Therapies (Ch. 14) Flashcards
primarily psychological therapy providers
- clinical psychologists
- marriage, family, and child counselor
- school psychologist and vocational counselor
- mental health counselor
- clinical social worker
what do all the primarily psychological therapy providers have in common?
all licensed to offer psychological therapies
primarily biological therapy providers
- psychiatrist
- general medical practitioner
- neurologist
- psychiatric nurse
can people practice without a license?
yes can still offer psychological therapies
what determines someone’s success as a therapist?
not: their years of experience or professional credentials
more so: their character
benefits of working with a trained professional
- their relationship with healthcare professionals
- ability to handle emergency situations
- adherence to code of ethics (ex. APA ethical principles)
can anyone administer biological treatments?
requires a license
- debate over who should be allowed to prescribe meds
- medical doctors only vs. medical doctors and clinical psychologists with additional training
do all get therapy who need it?
- women are more likely to seek therapy than men
- healthcare providers aren’t always available to people where they live
- financial barriers
- stigma and suppressed recognition of the disorder
how does the relationship between the healthcare provider and client impact treatment?
rapport (sense of trust) is important
cultural competence
understanding how clients’ beliefs, values, and expectations are shaped by their cultural background
culturally appropriate therapy
therapy conducted that is sensitive to patient’s cultural background and expectations
(ex. collectivist- oriented families who infrequently challenge the patriarch, if there is a therapist that emphasizes individual autonomy over family loyalties, it may violate a clients’ cultural tradition)
Freud and hysteria
pioneered the use of psychological therapies to treat psychological disorders such as hysteria (now known as conversion disorder)
believed hysterical symptoms was to suppress emotionally charged memories
psychoanalysis methods
- free association (saying whatever comes to mind) –by way of the talking cure
- an analysis of resistance (avoiding certain ideas)
- interpretation (explaining how certain thoughts and feelings arise)
- analysis of transference (clients’ tendencies to respond to analyst in ways to recreate their responses to major figures in their life)
psychodynamic approaches
expansion of Freud’s work
- emphasizes adaptive abilities of the ego and importance of an individual’s real relationship with others
interpersonal therapy (IPT)
helps patients understand how they interact with others and learn better ways of interacting and communicating
criticism of psychoanalysis in favor of humanist approach
believed it was too concerned with basic urges, decreasing tension, and the past
Gestalt Therapy
(humanist approach)
Fritz Perls
- aims to help patients integrate inconsistent aspects of themselves into coherent whole individuals to increase self-awareness and self-acceptance
Gestalt Therapy Techniques
- focusing (asking how clients felt in the moment and pointing out differences in how their acting)
- hot set technique (therapist directly challenges the client)
- empty chair technique (client imagines sitting across a significant person and tells them how they feel)
experiential therapies
a collective term for modern humanistic therapies that provides an empathetic and accepting but also challenging environment
cognitive therapy
Aaron Beck
- dysfunctional beliefs play a role in development and psychological disorders
- believe psychological disorders involve unhelpful/ maladaptive patterns of thinking
cognitive restructuring
technique to identify and change someone’s maladaptive belief
- combatting…negative cognitive triad (believed depressed people have negative views about themselves)
cognitive-behavioral therapy
hybrid form of psychotherapy focused on changing someone’s habitual interpretations of the world and ways of behaving
- cognitive and behavioral techniques
(ex. Oliver’s professor didn’t say hi, he assumed it was bc he asked a dumb question, but can restructure thought to be maybe bc he was tired)
3rd wave therapies
CBT’s that place less emphasis on direct cognitive change and more emphasis on changing the hold thoughts have on us
acceptance and commitment therapy
- less psychological rididity
goal: clients can pursue goal despite unwanted thoughts and feelings
mindfulness-based stress reduction
-be present, insubstantial/ fleeting nature of painful feelings
goal: clients can pursue goals despite irrational thoughts/ feelings of anxiety
couples and family therapy
-regard fam as single emotional system
-if one person has the “issues” (ex. abuse, bipolar, etc.) regarded as “identified patient)
group therapy
group of strangers with 1-2 therapists
(+) more people per therapist (can see more people at once and get insight into how people interact in a group)
self-help/ support groups (group therapy)
group therapy without a therapist, self-organized
(+) inexpensive but (-) little attention paid to each individual
telehealth
(+) convenience, confidentiality
(-) hard to eval the credentials of the therapist, can’t determine non-verbal vues
psychotrophic medication
drugs that control, or at least moderate, the symptoms of psychological disorders
typical antipsychotics
reduce positive symptoms of schizophrenia, but aren’t effective at reducing the negative symptoms & bad side-effects
atypical antipsychotics
(widely used) reduce positive and negative symptoms of schizophrenia & fewer side-effects
deinstitutionalization
(spurred by antipsychotics)
movement to get people with schizophrenia out of the hospital
(-) has led to many to be in jail or homeless instead
4 classes of antidepressants
- monoamine oxidase inhibitors (MAO)
- tricyclics
- selective serotonin reuptake inhibitors (SSRIs)
- atypical antidepressants
MAO and tycyclics
increase amount of norepinephrine and serotonin is available for synaptic transmission
SSRIs
increase serotonin turnover in the brain
- fewer side-effects than MAO and tycyclics
atypical antidepressants
(ex. Wellbutrin, operates on dopamine and norepinephrine systems)
- none of the bad side-effects from other antidepressants
how often do people use medication treatment for depression?
8 out of 10 people who seek treatment for depression receive antidepressant medication
mood stabilizers
(ex. lithium) used to treat bipolar disorder
what medication are people who high levels of anxiety treated with?
anti-anxiety meds: anxiolytics (tranquilizers)
- historically was benzodiazepine
who was anti-anxiety medication advertised to?
women, housewives especially, seen as something they can take to be calm so they can dote on their husband and cook dinners
other medication for high anxiety?
- beta blockers (control autonomic arousal)
- antidepressants
benefits of using psychoactive medication
proven effective at reducing symptoms of psychological disorders
limitations of using psychoactive medication
- need to continued use of medication
- difficulty in finding the right medication and dosage
- negative side-effects
tardive dyskinesia
results from long-term use of typical antipsychotics
- debilitative motor symptoms (involuntary, shakes, etc.)
over-prescription
especially a concern for psychotropic medication, for disorders prevalent in childhood (ADHD) especially
psychosurgery
aims to alter problematic patterns of thinking, feelings or behaving by removing brain areas/ disconnecting them from each other
contemporary lobotomy
precision lesions
vagal nerve stimulation
sending electrical pulses, with stimulator implanted in chest, to vagus nerve (thought to stimulate parasympathetic NS activity to promote mood regulation)
deep brain stimulation (DBS)
(depression ex. stimulation of subgenual cingulate cortex)
- effective for patients that haven’t responded to conventional treatment
repetitive transcranial magnetic stimulation (rTMS)
rapid pulses of magnetic stimulation leading to changes in neuronal activity
- effective for medication resistant depression
physical activity
associated negatively with psychological disorders and higher mental health outcomes
(mixed outcomes on impact of people with mental disorders)
exposure to nature
good to reduce stress
testing effects of therapy with self-response (survey of satisfaction)
(-) don’t know if its representative of the larger population (people who didn’t respond)
(-) regression to mean (seen therapist @ worst, so when start feeling better you assume its the therapy)
(-) people want to justify the time and money spent on therapy
testing effects of therapy with before and after approach
(-) vulnerable to spontaneous improvement (people may improve on their own with or without treatment
testing effects of therapy with a wait-list control condition
patients receive delayed treatment to compare them to the experimental group
(+) more effective
(-) still vulnerable to the placebo effect
double blind studies
(+) addresses placebo effect
(-) hard to apply the context of a therapy
do psychological therapies work?
- meta-analysis suggest they often do
- empirically supported treatments (EST) - clinical method research shows is effective for treating a disorder
- dodo bird verdict (widely different interventions can have comparable effects)
eclecticism
deliberate weaving together of different therapeutic traditions and approaches (endorsed by many psychologists today)
mid and match approach
drawing on many different approaches to personalize therapy
dialectical behavior therapy (DBT)
- arose out of mix and match approach
- for borderline personality disorder
matched treatment approach
selecting the best therapy/ combo of therapies for each patient’s presenting complaints
(therapist sticks with empirically validated treatments)
(ex. combining psychotropic medication and CBT)
