AP Psych Unit 8 Clinical Psychology Part 4

evaluating psychotherapies, biomedical therapies and preventing psychological disorders

90% clients say that

psychotherapy is effective

critics skepticism on client’s views on psychotherapy effectiveness

time entered therapy usually time of crisis and time usually heals people, placebo effect that therapy will heal you, be nice to therapist, want to believe time and $ was worth it aka effort justification

effort justification

being prone to selective and biased recall and to making judgements that confirm our beliefs

therapists believe they are successful because

they are vulnerable to confirmation bias and illusory correlation

meta-analysis

a procedure for statistically combining results of many different research studies

using meta analysis results show that

no therapy one will often improve but with therapy a person will be more likely to improve, quicker, and less likely to relapse

no therapy is the best the most important thing is to effective therapy

is having a specific problem

cognitive and cognitive-behavioral therapies effectively treat

anxiety, PTSD, insomnia and depression

behavioral conditioning therapies effectively treat

specific behavior problems such as bedwetting. phobias, and compulsions

psychodynamic therapies effectively treat

depression and anxiety

non directive/client-centered therapy effectively treat

mild to moderate depression

evidence-based practice

clinical decision making that integrates the best available research with clinical expertise and patient characteristics/preferences

EMDR eye movement desensitization and reprocessing

does seem to work but could just be due to exposure therapy of repetitively recall memory and reconsolidate them in safe and reassuring context and placebo effect

light exposure therapy

does seem to help those with a seasonal pattern in their depression symptoms by activating brain regions that influence arousal and hormones

all psychotherapies work by giving people

hope, a new perspective, an empathetic trusting caring relationship

therapeutic alliance

a bond of trust and mutual understanding between a therapist and client who work together constructively to overcome clients problems

therapy can be less effective if client and therapist do not match in

cultural beliefs (like individualism, focus on personal desires/identities and collectivism, focus on group goals, harmony, social/family responsibilities)

religion and gender

emotional bond between therapist and client is

an important factor

biomedical treatments

can change brain chemistry with drugs or brain circuit with electrical simulations/magnetic pulses/psychosurgery or influence responses with lifestyle changes

changing the way we think and behave is

a brain changing experience

therapeutic lifestyle change is

a biomedical therapy because it influences how brain responds

mind and body are a unit so

affect one you will affect the other

exercise, nutrition, relationships. recreation, relaxation, religious/spiritual engagement

affect mental health

people can find relief in depression symptoms by

aerobic exercise, adequate sleep, light exposure, social engagement, reduce rumination, and better nutrition

psychopharmacology

the study of the effects of drugs on mind and behavior

widely used and helps people get out of hospitals

to test drug effectiveness in psychopharmacology

double blind procedures are used

antipsychotic drugs

drugs used to treat schizophrenia and other severe though disorders

antipsychotic drugs decrease symptoms of schizophrenia by

dampening responsiveness to irrelevant stimuli and block dopamine activity

antipsychotic drugs side effects

tardive dyskinesia (involuntary muscle movements), tremors, and increased risk of obesity/diabetes

antianxiety drugs

drugs used to control anxiety and agitation

antianxiety drugs decrease symptoms of PTSD and OCD by

depressing central nervous system

antianxiety drugs side effects

don’t resolve root of problem, very addictive, and withdrawal symptoms occur without drugs

antidepressant drugs

drugs that are used to treat depression and anxiety disorders like PTSD and OCD

antidepressant drugs reduce depression by

increasing availability of serotonin and norepinephrine

some antidepressant drugs are

selective serotonin reuptake inhibitors (SSRIs) and these are used to treat many disorders

some use antidepressant drugs that work bottom up along with

CBT that works top-down to treat depression

mood stabilizing drugs

depakote and lithium are types that treat bipolar disorder

electroconvulsive therapy ECT

biomedical therapy for severely depressed patients in which a brief electric current is sent through the brain of anesthetized patient

ECT is used as

last resort and is effective (no one really knows why it works) but relapse possible

transcranial direct current

mild current to scalp that has probable efficacy

repetitive transcranial magnetic stimulation rTMS

the application of repeated pulses of magnetic energy to the brain to stimulate or suppress brain activity

rTMS may cause cells to

form new circuits through long-term potentiation

deep brain stimulations

calms overactive brain region, a neural hub that links frontal lobe to limbic system, linked with negative emotions

psychosurgery

surgery that removes/destroys brain tissue in an effort to change behavior

lobotomy

a psychosurgical procedure once used to calm uncontrollably emotional or violent patients by cutting nerves connecting frontal love to emotional controlling centers in the inner brain

brain surgery is

irreversible the last resort and rarely used today to change behaviors

the goal is to treat

the person and the source of the mental health issue

preventative mental health programs are based on the idea that many psychological diseases could be prevented by changing oppressive, esteem-destroying environment

into more benevolent nurturing environments that foster growth, self-confidence, resilience, and alleviate demoralizing situations

resilience

the personal strength that helps most people cope with stress and recover from adversity and trauma

posttraumatic growth

positive psychological changes as a result of struggling with extremely challenging circumstances and life crises

posttraumatic growth can lead to positive things like

increasing appreciation for life and meaningful relationships

suffering can beget

new sensitivity and strength

modern psychotherapy: psychodynamic theory

presumed problem: unconscious conflicts from childhood experiences

therapy aim: reduce anxiety through self-insight

therapy technique: interpret patients’ memories and feelings

modern psychotherapy: client-centered theory (a humanistic theory)

presumed problem: barriers to self-understanding and self-acceptance

therapy aim: enable growth via unconditional positive regard. acceptance, genuineness, and empathy

therapy technique: listen actively and reflect clients’ feelings

modern psychotherapy: behavior

presumed problem: dysfunctional behaviors

therapy aim: learn adaptive behaviors and extinguish problem ones

therapy technique: use classical conditioning via exposure therapy or aversion therapy or operant conditioning via token economy

modern psychotherapy: cognitive

presumed problem: negative, self-defeating thinking

therapy aim: promote healthier thinking and self-talk

therapy technique: train people to dispute negative thoughts and attributions

modern psychotherapy: cognitive-behavioral

presumed problem: self-harmful thoughts and behaviors

therapy aim: promote healthier thinking and adaptive behaviors

therapy technique: train people to counter self-harmful thoughts and to act out their new ways of thinking

modern psychotherapy: group and family

presumed problem: stressful relationships

therapy aim: heal relationships

therapy technique: develop an understanding of family and other social systems, explore roles, and improve communications

therapist: clinical psychologists

therapist description: most are psychologists with Ph.D or Psy.D supplemented by a supervised internship and often post-doctoral training. 1/2 work in agencies/institutions and 1/2 in private practice

therapist: psychiatrists

therapist description: psychiatrists and physicians who specialize in treatment of psychological disorders. Not all have had extensive training in psychotherapy but as M.D.s or D.O.s they can prescribe medications. Thus they tend to see those with the most serious problems. Many have their own private practice

therapist: clinical/psychiatric social worker

therapist description: a 2-year master of social work graduate program plus postgraduate supervision prepares some social workers to offer psychotherapy mostly to people with everyday personal and family problems. 1/2 have earned the national association of social workers’ designation of clinical social worker

therapist: counselors

therapist description: marriage and family counselors specialize in problems arising from family relations. clergy provide counseling to countless people. abuse counselors work with substance abusers and with spouse/child abusers and their victims. mental health and other counselors may be required to have a 2-year master’s degree

biomedical therapy: therapeutic lifestyle change

presumed problem: stress and unhealthy lifestyle

therapy aim: restore healthy biological state

therapy technique: alter lifestyle through adequate exercise, sleep, nutrition, and other changes

biomedical therapy: drug therapies

presumed problem: neurotransmitter malfunction

therapy aim: control symptoms of psychological disorder

therapy technique: alter brain chemistry through drugs

biomedical therapy: brain stimulation

presumed problem: depression (ECT is only used for severe, treatment-resistant depression)

therapy aim: alleviate depression, especially when it is unresponsive to drugs or other forms of therapy

therapy technique: stimulate brain through electroconvulsive shock, mild electrical stimulation, magnetic impulses, or deep-brain stimulation

biomedical therapy: psychosurgery

presumed problem: brain malfunction

therapy aim: relieve severe disorders

therapy technique: remove or destroy brain tissue