Therapies Flashcards
What is trephination?
Drilling a hole in the head! Was thought to drive out demons and evil spirits.
What are 4 advantages of getting therapy with trained professionals compared to someone who’s untrained?
○ Knowledge about specific treatments
○ Relationships with other professionals
○ Ability to detect and handle emergencies
○ Sensitivity to legal and ethical issues
What 5 ethical principles do psychologists adhere to?
○ Striving to benefit the people they work with (Benefit)
○ Establishing relationships based on trust (Trust)
○ Showing integrity to being accurate, honest, and truthful (Integrity)
○ Being vigilant about potential biases (Bias)
○ Showing respect for dignity and worth of all people (Respect)
What’s 1 advantage and 1 disadvantage of more practitioners being able to prescribe psychotropic medications?
Can be a good thing bc of high demand
Critics say if they want to prescribe biological therapies they should follow the usual educational path so that they understand potentially dangerous interactions
What are the 3 major barriers to care?
Access
Finances
Stigma
What 3 factors make someone find more value in therapy?
Those who do best have:
1) rapport with their therapist
2) a strong motivation to become well
3) a disorder that’s amenable to the type of treatment being provided
Subsyndromal disorder
do not meet DSM-V criteria but can nonetheless cause significant problems
What ethnic group is most likely to seek therapy in the US?
European Americans
What % of people in “developing” countries have access to psychological treatment?
90%
(I am not sure if this is quite as true as it appears; is it possible that treatment options are different and don’t neatly map onto western labels?)
What 3 things does a therapist have to adjust to to be culturally competent?
Client’s beliefs,
values,
and expectations for therapy
Why do people with schizophrenia have a better prognosis in India than in the US? (4)
○ Overreliance on medication at the expense of training someone to perform social roles
○ Having a supportive social network–99% of people who have schizophrenia in India live with their families compared to 15-20% in the US
○ Families wanting to distance members with schizophrenia in the US due to stigma
○ Healthcare insurance companies not wanting to pay for social programs
I would add less association with stigmatising label.
Rapport
whether person respects and trusts the provider and feels comfortable in therapy
Hysteria (now called conversion disorder) (4)
Wide catalog of symptoms including: • Blindness/deafness • Paralysis/numbness • Trembling/convulsing • Memory gaps
What are the 4 key stages of Freudian psychoanalysis?
- Free association–whatever comes to mind
- Analysis of resistance–avoiding certain ideas
- Interpretation–explaining how certain thoughts and feelings arise
- Analysis of transference–client’s tendencies to respond to therapist in ways that recreate their responses to major figures in their life
Glove anesthesia
People might have no feeling in their hand but have feeling above the wrist, which can’t be caused by a nerve injury because that would affect the nerves above the wrist too.
Free association
Patient says anything that comes to mind, no matter how trivial, embarrassing, or disagreeable. Birth of talking therapy.
What is resistance? What did it lead Freud to develop?
Freud’s patients avoided certain topics and censored what they said about people, when he thought they would mention everything that came to mind. Freud believed this resistance arose because certain memories were too painful or anxiety-provoking–so they pushed them out of their consciousness (repressed them). Because of resistance, he thought he had to develop indirect methods of analysis to uncover the ideas and memories his patients would not, or could not, reveal–i.e. psychoanalysis.
What is interpretation in Freudian psychoanalysis?
The psychoanalyst’s explanations of how a patient’s thoughts, feelings and behaviours are related to earlier experiences.
Transference
The tendency of patients to respond to the therapist in ways that recreate their responses to major figures in their lives. Freud thought it could be a powerful tool allowing analyst to show patient how they really feel about the important people in their lives. Therapist plays a neutral role and “stands in” for these people, allowing for emotional re-education
Ego psychology (4)
Psychodynamic therapy
Everyone deals with psychic conflict
Skills and adaptive abilities of the ego
Ego can be a clever strategist with intrinsic competencies
Object relations theory (2)
Form of psychodynamic therapy
Emphasises importance of individual’s real (as opposed to fantasized) important relationships with others and how these motivate behaviour
Interpersonal therapy (3)
○ Contemporary psychodynamic approach
○ Builds on the assumption that disorders are often the result of social isolation that cuts people off from the nourishment provided by healthy relationships
○ Focuses on helping people learn better ways of interacting with others, to help people learn to act the part of the roles they are now taking on
What are the fundamental concerns of the humanistic approach to therapy? (3)
- Meaning
- Self-actualization
- Willingness to take charge of their actions and their life’s trajectories.
Carl Rogers’ client-centered therapy
Therapists seek to help clients accept themselves as they are with no pretense or self-imposed limits
A therapist’s success in client-centered therapy is conditional on (3)
§ Genuineness
§ Unconditional positive regard
§ Empathic understanding
What is motivational interviewing?
What are the 3 steps?
Brief non-confrontational, person-centred intervention to change problematic behaviour by:
1) drawing out their goals,
2) reducing ambivalence, and
3) clarifying discrepancies between how they’re living and how they would like to live
What is gestalt therapy? What are the two things it works to increase?
Focuses on helping clients acknowledge and integrate previously disparate parts of the self by increasing self-awareness and self-acceptance
“Focusing” in therapy
asking clients what they’re feeling in the moment, which Perls developed as part of Gestalt therapy.
Hot seat technique
therapist directly challenges or confronts the client
Empty chair technique
client imagines being seated across from another person and tells them honestly what they feel
Experiential therapies (5)
- Modern humanist
- Person-centered + Gestalt
- Empathetic and accepting + direct challenge
- Client’s subjective experience
- Emotionally validating
What is the assumption behind behavioural therapy?
Assume disorders result from faulty learning–employ learning theories to create behavioural interventions
Exposure therapy
attempt to break association with stimulus and fear
In vivo exposure therapy
Patient is exposed to the stimulus in the real world or through interactive computer programs
Vicarious reinforcement
Patient attempts to acquire conditioned response by observing someone else have it.
Instrumental or operant conditioning
Aim to change behaviour by reinforcing relationships between acts and consequences, e.g. token economies
Classical conditioning
Reduce links between stimulus and impact on patient e.g. exposure therapy
Modelling
People learn new skills by watching and imitating other people.
What are token economies? What are two positive effects they have?
Patients earn tokens when they exhibit helpful or healthy behaviours.
1) Less apathy in wards that use them and 2) atmosphere improved.
Shaping
Slowly modifying types of reinforcement.
E.g. patient originally given tokens for getting out of bed, then they start getting out of bed every day, and instead are given tokens for getting out of bed and walking to dining hall.
Contingency management
Rewarding positive behaviours and punishing negative ones, to show someone that their actions change the way people react to them.
Observational learning principles
Using modelling to teach client to imitate another person’s thinking, decision-making process, or behaviour
What is the assumption behind cognitive therapy?
Assume that disorders involve unhelpful beliefs and maladaptive patterns of thinking
Rational-emotive behavioural therapy (ABC)
Disrupting and correcting faulty beliefs.
Action -> Belief -> Consequence.
Dispute B, then move on to D–disputing irrational beliefs -> E–substituting more effective beliefs.
Cognitive therapy
Cognitive restructuring to change maladaptive beliefs or patterns of thinking.
Uses various methods. Aim of all of them is to change both your behaviours and how you think about the world.
Negative cognitive triad
Depressed people have negative beliefs about:
themselves,
the world,
and the future
Give an example of all or nothing thinking
Now that I’ve done badly on this exam, I’ve failed at psychology
Give an example of overgeneralization
I lost my car keys, that’s just like me, I lose everything!
Give an example of disqualifying the positive
Doing well on the test was just a fluke
Give an example of emotional reasoning
I feel it, therefore it’s true
What time period does cognitive behavioural therapy focus on?
Now!
Third-wave therapies
First wave was behavioural, second wave was cognitive, third wave is cognitive-behavioural.
Third wave therapies place less emphasis on direct cognitive change and more on pursuing valued goals despite unwanted thoughts and feelings.
Acceptance and commitment therapy
Type of third wave therapy.
Help client achieve greater awareness and acceptance of thoughts and feelings.
Goal is to make it clear client can achieve goals despite unwanted thoughts and feelings.
Mindfulness-based stress reduction
Third wave therapy teaching clients to be fully present in the moment and observe thoughts, feelings and sensations without judgement
What are 5 reasons there’s an increased focus on non-traditional forms of therapy?
○ Need to focus on couple- and family-level issues
○ High cost of one-on-one therapy
○ Lack of therapists outside urban areas
○ Privacy
○ Convenience
What is family therapy? Give an example of when it works well.
Includes interventions designed to repair family dynamic. Shown people with bipolar are less likely to relapse if therapy includes family-level interventions as well as medication.
4 benefits of group therapy
○ Cheaper
○ Shows people they aren’t alone with their problems
○ Belonging in a group, shared support, encouragement
○ Group dynamic shows people what they might want to change, how to relate to people better, how their beliefs are not true