WK 12 - PSYCHOLOGICAL THERAPIES

Question 1

Approach differences: psychotherapy

Answer 1

Involves psychological techniques derived from psychological perspective, trained therapist uses psychological techniques to assist someone seeking to overcome difficulties to achieve personal growth

Question 2

Approach differences: Eclectic approach

Answer 2

Approach to psychotherapy that uses techniques from various forms of therapy

Question 3

Biomedical therapy

Answer 3

Involves treatment with medical procedures; trained therapist, most often medical doctors, offers medications and other biological treatment

Question 4

Psychoanalysis

Answer 4

1) Goals > to bring patients’ repressed feelings into conscious awareness: to help patients release energy devoted to id-ego-superego conflicts so they may achieve healthier, less anxious lives
2) Techniques > historical reconstruction, initially through hypnosis and later through free association; interpretation of resistance, transference

Question 5

Psychodynamic therapy

Answer 5

1) Goals > to help people understand current symptoms, to explore and gain perspective on defended-against thoughts and feelings
2) Techniques > client-centred face-to-face meetings; exploration of past relationship troubles to understand origins of current difficulties

Face-to-face therapy is a type of psychodynamic therapy > in this type of therapy session, the couch has disappeared. But the influence of psychoanalysis theory may not have, especially if the therapist seeks information from the patient’s childhood and helps the patient reclaim unconscious feelings

Question 6

Psychodynamic therapy: differences

Answer 6

Psychodynamic therapy is influenced by traditional psychoanalysis, but differs from it:
1) Lack of belief in id, ego and superego
2) Briefer, less expensive and more focused on helping the client find relief from current symptoms
3) Helps clients understand how past relationships create themes that may be acted out in present relationships

Interpersonal therapy: brief 12 to 16 session form of psychodynamic therapy that has been effective in treating depression

Question 7

Humanistic therapies: perspective

Answer 7

1) Theme > emphasis on people’s potential for self-fulfilment; to give people new insights
2) Goals > to reduce inner conflicts that interfere with natural development and growth; help clients grow in self-awareness and self-acceptance promoting personal growth
3) Techniques > client-centred therapy; focus on taking responsibility for feelings and actions and on present and future rather than past

Question 8

Humanistic therapies: Rogers

Answer 8

Person-centred therapy focuses on person’s conscious self-perceptions; non-directive; active listening; unconditional positive regard > most people possess resources for growth, therapists foster growth by exhibiting genuineness, acceptance and empathy

Question 9

Behaviour therapies: classical conditioning

Answer 9

1) Counterconditioning > uses classical conditioning to evoke new responses to stimuli that are triggering unwanted behaviours
2) Systematic desensitisation > associates a pleasant, relaxed state with gradually increasing, anxiety-triggering stimuli
3) Aversion therapy > associates noxious state with previously craving-triggering stimuli
4) Exposure therapies > treat anxieties by exposing people (in imagination or actual situations) to the things they fear and avoid

Question 10

Virtual reality exposure therapy

Answer 10

Treats anxiety by creative electronic simulations in which people can safely face their greatest fears such as airplane flying, spiders or public speaking

Question 11

Behaviour therapies: aversion conditioning

Answer 11

1) Goal > substituting negative response for a positive response to a harm stimulus; conditioning an aversion to something the person should avoid
2) Techniques > unwanted behaviour is associated with unpleasant feelings; ability to discriminate between aversive conditioning situation in therapy and all other situations can limit treatment effectiveness

Question 12

Aversion therapy: alcohol abuse

Answer 12

Therapist gave people with a history of alcohol abuse a mixed drink containing alcohol and a drug that produces severe nausea > after repeated treatments some people developed at last a temporary aversion to alcohol

Question 13

Operant conditioning therapy

Answer 13

Consequences drive behaviour > voluntary behaviours are strongly influenced by the consequences

Question 14

Behaviour modification

Answer 14

Desired behaviour reinforced, undesired behaviour not reinforced, sometimes punished

Question 15

Token economy

Answer 15

People earn a token for exhibiting a desired behaviour and can alter exchange those tokens for privileges and treats

Question 16

Critics maintain

Answer 16

Techniques such as those used in token economies may produce behaviours change that disappear when rewards end, deciding which behaviours should change is authoritarian and unethical

Question 17

Proponents argue

Answer 17

Treatment with positive rewards is more human than punishing people or institutionalising them for undesired behaviours

Question 18

Cognitive behavioural therapies

Answer 18

Helps people discover new, more adaptive ways of thinking > based on assumption that thoughts intervene between events and our emotional reactions. Gentle questioning seeks to reveal biased or distorted thinking, explore evidence for and against beliefs to ‘discover’ healthier, more balanced perspectives, verbally/intellectually and behavioural experiments (experimentally. Also commonly involves self-monitoring and skills training

Question 19

Behavioural disorders: cognitive perspective

Answer 19

The person’s emotional reactions are produced not directly by the event but by the person’s thoughts in response to the event

Question 20

Group therapy

Answer 20

Conducted with groups rather than individuals, providing benefits for group interaction > often used when client problems involves interactions with others. Benefits = save therapists’ time and clients’ money, encourages exploration of social behaviours and social skill development, enables people to see that others share their problems, provides feedback as clients try out new ways of behaving

Question 21

Family therapy

Answer 21

Attempts to open up communication within the family and help family members to discover and use conflict resolution strategies > treats the family as a system and views an individual’s unwanted behaviours as influenced by, or directed at, other family members. This type of therapy often acts as a preventative mental health strategy > the therapist helps family members understand how their ways of relating to one another creates problems > the treatment’s emphasis is not on changing the individuals, but on changing their relationships and interactions

Question 22

Is psychotherapy effective?

Answer 22

Clients’ and therapists positive testimonials cannot prove that psychotherapy is actually effective, the placebo effect makes it difficult to judge whether improvement occurred because of the treatment. Research indicates that those not undergoing treatment often improve, but those undergoing psychotherapy are more likely to improve quickly, with less chance of relapse

Question 23

Why psychotherapies works best?

Answer 23

CBT has a larger and better quality evidence base, for a greater range of problems than other psychotherapeutic approaches:
1) Most common finding in psychotherapy research > no difference between bona fide therapies (but superior to no treatment)
2) Trans-theoretical qualities of therapy delivery more important (e.g. structure, clearly explained and acceptable rationale, reduce avoidance)
3) Evidence-based practice > integration of best available research with clinicians’ expertise and patients’ characteristics, preference and circumstances

Question 24

Evaluating therapies

Answer 24

1) Alternative therapies > abnormal states often return to normal and the placebo effect can mislead effectiveness evaluation
2) Eye movement desensitisation and reprocessing (EMDR) > recommended treatment for PTSD; component studies support role of eye movements and patterns of response is different to exposure
3) Light exposure therapy > relief from depression symptoms for those with a seasonal pattern of major depressive disorder by activating a brain region that influences arousal and hormones

Question 25

Why do psychotherapies help people?

Answer 25

Three basic benefits for all psychotherapies:
1) Hope for demoralised people
2) New perspective for oneself and the world
3) Empathetic, trusting, caring relationship (therapeutic alliance)
A caring relationship > effective counsellor abroad a ship, form a bond of trust with people they are serving

Question 26

Psychotherapy: cultures and values

Answer 26

Psychotherapists’ personal beliefs and values influence their practice > difference in cultural and moral diversity and religious values can create a mismatch

Question 27

Finding a mental health professional

Answer 27

A person seeking therapy is encouraged to ask about > treatment approach, values, credentials, fees. An important consideration is whether the potential client feels comfortable and able to establish a bond with the therapist > and whether can reach agreement on tasks and goals for therapy

Question 28

Biomedical therapies: preventing psychological disorders

Answer 28

1) Psychopharmacology > includes study of drug effects on mind and behaviour, has helped make drug therapy the most widely used biomedical therapy
2) Drug therapies > are most widely used biomedical treatments - includes prescribed antidepressants for 27 million Americans. Involves placebo and double-blind techniques to evaluate drug effectiveness

Question 29

The biomedical therapies

Answer 29

Most common drug treatments for psychological disorders > antipsychotic drugs, antianxiety drugs, antidepressant drugs and mood-stabilising medications

Question 30

Antipsychotic drugs

Answer 30

Primarily block dopamine receptors (DA2); reduce overreaction to irrelevant stimuli > may produce sluggishness, tremors, twitches and tardive dyskinesia; Thorazine.
Successfully used with life-skills programs and family support to treat schizophrenia

Question 31

Antidepressant drugs

Answer 31

Increase availability of norepinephrine or serotonin; promote birth of new brain cells > slow synaptic vacuuming up of serotonin (SSRIs). Effectiveness sometimes questioned due to spontaneous recovery and placebo effect

Question 32

Antianxiety drugs

Answer 32

Depress CNS activity; Xanax or Ativan > Used in combination with psychological therapy.
May reduce symptoms without resolving underlying problems; withdrawal linked to increased anxiety and insomnia

Question 33

Mood-stabilising medication

Answer 33

1) Depakote > sodium valproate: controlling manic episodes
2) Lithium > levels emotional highs and lows of bipolar disorder

Question 34

Electroconvulsive therapy (ECT)

Answer 34

Manipulates brain by shocking it > involves administration of general anaesthetic and muscle relaxation to prevent convulsions. Causes less memory disruption then earlier version > AMA concluded that ECT methods among most positive treatment effects (reduce suicidal thoughts) - involve several theories about effectiveness

Question 35

Vagus nerve stimulation

Answer 35

Stimulates neck nerve that sends signal to limbic system; increases available serotonin by increasing firing rate of some neurons

Question 36

Deep brain stimulation

Answer 36

Manipulates depressed brain via pacemaker; stimulates inhibition activity related to negative emotions and thoughts

Question 37

Repetitive transcranial magnetic stimulation (rTMS)

Answer 37

Sends magnetic energy to brain surface through coiled wire held close to brain; fewer side effects; modest effectiveness

Question 38

Psychosurgery

Answer 38

Involves surgery that removes or destroys bran tissue in an effort to change behaviour, is irreversible > least used biomedical therapy

Question 39

Lobotomy

Answer 39

Psychosurgical procedure once used to calm uncontrollably emotional or violent patients, procedure cut the nerves connecting the frontal lobes to the emotion-controlling centres of the inner brain, today less invasive techniques used (MRI-guided surgery in severe disorders)

Question 40

Therapeutic lifestyle change

Answer 40

1) Training seminars > human brains and bodies were designed for physical activity and social engagement, ancestors hunted, gathered and built in groups with little evidence of disabling depression
2) Goals > aerobic exercise, adequate sleep, light exposure, social connection, anti rumination, nutritional supplements

Question 41

Preventing psychological disorders and building resilience

Answer 41

1) Preventative mental health programs work to build resilience > based on the idea that many psychological disorders could be prevented by changing oppressive, esteem-destroying environments into more benevolent, nurturing environments that foster growth, self-confidence
2) Resilience > involves personal strength that helps most people cope with stress and recover from adversity and trauma, can be seen in New Yorkers after 9/11, spinal cord injury patients, holocaust survivors and others

Question 42

Health professionals

Answer 42

Psychologist, mental health nurse, occupational therapist, psychiatrist, social worker, other mental health and health professionals