Clinical Psych 3/Therapies

Trephination

Historical evidence of healed holes drilled in people’s heads; used to release humors and bodily fluids, epilepsy, and melancholy

Thomas Willis

Coined the term neurology, advocated for trephination

Classical Psychoanalysis (Freud)

Emotionally charges memories and conflicts are repressed (motivated forgetting)

Emotions around the suppressed memories are expressed in aggression, anxiety, depression, and physical pain

Goal of psychoanalysis was to bring these repressed memories to the surface and address them

Free Association

A method in which the patient says anything that comes to mind,
no matter how apparently trivial, embarrassing, or disagreeable

Resistance

A patient’s self-censorship or avoidance of certain topics

Transference

Interpreting how the patient acted toward the therapist, considered
to be a re-enactment of significant relationships (emotional re-education)

Slips of the Tongue

mis-speaking provided insight into true beliefs

Interpretation of Dreams

considered the
content of dreams to be an expression of the
unconscious that could be interpreted thru
Interpreting symbols which he thought of as
the language of dreams

Interpersonal Therapy

Assumption is that mood is tied to relationship quality and life events
• Targets problems like life transitions, complicated grief, interpersonal
disputes, and interpersonal deficits
• Time limited (usually 12-16 weeks)
• First weeks are spent collecting information, creating an “interpersonal
inventory” of relationships, and choosing a focus for therapy
• Subsequent sessions consider actions that could improve the situation
• Identifying conflict in relationships
• Role-playing difficult conversations
• Identifying challenges related to life transitions and building social
support networks to help
• Patient works on solutions between sessions

Humanistic Approaches

Assumes all humans are orientated towards growth

Focuses on self-actualization, growth, the present and future

Motivational Interviewing

A brief, client-centred therapy designed to address specific problematic
behaviours such as alcohol or drug use.
• Draws out the client’s goals, reduce ambivalence, and clarify gaps
between how client says they want to live and how they are living
• used in Serious Mental Illness (e.g. schizophrenia), before beginning an
intervention to help the person identify with the purpose and goals and
autonomously choose to participate

Client Centered Therapy (Rogerian Therapy)

Therapist is genuine, empathetic, and unconditionally supportive

Aims to help clients accept themselves as they are

Exposure techniques

Aims to remove the anxiety connected to feared stimulus through repeated approach to the feared stimulus

Systematic Desensitization

Gradually increasing encounters with the feared stimulus with periods of relaxation in between

In vivo exposure

Patient is exposed to the phobia stimulus in the real world or through computer interactive programs (VR)

Exposure and Response Prevention

Behavioural treatment of OCD where the patient delays performing the compulsion to relieve anxiety

Rational Emotive Therapy

Therapist Challenges the Patient’s irrational beliefs

Cognitive Therapy

An approach that
aims to change patient’s habitual
modes of dysfunctional thinking about
themselves, their situation, and their
future

Negative Cognitive Triad

Three types of dysfunctional beliefs
related to oneself, the world, and
the future

Cognitive Restructuring

A set of
cognitive therapy techniques for
changing a person’s maladaptive
beliefs or interpretations through
persuasion and confrontation

Cognitive Behavioral Therapy

A hybrid approach focused on changing the patient’s habitual
interpretations of the world and behaviours by combining cognitive and
behavioural approaches to therapy.
General principles of CBT
• Present-focused
• Concerned with identifying and solving problems that clients wish to
address
• Sessions are highly structured, with assigned homework.
• Goals are transparent, set collaboratively, and progress is openly
discussed

Acceptance and Commitment Therapy

Aims to help clients achieve greater awareness and acceptance of thoughts and feelings; de-fuse from thoughts; emphasizes pursuing valued
goals despite unwanted thoughts and feelings

Mindfulness Based Stress Reduction

Draws from Southeast Asian meditative traditions to teach clients to be fully present by observing their thoughts, feelings, and sensations non-judgmentally

Eclecticism

Approach to treatment that weaves together multiple types of therapy

Dialectical Behavior Therapy

Brought together
different approaches to treat Borderline Personality Disorder)
“dialectic”-- a dialogue about two different points of view to arrive at the
truth through reasoned argument
• the relationship between things defines things (no single cause/effect,
no blame, focus on acceptance and adaptation)
• holding two opposite ideas simultaneously is the foundation of change
(e.g. accepting the present and working toward change)
• moves away from all-or-nothing, either/or thinking (“I am angry AND I
love you”

Matched Treatment Eclecticism

Therapist chooses the therapy based on the patient’s needs/complaints.

Group Therapy

A form of therapy in which two or more patients meet
with one or more therapists at time.
• Advantages over one-on-one therapy:
o More clients can be accommodated by a limited number of
therapists.
o Allows therapists to observe and treat problems that emerge in
group settings (interpersonal relations)
o Patients can see problems more objectively in other people
o A sense of group belonging, support, and encouragement

Self-Help and Support Groups

Individuals with a
particular type of problem gather to share information, advice, and support

Therapeutic Alliance

The relationship between patient and therapist that helps many people feel helped and supported

Antipsychotics (how they work)

Block the transmission of dopamine by binding to the D2 dopamine receptor

Reduced the positive symptoms of schizophrenia (less effective at reducing negative symptoms)

Long Term Use results in tardive dyskinesia (involuntary movement of face and tongue)

Common Side Effects: fatigue, weight gain, restlessness, sexual dysfunction,
amenorrhea, dry mouth, hyperprolactinemia (can disrupt menstruation,
cause milk discharge from nipples, cause males to grow breasts), falls
from sudden drops in blood pressure, heart arrhythmias

Clozapine

Antipsychotic medication that blocks the transmission of dopamine, but unbinds quickly,
and also binds to alpha-adrenergic receptors and serotonergic receptors.
• Reduce the positive symptoms of schizophrenia-like thought disorder and
hallucinations
• Better than typical antipsychotics at treating negative symptoms, like flat affect and
the inability to feel pleasure
• Reduces suicidality

Selective Serotonin Reuptake Inhibitor (SSRI)

Increases synaptic serotonin levels

Must be slowly trickled down to discontinue

Selective Norepinephrine Reuptake Inhibitors (SNRI)

Increases synaptic serotonin and norepinephrine levels

Limitations of Anti Depressants

One month to take effect
• Uncertainty about how much benefit can be attributed to
placebo effects.
• Necessary trial-and-error period of prescription to determine benefits and side-effects of different drugs for individuals
• Potential for reduced benefit after prolonged use
• Side effects: weight gain, insomnia, loss of sexual desire

Mood Stabilizer

A medication that treats manic, mixed, or depressive states

Used to tread Bipolar Disorder

EX: Lithium Carbonate & Carbamazepine

Benzodiazepines

Enhances the effects of GABA binding, which hyper polarizes the cell and prevents it from firth

EX: Xanax, Ativan, Valium

Beta Blockers

Blocks β-adrenergic receptors (involved
in fight or flight) so decreases physical symptoms of anxiety and prevents negative spiral. Used especially for situational anxiety (performance anxiety, social anxiety, flying phobia) Used also for PTSD