AP Pysch - 5.5 treatment of psychological disorders

meta analysis

a procedure for statistically combining the results of many different studies

• of multiple empirical research studies has established that psychotherapy is effective, especially when coupled with medications

therapeutic alliance

a caring and genuine relationship between the client and therapist

evidence based intervention

use research-based and outcome-oriented data to determine what works best

deinstitutionalization

the process of transitioning people with mental illness or developmental disabilities from long-stay psychiatric hospitals to community-based care

psychotropic medications

prescription drugs that affect mental processes, emotions, and behavior

• courts find that psychiatric hospital care violates basic human rights

• Community Mental Health Act (1963)

the American Psychological Association (APA) has outlined the ethical principles and code of conduct all psychologists must follow… 

• beneficence and non malfeasance

• fidelity

• integrity

• respect for rights and dignity

Beneficence & Nonmaleficence

“doing good” and “do no harm”

Respect for Rights & Dignity

maintain client’s confidentiality and privacy;  provide care regardless of race, ethnicity, gender, sexual orientation, age, disability, religion, or socioeconomic status

fidelity

establish and maintain trustworthy relationships

integrity

strive to be honest, accurate, and truthful with clients

free association

• method of exploring the unconscious in which the person relaxes and says whatever comes to mind, no matter how trivial or embarrassing

  • the therapist will interpret or help the patient interpret the missing pieces or why he/she is thinking about these things

dream interpretation

exploring and interpreting the symbolic meaning of dreams to uncover unconscious material

cognitive therapy

therapy that teaches people new, more adaptive ways of thinking and acting (cognitive restructuring); based on the assumptions that thoughts intervene between events and our emotional reactions

fear hierarchies

a structured list of feared situations or stimuli, ranked from least to most anxiety-provoking; used in exposure therapy to help individuals gradually confront their fears in a controlled and safe manner

cognitive triad

model with three interconnected components: negative views about oneself, negative perceptions of the world, and bleak expectations for the future

applied behavior analysis

applying principles of conditioning to address mental disorders and developmental disabilities

exposure therapy

exposing people to what they would normally avoid

systematic desensitization

associating a pleasant relaxed state with gradually increasing anxiety-triggering stimuli

aversion therapy

counterconditioning by associating an unpleasant state with an unwanted  behavior

• aims to induce anxiety or discomfort to make you STOP doing a behavior! (the OPPOSITE intention of systematic desensitization)

token economy

operant conditioning procedure that rewards a desired behavior

biofeedback

teaching individuals to consciously control physiological responses like heart rate and muscle tension, thereby regulating the sympathetic (fight-or-flight) and parasympathetic (rest-and-digest) nervous systems

cognitive behavioral therapy

combines methods of cognitive therapy and applied behavioral therapy

dialectical behavior therapy (DBT)

form of therapy that aims to help individuals manage intense emotions, improve relationships, and build a life worth living by teaching skills in mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness

rational emotive behavior therapy (REBT)

• roposes that unrealistic and irrational beliefs cause maladaptive behaviors; focuses on changing thinking patterns

  • primarily used to treat obsessive-compulsive and eating disorders

  • challenges people’s illogical, self-defeating attitudes and assumptions

steps of REBT

1. identify the underlying irrational thought patterns/beliefs

2. challenge the irrational beliefs

3. gain insight and recognize irrationality

reveal beliefs

 

question your interpretations

rank thoughts and emotions

test beliefs

 

examine consequences

decatastrophize thinking

change beliefs

 

take appropriate responsibility

resist extremes

person centered therapy

therapists offer acceptance, genuineness, and empathy which allows the client to express their true feelings

non directive therapy

the therapist just listens without directing, judging, or interpreting

unconditional positive regard

a caring, accepting, nonjudgmental attitude

• accepting and valuing a client as a person, even if their thoughts, feelings, or behaviors are not always approved of

active listening

empathetic listening in which the listener echoes, restates, and clarifies

group therapy does not allow for the same degree of individual attention, but…

• it is time and cost effective and has often been found to be no less effective than individual therapy

• the social context of group therapy often allows client to feel as if they are not alone in their problems; it can be a relief to find that others share your problems and feelings

hypnosis

induction of altered state of consciousness that uses the power of suggestion to change specific mindsets

• (cannot take away a person’s sense of control)

• ineffective for memory retrieval

• can change a person’s response to a stressor

  • effective for pain reduction

biomedical therapies

Physically changing the brain’s functioning by…

• altering chemistry with medication

• overloading its circuits with electroconvulsive shock

• using magnetic impulses to stimulate or dampen activity

altering tissue through surgery

psychoactive medications

• these drugs do not cure the disorders or treat the underlying causes, they are used to treat the symptoms of the disorder!

• these drugs are divided into classes based on their interaction with neurotransmitters and what they are intended to affect

• typically the drugs will be used in conjunction with psychotherapy to achieve the best results

antipsychotic drugs use for

treating schizophrenia, severe cases of bipolar disorder, and other mood disorders by blocking dopamine at the synapse (antagonist)

lessens positive symptoms (hallucinations, delusions)

antipsychotic drugs ex

 

Seroquel Abilify Risperdal Zyprexa

side effects of antipsychotic drugs

obesity, diabetes, tardive dyskinesia

tardive dyskinesia

involuntary movements of the facial muscles, tongue, and limbs

antidepressants useful for

treating depression, OCD, PTSD, and anxiety 

typically SSRIs (selective serotonin reuptake inhibitors) that block the reuptake of serotonin or SNRIs that impact norepinephrine

examples of antidepressants

Prozac

Paxil

Zoloft

Lexapro

side effects of antidepressants

weight gain, high blood pressure, fatigue, and insomnia

can take 4-8 weeks to feel positive impacts

elevated risk of suicidal ideation when starting medication

mood stabilizers are useful for

treating bipolar disorder

examples of mood stabilizers

 

lithium (the literal element) Lamictal Tegretol

side effects of mood stabilizers

lack of emotion, weight gain, increased thirst

antianxiety drugs are useful for

treating anxiety or phobia disorders by depressing the CNS and increasing the effects of GABA (which suppresses neural activity in the brain)

examples of antianxiety drugs

Xanax

Ativan

Valium

side effects of antianxiety drugs

dependency, increased anxiety, insomnia, drowsiness

transcranial magnetic stimulation (TMS)

magnetic pulses repeatedly pass through a coil held close to a person’s skull to treat depression that is nonresponsive to other interventions

• magnetic pulses induce electrical currents in the targeted brain tissue which stimulates neurons & changes brain activity

• non-invasive, completely painless, patient is wide-awake

electroconvulsive therapy

sending an electric current through the brain while the patient is anesthetized to treat extreme cases of depression

• electrodes are placed on either one or both sides of a person's head and an electric current is passed through the electrodes & will cause a seizure/convulsion for 30-60 seconds

• stigmatized because of reputation in history

lesioning

the removal or destruction of brain tissue

• in modern context, this is done to treat epilepsy (ex: severing the corpus callosum) or tumors

• in the last century, this has been done by performing a lobotomy

lobotomy

• a now rare procedure where brain tissue of the frontal lobe is irreversibly destroyed

  • crude, quick, and inexpensive (takes only 10 minutes)

  • thousands of “disturbed” people were lobotomized in the 1940-1950s; fell out of favor in 1950s with the invention of newer drug therapies

  • the procedure typically left a person lethargic, nonresponsive, and in a vegetative state