PSY339 Psychotherapy Exam 1

therapy

a healing practice based on verbal persuasion + human interaction occurring in social context

modifies thoughts and behaviors of patient to help them

what does a therapist’s role include?

• performing therapy (monitoring patient outcomes + conducting assessments)

who can perform therapy?

only licensed medical professionals

what is an issue in the therapy field?

there are so many different forms of therapy, some of which are not evidence-based and are questionable

this is bad because patients can have negative outcomes if they get bad therapy

what is an evidence-based practice, according to the APA?

an evidence-based practice is one that combines:

• research (for psychotherapy, this would be the best research that’s available in the field)

• clinical expertise (therapists are licensed medical professionals)

• patient characteristics (therapist listens to the client’s preferences, knows their culture, etc.)

is therapy effective?

yes; it’s effect size (a statistical measure to see if a treatment has meaningful effects) is around 0.6, which is pretty high

in addition, it lasts longer than medications since patients learn useful skills that help them

the Dodo bird verdict

states that all valid therapy techniques produce equivalent outcomes

criticism of this verdict include that not all standardized psychotherapy techniques work for everyone

number needed to treat (NNT)

another statistic that shows the effectiveness of a therapy technique

basically shows how many patients have to go through a treatment to get positive results

what is the NNT for therapy?

3 (for every 3 patients who undergo psychotherapy, 1 has a positive outcome)

what are the 3 pathways discussed in class?

• medical/EBP pathway: structured, step by step process to treating psychological conditions

• CARE pathway: being caring, attention, real, and empathetic will get the patient to feel better

• expectancy pathway: expecting that you’ll feel better will make you feel better

what are the 3 general things a therapist needs to consider when creating a treatment plan?

1. conceptualizing a case (considering all influences, developing treatment goals, etc.)

2. what interventions to use based on each patient

3. monitoring the patients progress

Outcome Questionnaire (OQ-45.2)

a form that can help therapists with monitoring patient’s symptoms

best for patients not making progress or those who are in jeopardy of leaving treatment

psychodynamic therapy

therapy based in the idea that psychological problems come from unconscious conflicts

• therapist notes patient’s unconscious conflict and decides whether to uncover those conflicts in a way that will best help the patient

according to Freud, what are the 3 parts that make up the psyche?

the conscious, preconscious, and unconscious

conscious (Freud’s psyche)

the things that we are aware of

preconscious (Freud’s psyche)

the things we can be aware of if we think of them

unconscious (Freud’s psyche)

the hidden reservoir that holds the true “us”; includes all our desires and fears

what psychodynamic therapists might uncover

what are the 3 parts that make up our personalities, according to Freud?

the id, ego, and superego

id (Freud’s personality)

our deepest desires that we are born with

unconscious

ego (Freud’s personality)

rational, decision-making aspect of personality

in the preconscious

superego (Freud’s personality)

contains memories of rules we learn over time

in the conscious; when it disagrees with the id, then guilty feelings emerge

what are the theories that make up psychodynamic therapy?

Freud’s wack theory (came earlier) and objects relations theory (came later)

object relations theory

focuses on one’s relationship with self and others

explains that psychological problems arise from disrupted attachments to caregivers early in life (healthy, secure attachment = good, disrupted attachment = bad)

ego defenses

psychological strategies that the ego implements to avoid confronting painful feelings

which one a patient uses repetitively is noted by psychotherapists

what are the different types of ego defenses?

• denial: refusing to accept real events

• displacement: transferring negative feelings onto a less threatening target

• projection: projecting uncomfortable feelings onto others

• rationalization: rationalizing bad behaviors with acceptable reasons

• reaction formation: adopting feelings contrary to your own

• regression: regressing to coping strategies of less mature stages of development

• repression: suppressing painful memories and feelings

• sublimation: redirecting unacceptable desires into socially acceptable ones

transference

when a patient unconsciously redirects feelings or desires from important relationships in their past onto the therapist

• includes romantic and erotic feelings

therapist responds ethically, compassionately, and without judgement

countertransference

when a therapist’s own reactions, feelings and personal history get triggered by a patient

bad because it can influence how a therapist treats their patient

are transference and counter transference avoidable?

they are unfortunately a normal and near-universal part of doing therapy

it becomes a problem when it goes unmanaged/unrecognized

relationship rigidity

the patterns in relationships a patient has

assessed by psychotherapists during intake

reflective functioning (RF)

the capacity to understand and interpret the thoughts and emotions of oneself and others to clarify and influence their interpersonal interactions

assessed by psychotherapists during intake

corrective emotional experience

when a patient comes to understand a relationship/event in a different/unexpected way that results in an emotional “coming to terms” with it all

a goal in psychodynamic therapy

what are the steps to getting a patient to experience a corrective emotional experience in psychodynamic therapy?

• re-exposing the patient to a painful/emotional stimulus

• repairing the traumatic influence by having the therapist respond differently to the patient than their original caregiver did

• making the patient abandon their maladaptive view to reduce their symptoms

how do psychodynamic therapists try to understand the patients unconscious?

through protective tests, where patients project their unconscious thoughts onto ambiguous stimuli and therapists look for patterns in their answers

includes the TAT, sentence completion/word association tests and Roscharch inklot slides

thematic appreciation test (TAT)

projective test that shows an ambiguous photo to the patient and asks them to tell a story with a beginning, middle, and end

Roscharch inkblot slides

projective test that shows ambiguous colors and shapes and asks the patient to describe what they see

scores are divided into form-color (FC), color-form (CF) and pure color (C)

form-color (FC) (Rorschach inkblot scoring)

patient’s response focuses on form more than color

signifies that the patient has good impulse control

color-form (CF) (Rorschach inkblot scoring)

patient’s response focuses on color more than form

signifies that the patient feels emotions stronger but has good emotional control

pure color (C) (Rorschach inkblot scoring)

patient’s response focuses only on color

signifies that the patient is feeling extreme emotions

sentence completion/word association tests

asks a patient to finish incomplete sentences to try and uncover their conscious thoughts