Psychological Treatments Flashcards

Psychotherapy

• Treatment for psychological disorders where a therapist works with clients to understand their problems and find solutions.
• Therapists aim to change clients’ thought or behavior patterns.

Understanding Psychotherapy

• Carl Jung's concept of the "Wounded Healer Phenomenon": A therapist's ability to heal is often related to their own experiences of pain and healing.

Role of Paraprofessionals

• The Friendship Bench Project: An example of using community resources to provide mental health support.

Psychotherapy Relationship

• Unique, healing relationship between psychotherapist and client.
• Differs from other relationships in five ways:
  • Focus entirely on the client’s needs and problems.
  • Therapist is paid for their time and expertise.
  • Takes place in a structured setting.
  • Meetings are time-limited.
  • Expected to terminate.

Ethical Standards of Psychotherapy

• Goals must be considered with the client.
• Choices for alternative treatment methods should be considered.
• Therapist must only treat problems they're qualified to treat.
• Effectiveness of treatment must be evaluated.
• Confidentiality explained to the client.
• Therapist must not use power to exploit the client.
• Therapist must treat the client with dignity and understand diversity.

Case Law

• Tarasoff vs. Board of Regents, University of California established a "Duty To Warn".

Therapy Approaches

• Overview of various therapy approaches:
  • Psychodynamic therapy: Aims to make clients aware of unconscious conflicts and defense mechanisms through psychoanalysis, dream analysis, and free association.
  • Humanistic therapy: Focuses on helping clients fulfill their potential for personal growth through client-centered therapy, active listening, and unconditional positive regard.
  • Behavior therapy: Seeks to replace harmful behaviors with beneficial ones using behavior modification techniques like rewards, punishments, token economies, social skills training, and modeling.
  • Cognitive therapy: Aims to eliminate distorted thoughts and replace them with more realistic ones, including cognitive restructuring and rational-emotive therapy.
  • Cognitive-behavioral therapy: Combines both cognitive and behavior therapy techniques to change distorted thoughts and maladaptive behaviors.
  • Group therapy: Provides support, improves social skills cost-effectively, and often uses an eclectic mix of psychotherapy approaches.
  • Family therapy: Focuses on healing family relationships utilizing a systems approach and often an eclectic mix of psychotherapy approaches.

Psychoanalysis

• Deals with the conscious, preconscious, and unconscious mind.

Intrapsychic Conflict

• Conflict between the id, ego, and superego leads to anxiety and reliance on defense mechanisms.

Psychoanalysis and Psychodynamic Therapy

• Psychoanalysis: the first form of therapy; expensive and lengthy.
  • Important concepts:
    • Insight
    • Transference
    • The Unconscious
    • Dream analysis
    • Free association

Interpersonal Psychotherapy for Depression

• Neo-Freudian psychotherapy
• Focuses on the “here and now”
• Brief duration: 12 to 16 weeks
• Highly focused and structured

Behavioral and Cognitive Treatments

• Aim to change behavior, emotion, and/or thought directly.

Behavior Therapy

• Treatment for psychological disorders to help clients unlearn behaviors that negatively affect their functioning.
  • Often uses token economies, social skills training, and modeling.

Behavioral Activation

• Therapist helps the client begin activities with naturally “anti-depressant” qualities.

Social Skills Training

• Shaping
• Positive reinforcement
• Role playing

Exposure Therapies

• Systematic desensitization
• Flooding
• Phobias are maintained by avoidance; solution involves facing fears directly.
• Systematic desensitization and flooding are less frequent now but formed the basis of contemporary exposure therapies.

Virtual Reality Therapy

Cognitive Therapies

• Rational-emotive behavior therapy
• Cognitive therapy
• Cognitive behavior therapy (CBT)
• Mindfulness-based cognitive therapy

Irrational Assumptions

• A: Activating event (e.g., loss of job)
• B: Belief (e.g., "How awful to lose my job. I must be worthless.")
• C: Emotional and behavioral consequence (e.g., depression and withdrawal)
• D: Disputing intervention (e.g., challenge belief: "Losing a job has nothing to do with my self-worth.")
• E: New effective philosophy (e.g., "I'm okay. I won't give up.")
• F: New feelings (e.g., "It's okay to feel frustrated. I won't give up.")

Humanistic Therapy

• Treatment for psychological disorders to help clients develop their full potential for personal growth through greater insight.
  • Client-centered therapy includes:
    • A safe and comforting setting for clients
    • Active listening
    • Unconditional positive regard

Integrative Therapy

• Integrative therapy (eclectic therapy) draws from many psychotherapeutic theories and techniques.
  • Adheres to one established style of therapy and utilizes techniques of other styles as they seem appropriate; or creates all new form of therapy.
  • “Use what works!”

Group and Family Therapy

• Group therapy:
  • Benefits that cannot be obtained by individual therapy
  • Receiving encouragement from other group members
  • Learning that one is not alone in one’s problems
  • Learning from the advice offered by others
  • Learning new ways to interact with others

Context of Therapy Matters

• Family therapy:
  • According to a systems approach, an individual is part of a larger context.
    • Any change in individual behavior will affect the whole system.
    • This effect is often easiest to see within families.

Family Therapy

• Therapist attempts to solve the problems of all the family members by improving the functioning of the family system.
• Gives the family insights into the general workings of family systems.
• Increases the amount of warmth and intimacy among family members.
• Improves communication
• Helps establish a reasonable set of rules

Couple Therapy

• Form of psychotherapy involving a couple
• Used to treat relationship distress or to address the mental health problems of a specific member of the couple.
  • Common reasons for entering therapy:
    • Feelings of lack of love, lack of commonality and inability to communicate
    • Worries about divorce
    • Frequent arguments
    • General desire to improve the relationship
    • Concerns about children
    • Sexual problems

Biological Therapies

• Effective for certain disorders.

Electroconvulsive Therapy (ECT)

• Alternative treatments for extreme cases
• Treatment for psychological disorders that involves administering a strong electrical current to the client’s brain to produce a seizure; ECT is effective in some cases of severe depression.
• The general public has a very negative view of ECT.

Transcranial Magnetic Stimulation (TMS)

• Treatment for psychological disorders that uses a magnetic field to interrupt function in specific regions of the brain.
• When rapidly switched on and off, this magnetic field creates an electrical current in the brain region directly below the coil, thereby interrupting the activity of neurons in that region.

Deep Brain Stimulation (DBS)

• Treatment for psychological disorders that involves passing electricity through electrodes planted in the client’s brain to stimulate the brain at a certain frequency and intensity.
• DBS may be especially valuable for treating severe obsessive-compulsive disorder (OCD) and depression.

Psychopharmacology

• Antianxiety Drugs: Valium, Xanax, Ativan, Buspar

Antidepressants

• Four principal classes of antidepressant drugs:
  • MAO inhibitors
  • Tricyclic antidepressants
  • Selective serotonin reuptake inhibitors (SSRIs)
  • Third-generation antidepressants

Clinical Psychologists

• Identifying with Each Therapeutic Orientation:
  • Eclectic/integrative (29%)
  • Cognitive (28%)
  • Psychodynamic (15%)
  • Behavioral (10%)
  • Other (16%)
  • Rogerian/Humanistic (2%)

Effectiveness of Psychotherapy

• Psychotherapy is more effective than no treatment at all.
• From 75 to 90 percent of people who receive therapy improve, the longer a person stays in therapy the better the improvement, and psychotherapy works as well alone as with drugs.

Common Factors

• Common to all legitimate forms of psychotherapy.
• Bruce Wampold suggests that there are three principal factors to successful treatment:
  • Therapeutic alliance
  • Therapist allegiance
  • Therapist competence

Dodo Bird Verdict

• Is there a "Dodo Bird Verdict" effect in psychotherapy?

Treatment and Harm

• Psychotherapy comes with it the potential for unintended side effects
• Psychotherapy can instill false beliefs about the nature and causes of their problems
• Harm in therapy can also occur as the result of simple incompetence on the part of the therapist

Scientific Evidence

• Indicates Which Treatments Are Safe and Effective.
• Some treatments widely believed to be effective not only lack scientific support but are actually counterproductive.
• It is important to recognize the difference between evidence-based psychotherapies and “fringe” therapies.
• The only way to determine whether a treatment is valid is to conduct empirical research using randomized clinical trials.

Dialectical Behavior Therapy (DBT)

• Is the Best Treatment for Borderline Personality Disorder
• Traditional psychotherapy approaches have been largely unsuccessful for treating borderline personality disorder.
• Form of therapy, used to treat borderline personality disorder, that combines behavior therapy, cognitive therapy, psychodynamic therapy, and a mindfulness approach.

Disorders in Children and Adolescents

• In the United States, an estimated 12–20 percent of children and adolescents experience psychological disorders.
• Problems not addressed during childhood or adolescence may persist into adulthood.

Medication to Treat Depressive Disorders in Adolescents

• Is Controversial
• Approximately 8 percent of 12- to 17- year-olds in the United States have reported experiencing a major depressive episode.
• Untreated adolescent depression is associated with drug abuse, dropping out of school, and suicide.

Risks of Antidepressants for Adolescents

• Shortly after SSRIs were introduced as treatments for adolescent depression, some mental health researchers raised concerns that the drugs might cause some adolescents to become suicidal.
• Many questions about the effects of SSRIs on young people need to be answered.

Biological Treatments for Autism Spectrum Disorder

• There is good evidence that autism spectrum disorder is caused by brain dysfunction.
• The neurobiology of autism spectrum disorder is not well understood.
• Children with Autism Spectrum Disorder Benefit From Structured Behavior Therapy

Prognosis in Autism Spectrum Disorder

• Despite a few reports of remarkable recovery from autism spectrum disorder, the long-term prognosis is poor.
• Early diagnosis clearly allows for more effective treatments.
• Early language ability is associated with a better outcome.
• Higher IQ is also associated with a better outcome.
• Children with Autism Spectrum Disorder Benefit From Structured Behavior Therapy

Children with ADHD

• Can Benefit from Various Approaches
• Is attention-deficit/hyperactivity disorder (ADHD) a psychological disorder that should be treated, or is it simply a troublesome behavior pattern that children eventually outgrow?
• Some individuals diagnosed with ADHD as children do grow out of it, but many more continue to experience the disorder throughout adolescence and adulthood.

Psychotropic Medications for ADHD

• The most common treatment for ADHD is a central nervous system stimulant, such as methylphenidate (Ritalin) or Adderall.
• The actions of these drugs are not fully understood, but they may affect multiple neurotransmitters, particularly dopamine.
• Side effects include sleep problems, reduced appetite, body twitches, and temporary slowing of growth.
• Some children on medication may see their problems as beyond their control.
• Most therapists believe medication should be supplemented by psychological therapies, such as behavior modification.