Topic 8: Psychological Treatments Flashcards
Goals of major therapies
(therapeutic context)
reaching diagnosis DSM-5
treatment planning - min/eliminate symptoms
making a prognosis
proposing possible aetiology (cause)
Who provides therapy/care?
clinical psychologists
counsellors/mental health workers
scientist-practitioner model (research based practice/research, based on empirical evidence, validity)
Psychodynamic therapies - goal
understanding own psychological processes (insight)
developed from Freud
Psychodynamic therapies
what the disorder results from
unconscious conflicts/compromises = anxiety
fears/wishes
maladaptive view of self/relationships
maladaptive ways of dealing with unpleasant emotions
What is the therapist-patient relationship within psychodynamic therapies?
therapeutic alliance
What are some varieties of psychodynamic therapy?
Freudian psychoanalysis
intensive/prolonged technique for exploring unconscious motivations/conflicts
guide patient to insight
3-5 sessions per week, several years
Psychodynamic therapies
shorter, goal directed
emphasis on clients current social environment
continuing experience of life and its influence
social motivation + interpersonal r/ships
ego functioning and development
Psychodynamic techniques
free association - say what comes to mind, reveal unconscious processes
interpretation - therapists interprets patient and conflicts/motivations
resistance
catharsis - emotional release
transference - reproduction of emotions/experiences for a new person
Does psychodynamic therapies work?
psychoanalysis functioning 75% better than those who didn’t receive treatment
conflicting evidence on brief psychotherapy
Psychoanalysis VS psychodynamic psychotherapy
analysis: therapist behind patient on couch, free association
therapy: face to face, goal directed
Behaviour therapies
observable behaviours
abnormal behaviour - acquired through learning processes (conditioning + reinforcement)
short-term, focus on current behaviours
What is behavioural analysis?
problem behaviour + stimulus associated
Behaviour therapies
Exposure therapies
Systematic desensitisation - prevent arousal by confronting fear relaxed
Flooding - put directly into phobic situation, all at once
Graded exposure - gradual exposure
Virtual reality exposure - virtual images of feared stimulus
Behaviour therapies
Skill training
teaching skills to accomplish goals
Social skills training/relaxation technique
Behavioural rehearsal - visualisation of behaviour
Behaviour therapies
Social/observational learning
observe models of desirable behaviours being reinforced
Imitation of models
participant modelling
self-efficacy
Behaviour therapies
Contingency management
based on operant conditioning - change behaviour by modifying consequence
Aversion therapy - attractive stimulus + noxious stimulus (eg electric shock)
Positive reinforcement strategies
Cognitive therapies
changing dysfunctional cognitions = what people think (content) and how they think (process)
changing false beliefs
Cognitive therapies
Beck’s cognitive therapy
challenging cognitive distortions + changing maladaptive patterns of thoughts/behaviour
may not be aware of neg thoughts (automatic thoughts)
- patient records thoughts
- therapist questions evidence which assumptions are based
= challenge/change thinking
challenging, evaluating, re-attributing, discussing
Cognitive therapies
Rational-emotive therapy
Irrational thought patterns (musts, shoulds, oughts) = rational thinking key to eliminating symptoms
polarized thinking - black/white with no middle ground
Humanistic therapies
way individuals consciously experience self, r/ships, world
self awareness - recognise one’s strength - full potential
Humanistic therapies
Gestalt therapy
focus on present self
acknowledge feelings to act in accordance with them
too much control over thoughts/behaviour to conform
Humanistic therapies
Client-centred therapy
accept difference between actual/ideal self
unconditioned positive regard
therapist facilitates client search for self-awareness/acceptance
Therapies with 1+ clients
Group therapies - work on therapeutic goals, exploration of own issues in context of group processes
Family/couples therapy - change maladative interaction patterns
Biomedical therapies
Drug therapy
restore normal function to brain
alter functions of neurotransmitters
antipsychotic drugs - dopamine (schizophrenia)
antidepressant drugs - norepinephrine, serotonin (depression)
antianxiety drugs - benzodiazepine (anxiety)
Biomedical therapies
Psychosurgery (neurosurgical approach)
intentional damage to the brain to alter behaviour - pacify psychotic patients, relieve extreme neurotic symptoms
laser psychosurgery, pre-frontal lobotomy
Biomedical therapies
Electroconvulsive therapy (ECT)
intentional induction of a brain seizure by shock (bi/unilateral)
= immediate improvement in mood
Evaluating psychological treatments
Successful treatment
duration, cost, symptom reduction, effectiveness, efficacy, relapse rates
Does therapy work?
Evaluating therapeutic effectiveness
psychotherapy + medication = most successful
lack of control group and what is success?
