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Clinical psychologist

degree needed- Ph.d or Psy.D. which takes 5-7 years. Psychological testing, diagnosis, treatment with insight or behaviour therapy.

Counselling psychologist

degree needed- Ph.d, Psy.D, or Ed.D. which takes 5-7 years. Similar to clinical psychologist, but more focused on work, career, and adjustment problems

Psychiatrist

degree needed- M.D. takes 8 years. Diagnosis and treatment, primarily with biomed therapies, but also insight therapies.

Clinical social worker

degree needed- M.S.W., D.S.W. takes 2-5 years. Insight and behaviour therapy, often help impatiens with their return to the community

Psychiatric nurse

degree needed- R.N., M.A.< or Ph.D. takes 0-5 years. Impatient care, insight and behaviour therapy.

Counsellor

degree needed- B.A. or M.A. takes 0-2 years. Vocational counselling, drug counselling, rehabilitation counselling.

Marriage and family therapist

degree needed- M.A. or Ph.D. takes 2-5 years. Marital/couples therapy, family therapy

Percentage of population with a disorder in one year

28%

Percentage of people with a diagnosis and no treatment

20%

Percentage of population receiving mental health services in one year

15%

Percentage of people with treatment with no diagnosis

7%

Percentage of people with a diagnosis and treatment

8%

Common therapeutic ingredients

Alliance with therapist, emotional support and empathetic understanding, rationale for one’s problems, gaining new insights and new coping tools

Therapeutic orientations- all approaches differ on

assumptions regarding the origins of the problem, therapist’s stance, method of treatment, goals of treatment

Different therapeutic approaches

psychodynamic, behaviour, cognitive

What does psychodynamic therapy treat

resides in unconscious conflicts, repressed memories

psychodynamic therapy- Therapist

blank screen

psychodynamic therapy- method

free association, dream analysis, transference analysis

psychodynamic therapy- goal

make the unconscious conscious

Distinctive features of psychodynamic therapy

focus on emotional experience, exploration of efforts to avoid distressing thoughts and feelings, identification of recurring patterns in patients’ lives, discussion of past experience, analysis of interpersonal relationships, focus on the therapeutic relationship, exploration of fantasy life.

What does behaviour therapy treat

resides in faulty learning

behaviour therapy- therapist

examines current conditions that elicit the problem

behaviour therapy- method

apply learning principles to get rid of symptoms, training/ exposure/ conditioning

behaviour therapy- goal

alleviate symptoms/ modify behavior

Examples of behaviour techniques- Systematic desensitization

effective with phobias, use counter conditioning, set up a hierarchy of anxiety-provoking situations while maintaining a relaxed state, imagine more difficult situations until the most difficult is imagined while maintaining a relaxed state. Practice with real life situations

The logic underlying systematic desensitization

behaviourists argue that many phobic responses are acquired through classical conditioning. It targets the conditioned associations between phobic stimuli and fear responses.

Claude has been seeing a therapist in an attempt to finally stop smoking. The therapist has described a number of specific techniques using reward and punishment that Claude might try to eliminate his behaviour of smoking. Which type of therapy is most consistent with this example?

Behavior

Which disorder would be least likely to be treated by psychiatrists?

marital problems

Josie has been in therapy for five years. Her therapist analyzes the symbolism in her dreams and other comments, and helps Josie understand the unconscious conflicts that underlie the dreams. In this case, which approach does Josie’s therapist use?

Psychoanalysis

What is the term for treating the therapist as though he were a very important person from one’s past, such as a parent?

transference

What does cognitive therapy treat

the function of the way you think

Cognitive therapy- therapist

more directive and challenging

Cognitive therapy- method

challenge your automatic thoughts and underlying beliefs, use of homework exercises

Cognitive therapy- goal

realistic thinking/ better perspective

Key points of mindfulness-based cognitive therapy

emerged from CBT, training in meditation and challenging negative thoughts, found to reduce depressive relapses, bring attention to the here and now, stop identification with irrational beliefs, interrupt negative cycles, practice acceptance and self compassion

What does client-centered therapy treat

incongruence with ones true self

Client-centered therapy- therapist

non-directive, genuine, empathetic and unconditional

Client-centered therapy- method

therapeutic relationship allows fuller experiencing and greater acceptance of the self

Client-centered therapy- goal

greater congruence and self realization

What does Biomedical treatment treat

chemical imbalance/ abnormalities in the brain

Biomedical treatment- therapist

medical doctor (family or psychiatrist) will monitor symptoms and adjust medication

Biomedical treatment- method depression\= antidepressants, \__________

ECT, TMS, jogging

Biomedical treatment- method bipolar disorder

mood stabilizers and more

Biomedical treatment- method anxiety

tranquilizers (includes SSRIs)

Biomedical treatment- method schizophrenia

anti-psychotics

Biomedical treatment- goal

reduce symptoms

Selective serotonin reuptake inhibitors (SSRIs)

slow reuptake at serotonin synapses so activity is increase only at serotonin synapses

Trycyclic antidepressants

inhibit reuptake at serotonin and norepinephrine synapses, which elevates activity at both types of synapses. Tricylics also blockade activity at several subtypes of postsynaptic receptors

MAO inhibitors

work by disabling MAO enzymes that would normally metabolize and in active neurotransmitters at dopamine, norepinephrine, and serotonin synapses.

According to Rogers, when does personal distress occur?

when there is incongruence between a person’s self-concept and reality

Which of the following is incompatible with anxiety, and is used in systematic desensitization in an attempt to recondition phobic cues?

deep muscle relaxation

Gerry has been diagnosed with depression and is seeing a therapist. His therapist encourages Gerry to think about his strengths and has asked him to keep a journal in which he notes all the good things that happen to him. Which approach is Gerry’s therapist using?

positive psychology

Which statement best represents the approach of a client-centred therapist in treating a chronically anxious client?

“So, you feel that your world is a very scary place to be.”

Saima has been experiencing anxiety ever since she moved to a new city for her job. Which of the following professionals would be best suited to help Saima with her problem?

counselling

Roy is in psychotherapy and has begun to talk to his therapist as though she was the overprotective mother that he resents. According to Sigmund Freud, what is Roy experiencing?

transference

Which of the following has been found to have the greatest positive impact on therapeutic outcomes?

accurate empathy

Positive psychotherapy has been found MORE effective than traditional therapy with medication for the treatment of which of the following disorders?

depression

Research suggests that half of people in psychotherapy reach clinically significant recovery after how many weeks of treatment?

20

Which of the following behaviour therapies has been found effective in the treatment of both depression and schizophrenia?

social skills training

Magdalena has generalized anxiety disorder and is receiving automatic computer-based therapy that is aimed at reducing her tendency to assume that situations are more threatening than they really are. What kind of therapy is Magdalena receiving?

cognitive bias training

Ricki has recently been diagnosed with bipolar disorder. Which of the following medications is she MOST likely to be prescribed?

valproate

Which of the following biomedical interventions often results in loss of autobiographical memories?

electro-convulsive therapy

Which of the following types of medication are most likely to produce tardive dyskinesia?

antipsychotics

The culture-bound origins of Western therapies have raised ____ about their applicability to other cultures and even to ethnic groups in Western societies.

doubts

Ethnic minorities underutilize mental health services because of

cultural distrust, language difficulties, and institutional barriers.

Clinicians are increasingly attempting to _______ to expand the delivery of mental health services and to reduce the costs of therapy.

harness technology

Combinations of insight, behavioural, and biomedical therapies are often used fruitfully in _____

treatment.

Disenchantment with traditional mental hospitals led to the ___________, which advocates local, community-based care and prevention of mental disorders.

community mental health movement

Deinstitutionalization refers to

the transfer of mental health care from inpatient institutions to community-based outpatient facilities.

Deinstitutionalization has worked for some patients, but it has contributed to the ______

revolving door problem.

Deinstitutionalization has also contributed to the growth of _________

homelessness and the increased incidence of mental illness among the homeless.

our society is not providing adequate care for a sizable segment of the mentally ill population, and the situation is getting ____

worse

Insight therapies involve

verbal interactions intended to enhance clients’ self-knowledge and thus promote healthful changes.

Behaviour therapies involve

the application of the principles of learning and conditioning to direct efforts to change clients’ maladaptive behaviours.

Biomedical therapies are

physiological interventions intended to reduce symptoms associated with psychological disorders.

In psychoanalysis, dream analysis and free association are used to explore the _____

unconscious.

When an analyst’s interpretations touch on sensitive issues, _____ can be expected.

resistance

The transference relationship can be used to overcome

resistance and promote insight.

Classical ________ is not widely practiced today, but a diverse array of ________ therapies remain in use.

psychoanalytic, psychodynamic

According to Rogers, neurotic anxieties are due to _________

incongruence between one’s self-concept and reality.

Rogers maintained that the process of therapy is not as crucial as _______

the therapeutic climate.

To create a healthy climate, therapists must be

genuine and provide unconditional positive regard and empathy.

The key process at work in client-centred therapy is \______

the clarification of clients’ feelings.

Behaviourists assume that even pathological behaviour is a product of \________

learning and that what has been learned can be unlearned.

In behaviour therapy, \______ procedures are used for different types of clinical problems.

different

Wolpe’s systematic desensitization is a

treatment for phobias, involves the construction of an anxiety hierarchy, relaxation training, and movement through the hierarchy pairing relaxation with each phobic stimulus.

Cognitive-behavioural treatments combine _________ techniques to help clients change maladaptive patterns of thinking.

verbal interventions and behaviour modification 

Cognitive therapy was devised by _________ as a treatment for depression, but is now used for a variety of disorders.

Aaron Beck

Which of the following statements is most accurate? \n a. Since Freud's time, all forms of treatment for psychological disorders have involved verbal interaction. \n b. The first systematic psychotherapy procedure was Freud's psychoanalysis. \n c. All psychotherapies employ essentially the same method of treatment. \n d. Insight therapy is the most effective method for treating psychological disorders.

The first systematic psychotherapy procedure was Freud's psychoanalysis.

Which type of psychotherapist participates in complex verbal interactions with clients in order to enhance clients' \n understanding of themselves and their problems?

a. biomedical therapist \n b. insight therapist \n c. homeopathic therapist \n d. behaviour therapist

insight therapist

Vicki is seeing a therapist in an attempt to improve her relationship with her father. During her meetings with her \n therapist, the two of them often engage in lengthy discussion, and her therapist tries to help Vicki work through a \n variety of potential solutions for the problems she is facing. Which type of therapy is most consistent with this \n example? \n a. behaviour \n b. systematic desensitization \n c. insight \n d. biomedical

 insight

Which of the following is NOT one of the main categories of treatment? \n a. insight therapies \n b. biomedical therapies \n c. behaviour therapies \n d. revelation therapies

revelation therapies

Leslie has been feeling depressed for a number of weeks. She thinks she may need to see a therapist to help her \n overcome her depression, but she doesn't want to see anyone who is going to dwell on her childhood and try to \n work through any problems she experienced years ago. She wants to see someone who will focus on direct \n treatment of her current symptoms. In this example, which type of therapy does Leslie want? \n a. behavioural \n b. psychoanalysis \n c. insight \n d. humanist

insight

What are the two most common problems faced by those who seek psychotherapy? \n a. excessive anxiety and depression \n b. loneliness and boredom \n c. low self-esteem and irrational thinking \n d. marital conflicts and a sense of emptiness

excessive anxiety and depression

Which component of the therapeutic triad has the greatest diversity? \n a. treatments \n b. therapists \n c. clients \n d. caregivers

clients

Which type of psychologist is most likely to deal with the most severe mental health problems? \n a. applied \n b. school \n c. clinical \n d. counselling

clinical

What is the main practical difference between a clinical psychologist and a counselling psychologist? \n a. Only the clinical psychologist can prescribe drugs. \n b. The severity of the problems that they tend to deal with. \n c. Clinical psychologists provide behaviour therapy; counselling psychologists provide insight therapy. \n d. The clinical psychologist has a doctorate; the counselling psychologist has a master's degree.

The severity of the problems that they tend to deal with.

Which of the following is true of psychiatrists? \n a. They have essentially the same education as clinical psychologists. \n b. They are physicians who specialize in the treatment of mental disorders. \n c. They are less likely to use psychoanalytic methods than psychologists. \n d. They focus exclusively on biomedical therapies in treating psychological disorders.

 They are physicians who specialize in the treatment of mental disorders.

Clive is a clinical psychologist, and his sister Grace is a psychiatrist. Which of the following would Clive be more \n likely to do? \n a. treat young children, while Grace would treat more adults \n b. deal with patients who have more severe problems than the patients Grace sees \n c. take a psychoanalytic approach to therapy, while Grace takesa behavioural approach \n d. have a degree in psychology, while Grace would have a medical degree

have a degree in psychology, while Grace would have a medical degree

Gilbert just graduated from medical school and has entered a four-year residency at a local hospital. He plans to \n specialize in the treatment of mental disorders. What is Gilbert training to be? \n a. counselling psychologist \n b. clinical psychologist \n c. psychiatrist \n d. psychiatric nurse

psychiatrist