Treatment for Psychological Disorders (Module 5 Ch 16) Flashcards
Memorize by Final exam 12/11
Dorothea Dix
An activist focused on the fair treatment of patients in hospitals
Went undercover in asylums in the 1850s = discovered the poor treatment of patients and wrote and expose on it
Was such a successful advocate that she got the pope to interfere on her behalf despite being protestant
Anna O
First person to undergo therapy
Originally presented with the inability to move the right side of her body; also had trouble with hearing and speech
Probably had meningitis, but was diagnosed with hysteria (“wandering uterus”)
Josef Breuer
First person to conduct therapy (“treated” Anna O)
Originally used talk therapy, which was later popularized by Freud
His methods didn’t work (cause her uterus obviously wasn’t the problem)
Psychoanalytic Therapy vs Psychodynamic Therapy
The original “talk therapy” popularized by Freud (but originally used by Josef Breuer)
Focuses on uncovering unconscious motives through talking and dream interpretation
VS
The modern offshoot of Freud’s ideas, in which talk therapy is used to confront unconscious impulses and ideas
Brodmann’s Area 25
Area in the prefrontal cortex that is overactive in depressed patients
Can be reset via overstimulation, which tends to leads to improvements in depression
PsyD
Doctorate of Psychology that focuses on counseling training without the research components required for a PhD
Incongruence
The difference between your self-concept and your reality
Greater difference = greater personal distress
Ecological Momentary Assessments
Using someone’s cell phone or smartwatch to monitor their thoughts, feelings, and behaviors in real-time (helps make therapy more effective)
Insight Therapies
The idea that you can improve someone’s psychological wellbeing if you give insight into their underlying motives or help them understand why it’s occurring
Active Listening
The therapist echoes, restates, or seeks clarification on what the patient is telling them
Patient knows that therapist is actually listening
Therapist understands what the patient is trying to communicate
Cognitive Therapy
Any type of psychotherapy that works to identify and restructure irrational thought patterns
Socratic Method
The therapists poses questions to the patient that are meant to highlight the lack of logic on their thought patterns
Helps with depressogenic thinking
Depressogenic Thinking
Thought patterns that keep people trapped in their depression
Helplessness Theory
Cognitive Restructuring
The patient is going through the process of taking irrational beliefs and replacing them with rational ones
Cognitive Behavioral Therapy (CBT)
Says that a person’s cognitions (thoughts), behaviors, and emotions are all interconnected, so making positive changes in one will positively affect the others
Rational Emotive Behavioral Therapy
Combative type of therapy in which the therapist is really explicit in their disagreement with the patient’s thought process
Helpful for some people and not others
Mindfulness-based Cognitive Therapy (MBCT) and Dialectical Behavior Therapy (DBT)
Combines CBT with mindfulness techniques so that cognitive restructuring and positive change can occur in a non-judgmental place
DBT specifically tries to cultivate mindfulness without meditation and is used to treat borderline personality disorder
Applied Behavioral Analysis (ABA)
Similar to CBT, but it focuses specifically on changing behaviors in order to change cognitions
Makes a list of negative behaviors the patient does; therapist helps them create a plan to change each of those behaviors
Behavior Therapies
Applies the principles of classical and operant conditioning, such as token economies, as a way of changing behaviors
Flooding
Way of addressing phobias that involves putting someone in a space with their phobic trigger and not letting them leave until they stop having a phobic reaction
Systematic Desensitization
Building up to an interaction with the phobic trigger by addressing the reasons they’re afraid of it
Pairs relaxation with gradual exposure to a phobic trigger
Occurs in 3 levels: imagined contact, virtual contact, and real contact
More effective than flooding
Social Skills Training
Commonly used to address autism or severe social anxiety
Includes 4 stages: modeling, behavioral rehearsal, shaping, and disengagement
Modeling (in Social Skills Training)
Having the individual watch somebody with good social skills interact with others so they can learn by watching them
Behavioral Rehearsal (in Social Skills Training)
Practicing the skills learned via modeling in a safe environment (usually a therapist office)
Shaping (in Social Skills Training)
Practicing the techniques learned from modeling in the real world
Starting with small techniques and social situations before working up to bigger ones
Disengagement (in Social Skills Training)
When the individual now feels comfortable with social interactions
Unconditional Positive Regard
The therapist must accept the patient as a person of worth regardless of the behaviors they’ve engaged in
Doesn’t mean that you have to approve of the behaviors
Stress Inoculation Training
Teaching people how to restructure their thinking during stressful times
Includes reappraisal
Virtual Reality (in Cognitive Therapy)
Helps with systematic desensitization by having the individual interact with the phobic trigger online before doing it in the real world (creates a safe space to practice their interaction)
Can also be used in avatar therapy (interacting with others online in real-time via avatars)
Apps and Cognitive Therapy (Technology-based Therapy)
Zoom + Facetime make remote visits with therapists possible
Mindfulness and meditation apps help with CBT
Group Therapy
When a facilitator starts conversations among the group and keeps them on track (without talking over them)
Includes supports groups
Can be just as effective as individual therapy because it teaches people that they’re not alone in their struggles
Integrative Therapy
Drawing on various treatment approaches and using the one that seems most appropriate for the given situation (no loyalty to any particular method)
What are some common denominators or similarities among most kinds of therapy?
Therapeutic Analysis, Providing Emotional Support/Empathy, Giving Hope and Positive Expectation, Rationale, and Opportunity for Expression
Therapeutic Analysis
The therapist provides external, objective insight into the person’s thought and behavior patterns, helping them to recognize their irrational thinking
Providing Emotional Support and
Empathy
The therapist shows the patient that they’re not alone in their feelings, wrong for feeling them, and they won’t be rejected for them
Hope and Positive Expectation
Creating a plan or guide for where the patient wants to be at the end of their therapy journey, providing them with a sense of hope and motivation during the process
Rationale
Helping someone understand the cause of certain thoughts and behaviors can help create change
Opportunity for Expression
Therapy provides a critical space for people to express their thoughts and feelings, which they might not be able to do elsewhere
What are some barriers to therapy?
Lack of insurance, cost concerns, time concerns, and stigma
What does lack of insurance become a barrier to therapy?
Not having insurance and having insurance that doesn’t cover mental health problems can make therapy expensive and inaccessible to lower-income individuals
What are some cost concerns with therapy (even if you have insurance)?
Lost income due to taking time off from work, finding transportation (gas $), childcare costs
What are some time concerns with therapy?
At the beginning of the process, therapists want you to go fairly often and for long periods of time (in order to build a relationship)
This may take time away from other commitments or work
How does stigma affect the desire to seek therapy? Who is less likely to seek therapy? How can this be combated?
May make people uncomfortable going to therapy or admitting they have a mental health problem
Men, the elderly, and religious people are less likely to seek help
Can be combated by open discussion
How are psychiatrists different from psychologists?
Psychiatrists are MD’s that are allowed to prescribe medication
How does length of time affect medication?
Some people only need to be on meds for a short period of time while others (like those with schizophrenia) may need to be on it for the rest of their lives
Joint Treatment
Combining medication with therapy
Selective Serotonin Reuptake Inhibitor (SSRIs)
Serotonin agonists
One of the newest and most commonly prescribed antidepressants
Only works on one neurotransmitter, meaning it has fewer side effects
Tricyclic Antidepressants
Serotonin and Norepinephrine agonist
Older than SSRIs and less commonly prescribed
Common side effects include weight gain, irritability, and dry mouth
Similar drug: SNRIs (like SSRIs but they also target norepinephrine)
MAOIs
Affects Serotonin, Norepinephrine, Epinephrine, and Dopamine
Oldest and least prescribed antidepressant (most likely to have side effects)
Can interact with other medications (ex: allergy meds) and foods (ex: grapefruit) in a harmful way
Time delay for antidepressants
Takes about 4 weeks to see a therapeutic change (noticeable decrease in depressive symptoms)
What is the shared side effect among antidepressants?
Increased suicidal risk
Short-term (meds increase energy levels first but take longer to improve mood)
Anxiety medications
Benzodiazepines and Barbiturates
Anti-psychotics
Dopamine antagonists commonly prescribed for schizophrenia, but can also be used to treat similar symptomology in bipolar disorder
What kind of schizophrenic symptoms do anti-psychotics target?
Positive symptoms like hallucinations and delusions
Doesn’t work on negative symptoms like catatonia
Why do patients on anti-psychotics struggle with adherence?
Common for patients to stop taking meds when having delusions of grandeur or manic phases
Patients who are unhoused also have difficulty staying on meds due to lack of money and means to get prescribed
Time delay for anti-psychotics
Pills - typically take a week to see changes
Liquids - typically work quicker than pills but have stronger side effects
Tardive Dyskinesia
Overcorrecting of dopamine levels when taking anti-psychotics can lead to Parkinson’s-like symptoms such as uncontrollable muscle movements (which are usually temporary, but can become permanent)
Stimulants
Medication primarily used for ADHD (calms them down)
Can ramp up or energize people without ADHD
Prescription stimulants are less addictive than illegal kinds such as cocaine
Lithium
Mood stabilizer medication used to treat bipolar disorder
Can lead to a build-up in and dysfunction of the kidneys, which is potentially fatal (because of this, it’s typically not prescribed unless other mood stabilizers prove ineffective)
Electro-Convulsive Therapy (ECT)
Technique used to treat depressive patients that don’t respond to medication
Uses electrical currents to reset certain areas of the brain by inducing a seizure
Takes between 6 and 8 sessions to be effective (usually done in outpatient care)
Major side effect: anterograde or retrograde memory loss (that usually goes away or improves with time, but may become permanent)
Repetitive Transcranial Magnetic Stimulation (rTMS)
Technique to treat severe depression (similar to ECT)
Exposes particular brain structures to intense magnetic fields
Deep Brain Stimulation
Similar to ECT, but electrodes are implanted into the brain for stimulation of more specific neuron clusters (such as Brodmann’s Area 25)
Optogenetics
Using light to stimulate neural activity in certain brain regions by altering the expression of certain genes
Can be helpful in treating substance abuse disorders
Psychedelic Medicine
The controlled use of psychedelic drugs for the treatment of mental disorders
May have long-lasting beneficial impacts after one administration or session
Transference
Reacting to someone in a current relationships as if they’re someone from a past relationship
Similar to projection
