Treatment of Psychological Disorders Flashcards
psychotherapy
approaches used in treatment of mental disorders and psychological problems
3 types of psychotherapy
- > insight therapies (talk therapy)
- > cognitive and behaviour therapies
- > biomedical therapies
who seeks therapy
- > most common presenting problems: anxiety and depression
- > long delays before seeking treatment
- > half do not have diagnosable problem
- > barriers: stigma, finances, access
who provides therapy
- > clinical psychologists (Ph.D)
- > counselling psychologists
- > psychiatrists (M.D)
- > clinical social workers
- > psychiatric nurses
- > counsellors
insight therapy
- > uses psychoanalysis
- > started by Freud and followers
4 techniques of insight therapy
Free association
- > spontaneous expression of thoughts and feelings
Dream analysis
- > symbolic meaning
Analysis of resistance
- > defensiveness: inability to talk about certain things
Analysis of transference
- > (projects onto therapist) and counter-transference (therapists reacts in accord to projections rather than objectively)
client centred therapies
- > nondirective
- > help client self-actualize
Techniques
- > provide positive supportive therapeutic climate
Communicate
- > genuineness
- > empathy
- > unconditional positive regard - non judgmental attitude
client-centered therapy
- > clarification and emotion-focused therapy (so what you’re saying is X)
- > active listening (echo, restate, clarify)
- > therapists and clients work together as equals
- > key tasks: clarify clients feelings
- > distress reflects lack of congruence in self concept (want view of self to reflect reality…. in a nice way)
positive psychology
- > increase understanding of positive, adaptive, creative and fulfilling aspects of life
2 main approaches
- > well being therapy
- > positive psychotherapy
relationship therapy
couples counselling: often combines marital and sexual therapy
family system therapy
- > assumes all in family are interconnected
- > we need to connect to members emotionally
- > mend broken relationships
- > rules and boundaries: differentiating self from family
group therapy
- > simultaneous treatment of several clients in a group
- > participants: describe problems, share viewpoints, discuss strategies
- > therapist: select participants, set goals, protect clients, model behaviours, promote cohesiveness
- > self-help groups, i.g. eating disorders, substance use
- > efficient, effective, normalize problems, support
behaviour therapies
- > apply learning principles to change maladaptive behaviours
- > don not focus at all on underlying causes
BF Skinner (founder) and colleagues
- > assumed all behaviour is a product of learning
- > learn new, adaptive ones
techniques of behaviour therapies
- > Flooding
- > Systematic desensitization
- > Aversion therapy
- > Modelling, imitation roleplaying/behavioural rehearsal
- > Token economy
flooding
- > intense exposure to feared stimuli
Systematic desensitization
- > client exposed (in vivo or imagined) to series of stimuli related to their phobia (fear) and taught to relax at each stage and not avoid it
*create anxiety hierarchy
*teach relaxation skills
*work through hierarchy systematically
aversion therapy
- > counter-conditioning that links unpleasant state (i.e. nausea) with unwanted behaviour (i.e. drinking, porn use, phone use)
Modelling, imitation roleplaying/behavioural rehearsal
- > i.e. public speaking; learn how to do it well if you’re scared
token economy
operant conditioning where earn token for desired behaviour
- > exchange later for privileges or treats
cognitive therapy
teaches people new and adaptive ways of thinking and behaviour
- > thoughts, feelings and behaviours are linked
- > errors in thinking affects how we react to events
- > reality testing (find evidence for and against thoughts)
Goal: change the way clients think
cognitive-behavioural therapy and its techniques
combines cognitive therapy (change how you think) with behaviour therapy (change how you behave)
Techniques:
Self -instructional training
- > detect negative thoughts
- > reality testing
- > homework assignments
Beck’s Cognitive therapy
- > focus on illogical thinking about self, world, future
Rational Emotive therapy (Albert Ellis)
- > change core irrational beliefs
Goa of CBTl: change maladaptive thought patterns and change behaviour
mindfulness-based CBT
- > increase awareness
- > be present in moment
- > self-compassion
- > accepting things as they are
dialectical behaviour therapy (DBT)
- > developed by Marsha Linehan, aim to understand and accept, learn to manage emotions
4 pillars: mindfulness, distress tolerance, emotion regulation and interpersonal effectiveness
- > created to help those with borderline personality disorder
- > type of talking therapy
- > made especially for those who feel emotions intensely, or have trouble regulating their emotions
Evaluating psychotherapies
Client perceptions
- > 3 out of 4 generally satisfied : 1 in 2 very satisfied
- > reports biased by crises effect, effort, therapist factors
Therapist perceptions
- > most report therapy success (big surprise)
Actual outcome research
- > those not going to therapy often improve, but those going to therapy are more likely to improve
- > average psychotherapy is somewhat effective
- > some approaches are more effective than others
biomedical therapy
perscribed medications or procedures that act on patients nervous system
- > alter brain chemistry with drugs
- > affect circuitry (e.g. with electroconvulsive shock, magnetic impulses, surgery)
- > prescribed medicines only psychiatrists
- > generally short-term effect; drugs are a bandaid
- > over prescribed and over-medication (especially kids and elderly)
- > side effects
psychopharmacotherapy (drug therapy)
Anti anxiety: relieve nervousness
- > benzodiazepine family (i.e. valium and Xanax)
- > side effects: drowsy, depression, nausea, confusion
- > addiction and withdrawal issue
Antipsychotic: gradually reduce psychotic symptoms
- > thorazine, Haldol
- > side effects: dizzy, drowsy, anxiety, insomnia, weight gain
Antidepressants: gradually elevate your mood
- > tricyclics, SSRIs, MAOIs
- > side effects: nausea, weight gain, sex problems, insomnia
Mood stabilizers: manage bipolar disorder
- > lithium
- > side effects: tremor, thirst, wight gain, impaired memory, poor concentration, vomiting/diarrhea
evaluating drug therapies
- > effective with most severe disorders
- > not as effective as advertised
- > over-prescribed
- > side effects
- > doctors become drug pushers (financial arrangements)
Electroconvulsion therapy (ECT)
for severely depressed patients
- > type of biomedical therapy
- > series of brief electric currents sent through brain
- > patient is anesthetized
- > induces seisure
- > short term memory loss
new brain stimulation techniques
- > Transcranial magnetic stimulation (TMS)
- > Deep brain stimulation (electrodes in brain produce impulses that regulate abnormal impulses)
