Psyc Chapter 17 Class

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jarrettmoore
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Psyc Chapter 17 Class
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2014-04-16 18:07:53
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psyc chapter 17 class
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  1. three essential features of all therapies
    • A sufferer who seeks help
    • A trained, socially accepted healer
    • A series of contacts with the goal of changing attitudes, emotional states, or behaviours
  2. psychotherapies
    use words and acts to overcome psychological difficulties
  3. who seeks therapy
    • About 20 million North Americans per year 
    • More than 3/4 of them seek help with
    • More than 3/4 of them seek help with anxiety or depression anxiety or depression
    • People with “problems in living
    • About 2/3 of clients are women, 1/3 are men
    • White individuals more likely to seek treatment than members of other ethnic groups 
  4. Stigma
    • There has been a significant reduction in the stigma associated with mental illness
    • perceptions of stigma continue to play a role in people's decisions about whether or not to acknowledge their mental issues and whether or not to seek treatment
  5. Canadian mental health act
    outlines patients rights and conditions for involuntary admittance
  6. Where is treatment conducted
    • Most people are treated as outpatients
    • Negative effects of long-term hospitalization
    • Reduction in psychiatric beds in Canada since 1964; brief stay in hospital
    • 1/3 of Canadians released from hospital following treatment for mental illness are readmitted to hospital within a year
    • Canadians with severe psychological disorders often face a cycle of hospital discharges and re-admissions and are often homeless
  7. Treatment Models
    • Medical-biological: Focus on genetics, neurology
    • Psychodynamic: Focus on unresolved conflicts
    • Humanistic: Focus on fulfilling missing needs
    • Behavioral: Focus on changing behavior through rewards and punishment
    • Cognitive: Focus on helping people change their ways of thinking and developing coping strategies
    • Sociocultural: Focus on cultural and social variables
  8. Biomedical therapies
    • psychopharmacology
    • electroconvulsive therapy
    • trans-cranial magnetic stimulation
  9. Psychotropic drugs
    • drugs that act primarily on the brain
    • Antianxiety drugs
    • Antidepressants
    • Antibipolar drugs (mood stabilizers)
    • Antipsychotics
  10. Anti-anxiety drugs
    • Benzodiazepines: increase efficiency of GABA to bind to receptors
    • Buspirone: stabilize serotonine levels
    • Beta blockers: compete with norepinephrine at receptor sites on heart and other muscles 
  11. antidepressants
    • Monoamine Oxidase Inhibitors (MAOI’s): inhibit metabolization of serotonin and norepinephrine
    • (Tri)Cyclic antidepressants: inhibit reuptake of serotonin and norepinephrine
    • Selective Serotonin Reuptake Inhibitors (SSRI’s): selectively inhibit reuptake of serotonin
  12. mood stabilizers (anti-bipolar drugs)
    • Lithium: decreases noradrenaline, increases serotonin
    • Anticonvulsive drugs: increase levels of GABA, inhibit norepinephrine reuptake
  13. antipsychotics
    • Conventional antipsychotics: block postsynaptic dopamine receptors
    • Serotonin-dopamine antagonists: block activity of serotonin and/or dopamine , clozapin 
  14. Psychopharmacology: schizophrenia
    • Antipsychotic medications: Target positive symptoms, Tardive dyskinesia
    • Atypical antipsychotics: Newer, Target positive and negative symptoms  
  15. electroconvulsive therapy
    • used to treat depression by sending an electrical current through the brain, producing a brain seizure
    • Reduces depression in 70% of patients
    • Causes short-term memory problems
    • Developed in the 1930s
    • More traumatic than newer treatments
    • Used when medication and therapy is ineffective
    • Depression
    • Fell out of favor because: Abuse - “One Flew Over the Cuckoo’s Nest” (movie) - Memory loss
    • Regaining popularity
  16. vagus nerve stimulation
    • electrical signals sent to the brain through the (left) vagus nerve
    • Used to treat depression
    • Significant improvement in 65% of patients
  17. transcranial magnetic stimulation
    • an electromagnetic coil placed on or above a person’s head sends a current into the prefrontal cortex
    • Used to treat severe depression
    • Improvement in 65% of patients
  18. psychosurgery
    • brain surgery to alleviate abnormal functioning
    • Trephination: among oldest forms of surgery; holes cut in skull to treat illness
    • Lobotomy: surgical practice of cutting the connections between the frontal lobe and the lower centres of the brain
    • Deep brain stimulation: implanted electrodes deliver low doses of electricity, used to treat depression
  19. assessing the biological approaches
    • Strengths: Biological treatments often bring relief when other approaches have failed - Research offers promising options
    • Criticisms: Undesirable side effects - Does not consider interaction between biological and non-biological factors such as environment and experience
  20. Insight-oriented Therapy: Psychoanalysis
    • Developed by Sigmund Freud
    • First use of a “talking cure”
    • Identify unconscious motivations
    • Free association
    • Dream analysis
  21. Psychodynamic therapies: how we develop
    • Focus on past emotional trauma - Used by about 15% of contemporary clinical psychologists
    • Several types: Psychoanalysis: Short-term psychodynamic therapy: patients choose a single problem to work on (dynamic focus)
    • Relational psychoanalytic therapy: therapists are active participants in the therapy and they should share their views with the patient, disclose things about themselves, and establish equal relations with clients
  22. Psychodynamic Therapy
    • Similar to psychoanalytic therapy
    • Less frequent sessions
    • Less emphasis on sexual and aggressive drives Techniques: - Interpretation - Resistance - Transference
  23. psychodynamic techniques
    • Free association: discussions initiated by client with therapist probing to uncover relevant unconscious events
    • Therapist interpretation:
    • - Resistance: block in free associations or change in subject
    • May expose underlying conflicts or pain
    • Transference: shift feelings for figures from childhood to therapist
    • May act and feel as they did with parents or siblings
    • Dream interpretation: manifest content and latent content
    • Catharsis: reliving of past repressed feelings to resolve conflicts
    • Must be accompanied by intellectual insight
    • Working through: repeatedly examine an issue to improve clarity
  24. assessing psychodynamic approaches
    • Strengths: First practitioners to demonstrate the value of systematically applying both theory and techniques to treatment
    • First to suggest the potential of psychological instead of biological treatment
    • Their ideas have served as a starting point for many other psychological treatments
    • Criticisms: Effectiveness not supported by research
  25. Humanistic Therapy
    • Carly Rogers
    • Client-centered therapy: reflection, empathy, unconditional positive regard, self-actualization
    • incongruence: real self, ideal self
  26. Behaviour Therapy
    • A type of therapy based on learning principles, focusing on changing observable, measurable behaviors
    • The ABC’s: Antecedents, Behaviour, Consequences
  27. Behaviourist views of abnormal behaviour
    • Learned in the same way adaptive behaviours are learned
    • Classical conditioning
    • Operant conditioning
    • Modelling
    • Goal is to discover specific problem-causing behaviours and replace them with healthy behaviours
    • Behavioural therapy is often effective with phobias and anxiety issues
  28. Behaviour Therapy: techniques based on classical conditioning
    • Exposure: Imaginable exposure, Virtual reality exposure
    • Stimulus control
    • Systematic desensitization: Progressive muscle relaxation
    • Systematic desensitization: effective in treating phobias, PTSD, asthma attacks
    • Aversion therapy: increase anxiety response to harmful stimuli desired by the client 
  29. Behaviour Therapy: Techniques based on operant conditioing
    • Behavior modification
    • Primary and secondary reinforcers
    • Token economies
    • Self-monitoring techniques
    • Observational learning

    • Consistently provide rewards for desirable behaviour and withhold rewards for undesirable behaviour
    • Successful in hospitalized psychotic patients
    • Works best in institutions and schools
    • Token economy: desirable behaviours are reinforced with tokens that can be exchanged for rewards
  30. assessing the behavioural approaches
    • Strengths: Widely studied in research and strongly supported
    • Effective for numerous problems, including specific fears, social deficits, and intellectual disabilities
    • Criticisms: Changes sometimes require later therapies to sustain
    • Not effective with disorders in which distress is non-specific, such as generalized anxiety disorder
  31. Cognitive views of abnormal behaviour
    • Disorders are caused or worsened by maladaptive thinking
    • Three kinds: Ellis’s rational-emotive behavioural therapy, Beck’s cognitive therapy, Second-wave cognitive-behavioural therapies

    • Ellis was more about talking people out of their stupid chit
    • Beck was a learn by doing type of guy
  32. cognitive thearpy
    • A type of therapy that focuses on thoughts rather than feelings or behaviors
    • Cognitive distortions
    • Psycho-education
  33. Cognitive Therapy Techniques: Beck's Cognitive therapy
    • Cognitive restructuring
    • Daily record of dysfunctional beliefs
    • Identify automatic thoughts
    • Identify rational responses
    • Widely used for depression
    • Therapists help clients identify negative thoughts and perceptions and guide them to apply alternative ways of thinking
    • About as effective as drug therapy for depression (2/3 improve)
    • Also used for panic disorder and social anxiety disorder
  34. Cognitive Therapies: Ellis's rational-emotive therapy
    • Goal is to identify irrational assumptions that lead to disordered emotional and behavioural responses
    • Point out irrational assumptions
    • Model the use of alternative assumptions
    • Uses cognitive restructuring
    • Effective for anxiety and assertiveness problems
  35. Second-wave cognitive-behavioural therapies
    • recognize problematic thoughts as just thoughts
    • clients accept thoughts rather than try to eliminate them
  36. Assessing cognitive-behavioural therapies
    • Strengths: Well supported by research
    • Good at treating depression, social anxiety disorder, generalized anxiety disorder, panic disorder, sexual dysfunctions, and other disorders
    • Criticisms: Role of cognition unclear (cause or effect?)
    • Unclear whether cognitive features, behavioural features, or combination are effective
  37. Humanisitc and existential Therapies
    • Humanists: we are all born with the tools to fulfill our potential
    • Existentialists: accept responsibility for our lives and choices
    • Emphasize present events, focus on helping clients see themselves accurately and acceptingly
    • Gestalt therapy: guide clients toward self- acceptance by challenging and frustrating them
    • Skillful frustration, role playing, rules 
  38. Roger's client-centred therapy: Humanisitic
    • goal is to create an environment in which clients can see themselves honestly with acceptance
    • Client-centred therapy: supportive environment for clients to feel accepted and to accept self
    • Unconditional positive regard: total acceptance of client
    • Accurate empathy: skillful listening
    • Genuineness: sincere communication 
    • Reflection
  39. Assessing Humanistic and Existential Therapies
    • Strengths: Appealing to clinicians
    • Emphasize positive human qualities
    • Criticisms: Difficult to research, and little research has been done
    • Partially supported by research
  40. formats of therapy
    • Individual therapy: one on one with therapist and client
    • Group therapy: therapist meets with several clients with similar problems simultaneously
    • Self-help groups: people with similar problems meet for support without guidance from clinician
    • Assessing group therapy: Varies and is therefore difficult to assess
    • Helps many
  41. Family therapy
    • whole family meets with therapist, who considers family interactions
    • Family systems theory: each family has own rules, structure, and communication patterns that shape behaviour
    • For one person to change, the family system may need to change
  42. Couple Therapy
    • two people in a relationship meet together with therapist to consider relationship structure and communication
    • Marital therapy
    • 38% of Canadian marriages do not survive past the 13th anniversary and 25% of all treated couples eventually divorce
  43. are particular therapies effective for particular problems
    • Behavioural: phobias
    • Cognitive-behavioural: social anxiety disorder, generalized anxiety disorder, panic disorder, and depression
    • Drug: schizophrenia and bipolar
  44. Is therapy effective across race and gender
    • Members of ethnic minority groups worldwide seek therapies less and benefit less from them than do majority-group members
    • Culture-sensitive therapies take into account cultural values and stresses specific to the group
    • Gender-sensitive or feminist therapies acknowledge stressors girls and women face

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