Therapies Flashcards
psychosocial interventions
non-pharmacological therapeutic techniques
support for clients and families
individual or group therapy
promote mental wellness
(limit setting, coping skills, self esteem, stress reduction, relaxation, spiritual support, psychological safety, discharge planning)
types of behavioral therapy
modeling- role playing
operant conditioning- tokens or positive reinforcement (Pavlov’s dog)
systematic desensitization- exposure to fear slowly over time
aversion therapy- negative stimulus leads to decreased behavior
biofeedback- control of body
types of talk therapy
interpersonal therapy
Cognitive Behavioral Therapy (Rational emotive therapy, DBT)
challenging stinkin thinkin (cognitive distortions)
types of cognitive therapies
cognitive behavioral therapy
rational emotive therapy
dialectic behavior therapy
Cognitive Behavioral Thearpy
changing the way we think in order to act and feel better even if the situation does not improve
thoughts cause feelings and behaviors not external things like people, situations, or events
good for depression, anxiety, phobia’s and pain)
stinkin thinkin
- all or nothing thinking (black and white)
- overgeneralization
- mental filter (dwelling on negative thoughts, OCD)
- discounting the positive (rejecting positive experiences as they don’t count)
- jumping to conclusions (interpreting things negatively)
- magnification
- emotional reasoning
- Should statements (should have done this or that)
- Labeling “i am a loser”
- Personalization and blame (take responsibility when you had no control)
Rational emotive therapy
focuses on irrational thinking or beliefs
helps identify situations and negative emotions that lead to irrational beliefs
change in thinking that leads to positive change in behavior
the ABC’s of RET
Activating event
beliefs
emotional consequences
Dialectic behavior therapy (DBT)
used to treat chronically suicidal individuals or borderline personality disorder, self harm, eating disorders
combines cognitive and behavioral techniques and mindfulness
1-2 yrs before good results
what is mindfulness
being present in the moment
the present moment is the only one we can experience
four primary modes of treatment in DBT
group skills
individual psychotherapy
telephone contact
therapist consultation and team meetings
group dynamics
size defined purpose degree of similarity among members rules boundaries content process
psychoeducational groups
increase knowledge or skills about specific psychological or somatic subject.
types of groups
psychoeducational medication or health education symptom management goal setting/Review recreational activity interpersonal skills
therapeutic community meeting group
occurs in impatient milieu and has potential to be therapeutic
support and self help groups
structured to provide patient with the opportunities maintain or enhance personal and social functioning through sharing
group psychotherapy
lead with APRN
purpose is the bring out personality change
yaloms therapeutic factors of group therapy
instillation of hope- universality- imparting information- corrective recapitulation development of socializing skills imitative behavior interpersonal learning group cohesiveness catharsis existential resolution
instillation of hope
leaders share optimism about success of group treatment, and members share improvement
universality
members realize they are not alone
imparting of information
formal teaching by leader or advice from peers
altruism
members gain/profit from giving support of others improving self-value
corrective recapitualtion
member repeats patterns of behaviors learned from family, with feedback from leader and peers, they learn their own behavior
development of socializing skills
learn new social skills based on others feedback and modeling
imitative behavior
members may copy behavior from leaders or peers and can adopt healthier habits
interpersonal learning
gain insight based on feedback
group cohesiveness
arises in a mature group when members feel connected to each other. members can accept both positive and constructive feedback
catharsis
through experiencing and expressing feelings, therapeutic of emotion is shared
existential resolution
members examine aspect of life that affect everyone in constructing meaning
advantages of group therapy
engage with multiple patients at a time
clients benefit from feedback, knowledge, and life experience
safe environment to try out new behaviors and communication skills
promotes a sense of belonging
disadvantages of group therapy
time constraints and individual may feel cheated for participation time
concern for confidentiality
disruptive members
not all patients benefit from group tx
autocratic leader style
exerts control over the group and does not encourage much interaction
democratic leader
supports group interaction for problem solving
laissez-faire leader
allows group members to behave in any way they choose and does not attempt to control direction
phototherapy/ light therapy
first line tx for seasonal depression done with seasonal onset
effective as medication
light works on melatonin
negative effects of photothearpy
headache and jitteriness
ECT therapy
noninvasive
most effective depression tx
primary tx in severe malnutrition, exhaustion, and dehydration
psychotic illnesses are second most common cause
safer than meds with certain conditions
How is ECT administered
under anesthesia with a muscle relaxer
temporal area of brain
can be done unilateral or bilateral
2-3 treatments per week
risks of ECT and adverse reactions
stress on heart at seizure onset up to 10 min ( assess and manage HTN, CHF, cardiac dysrhythmias)
confusion and disorientation
retrograde amnesia
transcranial Magnetic Stimulation
non-invasive
MRI strength magnetic pulses stimulate focal areas of the cerebral cortex
metal is contraindicated
adverse reactions of transcranial magnetic stimulation
HA, light headedness
no neuro deficits or memory problems
seizures rarely
scalp tingling and discomfort at administration sight
Vagus Nerve stimulation
invasive
originally used to treat epilepsy
decreases seizure activity and improves mood
used to treat resistant depression
electrical stimulation boosts neurotransmitters
vagus nerve stimulation side effects
voice alteration
neck pain, cough, paresthesia, dyspnea, which can decrease over time
DBS
more invasive than VNS
surgically implanted electrodes in brain
treatment for Parkinson’s, now depression
stimulates regions identified as underactive in depression
