Chapter 15: Key Concepts in Psychology - PSYC 101 (Loeb)

How many of those who seek therapy actually have a diagnosable mental disorder?

Around half of those who seek therapy have diagnosable mental disorders

What are the obstacles for people seeking treatment?

- cost barriers (lack of insurance)

- stigma surrounding mental health

- lack of awareness about mental health/resources

- women are more likely than men

- white people are more likely than black or hispanic people

- educated people more likely than uneducated people

How much does the degree that a counselor holds matter when considering a therapist?

- Psychiatrists (MD): physicians who specialize in the diagnosis and treatment of psychological disorders --> best for those who need medication

- Clinical psychologists (PhD or PsyD) and specialize in the diagnosis and treatment of psychological disorders

- Counseling psychologists (PhD, PsyD, or EdD): everyday behavioral problems/adjustment issues

What sorts of people are trained to practice counseling?

Psychiatric social workers, psychiatric nurses, marriage and family therapists, or clergy members

Insight therapies

verbal interactions intended to enhance clients' self-knowledge, and thus promote healthful changes in personality and behavior

Psychoanalysis

an insight therapy that emphasizes the recovery of unconscious conflicts, motives, and defenses through techniques such as free association and transference

Free association

clients spontaneously express their thoughts and feelings exactly as they occur, with as little censorship as possible

Dream analysis

the therapist interprets the symbolic meaning of the client's dreams.

Resistance

largely unconscious defensive maneuvers intended to hinder the progress of therapy

Transference

occurs when clients start relating to their therapists in ways that mimic critical relationships in their lives

How does psychopathology arise from the psychoanalytic perspective?

Improperly resolved unconscious/psychosexual crises

What would be the logical treatment from the psychoanalytic perspective?

Uncover and resolve these conflicts to achieve insight and catharsis:

- Free association

- Dream analysis

- Analyzing resistance

- Analyzing transference

How does psychopathology arise from the humanistic perspective?

Lack of unconditional positive regard to explore true self → leading to incongruence between self-perception and reality

What would be the logical treatment from the humanistic perspective?

Help person decrease incongruence by providing unconditional love, genuineness, accurate empathy

- mirroring

- client centered therapy

How does psychopathology arise from the cognitive perspective?

Maladaptive thoughts

What would be the logical treatment from the cognitive perspective?

Identify and then challenge/change negative or maladaptive thoughts

How does psychopathology arise from the behavioral perspective?

Learned maladaptive behavior

What would be the logical treatment from the behavioral perspective?

Identify and then extinguish maladaptive behavior, condition adaptive behavior

What is CBT?

CBT uses practical self-help strategies to help patients become aware of inaccurate or negative thinking. This allows them to view challenging situations more clearly and respond to them in a more effective way.

What are the 3 CBT techniques?

Cognitive Restructuring: Identifying and challenging negative thought patterns to replace them with more balanced and realistic thoughts.

Behavioral Activation: Encouraging individuals to engage in positive behaviors and activities to improve mood.

Exposure Therapy: Gradual and controlled exposure to feared or avoided situations to reduce anxiety.

How do CBT and DBT differ?

DBT is distinct in its emphasis on acceptance, validation, and mindfulness

What does CBT treat?

It is commonly used to treat a wide range of mental health issues, including depression, anxiety disorders, phobias, eating disorders, and stress-related disorders.

Systematic desensitization

A behavior therapy used to reduce clients’ phobic responses by weakening the association between the conditioned stimulus (the bridge) and the conditioned response of anxiety

Anxiety hierarchy

Deep muscle relaxation

Imagined exposure

Flooding

exposing an individual to the feared object or situation in an intense and prolonged manner until the anxiety response diminishes

What’s the difference between “systematic desensitization” vs. “flooding”?

Systematic desensitization uses imagined exposure while flooding is based on real exposure

Have you noticed that some drugs treat more than one type of psychopathology?

Antipsychotics: schizophrenia, bipolar disorder, or depression

Antianxiety: depression, anxiety, and OCD

Antidepressants: bulimia, anxiety, OCD, and bipolar

Know some of the most common types of treatments per mental disorder

Schizophrenia: antipsychotics and CBT

Anxiety: antianxiety medication and CBT

OCD: SSRIs and CBT

Borderline personality disorder: DBT, CBT, and mood stabilizers

Dissociative identity disorder: Integration therapy

Bipolar disorder: mood stabilizers and CBT

Eating disorders: counsling, nutrition services, and CBT

Autism: behavioral therepy

Why is ECT controversial?

Electroconvulsive therapy (ECT) is controversial due to its historical misuse, potential side effects, and concerns about its mechanism of action.

Can cause memory loss and brain damage

What does “small therapeutic index” mean and for which drug is this an issue for, in particular?

The ratio of a drug's toxic to therapeutic dose.

A small therapeutic index, as seen with lithium, means there's a narrow margin between effective and toxic doses

What’s one of the quickest ways to address depressive symptoms?

SSRIs

What are some of the challenges involved with trying to assess the effectiveness of psychopathological treatment, whether talk therapy or biological forms of treatment?

Placebo, variability, subjectivity , and spontaneous remission (symptom improvement without treatment)

What is “spontaneous remission” and explain why this is an issue when trying to assess effectiveness of both talk therapies and biological forms of treatments?

Spontaneous remission refers to the natural resolution of symptoms without treatment. It can complicate assessments of treatment effectiveness, as improvement may occur without any intervention.

What are the pros and cons of using talk therapies?

Pros: addressing root causes, personal empowerment.

Cons: time commitment, cost, and efficacy variability.

What is “fee for service” vs. “managed care?” What are the benefits and disadvantages of managed care?

Fee for service involves paying for each service rendered, while managed care involves a prearranged payment for a package of services.

Managed care can streamline costs but may limit choices in services and providers.

What was the deinstitutionalization movement? Was it a success? Why or why not?

Deinstitutionalization: transferring the treatment of mental illness from inpatient institutions to community-based facilities that emphasize outpatient care

caused by new drugs and community acre centers

Sucesses: many people avoid long-term hospitalization and there are far less people in hospitals

Failures: lack of support meant increased mental ilness in homeless people and “revolving door”

When it comes to the homeless, what do we know about mental health issues?

- ⅓ of homeless people are mentally ill (schitzophrenia or mood disorders)

- ⅓ have drug or alcohol problems

- Co-morbidities

- Homeless shelters and prisons (3x more mentally ill patients than psychiatric hospitals)

What diversity issues do we have when it comes to mental health treatment?

- Psychotherapy is based on western values

- Language barrier

- Cost barrier

- Fear of institutions/government support

- Lack of understanding about the ways cultural values influence personhood

Antidepressants

Antidepressant drugs: gradually elevate mood and help bring people out of a depression

Selective serotonin reuptake inhibitors (SSRIs): slow the reuptake process at serotonin synapses with fewer side effects than earlier drugs

How fast: Can provide relatively quick relief of depressive symptoms, but take a few weeks for full effect

Side effects: nausea, drowsiness, sexual difficulties, weight gain, feeling emotionally numb, agitation, and increases in suicidal thinking

biological treatments for depression vs. CBT

- CBT may work slightly better than antidepressants for anxiety

- SSRIs may be more effective than CBT for improving depressed mood

- CBT has less side effects

How do biological treatments compare to therapy?

Biological Treatments: Address neurochemical imbalances in the brain. Provide relatively rapid symptom relief.

Psychotherapies: Address cognitive and behavioral patterns. May take longer to show effects, but benefits may be more enduring.

Motivational interviewing

reducing ambivalence about change and increasing intrinsic motivation to bring changes about

Participant modeling

technique in which a model demonstrates the desired behavior in a step-by-step