Treatment of psychological disorders Flashcards
A clinical psychologist works with
people who have clinically diagnosed mental disorders
Psychodynamic therapies rest on two principles:
(i) insight and (ii) therapeutic alliance
Insight refers to
an understanding one’s own psychological processes
Insight helps address:
(i) maladaptive ways of viewing the self and interpersonal relationships, (ii) unconscious conflicts and compromises among competing wishes and fears and (iii) maladaptive ways of dealing with unpleasant emotions
Therapeutic alliance refers to
the relationship between the patient and therapist; if the patient feels comfortable to speak then you will get more disclosures about emotionally significant experiences and therefore aid the therapeutic process
There are three techniques psychodynamic therapists often use:
(i) free association, (ii) interpretation and (iii) transference
Free association means
to speak freely about anything (e.g. thoughts, feelings, images, fantasies, memories, dreams) without censorship
Interpretation is
where the therapist helps the patient understand their symptoms because: (i) they have training, (ii) they have ‘an outsider’s perspective’ so they are not emotionally embroiled in the issues like the client is, and (iii) they can help patients overcome any resistance they have to uncovering their maladaptive patterns of thought and behaviour (which initially developed to avoid the anxiety they would otherwise provoke)
Transference occurs
when people transfer the thoughts, feelings, fears, wishes and conflicts that are troubling them from the real source (e.g. father) to the therapist
cognitive behavioural therapies:
(i) are more short term, (ii) focus on the client’s current symptoms and behaviour and doesn’t try to uncover any childhood traumas/experiences that may be unconscious and underlying the conflicts and motives of the mental illness, (iii) are more directive (they suggest specific ways patients should change their thinking and behaviors, assign homework and structure sessions with questions and strategies etc., (iv) use behavioral analysis (by examining the stimuli or thoughts that precede or are associated with behavioural symptoms) and (v) address specific psychological processes
Two common techniques used in CBT that derive from behaviourism side and so focus on changing dysfunctional behaviours are:
(i) systematic desensitisation and (ii) exposure techniques
two common techniques used in CBT that derive from cognitive psychology and so focus on changing dysfunctional thoughts are:
(i) Ellis’ rational-emotive therapy and (ii) Beck’s cognitive therapy
In systematic desensitisation,
the patient gradually confronts the stimulus that causes them phobia in their mind while they are in a relaxed state that inhibits emotional anxiety
In exposure techniques,
the patient confronts the stimulus so that they cannot avoid or escape it (response prevention)
In flooding, the patient
confronts the phobia stimulus all at once, so there is inescapable exposure to the conditioned stimulus which eventually desensitises the patient through extinction
In graded exposure, the patient
is gradually exposed to the phobic stimulus instead of all at once
In virtual reality exposure therapy, patients
are not exposed to the real stimulus but only virtual images of it, which is helpful if it would be costly and time-consuming otherwise
In Ellis’ rational-emotive therapy (RET), Ellis proposes that
clients can rid themselves of most psychological problems by maximising their rational and minimising their irrational thinking
A=
Activating conditions, e.g. job loss, triggers, life events
B=
Belief systems, e.g. I am not a worthy person unless I am very successful, maladaptive cognitive patterns
C=
Emotional consequences
In Beck’s cognitive therapy, the
therapist and patient work together to identify, challenge and change maladaptive patterns of thought and behavior/cognitive distortions and errors in thinking
the two most common humanistic therapies are:
(i) Gestalt therapy and (ii) Client-centered therapy
In Gestalt therapy
there is emphasis on awareness of one’s own true, authentic, unsocialised feelings; that is, a focus on the ‘here and now’
In client-centered therapy
there is a focus on everyday problems in living and how they have resulted from a discrepancy between a person’s self- concept (i.e. how they see themselves or how they’d like to see themselves)
biological treatments include:
(i) pharmacotherapy (e.g. antipsychotic medication, anti-depressant and mood stabilising medications, antianxiety medications), (ii) electroconvulsive therapy (ECT) and (iii) pychosurgery; most biological treatments can only be administered by medical doctors (e.g. psychiatrists)
Antipsychotic medications are used to
address psychotic disorders like schizophrenia; they are also known as ‘major tranquillisers’ because they are highly sedating; they work by inhibiting dopamine because this neurotransmitter is implicated in the positive symptoms of schizophrenia (e.g. hallucinations);
the most serious side effect of antipsychotic medications is
a movement disorder known as tardive dyskinesia characterised by involuntary twitching including in the tongue, face and neck
Antidepressant and mood stabilising medications work by
increasing the amount of norepinephrine and/or serotonin in the synapses
3 common types of Antidepressant and mood stabilising medications
(i) tricyclic antidepressants, (ii) MAO (monoamine oxidase) inhibitors and (iii) SSRIs (selective serotonin reuptake inhibitors)
Tricyclic antidepressants work by
blocking the reuptake of norepinephrine and serotonin in the presynaptic membrane, so they force the neurotransmitters to stay in the synapse for longer
MAO (monoamine oxidase) inhibitors work by
preventing the chemical MAO from breaking down neurotransmitters while they are inside the pre-synaptic neuron
SSRIs (selective serotonin reuptake inhibitors) are the most commonly used first type of medical treatment prescribed because
they have fewer side effects and are better tolerated over longer periods
SSRIs work by
preventing the reuptake of serotonin from the synapse back into the presynaptic neuron so they keep the neurotransmitter serotonin active in the synapse for longer
Antianxiety medications are
also known as benzodiazepines; they are especially useful for short-term treatment for anxiety and are often used in combination with other types of therapies such as psychotherapy or exposure-based therapies
Two types of biological treatments that are used as a last report when pharmacotherapy fails are:
(i) electroconvulsive or electroshock therapy (ECT) and (ii) psychosurgery
ECT refers to the
intentional induction of a brain seizure by giving a person an electric shock either to one or both of their hemispheres
the main side effect of ECT is
memory loss and another is cognitive impairment (in particular, slowed information-processing)
in psychosurgery there is
intentional lesioning or cutting of the brain part thought to be involved in producing the psychological symptoms
