Therapies and Prevention Flashcards
What are the 2 biological treatments?
Electroconvulsive therapy
Psychopharmacology
What is electroconvulsive therapy?
Applied to severe, treatment-resistant depression. Last resort treatment. Many precautions are taken, and a main side effect is retrograde amnesia
Why is the side effect of retrograde amnesia not super serious?
Because depression also causes retrograde amnesia
What is psychopharmacology?
Treatment of mental disorders through the use of drugs. There’s hundreds of meds available and a large number of antidepressants
What happened in the 1960s with psychopharmacology?
Tricyclics occured. Most effective medications, but with lots of side effects.
What is the definition of psychotherapy?
Use of psychological techniques and therapist-client relationship to produce emotional, cognitive, and behavioural changes
What is the most important factor of psychotherapy?
Therapist client relationship has to foster trust, respect, stability, reliance, quality etc
What was the psychodynamic technique that Freud started with?
Free association-tell him anything that comes to mind. Conscious censorship and unconscious censorship occurs. Have to learn how to get around conscious censorship.
What is dream interpretation (psychodynamic)
A way to get into the unconscious. Dreams are an expression of unconscious conflict
What happens in the process of interpretation and resistance analysis?
Interpreting aspects of dreams. Patient either accepts or rejects interpretation. When people resist, you’re getting closer to what’s bothering them. Study resistance.
What is analysis of transference (psychodynamic)
Projecting onto the therapist as if they are a person from your childhood
What is countertransference?
How the therapist reacts to transference
How long does the psychodynamic process take?
A year to 2 years
How does psychodynamic psychotherapy work?
Focus is on current life circumstances. Therapist actively directs patient recollections and offers interpretations quickly and directly, and is supportive. Patient sits on a chair. Can be a complex process especially for personality disorders. Outcome oriented (patients progress is tracked)
What is the focus of behavioural and CBT?
Focus is on behaviour change in the present, and is outcome oriented
How is behavioural therapy conducted?
Personal history is learned, and then we try to correct behaviours
What are the principles behind CBT?
Everything is a skillset. Based on learning theory. Ways people deal are learned, and people can learn other ways.
What are some of the techniques based on classical conditioning?
- Systematic desensitization
- In-vivo desensitization
- Flooding
- Aversion Therapy
What is systematic desensitization?
Used for phobias. Looking at the hierarchy of what scares you, then systematically exposing you to them
What is in-vivo desensitization?
Progressive approaches of an object of fear.
What is flooding?
Exposure all at once to fears. Have to be careful with this one and make sure person doesn’t have a heart condition
What is aversion therapy?
Pairing an aversive stimulus with the thing you are addicted to. Can expire. Works good in the short-term
What are some techniques based on Operant Conditioning?
- Contingency management
- Social skills training
- Behavioural activation therapy for depression
What is contingency management?
How you organize your life. Routines are good, reduces anxiety
What is social skills training?
Assertiveness training, social problem solving for anxiety. Can be applied to schizo, eating disorders etc
What is behavioural activation for depression?
When people are depressed, they don’t do much. No routines, no pleasure, sink lower to depression. Encourage people to do activities that they have mastery in and pleasure in. Self-efficacy evolves
What are some cognitive therapies?
- Problem solving therapy
- Self-instruction training
- Cognitive therapy
- Rational emotive therapy
What is problem-solving therapy?
Helping people systematically find solutions to their problems
What is self-instruction training?
Used for management of stress and negative emotions. Talking to self carefully and constructively.
What is cognitive therapy?
Challenging negative and distorted beliefs through collaborative empiricism-assumptions are overblown or incorrect
What is rational emotive therapy?
Challenging irrational beliefs through direct disputation ex: “What a load of crap, why would you think this”
What is characteristic of humanistic therapies?
Client centred. Focus is on how patient sees themselves. Therapist and patient work together and are on equal terms. Patient has a good sense of their own needs
What did Carl Rogers believe was essential in the humanistic therapies?
Empathy (understanding), warmth (welcoming), and genuineness (feedback, direct and honest). Therapist is honest with themselves and patient. Empathy, warmth and genuineness are fundamental.
What are some of the types of humanistic therapies?
- Client-Centred (Carl Rogers
- Existential (Irvin Yalom
- Gestalt Therapy (Fritz Perls)
- Emotion focused therapy (Lesley Greenberg)
What is existential therapy?
People face inevitable existential challenges (being born, living in certain culture, death and dying). People struggle with these and need help with this
What is Gestalt Therapy?
Increasing patients awareness of their behaviour. Challenge their view of the self and others. Get in touch with feelings and relationships. Used to come to terms
What is emotion focused therapy?
New form of therapy, where human emotions are connected to needs. Emotions are activated and worked through, can help change emotional states. Originally known as process experiential therapy.
How is the effectiveness for therapies determined?
By using randomized clinical trials. 2-3 groups, program is compared to an already existing program, control, or other intervention. Does the therapy work equal or better than the other intervention?
What percentage of people are better off after receiving psychotherapy?
80%
How is psychotherapy and psychological intervention economical?
Psychological services result in savings on medical services, medication use, and loss of manpower. Many psychosocial services actually pay for themselves in terms of cost recovery
What is the most common form of recovery with addictions?
Self-recovery. But psychotherapy works better
What kinds of therapies work best for depression and anxiety?
Behavioural
What kind of therapies work best for trauma and personality disorders?
Psychodynamic
How many different forms of psychotherapy are there?
400
What is the dodo bird verdict?
Every therapy (main therapy: cognitive, psychodynamic, humanistic), is effective. Hard to identify one that is better
Why does therapy sometimes not work?
Because many people don’t attend enough sessions for it to work. Most require 10 one hour sessions or more
Which therapy sessions are the most important?
The first, second, and third. The most change develops here
What are some of the controversies in psychotherapy?
CBT largely dominates the field of efficacy research. Promoted as more effective. Should psychotherapist that are not as affective be used? Does psychotherapy research generalize to clinical settings?
What are Jerome Franks common factors?
- A trained healer who the sufferer believes in and seeks treatment from (can be psychologist, religious healers etc)
- Structured interaction between healer and sufferer. Change occurs as a consequence of words, acts, rituals
What is the major ingredient in healing?
Instillation of hope (therapist gives hope)
Alternative explanations (healer provides a name for what is wrong
Expectation that client will think, act, or feel differently as a result of the interaction.
Psychotherapy as culturally dependent
What is success dependent on in psychotherapy?
Relationship between therapist and client, diagnosis, severity of problem, client characteristics)
What is YAVIS and why does it determine success in psychotherapy?
Young, attractive, verbal, intelligent, successful. Dictates the type of person who will have the most success in therapy
What is the typical patient?
Young, middle class, female, at least some uni education (14 years of education to be exact)
What types of new approaches are we seeing with therapies?
Different psychotherapeutic modules are being put together to address complex problems and comorbid disorders.
What does it mean that some approaches are transdiagnostic?
Therapist addresses common elements of mood and anxiety disorder. Acceptance, commitment, alignment of values.
What is community psychology?
Provides and ecological perspective which emphasises the interdependence of individuals, families, communities and society. Want for a society free from mental disorders
What percentage of Canadians suffer from mental disorders?
20%
What percentage of Canadia children aged 4-17 have a mental disorder?
14%
What percentage of mental health problems arise in childhood and what does this mean?
70%-this makes it so young people are usually the targets of mental health strategies.
What is primary prevention?
Interventions aimed at preventing the occurrence of the problem ex: programs for learning disabilities prevent academic failure
What is secondary prevention?
Interventions performed after problem is identified, but before it has caused suffering. Intervention before escalation
What is tertiary prevention?
Preventing further deterioration once problem has caused damage (ex: harm reduction).
What is mental health promotion?
An approach to mental health which emphasises strengths and resilience as opposed to reacting to pathology. Mental health is more than the absence of a disorder.
What is universal prevention?
Includes all individuals in a geographical area or particular setting (schools, workplaces, disadvantaged part of the city etc)
What is selective prevention (aka high risk approach)
Assumes that there are known factors that affect mental health and an intervention is directed at the population where those factors are most prevalent (ex: schools in a lower income part of the city)
What is indicated prevention (aka early prevention)
Programs directed at individuals showing early signs of mental health problems (Ex: children or adolescents known to be using drugs, tobacco etc)
What is positive mental health?
Mental health is more than the absence of a mental disorder. Includes enjoying life, ability to deal with life’s challenges, emotional and spiritual well-being, social connections and respect for culture, equity, social justice, and personal dignity
What are some of the current approaches to prevention?
Identification of risk factors and issue of cumulative risk
Identification of protective factors
Wellness enhancement and promotion of resilience
What are some examples of protective factors?
Education and health
What does it mean that prevention is proactive?
Does things ahead of the problems
What does it mean that prevention has a population focus?
Focus is on groups of people
What does it mean that prevention is multidimensional?
Addresses a number of problems
What does it mean that prevention is ongoing?
Programs carry an expense. Politicians may cut funding, makes people believe we are saving mony
How do we promote resilience?
Secure attachment to caregivers encourage the development of age-appropriate competencies (play school and kindergarten!!). Creating healthy, safe, and just social environments, empowering people psychologically and politically, helping people develop resources to cope with stress
What are Rutter’s ideas on risk and protection (4)
1) Reducing risk impact
2) Interrupting unhealthy chain reactions stemming from stressful life events
3) Enhancing self esteem and self-efficacy
4) Creating opportunities for personal growth
What is a narrowly focused versus ecological approach?
Narrow: Only certain populations
Ecological: Focuses on different environments
For every dollar invested in mental health, how much do we get in return?
1.50-17.00
