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psychiatry > Therapies / Theories > Flashcards

Therapies / Theories Flashcards

1
Q

What is interpersonal and social rhythm therapy?

A

— Used for bipolar disorder to control manic and depressive episodes
— Helps establish sleep and physical activity schedules
—Patients use a self-monitoring instrument to monitor daily activities

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2
Q

What is sensory stimulation therapy (SST)?

A

May be used for dementia to improve cognition and memory
—Stimulation meaningful to patient
—Pictures, music
—Smells

May be used for SAD
—phototherapy; 10 000 lux in the mornings 30 min daily; reduced depression in 1-2 wks
—start in Oct/Nov and stop March/April

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3
Q

Erikson’s psychosocial theory;

Identity vs Role Confusion

A

—Age 12 to 20

—Develop strong sense of independent self away from parents

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4
Q

Cognitive Behavioural Therapy for drug relapse

A

—Identify triggers that lead to relapse

—Provide behavioural tools if faced with triggers including peers

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5
Q

What is the Transtheoretical Model (TTM)?

A

—Stages of Change
— Prochaska and Velicer

  1. Precontemplation
  2. Contemplation
  3. Preparation (planning to change within 30 days)
  4. Action
  5. Maintenance
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6
Q

What are the steps to facilitating change in the workplace?

A
  1. Believing
  2. Deciding
  3. Acting
  4. Evaluating
  5. Understanding
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7
Q

What are the characteristics of a teaching group?

A

Closed

Set number of classes

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8
Q

What are the four types of readiness to learn?

A
  1. Physical readiness
  2. Emotional readiness
  3. Experiential readiness
  4. Knowledge readiness
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9
Q

What traits affect physical readiness to learn?

A

Health
Gender
Vision
Hearing

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10
Q

What characteristics affect emotional readiness to learn?

A 
Motivation
Frame of mind
Anxiety level
Support system
Developmental stage
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11
Q

What characteristics affect experiential readiness to learn?

A

Cultural background
Orientation
Aspiration level

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12
Q

What characteristics affect knowledge readiness to learn?

A

Cognitive ability
Learning style
Learning disabilities
Educational background

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13
Q

What are the three determinants in the assessment of a learner?

A

Learning needs
Readiness to learn
Learning style

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14
Q

Erikson’s psychosocial theory

Generativity vs. Stagnation

A 
—Age 45-65
—Has raised children into responsible adults
—Relinquishing control of adult children
—Using leisure time creatively
—Adjusting to physical changes
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15
Q

What is habit reversal training?

A

—A behavioural therapy
—Used for Tourette’s and tic disorders
—Help patients recognize habit pattern and motor sequences associated with tics
—Helps patient recognize triggers
—Patients learn routines to counter the tic

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16
Q

What is Caplan’s public health model of mental health care?

A

—Based on primary, secondary, and tertiary prevention.
—Primary: prevent incidence
—Secondary: catch it early
—Tertiary: prevent complications, promote recovery

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17
Q

What is primary prevention?

A

—Preventative efforts for the individual and environment
—Enhance coping
—Decrease stressors
—Reduce incidence of disease

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18
Q

What is secondary prevention?

A

—Promptly providing effective treatment for identified problems
—Catch it early; screening

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19
Q

What is tertiary prevention?

A

—Treat illness
—Prevent complications
—Promote rehabilitation and recovery

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20
Q

What is a transitional living facility?

A

—Provides supervision

—Assistance with medications, learning to live independently, and finding a job

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21
Q

What is Mindfulness Based Stress Reduction (MBSR)?

A 
—Combines mindfulness and yoga
—Reduce BP, promote healing and muscle development
—Modify emotional reactions
—Enhance self-esteem
—Weekly for 8 weeks
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22
Q

What is the purpose of aromatherapy?

A

—Induce relaxation and promote sleep
—Most common: lemon, lavender
—Can reduce agitation in patient’s with Alzheimer’s

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23
Q

What is a Johari window?

A 
Four quadrants:
—Quadrant 1: open/public self
—Quadrant 2: blind/unaware self
—Quadrant 3: hidden/private self
—Quadrant 4: unknown/undiscovered self

Input from individual and others

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24
Q

Erikson’s psychosocial development theory: Trust vs. Mistrust

A

—Infant 0-2 years
—Acquisition of hope vs withdrawal
—Focus on oral needs

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25
Q

Erikson’s psychosocial development theory: Autonomy vs. Shame and Doubt

A

—Toddler 1.5-3 years
—Focus on anal needs
— Autonomy, acquisition of skill

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26
Q

Erikson’s psychosocial development theory: Initiative vs. Guilt

A

—Preschooler 3-6 years
—Genital needs
—Acquisition of purpose
—Is it okay to act, speak, etc

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27
Q

Erikson’s psychosocial development theory: Industry vs. Inferiority

A

—School-age 6-12

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28
Q

Erikson’s psychosocial development theory: Intimacy vs Isolation

A

—Young Adult 20-45

— Romantic relationships and close friendships

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29
Q

Erikson’s Theory of Psychosocial Development

A 
Trust vs. Mistrust (infant)
Autonomy vs. Shame/Doubt (toddler)
Initiative vs Guilt (pre-school)
Industry vs. Inferiority (school age)
Identity vs. Role Confusion (adolescent)
Intimacy vs. Isolation (young adult)
Generativity vs. Stagnation (adult)
Ego Integrity vs. Despair (older adult)
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30
Q

What is massed negative practice?

A

-

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31
Q

What is interoceptive exposure?

A

-

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32
Q

What is contingency management?

A

-

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33
Q

What are repression and suppression?

A

REPRESSION is unconscious forgetting.

SUPPRESSION is the conscious dismissing from the mind of an unacceptable idea.

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34
Q

What is introjection? What is identification?

A

INTROJECTION is taking on the beliefs and values of someone else.

IDENTIFICATION is looking up to someone enough that one dons their style of dress, mannerisms, etc.

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35
Q

What is Motivational Interviewing?

A

Outgrowth of stages of change theory
Miller and Rollnick

Counseling style uses communication designed to strengthen motivation to change
Directly poses back to the patient his or her ambivalence
Atmosphere of acceptance and compassion

Helps the patient “discover advantages and disadvantages of their behaviours for themselves”

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36
Q

What is Social Learning Theory?

A

—Albert Bandura

Proposes that self-efficacy is an important factor in learning success. Without it patient will not have the desire to learn.

SELF EFFICACY: patient’s perception of own ability to perform an action

—Break down learning into manageable segments
—Set patient up for success
—Allows patient to develop internal sense of competence

Three kinds of motivators: physical, social, cognitive

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37
Q

What are physical motivators?

A

Social learning theory

-Memory of previous discomfort or current symptoms

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38
Q

What are social incentives?

A
  • Social learning theory

- Praise, encouragement

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39
Q

What are cognitive motivators?

A

Social learning theory

—Perceived self-efficacy

40
Q

What is Nola Pender’s theory?

A

Health Promotion Model

People are willing to engage in health teaching based on their perceptions and beliefs about:

  1. Their risk for disease
  2. How bad a disease is
  3. Whether acting will prevent the disease

“Cues to action” encourage people to engage in health promotion and include mass media, preventive education, interpersonal interactions.

Passive vs. active strategies

41
Q

What are passive and active health promotion strategies?

A

Passive: e.g. no smoking policies
Active: community health fairs

42
Q

What are the domains of learning?

A

Cognitive - content recognition/recall
Affective - feelings/values/motivation
Psychomotor

Effective teaching targets all three

43
Q

What is neurolinguistic programming (NLP)?

A

—Bandler and Grinder

People create representational models of the world and use language to symbolize them.

44
Q

What is interpersonal therapy (IPT)?

A

Brief form of psychodynamic therapy
Treatment goal is to improve patient’s interpersonal skills
Clarifying feeling states, areas of conflict, dysfunctional behaviour

—Work on one or two key issues
—Understand that corrective action in one sphere has a ripple effect

45
Q

What is Eye Movement Desensitization and Reprocessing (EMDR)?

A

-Used in PTSD and for sexual predators
-Eye movements, tones, or taps
—Accessing insight, changes in memories, or to make new associations

46
Q

What is reinforcement and punishment?

A

Positive reinforcement: Giving a reward for desired behaviour
Negative reinforcement: Removing something unwanted in return for desired behaviour. OR someone avoids consequences/tasks/situations by doing a behaviour and so it is reinforced

Positive punishment: Applying a consequence for undesirable behaviour
Negative punishment: Taking something away for undesirable behaviour

47
Q

Who benefits from behavioural modification therapies?

A

—Children with developmental disabilities
—ADD
—Conduct disorder
—Phobias/OCD/anxiety (flooding, desensitization)
—Addictions

Behavioural therapy does not take into consideration insight, motivation, or past life experiences.

48
Q

What are behavioural modification strategies?

A 
Reinforcement/punishment
Contingency contracts
Token economy
Shaping
Modeling
Discrimination
Extinction
49
Q

What are the different reinforcement schedules?

A 
Intermittent
Continuous
Fixed interval
Variable interval
Fixed ratio
Variable ratio
50
Q

What are primary and secondary rewards?

A

Primary reward: The desired reward (toy, privilege, candy)

Secondary reward: Points/tokens that can be traded for primary rewards

51
Q

What are contingency contracts?

A

Used with children particularly
Identify behaviours requiring change, conditions under which reinforcement will occur, and specific time periods for achieving desired behaviours

52
Q

Who benefits from token economies?

A 
Behavioural disorders
ADHD
Developmental disorders
Hospital inpatient treatment
Juvenile justice setting
53
Q

What is shaping?

A

Behavioural strategy
—Start with small component of behaviour and gradually add more parts to the task
—Each component is successively rewarded until final desired behaviour is achieved (successive approximation)

54
Q

What is modeling?

A

Behavioural strategy

—Imitation of behaviour

55
Q

What is behavioural rehearsal?

A

Behavioural strategy

Patient practices desired behaviour with therapist

56
Q

What is coaching?

A

Behavioural strategy

Therapist provides constructive feedback

57
Q

What is discrimination (therapy)?

A

Behavioural strategy
Teaches patient to act one way under one set of circumstances, but not in another, by rewarding behaviour response only in the desired set of circumstances.

58
Q

What is extinction?

A

The opposite of reinforcement

Not responding to behaviour

59
Q

What is a fixed interval reinforcement schedule?

A

At distinct TIME intervals (30 minutes), the reinforcer is given.

60
Q

What is a variable interval reinforcement schedule?

A

For the first response after a VARIABLE time interval has elapsed, a reinforcer is given.

61
Q

What is a variable ratio reinforcement schedule?

A

Initially very frequently, and then less frequently as performance improves;

e.g. every time, then every second time, then every third or fourth time, etc.

62
Q

What is a fixed ratio reinforcement schedule?

A

Every second response, every fifth response, etc. Not to do with time, but repetitions.

63
Q

Who developed CBT?

A

Aaron Beck

64
Q

What is the Socratic method and when is it used?

A

The Socratic method is used in CBT to challenge dysfunctional thinking. It uses an inductive, questioning format.

65
Q

Who developed rational emotive behaviour therapy (REBT)?

A

Albert Ellis

66
Q

What is rational emotive behavioural therapy (REBT)?

A

Psychotherapy based on the idea that our perceptions shape how we feel and behave (related to CBT).

Involves ABCs (Activating event, irrational Belief, unhealthy emotional Consequence) and three irrational core beliefs

67
Q

What is CBT?

A

Cognitive behavioural therapy
Time-limited form of psychotherapy; involves homework assignments
Basic premise: Perception/Thought —> Feeling —> Behaviour

68
Q

What is the cognitive triad?

A

Part of CBT theory
Cognitive distortions related to a person’s negative view of self, the world, and the future
Related to depression

69
Q

What is cognitive restructuring?

A

Part of CBT

Teaching patients to challenge irrational beliefs and to substitute positive self-statements for negative thoughts

70
Q

What is thought-stopping?

A

Intentional detachment from maladaptive thoughts

Using opposing internal self-talk to make self-made rules less absolute

71
Q

What are the ABCs of REBT?

A

Activating event
irrational Belief
unhealthy Consequence

72
Q

What are the three core irrational beliefs in REBT?

A
  1. I must do well and win approval or else I am no good.
  2. Other people must treat me kindly and fairly and in exactly the way I want them to treat me. If they don’t, they are no good.
  3. I must get what I want, when I want it; and I must not get what I don’t want. It’s terrible if I don’t get what I want, and I can’t stand it.
73
Q

Who is a theorist behind play therapy in children?

A

Landreth

74
Q

Who invented DBT?

A

Marsha Linehan

75
Q

Who is a major figure in psychiatric health promotion?

A

Gerald Caplan
—biopsychosocial risk factors
—population health
—patterns of crisis

76
Q

Who is the theorist behind Family Systems Theory?

A

Murray Bowen

77
Q

What is Family Systems Theory?

A

Framework of family systems therapy with eight interconnected concepts:

Triangles
Differentiation of self
Nuclear family
Family projection process
Multigenerational transmission process
Emotional cutoff
Sibling position
Societal emotional process
78
Q

What are triangles in family systems theory?

A

Three-person relationship systems in which a two-person system becomes unstable and involves a third person to reduce the tension.

79
Q

What is the family projection process?

A

Parents transmit emotional fears or issues onto one of their children, affecting child’s normal development.

Child may take on caretaker role.

80
Q

What is emotional cutoff in family systems theory?

A

Occurs when family members reduce tension of unresolved conflict by reducing or cutting off emotional contact.

81
Q

What is the societal emotional process in family systems theory?

A

Bowen asserts that family systems theory can be broadly applied to larger social groups such as work, social organizations, and society.

82
Q

Who is the theorist behind the structural model of family therapy?

A

Salvador Minuchin

83
Q

What is the structural model of family therapy?

A

Emphasizes:

Family structure — interactional patterns between members, family rules, automatic responses
Subsystems — based on generation, gender, or function
Boundaries — between family/not family, between subsystems. may be diffuse or rigid

Enmeshment vs disengagement

84
Q

What are diffuse vs. rigid boundaries?

A

Structural model of family therapy

Diffuse: family members become overly involved in each other’s affairs (enmeshment)
Rigid: Family members are isolated from each other or society (disengagement)

85
Q

Who developed strategic family therapy?

A

Jay Haley and Cloe Madanes

86
Q

What is strategic family therapy?

A

Premise: symptoms and problem behaviours serve a function in the family system and are attempts to control a relationship

Families may scapegoat members into a sick role that distracts everyone else from their dysfunctions

“Identified patient” may not be the one who needs the most help

Therapist works to help family uncover interactions that maintain symptom

Double-bind clinical strategy

87
Q

What is Multi-Systemic Therapy (MST)?

A

Home-based, family-oriented services for adolescents age 12-17 within the juvenile justice system.

Involves community systems (peer, school, neighbourhood).

88
Q

What is solution-focused therapy?

A

Short-term collaborative therapy focused on problem-solving

Strategies include:

miracle questioning (if everything could instantly be better, what would that look like)
scaling questioning (on a scale of 1 to 10 where are you in terms of goals)
exception-finding questioning (when in your life was this not a problem?)
89
Q

What is the optimal size of a psychotherapy group?

A

6-8 members

90
Q

Open vs. closed groups

A

Open: membership fluctuates from session to session

Psychotherapy groups are typically closed
Psychoeducation and bereavement groups are more open

91
Q

What are the five stages of group processing?

A

Forming: leader most active
Storming: control and power issues, acting out and transitioning
Norming: cohesiveness, group-specific standards
Performing: productivity
Adjourning/termination: closure, review goals

Tuckman

92
Q

What is WRAP?

A

Wellness Recovery Action Plan
—driven and managed by person receiving services
—wellness tool box, daily maintenance plan, crisis action plan

93
Q

What are Wrap-Around services?

A

Community-based intensive mental health services for families with children and adolescents with multiple psychosocial issues.

Home- and school-based supports

94
Q

What is SBIRT?

A

Substance Abuse Brief Intervention, Referral, and Treatment

— motivational interviewing in outpatient settings

95
Q

What is the Therapeutic Community Model?

A

“living-learning situation”
staff and patients work together in a milieu
patient self-governance; community meetings
microcosm of larger society

psychiatry (6 decks)

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