherapy & Defense Mechanisms Flashcards

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1
Q

How does medication compare to cognitive therapy in the treatment of moderate-severe depression?

A

The positive response to medication and cognitive therapy is the same; however, in long term studies cognitive therapy demonstrates greater improvement.
- Relapse increases with medications in the long term

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2
Q

What is the correlation between counseling and neuroimaging?

A

When applied to mental illness, change in symptoms corresponds to changes in brain function as measured by various neuroimaging paradigms

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3
Q

What are the advantages of cognitive therapy?

A

1) Improve problem solving
- Dorsolateral prefrontal cortex
2) Improve perspective on self and others
- ventral anterior cingulate cortex, dorsal anterior cingulate cortex, precuneus
3) Assist with regulating distressing affective states
- Insular cortex, amygdala, ventral ant cig cortex, dorsal ant cing cortex, dl prefrontal cortex and vl prefrontal cortex, ventral and dorsal medial prefrontal cortex

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4
Q

What are the (4) main aspects of a psychological assessment?

A

1) Cognition: intelligence, learning, attribution of meaning
2) Emotion/affect: feeling state
3) Motivation: goals, wishes, desires, drives
4) Behaviors: Observable actions

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5
Q

What are the primary methods in psychotherapy?

A

Creating cognitive linkages:

1) Linking thoughts, emotions, behaviors, physical symptoms
2) Linking past to present
3) Linking patient to others
4) Linking patient to higher meaning

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6
Q

What does supportive therapy focus on?

A
  • Focus on education, strengthening existing adaptive behaviors, advice*
  • Supportive therapy/ coping strategies
  • Crisis intervention (i.e. problem solving)
  • Mutual self help
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7
Q

What does expressive psychotherapy focus on?

A
  • Involves developing insight or better understanding of meaning of current behavior, symptoms, situation
  • Exploration of unconscious thoughts & feelings
  • Psychoanalysis
  • Psychodynamic psychotherapy
  • Insight-oriented psychotherapy
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8
Q

What do psychoanalysis and psychoanalytic therapy focus on?

A
  • Involves concepts of the unconscious, conflicts and transference
  • Involves concept of psychological defenses
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9
Q

Define defenses.

A

Mostly automatic mechanisms that help people maintain emotional equilibrium

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10
Q

Define sublimation.

A

Changes an unacceptable wish into one that is socially acceptable
- ie “I want to hit my father, but instead I play rugby”

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11
Q

Define displacement.

A

Transfers the problematic feeling or impulse from its original context to a substitute that carries less intensity
- ie kicking the dog

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12
Q

Define reaction formation.

A

Deals with an unacceptable thought or feeling by substituting its opposite.
- i.e. treating someone you strongly dislike in an excessively friendly manner in order to hide your true feelings.

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13
Q

What is behavior therapy?

A

Focus on changing behavior rather than understanding the problem

- can be used in the treatment of most mood, anxiety, psychotic and substance use disorders
  - based on operant conditioning (reward) and classical conditioning (conditioned response)
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14
Q

What are the methods of behavior therapy?

A
  • relaxation training
  • social skills training
  • exposure with or without response prevention
  • contingency management
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15
Q

What is cognitive therapy?

A

Focus on changing cognitions (patterns of thinking) that contribute to the problem

  • Used in many mental illnesses
  • Uses linkages between behaviors, cognitions, and emotions
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16
Q

What is the basic premise of cognitive therapy?

A

Automatic thoughts, which are distorted or dysfunctional, are related to dysfunctional behaviors and uncomfortable emotions.

  • Modification of thoughts will lead to changes in behavior and emotion => patients are taught to recognize these thoughts and change
  • Key is the patient monitors their cognitions/behaviors
17
Q

What are the ABCs of CBT?

A

A: actual event or antecedent

B: automatic thought (or problem behavior)

C: consequences
- CBT offers the option to think and act differently

18
Q

How does the brain change in reaction to CBT?

A
  • Decreased amygdala activity

- Increased prefrontal control

19
Q

What are common dysfunctional styles of thinking?

A
  • All or none thinking
  • Overgeneralization
  • Evaluative statement “Must, never, should”
  • Catastrophizing/ Fortune telling
  • Emotional reasoning
  • Labeling
20
Q

What are ways of challenging automatic thoughts?

A
  • Identify the distortion
  • Examine the evidence
  • Thinking in shades of grey
  • The double standard method
  • The experimental technique
  • The semantic method
  • Define your terms
  • The survey method
  • The cost benefit analysis