Week 6 Flashcards
Deinstitutionalization
A movement in the 1950’s driven much by the greenroots community standing up for the mental disorder population, fighting for individuals to be taken out of the terrible conditions in “asylums” and integrate into society, work a normal job, live in a home and participate in social activities.
How do we know if treatment works?
Measure symptoms before treatment and measure after treatment in a reliable and verifiable way.
Diagnostician
Specializes in making diagnosis or determining the cause of symptoms.
Clinical Interview
Thorough interview conducted by a mental health professional designed to gain information about the patient’s symptoms and history.
Behavioural Monitoring
Recording specific behaviours and the circumstances around these behaviours.
WHY: to notice patterns about what happens before and after behaviours.
Usually recorded by the client. Sometimes by the clinician.
Cognitive and Neurophysical Tests
Client takes questionnaires or mechanical tests to see how the brain is functioning.
Psychiatrist
MD and further specializations in psychiatry.
Only professional that can prescribe medication.
Clinical Psychologist
Doctorate in Psychology (PhD) in clinical psych and training in treatment AND the research and statistical branch of psychology.
Counselling Psychologist
Doctorate in Psychology (PhD) in counselling psych and training in treatment methods not statistics and focuses on “practice.”
Psychiatric Social Workers
Masters degree in Social Work with specialization in psychiatric issues.
Psychiatric Nurse
Nursing Degree with additional training in psychiatric issues.
Psychological Associates
Masters Degree in clinical psych but not a PhD.
Counsellor/ therapist
A person with no education background or some education background can throw this term around loosely.
Why is it important to get the right fit of setting and service provider in terms of treatment?
Combo of these helps the patient to feel comfortable, motivated, hopeful. If the individual is motivated, feels support and hopes to get better than treatment will be effective. (In part has to do with the placebo affect). Just as important as assessment.
The process of diagnosis and treatment
Assessment > Treatment Plan > Treatment > Evaluation
Evaluate the patients symptoms > Decide what to do > Appropriate Service provider and setting + patient undergoes treatment > re-evaluate symptoms
Pharmacotherapy
Drug Therapy - treatment of a mental disorder by medication (usually that inhibit or stimulate neurotransmitters in the brain that send signals to nerves in brain).
Do neurotransmitters and phycological conditions have a cause & effect relationship?
NO. we can not say for certain that CONDITION has caused the NEUROTRANSMITTER function to change or vice versa.
But a disorder is associated with neurotransmitter dysfunction in neurotransmitter X, and drug A has restored normal function to neurotransmitter X and helped behaviour and cognition, then it can be said that dysfunction of neurotransmitter X was maintaining the behavioural/cognitive manifestation of the disorder.
The four neurotransmitters
DOPAMINE
NOREPINEPHRINE
SEROTONIN
GABA (gamma-amino-butyric acid)
Dopamine
Responsible for:
- motor control
- problem solving
- memory
- reward system which attaches emotional value to external events > motivation
TOO MUCH = schizophrenia
TOO LITTLE = forms of depression
Norepinephrine
Responsible for:
- fight or flight response
- alertness
- arousal
TOO MUCH = schizophrenia
TOO LITTLE = forms of depression
Serotonin
Responsible for:
- aggressive behaviour
- impulsive beahviour
- sleep regulation
- apetite
- mood
TOO LITTLE = depression, anxiety disorders (esp. OCD)
Gamma-amino-butyric-acid
Responsible for:
- induces relaxation
- inhibits anxiety and excitement
TOO LITTLE = anxiety disorders, mood disorders
Antipsychotic Drug
Drug used to treat psychotic disorders.
First “wonder drug”
Chlorpromazine
Tardive Dyskinesia
A side-effect of taking first-gen antipsychotics (when they didn’t work out the kinks yet)
Clozopine
Newest drug that treats the positive symptoms of schizophrenia (hallucinations & delusions) AND the negative symptoms without any motor-related side effects.
Antidepressant drugs
Tricyclics
Monoamino oxidase inhibitors (MAOI’s)
Selective Seratonin Reuptake Inhibitors (SSRI)
Tricyclics
Block the reuptake of norepinephrine and seratonin
treatment for disorders that have too much of these neurotransmitters so anxiety disorders
MAOI’s
Monoamino oxidase inhibitor
Inhibits the enzyme (oxidase) that breaks down dopamine and norepinephrine in cells.
(treatment for disorders that have too little dopamine and norepinephrine so depression).
SSRI’s
Selective Serotonin Re-uptake Inhibitors
Inhibits the re-uptake of serotonin by the pre-synaptic cell so that it increases the level of serotonin in the synaptic cleft to bind with the post-synaptic receptor.
(treatment for disorders that have too little serotonin, so depression and anxiety disorders).
Anti-manic drugs
Prevent manic episodes
- Lithium Carbonate
- Mood Stabilizers
Lithium Carbonate
Naturally occurring molecule that has bad side effects and is toxic in overdose. The amount of lithium needed for a response is close to toxic levels.
Mood Stabilizers
Used to treat epilepsy by working upon the GABA (gamma amino butyric acid) by inhibiting general neural activity. So also used for treating schizophrenia in individuals who do not response to lithium.
Anti-anxiety Drugs
A class of drugs used to treat anxiety disorders.
- Benzodiazepines are most common
- Addictive after long term
- Careful supervision and cognitive behaviour therapy together
Humanistic Therapy Approach
- individuals are thwarted from being able to see their full potential
- therapy goal: tries to help the client realize dreams and wishes
Psychoanalytical Therapy Approach
- subconscious forces and desires influence/control our behaviour (internal conflict = disorder)
- therapy goal: becoming aware of the subconscious helps to cure the disorder
- takes years and is not easy to measure
Gestalt Therapy Approach
- “mindfulness training” becoming aware of feeling, thinking and doing
- therapy goal: if you are aware of your feelings and thoughts at every moment then you can gain control of them
Systematic Desensitization
- learns relaxation techniques
- exposed to the stimulus (harmless) in a mild form
- if the individual can stay calm, progress to another step of harmless stimulus (pictures of spider, toy of spider, real harmless spiders).
- sees there is no reason to be afraid
Behavioural Therapy
Treats addictions and definable problems - like phobias based of CLASSICAL CONDITIONING techniques.
Exposure therapy
(branch of behaviour therapy)
- systematic desensitization
- imaginal exposure
- flooding
- aversion therapy
What kind of anxiety disorder is the most difficult to treat or disconfirm?
Social anxiety disorder
- a person may not be able to rid of the thought that another person is judging an aspect about them “he thinks I’m boring”
- it is hard to show them that the other person is not thinking this (no proof)
- must conduct treatment in a different way (video tape the conversation and see that the other person was engaged)
Flooding
Exposure to the feared stimuli fully and for the entire time of a panic attack until the panic attack subsides.
Aversion Therapy
Pairing an undesirable stimulus (one that you ant to change) with an aversive stimulus aka nausea chemical in alcohol so you associate drinking with unpleasant things and will decrease the reward value.
Imaginal Exposure
Used in PTSD patients because of the nature of PTSD. A re-living of a traumatic event by closing eyes and experiencing it again in order to put memories in chronological order and remember the parts that were correct, get rid of parts that are incorrect and close the door to the bad memory.
Behaviour Modification
Treatment aims to alter behaviour using OPERANT CONDITIONS
Token Economies
Reward is given in a token form in order to increase desirable behaviours and decrease undesirable behaviours.
Cognitive Therapy
Aaron Beck - 1950
Helping the patient examine their logic to realize how inaccurate their thoughts are so that they can change their way of thinking.
Albert Ellis
Ration Emotive Therapy
CBT
Cognitive-Behaviour Therapy
Most of the time changing the way of thinking is not the only problem and needs to be done in combination with behaviour therapy as well.
Maladaptive thoughts lead to adaptive behaviour. Trying to replace with adaptive thoughts to that the behaviour also changes.
RET
Rational Emotive Therapy
Albert Ellis (Beck's colleague) Says that A > B > C
A = the antecedent B = the beliefs C = the consequences
The antecedent or event happens, resulting in an emotion or consequence because of the persons beliefs not because of the actual event.
How are RET and Beck’s style of cognitive therapy different
RET focuses on changing a person’s inaccurate beliefs rooted in emotion, very direct and confrontational.
Beck focuses on formal logic and thinking processes.
Group Therapy
A setting NOT a type of treatment.
Therapist sees clients in groups of two or more (not individual).
- more efficient in terms of cost of resources
- groups are compiled based on similar experiences or disorders
- individuals in groups do not know one another outside of group
Psycho-educational Interventions
Large group (ex. 20) learning about a certain disorder and q & a from therapist
Family/couples therapy
Therapist meets with couple or family and observes the maladaptive interactions so that he knows what they need to work through.
Community psychology
Work in the community to promote well-being and destroy the stigmas of mental health. Also to seek out those with disorders that do not know where to turn.
Self-help groups
Not medically based, no psychologists but book clubs, exercise groups offer individuals with hope, expectations, motivation and support doing similar interests. AA groups are a good example.
What is the best form of treatment?
No single therapy is best for every situation but there is a BEST APPROACH to PSYCHOLOGICAL CARE: providing the knowledge/ skills/ support neccesary to reduce or remove symptoms that prevent of interfere with his/her quality of life.
