Worksheet 1 Flashcards
The DSM stands for-
The Diagnostic & Statistical Manual
Originally publicated by the American Psychiatric Association (APA) in 1952, but the most recent edition was made in 2013 =
The DSM
The dominant method of categorizing and diagnosing mental illness in America =
The DSM-5
The latest DCM publication (DCM-5) describes criteria for how many disorders?
157
Where is the DSM used?
Inpatient, outpatient, partial hospitalization, consultation-liaison, clinics, private practice, and community settings
What is the list of disorder categories in the DSM-5 =
1) Neurodevelopmental disorders
2) Schizophrenia spectrum disorders
3) Bipolar and related disorders
4) Depressive Disorders
5) Anxiety Disorders
6) Obsessive-compulsive disorders
7) Trauma and stressor-related disorders
8) Dissociative Disorders
9) Somatic Symptom Disorders
10) Feeding and eating disorders
11) Elimination Disorders
12) Sleep-Wake Disorders
13) Sexual Dysfunctions
14) Gender Dysphoria
15) Disruptive, Impulse Control, & Conduct Disorders
16) Substance-related and addictive disorders
17) Neurocognitive disorders
18) Personality disorders
19) Paraphilic disorders
20) Other Disorders
What’s a common misconception of the DSM-5?
It doesn’t classify people, it classifies disorders
What are the 2 major classification systems in America?
The DSM-5
The ICD-10-CM
Psychoanalytic therapy is used to treat what disorders?
This is a trick question.
Although this was the foundation for many other different therapies, this therapy isn’t really used anymore. It’s too long, (requires 3-5 sessions a week for many years) and insurance companies don’t want to cover the cost
The best candidates for this therapy are people who are relatively healthy and are well-functioning (People who have a clear area of difficulty but are intelligent, psychologically minded, and are well-motivated for change) =
Psychodynamic Therapy
The target audience of psychodynamic therapy are sometimes referred to as-
“Worried Well” people
PT’s with psychosis, severe depression, borderline personality disorders, and severe personality disorders are not a good fit for-
Psychodynamic Therapy
Psychodynamic Therapy is rooted in psychoanalysis and uses many of the same tools such as-
Free Association
Dream Analysis
Transference
Counter-Transference
Unconscious feelings a PT has toward a healthcare worker =
Transference
Unconscious feelings a healthcare worker has toward a PT =
Counter-Transferrence
When an analyst actively encourages a PT to freely share whatever thoughts or words come to mind to access the unconscious =
Free Association
Developed Interpersonal Theory =
Harry Stack Sullivan
Is Interpersonal Therapy an effective therapy? Is it long-term or short-term?
It’s an effective short-term therapy
What is the goal of interpersonal therapy?
To reduce / eliminate psychiatric symptoms (especially depression)
How does Interpersonal Therapy reduce / eliminate psychiatric symptoms (especially depression)?
By improving interpersonal functioning + satisfaction with social relationships
What 3 types of problems in particular respond well to interpersonal therapy?
Grief & Loss
Interpersonal Disputes (Conflicts with a significant other)
Role Transition (Problematic change in life status/ social/ vocational role)
This therapy works best when targeted toward specific problems and the goal is well-defined=
Behavioral Therapy
What type of therapy tries to change someone’s behavior without looking into why they are the way that they are?
Behavioral Therapy
What is behavioral therapy best at treating?
Phobias, alcohol use disorder, schizophrenia, etc.
What are the 5 types of behavioral therapy?
Modeling
Operant Conditioning
Exposure Therapy
Aversion Therapy
Biofeedback
When the therapist provides a role model for specific identified behaviors, and the PT learns through imitation =
Modeling
The basis for behavior modification + uses positive reinforcement to increase desired behaviors =
Operant Conditioning
How is “token economy” used in operant conditioning?
Desired goals are achieved = Get tokens that can be traded in for things like food, small luxuries, or privileges (positive reinforcement) = More motivated to achieve more goals + behaviors change for the better over time
Operant conditioning is useful in treating-
The verbal behaviors of children who are mute, autistic, and developmentally disabled
In PT’s with severe + persistent mental illness, behavior modification has helped to increase levels of-
Self-care, social behavior, group participation, etc.
Used for people who experience anxiety due to fears, phobias, or traumatic memories =
Exposure Therapy
What are the 3 types of exposure therapy?
Imaginal exposure
Vivo exposure
Virtual reality exposure
When the PT imagines facing their fear =
Imaginal Exposure
When the PT actually confronts their fear in real life =
Vivo Exposure
Combination of Imaginal and Vivo Exposure =
Virtual Reality Exposure
Used to treat things like alcohol use disorder, Paraphilic disorders, shoplifting, aggressive behavior, and self-mutilation =
Aversion Therapy
Pairing a target behavior with a negative stimulus, to extinguish an undesirable behavior =
Aversion Therapy
Putting bitter-tasting stuff on your fingernails keeps you from biting them. This is an example of-
Aversion Therapy
When you wear technology that you can use to monitor your physical responses to things like stress/anxiety =
Biofeedback
Who developed Rational-Emotive Therapy?
Albert Ellis
What is the goal of Rational-Emotive Therapy?
To remove core irrational beliefs by helping people to realize beliefs that are inaccurate, sensible, or useful
How did Ellis describe negative thinking?
An A-B-C process
A = Activating Event (Being invited to a birthday party)
B = Beliefs (“People don’t like me”)
C = Emotional Consequence (“If I go to this party, I’ll just bring everyone else down”)
Who developed Cognitive Behavioral Therapy (CBT) after realizing that people with depression have different thinking than those without =
Aaron T. Beck
CBT is based on both-
Cognitive psychology & behavioral therapy
The basis of CBT is what kind of approach?
An active, directive, time-limited, structured approach
CBT can be used to treat -
Depression, anxiety, phobias, pain
Beck believed that everyone has unique assumptions about themselves, others, and the world in general called-
Schemas
Rapid, unthinking responses based on schemas =
Automatic Thoughts
Automatic thoughts are particularly intense and frequent in disorders like-
Depression & Anxiety
Internal mental filters or biases that increase negative thinking =
Cognitive Distortions
Automatic thoughts are a form of-
Cognitive distortion
When PT’s are taught to challenge their own negative thinking and substitute it with healthier thinking =
CBT
Was developed to address sexual abuse trauma in children but was subsequently expanded to address the needs of people effected by any trauma or abuse =
Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)
Developed Dialectical Behavioral Therapy (DBT) =
Marsha Linehan
DBT is a specific type of-
Cognitive behavioral therapy
DBT was developed for people with-
Intractable behavioral disorders involving emotional regulation
DBT can treat-
Chronically suicidal people and self-injuring women with borderline personality disorder
Depression, suicidal thoughts, hopelessness, anger, substance use, and dissociation
How long is DBT?
Long-term (1-1.5 years)
Mindfulness, distress tolerance, interpersonal effectiveness, and emotional regulation are all things that are benefitted by which therapy?
DBT
Drug therapy =
Pharmacotherapy
What do psychotropic meds do?
Exert differential effects on a variety of neurotransmitters and helps restore brain function
The oldest brain stimulation therapy =
Electroconvulsive Therapy (ECT)
Treats psychiatric disorders as well as neurological ones like Parkinson’s disease, epilepsy, and pain conditions =
Brain Stimulation Therapies
Voluntary Admission =
Come in on your own
Involuntary Admission =
Court-ordered without PT’s approval
Friendship, family, and intimacy are all examples of what part of Maslow’s heirarchy?
The middle of the pyramid (Love & Belonging)
Confidence, achievement, respect of others, respect by others all fall into what part of Maslow’s hierarchy?
Self-Esteem (Just below the tip of the pyramid)
Morality, creativity, spontaneity, problem-solving, acceptance of facts all falls into what part of Maslow’s pyramid?
The tip (Self-Actualization)
Empathy =
Ability to understand how someone feels
Sympathy =
Feeling pity for another
Sympathy is untherapeutic, why?
Because you’ll let the emotions of your PT’s get to you and you can’t help someone else if your own emotions aren’t in check
Empathy is therapeutic, why?
Because you need to understand how your PT feels in order to properly care for and monitor them
Who discovered the relevance of therapeutic communication?
Florence Nightingale
Professional and Goal-Directed Communication =
Therapeutic Communication
Therapeutic communication benefits:
Makes the PT feel safe and protected, being more satisfied with the care, increased recovery rates, and improved adherence to treatment
Therapeutic technique examples:
Silence, Summarizing, Reflecting, Active listening, Making observations, Focusing, Offering self, Open-ended questions, Clarification, Eye contact, Offering hope, etc.
Non-therapeutic communication is-
Communication that doesn’t make the PT feel comfortable, takes the spotlight away from the PT and how they feel, or cuts the PT off and doesn’t allow them to give their proper imput
Occurs before any problem manifests and seeks to reduce the incidence/rate of new cases. May prevent/delay the onset of symptoms in genetically or otherwise predisposed people =
Primary Prevention
Aimed at lowering the prevalence of psychiatric disorders. Problem screening, and prompt + effective treatment
(To simplify, you’re just trying to figure out if you have something to get treatment for it as soon as possible if so) =
Secondary Prevention
Treatment of disease with a focus on preventing the progression to a severe course, disability, or death. An example is rehabilitation =
Tertiary Prevention
Stages of grief and loss =
Anger, Denial, Bargaining, Depression, Acceptance
Elopement =
Leaving the hospital whenever doing so can cause harm to either yourself or others
Tarasoff Law =
If a PT is being discharged and they say “Imma kill old Billy Boe who lives on down the street from me.”, you are required to warn Billy Boe about the potential attacker and also take other precautions
ACT stands for-
Assertive Community Treatment
What does an ACT Team do?
They provide services by providing 24/7 care to people with severe mental illnesses in their own home/community
What are the phases of a process recording?
Pre-Orientation
Orientation
Working Phase
Termination Phase
(POWT)
Preparing for assignment =
Pre-Orientation
Initial interview. PT begins to express feelings =
Orientation
Nurse + PT identify and explore areas that are causing problems in the PT’s life =
Working Phase
Final, integral phase. Ending treatment after goals are accomplished =
Termination Phase
Can we survive without defense mechanisms?
No
Ward off anxiety by preventing conscious awareness of threatening feelings =
Defense Mechanisms
What makes a defense mechanism?
The Ego
What are the 2 common features that all defensive mechanisms share?
They operate on an unconscious level
They deny, falsify, or distort reality to make it seem less threatening
Milieu therapy =
Creating a comfortable and safe environment
Adaptive defense mechanism help you in the-
Long-term
Maladaptive defense mechanisms help in-
The short-term, but becomes a problem in the long-term
AIMS stands for-
Abnormal Involuntary Movement Scale
Used to detect and scale tardive dyskinesia levels + monitoring the effects of certain long-term treatment over time =
AIMS
Tardive Dyskinesia (TD) =
A nervous issue problem caused by long-term use of some psychiatric drugs
The AIMS ranges from -
Zero (no dyskinesia) to Four (severe, maximal amplitude, and persistence during observation or abnormal movements)
