unit 8 AP Psychology "Clinical Psychology" (copy)

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Psychology student syndrome

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Psychology student syndrome

Psychology students studying abnormal behavior can also become convinced that they have some mental disorder

Also you, as a psychology major, try to use what you have learned in class “diagnose someone of a psychological condition without full knowledge or proper certification

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Abnormal psychology

The scientific study of abnormal behavior undertaken to describe, predict, explain, and change abnormal patterns of functioning

Defining what is normal and abnormal is a subject of much debate

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Clinical psychology

The applied field of psychology that seeks to assess, understand and treat psychological conditions in clinical practice

  • Psychologist-can prescribe meds, identify disorders, generally works inside hospitals 

  • Psychiatrist-can’t prescribe meds, supports people through psychotherapy

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Scientific study of the nature of disease and its causes, processes, development, and consequences

Etiology- cause of disease

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Abnormal behavior, thoughts and emotions that differ markedly from a society’s ideas about proper functioning

Different,extreme, unusual, perhaps even bizarre.

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The person reports feeling pain and discomfort associated with his or her emotions, thoughts or behaviors

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Interfering with the ability to conduct daily activities in a constructive way

People cannot care for themselves properly, participate in ordinary social interactions or work productively.

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Abnormal behavior becomes dangerous to oneself or others

Individuals behavior is consistently careless, hostile or confused may be placing themselves or those around them at risk

This is the exception rather than the rule

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Diagnostic and statistical manual of mental disorders (DSM-5)

Manual that lists 541 diagnoses most widely used classification system

DSM-Published by american psychiatric Association in 2013, continues to change and evolve

Production was a 12 year undertaking it cost the APA 25 million to produce

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Diagnostic Labels

Help health care professionals when communicating about establishing and causes

Formal diagnosis

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David Rosenhan

 David Rosenhan (1973), once labeled, the label itself can determine not only how professionals perceive and react to a person but also how the labeled persons themselves will begin to act differently

  • Self-fulfilling prophecy 

  • Different  

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Legal term pertaining to a defendants ability to determine ability to determine right from wrong when a crime is committed

Concept discussed in court to help distinguish guilt from innocence

There’s not “insane” diagnosis listed in the DSM

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Set of assumptions and concepts that help scientists explain and interpret observations (synonym-paradigm)

Today several models are used to explain and treat abnormal functioning 

  • Biological Model 

  • Psychodynamic Model 

  • Behavioral Model 

  • Cognitive Model 

  • Eclectic Model 

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Medical/Biological Models

View abnormal behavior as an illness brought about by the malfunctions parts of the organism, believe that the most effective treatments are biological ones 

  • Genetics, evolution and viral infections can explain biological abnormalities

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Psychodynamic Model

Believe that a person’s behavior, whether normal or abnormal, is determined largely by underlying psychological forces of which he or she is not consciously aware

  • The forces interact with one another, abnormal symptoms are result of conflict between the forces 

Conscious vs unconscious awareness

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Behavioral Model

Believe that our actions are determined largely by our experiences in life

Stimulus, response and rewards influence abnormal behavior

  • 15% of today’s clinical psychologists report that their approach is mainly behavioral 

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Cognitive model

Cognitive processes are at the center of behaviors, thoughts, and emotions

Abnormal behavior is caused by faulty and irrational cognitions

Individuals can overcome mental disorders by learning to use more appropriate cognitions

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Eclectic Model

Broad-based approach, trusting a combination of established approaches to diagnoses and treat individuals with psychological disorders

Most mental health professionals today do not rely exclusively on one approach

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The societal disapproval and judgement of a person with mental illness because they do not fit their community’s social norms

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Effects of stigma

  • Refusal to receive treatment, stigma deters people from seeking help 

  • Social isolation, fear of “bringing them down” or “being a burden.” 

  • Distorted perception of the incidence of mental illness, leads to fewer diagnoses and fewer people getting help,  mental illness seems far less common than it actually is

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History of diagnoses

Throughout time, societies have proposed several explanations of abnormal behavior within human beings and treatment

  • Supernatural (Demons/Evil) 

  • Biological (Medical Factors) 

  • Psychological (Thoughts) 

  • Multiple Causality/Factors

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Trephining(ancient times)

Holes are drilled into a living person’s skull in order to release demonic spirits thought to be causing the persons disordered behaviors

Human skulls from as far back as five thousand years ago show treatment of trepanning

  • Most people treated in this manner died

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Hippocrates, Ancient Greek Physician 500 B.C.

Believed that abnormal behavior was a disease.arising from internal physical problems(imbalance of four fluids or Humors)

First recorded attempt to explain abnormal behavior as due to some biological process

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A type of institution that first became popular in the sixteenth century to provide care for persons with mental disorders

ONce the asylums started to overflow, they became virtual prisons where patients were held in filthy conditions and treated with unspeakable cruelty

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Philippe pinel

In the late 1700s, French physician, argued for more human treatment of the mentally ill, brought reform in the way mental institutions would be run

  • Patients should be treated with sympathy and kindness rather than chains and beatings, Pinel unchained patients

  • Death rates for patients went from 60% to 10%

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Dorothea dix

School teacher who made humane care a public and political concern in the united states from 1841 to 1881

Dix’s campaign led to new laws and greater government funding to improve the treatment of people with mental disorders

Each state was responsible to develop mental hospitals or state hospitals

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Psychopharmacologic revolution

Effective drugs for conditions like schizophrenia and depression were found in the 1950s by accident

  • The antipsychotic chlorpromazine was first investigated as a drug that reduces allergies (sedative effects). Henri Laborit use it for patients going into surgery and encouraged  psychiatrists use it for psychosis 

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When better psychotropic drugs were created this movement began to remove patients who were not considered a threat to themselves or the community from metal hospitals

  • Patients improve rapidly in familiar community settings 

  • In the 1960s Congress passed aid bills to establish community mental health facilities in neighborhoods in the U.S. 

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Unintended consequences distinutionalization

  • A large portion of the homeless population is considered to be mentally ill. Statistics show that 26% of homeless adults living in shelters experience mental illness (the % of those with mental illness that don’t live in a shelter or choose not to report is believed to be over 50%+)

  • Families and communities have failed to meet the needs of these people

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Preventing disorders and promoting mental health

  • Rather than wait for psychological disorders to occur, many of today’s community programs try to deter mental disorders before they can develop

  • Programs have grown in number with limited funding 

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Mental Health Services 

  • Medical doctors, pediatricians, nurse practitioners and neurologists

  • Psychiatrists 

  • Licensed social workers/ social workers 

  • Counselors and therapists 

  • Peer support providers or specialists 

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Anxiety Disorders

Anxiety is the primary symptom or the primary cause of other symptoms for all anxiety disorders

  • Anxiety disorders are the most common mental disorder in the United States (19 million adults) 

  • People with one anxiety disorder usually experience another as well 

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Generalized Anxiety Disorder (GAD)

Experience excessive anxiety under most circumstances and worry about practically anything 

  • Feeling of “free-floating anxiety”

  • The anxiety has no definite trigger or starting point, they experience little relief

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Panic Disorder

Anxiety disorder marked by recurrent and unpredictable panic attacks 

  • Attacks of intense anxiety along with severe chest pain, tightness of muscles, choking, sweating, other acute symptoms during 

  • Symptoms can last a few minutes to a couple of hours (have no trigger)

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Specific Phobia

Intense, irrational fear responses to specific stimuli 

  • Some people with a specific phobia may go to great lengths to avoid the phobic stimulus

  • When confronted with the object of their phobia, a person will generally enter a state of panic

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Afraid to be in public situations from which escape might be difficult or help unavailable if panic-like or embarrassing symptoms were to occur

Panic attacks in public places

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Obsessive-Compulsive Disorder (OCD)

Compound disorder of thought and behavior

Obsessions are persistent, intrusive, and unwanted thoughts that an individual cannot get out of his or her mind

Compulsions are ritualistic behaviors performed repeatedly

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Hoarding disorder

characterized by persistent difficulty discarding or parting with possessions due to a perceived need to save the items and distress parting with them

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post traumatic stress disorder

result of some trauma experienced by the Victim.Victims re-experience the traumatic event in nightmares about the event, or flashbacks in which they relieve the event

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Bipolar Disorder

Mood swings alternating between periods of. major depression and mania

Rapid cycling is usually short periods of mania followed almost immediately by deep pression, usually for longer duration

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Major depressive disorders

Involves intense depressed mood, reduced interest or pleasure in activities, loss of energy, and problems in making decisions for a minimum of 2 weeks

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General term that is used to describe the process of treating psychological disorders and mental distress by the us of verbal and psychological techniques

  • One of the major criticisms leveled against psychotherapy is one that calls into question its effectiveness

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Confidentiality & The Law

Psychotherapists and psychiatrists are required by law to protect the confidentiality of their clients 

  • Health Insurance Portability and Accountability Act (HIPAA), sets limits on the way patient or client information can be shared

  • Therapists can break confidentiality when people are a threat to themselves or others (also court orders)

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Behavior Therapy

Goal is to extinguish unwanted behavior and replace it with more adaptive behavior

  • Abnormal behavior is a result of maladaptive behavior learned through faulty rewards and punishment 

  • Therapies based on learning principles of classical conditioning, operant condition, and observational or social learning theory

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Exposure Treatments

Behavioral treatments in which persons are exposed to the objects or situations they dread 

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Systematic Desensitization

Developed by Joseph Wolpe, reconditioning so that the crucial conditioned stimulus elicits the new conditioned response

  • Client learns to practice deep relaxation 

  • Client creates hierarchy of anxieties (lowest to highest stimulus) 

  • Led by therapist, client is introduced to the least feared object during deep relaxation then next, etc. 

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Client is fully exposed to the anxiety-producing stimulus in a harmless and controlled situation from which he or she cannot escape in which extinction is achieved 

  • Classical conditioning treatment for phobias and other anxiety disorders

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Aversion Therapy

Trains the client to associate physical or psychological discomfort with behaviors, thoughts or situations he or she wants to stop or avoid

  • Unpleasant consequence will eventually stop the behavior 

  • Aversion therapy & flooding could be harmful if done carelessly

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Behavior Modification

The client selects a goal and with each step toward it, receives a small reward until the intended goal is finally achieved

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Token Economy

Positive behaviors are rewarded with secondary reinforcers (tokens, points, etc.) which can eventually be exchanged for extrinsic rewards 

  • Often used to encourage socially acceptable behaviors and to discourage socially unacceptable ones 

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Social Skills Training

Behavior therapy to improve interpersonal skills by using modeling, behavioral rehearsal, and shaping

  • With modeling, the client is encouraged to observe socially skilled people in order to learn appropriate behaviors 

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 Provides feedback, or information about our biological reaction to the environment

Involves giving the individual immediate information about the degree to which he or she is able to change anxiety-related responses such as heart rate, muscle tension, etc. to improve control of physiological process

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Rational-Emotive Behavior Therapy (REBT)

Developed in 1950s by Albert Ellis, psychological problems arise when thoughts are irrational and lead to behavioral consequences that are distressful 

  • (ABS of Treatment) Help client confront irrational thoughts by discussing his or her actions, his or her beliefs about those actions, and consequences of those beliefs 

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Aaron Beck’s Cognitive Therapy

Researched by Aaron Beck, concluded that the symptoms of depression grew as a result of cognitive dysfunctions 

  • Cognitive Therapy to alleviate faulty and negative thoughts

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Cognitive-Behavioral Therapists

Abnormal behavior is the result of faulty thought patterns 

  • Cognitive restructuring, is turning the faulty, disordered thoughts into more realistic thoughts, client may change abnormal behavior

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Autism Spectrum Disorder

Disorder marked by extreme unresponsiveness to others, severe communication deficits, and highly repetitive and rigid behaviors, interests, and activities

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Intellectual Disability (ID)

Disorder marked by intellectual functioning and adaptive behavior that are well below average 

  • Previously called mental retardation

Low IQ score of 70 or below

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Neurocognitive Disorders

Group of disorders in which the primary problem is in cognitive function, impairments in cognitive abilities such as memory, problem solving, and perception

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A rapidly developing, acute disturbance in attention, and orientation that makes it very difficult to concentrate and think in a clear and organized manner

  • Common in elderly people, state of massive confusion 

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Alzheimer’s Disease

 Fatal degenerative disease in which brain neurons progressively die, characterized by loss of memory, reasoning, emotion, and control of bodily functions 

  • Alzheimer’s strikes 3 percent of the world’s population by age 75

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Personality Disorders

Longstanding, maladaptive thought and behavior patterns that are troublesome to others, harmful, or illegal

  • Impair people’s social functioning, individuals do not experience anxiety, depression, or delusions

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Personality disorders

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Paranoid Personality Disorder

Pattern of distrust and suspiciousness about other people’s motives, and usually those motives are considered malevolent 

  • Overly sensitive; often envious (more common in males) 

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Schizoid Personality Disorder

Characterized by persistent avoidance of social relationships and little expression of emotion

  • Genuinely prefer to be alone, no effort to start of keep relationships

  • Withdrawn behavior, considered “cold” (more common in males)

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Personality disorder

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Antisocial Personality Disorder (APD):

Characterized by a general pattern of disregard for and violation of other people’s rights (closely linked to criminal behavior)

  • Used to be called sociopaths or psychopaths 

  • Violate other people’s rights without guilt or remorse

  • Manipulative, exploitive, self-indulgent, irresponsible (more common in males)

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Borderline Personality Disorder

Characterized by repeated instability in interpersonal relationships, self-image, and mood and by impulsive behavior

  • Unpredictable and prone to boredom (more common in females) extreme mood swings, trouble controlling their emotions, self-destructive behavior

  • Always in conflict with the world around them, suicidal threats and actions are also common

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Borderline Personality Disorder

Characterized by repeated instability in interpersonal relationships, self-image, and mood and by impulsive behavior

  • Unpredictable and prone to boredom (more common in females) extreme mood swings, trouble controlling their emotions, self-destructive behavior

  • Always in conflict with the world around them, suicidal threats and actions are also common

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Histrionic Personality Disorder

Characterized by a pattern of excessive emotionality (dramatic) and attention seeking

  • Tend to overreact and be egocentric (more common in females) 

  • Exaggerate physical illnesses, depth of their relationships

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Narcissistic Personality Disorder

Characterized by a proad pattern of grandiosity, need for admiration, and lack of empathy 

  • Unrealistically self-important, manipulative, can’t take criticism, expects special treatment (more common in males) 

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Personality disorder

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Avoidant Personality Disorder

Characterized by consistent discomfort and restraint in social situations, overwhelming feelings of inadequacy, and extreme sensitivity to negative evaluation/potential rejection, humanilitation

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Dependent Personality Disorder

Characterized by a pattern of clinging and obedience, fear of separation, and an ongoing need to be taken care of 

  • Excessively lacking in self-confidence, subordinates own needs and allows others to make all decisions (more common in females)

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Obsessive Compulsive Personality Disorder

Characterized by an intense focus on orderliness, perfectionism, and control that the person loses flexibility, openness, and efficiency 

  • Preoccupied with rules, schedules, details and extremely conventional 

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Eating & Feeding Disorders

Mental disorders defined by abnormal eating habits. May involve either insufficient or excessive food intake to the detriment of an individual’s physical and mental health

  • People with eating disorders can appear underweight, of healthy weight, or overweight

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Anorexia Nervosa (Anorexia)

Life-threatening eating disorder that involves intense fear of weight gain or becoming overweight, distorted perception of one’s weight/body shape, persistent restriction of caloric intake

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Bulimia Nervosa (Bulimia)

Recurrent binge eating followed by compensatory behaviors for the intake of food, such as purging 

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Binge Eating Disorder “Compulsive Overeating

Uncontrollably eating a large amount of food in a short period of time; after a bingeing episode a person will not purge and will feel an extreme sense of guilt

  • Episodes of bingeing may be a method of self-soothing in the face of emotional stressors; social isolation and loneliness

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Insight Therapies

Designed to help clients understand the causes of their problems.  This understanding or insight will then help clients gain greater control over their thoughts, feelings, and behaviors 

  • Psychodynamic Therapies 

  • Humanistic Therapies

  • Gestalt Therapies 

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The primary focus of psychodynamic therapy is to uncover the unconscious content of a client’s psyche in order to alleviate psychic tension

  • To resolve unconscious conflicts psychoanalysis involves going back to discover the roots of the problem

  • Traditional psychoanalysis, often required two or three session a week for up to seven years

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Psychodynamic Therapy

Evolved from Freud’s original approach, based on the ideas that a person’s development is often determined by forgotten events in early childhood, human behavior and dysfunction are largely influenced by the unconscious

  • Less expensive and extensive therapy

  • The relationship between client and therapist as an agent of change

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Free Association

The client spontaneously reports thoughts, feelings, and mental images that come to mind (no censorship) 

  • The psychoanalyst asks questions to encourage the flow of associations in order to provide clues as to what the patient’s unconscious wants to hide

  • As trust increases, ego will lower to reveal unconscious 

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The patient’s conscious or unconscious attempt to block disturbing memories, motives, and experiences (sensitive material)

  • The client reached an important issue that needs to be discovered

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The process by which a patient projects or transfers unresolved conflicts and feelings onto the therapist

  • Freud believed that transference helps patients gain insight by reliving painful past relationships

  • The job of the therapist is to detect when transference is happening & help patient understand what it reveals

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Dream Analysis

Freud believed that dreams are symbolic representations of unconscious conflicts and repressed impulses

  • He also believed that dream interpretation is a means of interpreting their unconscious conflicts, motives, and desires

  • Psychoanalysts look at the latent (underlying) content as opposed to the manifest (storyline) content

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Interpersonal Psychotherapy (IPT)

Enable people to gain insight into the causes of their problems, but it focuses on current relations to relieve present symptoms

  • Short-term therapy

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Humanistic Therapy

Aim to boost self-fulfillment by helping people grow in self-awareness and self-acceptance

  • The present and future more than the past

  • They explore feelings as they occur, rather than achieving insights into the childhood origins of the feelings

  • Conscious rather than unconscious thoughts

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Person-Centered (Rogerian-Therapy)

One of the most widely used models in psychotherapy today developed by Carl Rogers. Nondirective therapy, the therapist listens, without judging or interpreting, and seeks to refrain from directing the client toward certain insights

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Person-Centered (Rogerian-Therapy)

Client-centered therapy uses the following:

  • Unconditional Positive Regard, allow client to steer the direction of the therapy, clients have value

  • Empathy, ability to truly see, feel, & understand what client is experiencing 

  • Genuineness, therapist is willing to foster honest/open relationship

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Person-Centered (Rogerian-Therapy)

Client-centered therapy uses the following:

  • Active listening, therapist listens to client, paraphrasing what the client says, prevents advice or judgements 

  • Echoing, restating, and seeking clarification of what the person expresses (verbally or nonverbally) and acknowledging the expressed feelings

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Gestalt Therapy

 Developed by Fritz Perls, therapists goal is to push clients to decide whether they will allow past conflicts to control their future or whether they will take control of their own destiny

  • Empty-chair technique in which a patient sits in front of an empty chair and imagines that the person to whom she/he needs to express his/her feelings is in the chair

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Group Therapy

In a small group, usually around 6 to 12, persons with similar problems come together under the direction or facilitation of a trained therapist or counselor to discuss their psychological issues 

  • Provides a vital element to mental healing: knowing you are not alone in suffering and struggles (reduces isolation and hopelessness) 

  • Enables therapist to treat more clients at same time, less expensive

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Self-Help Groups

Facilitator organizes meetings, but there is an absence of a trained psychotherapist directing the process of the group 

  • The responsibility for leading the group is up to the group members themselves

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Couples/Family Therapy

Trained professionals can direct spouses and family members to openly discuss their individual perspectives on the same issue

  • Understand how their behavior affects others

  • Practice better communication skills and bring about improved relationships

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Biomedical Therapy

Based on the premise that the symptoms of many psychological disorders involve biological factors, involves medication and/or medical procedures to treat psychological disorders

  • In order to treat disorders, biomedical therapy uses drugs or brain stimulation in combination with psychotherapy 

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The study of how psychotropic drugs affect mental processes and behavior

  • Medications used to treat psychological disorders are called psychotropic medications 

  • They do not cure the disorders; they only treat the symptoms (effectiveness is upwards of 80%)

  • The drugs are more effective when used in conjunction with psychotherapy

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Antianxiety Drugs (Anxiolytic)

Designed to reduce anxiety and produce relaxation by lowering sympathetic activity in the brain

  • Short term treatment of anxiety-antianxiety drugs, long term treatment of anxiety-antidepressant drugs

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Antidepressant Drugs

Elevate mood by affecting neurotransmitters such as serotonin that are linked to depression

  • SSRI (selective serotonin reuptake inhibitor) – blocks the reuptake of serotonin

  • NDRI (norepinephrine and dopamine reuptake inhibitors)

  • SNRI (serotonin and norepinephrine reuptake inhibitors) 

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