AP Psychology Notes on Behavior, Cognitive, Insight, and Biomedical Therapies

Behavior & Cognitive Therapy

Psychotherapy

  • Psychotherapy involves a psychologist or trained professional working with an individual or group to identify problems and develop solutions, typically through talking and thinking.

Confidentiality & The Law

  • Psychotherapists and psychiatrists are legally required to protect client confidentiality.
  • The Health Insurance Portability and Accountability Act (HIPAA) sets limits on sharing patient information.
  • Therapists can break confidentiality if a client is a threat to themselves or others, or under court orders.

Behavior Therapy

  • Based on classical and operant conditioning theories.
  • Aims to extinguish unwanted behaviors and replace them with adaptive ones.
  • Behavior therapy is action-based.
Exposure Treatments
  • Exposure therapy treats anxiety disorders by exposing the patient to the anxiety source without causing danger.
  • Effective for:
    • Phobias
    • Panic Disorder
    • Social Anxiety Disorder
    • Obsessive-Compulsive Disorder
    • Posttraumatic Stress Disorder
    • Generalized Anxiety Disorder
Flooding
  • Intensely and rapidly exposing people to fear-invoking objects or situations.
  • Often used to treat phobias, preventing escape or avoidance.
  • Phobias are learned fears that need to be unlearned through exposure.
Systematic Desensitization
  • Developed by Joseph Wolpe.
  • Client creates a list of fears and learns to relax while concentrating on them.
  • Involves:
    • Deep relaxation techniques
    • Creating a hierarchy of anxieties (lowest to highest stimulus)
    • Gradual introduction to feared objects during deep relaxation, led by a therapist; typically accomplished within 10 sessions.
Aversion Therapy
  • Pairing an undesirable behavior with an aversive stimulus to reduce the unwanted behavior.
  • Unpleasant consequences should stop the behavior.
  • Can be harmful if done carelessly.
  • Example: Antabuse, which causes extreme nausea when paired with alcohol, used to discourage alcohol use.

Operant Conditioning Based Behavior Therapy

Token Economy
  • Uses reinforcement to modify behavior.
  • Clients earn tokens (e.g., poker chips, stickers, points) that can be exchanged for privileges or desired items.
  • Target behaviors include self-care, medication adherence, work skills, and treatment participation.
Biofeedback
  • A mind-body technique using visual or auditory feedback to gain control over involuntary bodily functions.
  • Useful for managing stress and symptoms exacerbated by stress.

Cognitive-Behavioral Therapy

  • Human emotions and behavior are generated by ideas, beliefs, attitudes, and thinking.
  • Feelings come from thoughts, and negative feelings often come from distorted thoughts.
  • Automatic thoughts come to mind with little effort.
Thinking Errors
  • Generated during conflict, instability, or stressful events.
    • Black and White Thinking / All or Nothing Thinking
    • Overgeneralization
    • Filtering out the Positive / Disqualifying the Positive
    • Mind Reading
    • Fortune-telling
    • Catastrophizing/Magnification & Minimization
    • Should Statements
    • Personalization or Blame
    • Emotional Reasoning
    • Labeling

Rational-Emotive Behavior Therapy (REBT)

  • Developed by Albert Ellis in the 1950s.
  • Psychological problems arise from irrational thoughts leading to distressful behavioral consequences.
  • Involves restructuring to bring attention to unrealistic thoughts.

Aaron Beck’s Cognitive Therapy

  • Based on the interaction between cognition, emotion, and behavior.
  • Skills are taught to change thinking patterns to be more accurate.

REBT vs. CBT

  • REBT (Albert Ellis):
    • Therapist directly challenges irrational thoughts (more direct).
    • Challenged thoughts with restructuring.
  • CBT (Aaron Beck):
    • Maladaptive thoughts are treated as hypotheses to be tested collaboratively by therapist and patient.
    • Uses behavioral techniques like graded exposure or systematic desensitization.

Three Column Technique

  • Automatic Thought
  • Distortion
  • Rational Thought/Replacement Thought

Follow Your Thoughts

  • Automatic Thoughts -> Intermediate Thoughts -> Core Beliefs

Insight & Biomedical Therapies

Insight Therapies

  • Designed to help clients understand the causes of their problems to gain greater control over their thoughts, feelings, and behaviors.
    • Psychodynamic Therapies
    • Humanistic Therapies
    • Gestalt Therapies

Psychoanalysis

  • Focuses on uncovering unconscious content to alleviate psychic tension.
  • Resolves unconscious conflicts by exploring the roots of the problem.
  • Traditional psychoanalysis often required two or three sessions a week for up to seven years.
Free Association
  • Client spontaneously reports thoughts, feelings, and mental images without censorship.
  • Psychoanalyst asks questions to encourage the flow of associations.
  • Aims to reveal unconscious desires as trust increases and the ego lowers.
Resistance “Mental Blocks”
  • Patient's conscious or unconscious attempt to block disturbing memories, motives, and experiences.
  • The analyst notes resistance and provides insight into its meaning.
Transference
  • The process by which a patient projects unresolved conflicts and feelings onto the therapist.
  • Helps patients gain insight by reliving painful past relationships.
  • The therapist detects transference and helps the patient understand its implications.

Psychodynamic Therapy

  • Evolved from Freud’s approach, influenced by neo-Freudians.
  • Based on the idea that early childhood events and the unconscious influence human behavior.
  • Less expensive and extensive than traditional psychoanalysis.
  • Focuses on the relationship between client and therapist as an agent of change.

Humanistic Therapy

  • Aims to boost self-fulfillment by helping people grow in self-awareness and self-acceptance.
  • Focuses on the present and future rather than the past.
  • Explores feelings as they occur and emphasizes conscious rather than unconscious thoughts.
Person-Centered (Rogerian-Therapy)

  • Developed by Carl Rogers; a widely used model in psychotherapy.

  • Nondirective therapy where the therapist listens without judging or interpreting.

  • Relies on:

    • Unconditional Positive Regard
    • Empathy
    • Genuineness
    • Active listening (paraphrasing, preventing advice or judgements)
    • Echoing, restating, and seeking clarification of what the person expresses and acknowledging the expressed feelings

Gestalt Therapy

  • Developed by Fritz Perls.
  • Therapist pushes clients to decide whether to allow past conflicts to control their future or to take control of their own destiny.
  • Involves techniques like the empty-chair technique.

Group Therapy

  • Small groups (6-12 people) with similar problems discuss psychological issues under the direction of a trained therapist.
  • Provides a sense of not being alone in suffering, reducing isolation and hopelessness.
  • Enables therapists to treat more clients simultaneously at a lower cost.

Self-Help Groups

  • Facilitator organizes meetings, but there is no trained psychotherapist directing the process.
  • Group members lead the group.

Couples/Family Therapy

  • Trained professionals direct spouses and family members to discuss their perspectives, understand how their behavior affects others, practice better communication skills, and improve relationships.

Insurance Coverage for Mental Health

  • Limits exist on the amount of time a person can spend in therapy within a plan year.

Biomedical Therapy

  • Based on the premise that symptoms of many psychological disorders involve biological factors.
  • Involves medication and/or procedures to treat psychological disorders, often in combination with psychotherapy.

Psychopharmacology

  • The study of how psychotropic drugs affect mental processes and behavior.
  • Psychotropic medications treat symptoms but do not cure the disorders (effectiveness upwards of 80%).
  • More effective when used with psychotherapy.
  • Message is sent across synaptic gap.
  • Sending Action potential neuron Synaptic gap Receiving neuron Neurotransmitter molecule Receptors.
  • Message is received; excess neurotransmitter molecules are reabsorbed by sending neuron.
  • Prozac partially blocks normal reuptake of the neurotransmitter serotonin; excess serotonin in synapse enhances its mood-lifting effect.
  • Reuptake Serotonin Prozac
Antianxiety Drugs (Anxiolytic)
  • 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.
  • Used For: PTSD, Panic Disorder, Social Phobia, OCD
  • Brand Names: Xanax, Librium, Ativan, Valium
  • Effects: Depresses central nervous system; reduces apprehension and nervousness.
  • Side Effects: Sleepiness, dizziness, fatigue, headaches, slurred speech
Antidepressant Drugs
  • Elevate mood by affecting neurotransmitters (e.g., serotonin).
  • SSRI (selective serotonin reuptake inhibitor) – blocks the reuptake of serotonin
  • NDRI (norepinephrine and dopamine reuptake inhibitors)
  • SNRI (serotonin and norepinephrine reuptake inhibitors)
  • Antidepressants Used For: Depression (Long-term treatment of anxiety disorders), PTSD, OCD
  • Brand Names: Prozac, Zoloft, Paxil, Lexapro, Wellbutrin
  • Effects: Improves mood by reducing absorption of neurotransmitters serotonin and norepinephrine
  • Side Effects: Depending on class of antidepressant: nausea, weight gain, dry mouth, reduced sex drive, blurred vision, suicidal ideation
Mood-Stabilizing Drugs
  • Treat the combination of manic episodes and depression characteristic of bipolar disorder.
  • Mood Stabilizers Used For: Bipolar Disorders
  • Brand Names: Lithium, Lamotrigine
  • Effects: Reduces manic episodes and depressive episodes
  • Side Effects: Drive mouth, heart arrhythmia, swelling, nausea, loss of appetite
Stimulants
  • Stimulate the central nervous system, stop the absorption of dopamine and norepinephrine and allow the brain to experience more stimulation
  • Stimulants Used For: ADD/ADHD
  • Brand Names: Ritalin, Adderall, Dexedrine
  • Effects: Improves focus and attention by preventing absorption of dopamine and norepinephrine
  • Side Effects: Decreased appetite, difficulty sleeping, headache, stomach ache
Antipsychotic Drugs
  • Diminish or eliminate positive symptoms of schizophrenia by decreasing activity at dopamine receptors.
  • Antipsychotics Used For: Schizophrenia, Extreme cases of bipolar
  • Brand Names: Haldol, Prolixin, Thorazine
  • Effects: Reduces positive psychotic symptoms such as delusions and hallucinations through inhibiting the neurotransmitter dopamine
  • Side Effects: Tardive dyskinesia

Assessing Psychotropic Drugs

  • Prescribed after careful diagnosis by a medical doctor.
  • All drugs have potential side effects.
  • Psychotropic drugs used with psychotherapy are more effective.

Prescriptions

  • Most antidepressants are prescribed by primary-care physicians with limited mental health training.
  • Research indicates Americans are often prescribed medications that may not work or may be inappropriate.

Electroconvulsive Therapy (ECT)

  • A biological treatment where a brain seizure is triggered by passing an electric current through electrodes on the patient’s forehead.

Psychosurgery/Neurosurgery

  • Most dramatic and least used biomedical intervention.
  • Involves removing or lesioning brain tissue; irreversible.
  • Bilateral anterior cingulotomy (collaboration between psychiatrists and neurosurgeons).

Deep Brain Stimulation

  • Treats severe depression by surgically implanting a thin wire in the brain area associated with depression.
  • Wire is connected to a battery to stimulate neuronal growth.

Repetitive Transcranial Magnetic Stimulation (rTMS)

  • An alternative to ECT involving a pulsating magnetic coil over the prefrontal regions of the brain.
  • Treats depression with minimal side effects; after repeated exposure, specific neurons grow to reduce symptoms.

Assessing the Biomedical Approach

  • Psychotropic drugs reduce symptoms but do not cure the illness.
  • Increasing reliance on drugs as the first or only treatment can lead to dependence.
  • Psychotherapy treats the underlying psychological cause of the disorder.