Ch. 13 Psych

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Ch. 13 Psych
2014-12-09 03:36:12

Treating Psychological Disorders
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  1. Pychotherapy
    Any psychological technique used to facilitate positive changes in personality, behavior, or adjustment
  2. Dimensions of Therapy: Individual
    • Involves only one client & one therapist
    • Client (patient)- the one who participates in psychotherapy
    • Rogers used "client" to equalize therapist-client relationship & de-emphasize doctor-patient concept
  3. Dimensions of Therapy: Group
    Several clients participate at the same time
  4. Dimensions of Therapy: Insight
    Goal is for clients to gain deeper understanding of their thoughts, emotions, and behaviors
  5. Dimensions of Therapy: Action
    Goal is to change maladaptive behaviors, thoughts, or habits without seeking insight into origins or meanings
  6. Dimensions of Therapy: Directive
    Therapist provides strong guidance
  7. Dimensions of Therapy: Non-Directive
    Clients are largely responsible for solving their own problems with limited assistance from the therapist
  8. Dimensions of Therapy: Open-Ended
    Unlimited amount of time and/or sessions
  9. Dimensions of Therapy: Time-Limited
    • Any therapy that limits numbers of sessions
    • Partial response to managed care and to ever-increasing caseloads
    • Caseload: number of clients a therapist actively sees
  10. Psychotherapy Myths
    • Therapy is not equally effective for all problems
    • Major benefit of therapy is to provide comfort, support, & a way to make constructive changes
    • Unrealistic to expect therapy to undo a person's past
    • Positive Therapy- designed to enhance personal strengths rather than "fix" weaknesses
  11. Origins of Therapy: Trepanning
    • For primitive "therapists," refers to boring, chipping, or bashing holes into a patient's head
    • Goal presumably to relieve pressure or rid the person of evil spirits
    • In primitive times it was unlikely the patient would survive; this may have been a goal
    • For modern usage, refers to any surgical procedure in which a hole is bored into the skull
  12. Origins of Therapy: Demonology
    • Study of demons & people plagued by spirits
    • People were possessed, & they needed an exorcism to be cured
    • Exorcism: practice of driving off an "evil spirit"
  13. Origins of Therapy: Ergotism
    • Psychotic-like condition due to ergot poisoning
    • Ergot
    • Natural source of LSD
    • Grew on rye (grain) fields in Middle Ages
    • Eating tainted bread would have produced symptoms of "madness" or "bewitchment"
    • May have given rise to demonology
  14. Origins of Therapy: Phillippe Pinel
    • French physical who initiated humane treatment of mental patients in 1793
    • Created the first mental hospital
  15. Origins of Therapy: Sigmund Freud
    • -Hysteria: Physical symptoms (like paralysis or numbness) occur without physiological causes; now called somatoform disorders
    • -Became convinced that hysterias were caused by deeply hidden unconscious conflict
    • -Developed therapy to help patients gain insight into those conflics
  16. Psychoanalysis
    • Developed by Sigmund Freud
    • Individual, directive, insight therapy
    • "Neurosis" and "hysteria" were caused by repressed memories, motives, & conflict
    • Goal: reduce internal conflicts
  17. Psychodynamic Therapy
    • Based on psychoanalytic theory but designed to produce insights more quickly
    • Uses direct questioning to reveal unconscious conflicts
  18. Interpersonal Psychotherapy (ITP)
    Designed to help depressed people improve relationships with others
  19. Client-Centered Therapy: Carl Rogers
    • Carl Rogers; also known as Person-Centered
    • Individual, nondirective, & based on insights from conscious thoughts & feelings
    • Therapist creates a safe "atmosphere of growth"
    • Emphasizes accepting one's true self
    • Rogers used "client" to equalize therapist-client relationship & de-emphasize doctor-patient concept
  20. Client-Centered Therapy: Unconditional Positive Regard
    Unshakable acceptance of another person, regardless of what they tell the therapist or how they feel
  21. Client-Centered Therapy: Empathy
    Ability to feel what another person is feeling; capacity to take another person's point of view
  22. Client-Centered Therapy: Authenticity
    Ability of a therapist to be genuine & honest about his or her feelings
  23. Client-Centered Therapy: Reflection
    • Rephrasing or repeating thoughts & feelings of the clients'
    • Helps clients to become aware of what they are saying & to see themselves more clearly
  24. Existential Therapy
    • Insight therapy that focuses on problems of existence
    • Existence, realities of death, burden of responsibility, choice, & meaninglessness create anxiety
    • Emphasis on Free Will
    • Gives clients courage to make rewarding & socially constructive choices
  25. Gestalt Therapy
    • Fritz Perls
    • Focuses on immediate awareness to help clients rebuild thinking, feeling, & acting into connected wholes
    • Clients are taught to expand their personal awareness & to accept responsibility for their thoughts, feelings, & actions
    • Emphasizes integration of fragmented experiences (filling in the gaps)
  26. Gestalt Therapy pt. 2
    • More directive than client centered or existential therapy
    • Emphasizes present experiences
    • According to Fritz Perls, emotional health comes from knowing what you want to do, not dwelling on what you should do, ought to do, or should want to do
  27. Behavior Therapy
    • Use of learning principles to make constructive changes in behavior
    • Deep insight is often not necessary
    • Focus on the present; cannot change the past, and no reason to alter that which has yet to occur
    • Behaviorists assume that people learned to be the way they are; they can relearn more appropriate behaviors
  28. Behavior Therapy: Conditioned Aversion
    Learned dislike or negative emotional response to a stimulus
  29. Behavior Therapy: Aversion Therapy
    • Associate a strong aversion to an undesirable habit like smoking, overeating, or drinking alcohol.
    • Example: Rapid Smoking
    • Example: Response-contingent shocks for alcoholics
  30. Behavior Therapy: Hierarchy
    • Rank-ordered series of steps, amounts, or degrees
    • Begin with least offensive & gradually move to more threatening stimuli
  31. Behavior Therapy: Reciprocal Inhibition
    • One emotional state is used to block another
    • Example: impossible to be anxious & relaxed at the same time
  32. Behavior Therapy: Systematic Desensitization
    • Guided reduction in fear, anxiety, or aversion
    • Attained by approaching a feared stimulus gradually while maintaining relaxation
    • Best used to treat phobias: intense, unrealistic fears
  33. Behavior Therapy: Vicarious Desensitization
    Reduction in fear that takes place secondhand when a client watches models perform the feared behavior
  34. Behavior Therapy: Model
    Live or filmed person who serves as an example for observational learning
  35. Behavior Therapy: Virtual Reality Exposure
    • Uses computer-generated, 3D "world"
    • Presents computerized fear stimuli to patients in a controlled fashion
  36. Behavior Therapy: Eye Movement Desensitization
    • Reduces fear & anxiety by holding upsetting thoughts in your mind while rapidly moving your eyes from side to side
    • Highly controversial
    • Some argue it is effective
    • Some argue that eye movement is ineffective; vale comes from gradual exposure to upsetting stimuli
  37. Positive Reinforcement
    Responses that are followed by a reward tend to occur more frequently
  38. Nonreinforcement
    A response that is not followed by a reward will occur less frequently
  39. Extinction
    If response is NOT followed by reward after it has been repeated many times, it will go away
  40. Punishment
    If a response if followed by a discomfort or an undesirable effect, the response will decrease/ be suppressed (but not necessarily extinguished)
  41. Shaping
    Rewarding actions that are closer & closer approximations to a desired response
  42. Stimulus Control
    Controlling responses in the situation in which they occur
  43. Time Out
    Removing individual from a situation in which reinforcement occurs
  44. Tokens
    • Symbolic rewards like poker chips, gold stars, or stamps that can be exchanged for real rewards
    • Can be used to reinforce positive responses immediately
    • Effective in psychiatric hospitals & sheltered care facilities
  45. Cognitive Therapy
    • Aaron Beck
    • Therapy that helps clients change thinking patterns that lead to problematic behaviors or emotions
    • Cognitive therapy is VERY effective in treating depression
  46. Cognitive Therapy for Depression
    • Cognitive therapists make a step-by-step effort to correct negative thoughts leading to depression
    • Clients are taught to keep track of thoughts
    • Client & therapist challenge ideas & beliefs
    • Clients gather information to test their beliefs
    • Look for the absence of effective coping skills, not presence of self-defeating thoughts
  47. Cognitive Therapy for Depression: 3 Major Thinking Distortions
    • Selective perception: perceiving only certain stimuli in a larger group of possibilities
    • Overgeneralization: allowing upsetting events to apply to unrelated situations
    • All-or-Nothing Thinking: seeing objects and events as absolutely right or wrong, good or bad, & so on
  48. Rational Emotive Behavior Therapy (REBT)
    • Albert Ellis
    • Attempts to change irrational beliefs that cause emotional problems
    • Example: Anya thinks, "I must be liked by everyone; if not, I'm a rotten person."
  49. REBT's ABCs of Behavior
    • Analyzes ABCs of behavior:
    •  -A= Activating Experience
    •  -B= Beliefs (often irrational & unrealistic)
    •  -C= Consequence
    • General pattern (example):
    •  -Person who is rejected (A)
    •  -Feels depressed or hurt (C)
    •  -Because of (B)
  50. REBT 3 Core Ideals of Unrealistic Beliefs
    • 1. I must perform well & be approved of by significant others. If I don't, then it is awful, I cannot stand it, & I am a rotten person.
    • 2. You must treat me fairly. When you don't, it is horrible, & I cannot bear it.
    • 3. Conditions must be the way I want them to be. it is terrible when they are not, & I cannot stand living in such an awful world.
  51. Irrational Beliefs: Gambler's Fallacy
    • Chronic Gamblers often hold several irrational beliefs or cognitive distortions
    •   -Magnified gambling skill
    •   -Attribution errors
    •   -Gambler's fallacy
    •   -Selective memory
    •   -Overinterpretation of cues
    •   -Luck as a trait
    •   -Probability biases
  52. Psychotherapy: Core Features
    • Therapeutic Alliance: caring relationship between the client & therapist
    • Work to "solve" client's problems
    • Therapy offers a protected setting where emotional catharsis (release) can occur
    • Provides clients with a new perspective about themselves & their situations, & a chance to practice new behaviors
  53. Medical Therapies
    • Major mental disorders are often treated medically
    • Somatic (bodily) therapies include:
    • Pharmacotherapy
    • Electrical stimulation therapy
    • Psychosurgery
    • Often done in a psychiatric hospitalization context
    • Typically administered by psychiatrists
  54. Pharmacotherapy
    • Use of drugs to alleviate emotional disturbance
    • Three classes--
    • Anxiolytics: produce relaxation or reduce anxiety
    • Antidepressants: elevate mood & combat depression
    • Antipsychotics/Major Tranquilizers: Tranquilize & also reduce hallucinations & delusions in larger dosages
  55. Electrical Stimulation Therapy
    • Work to alter the electrical activity of brain
    • Electroconvulsive Therapy (ECT):
    • 150 volt electric shock is passed thru brain for about 1 sec, inducing a convulsion
    • Based on belief that seizure alleviates depression by "resetting" biochemical & hormonal balance
  56. Psychosurgery
    • Any surgical alteration of the brain
    • Cannot be reversed
    • Prefrontal Lobotomy: (1) Frontal lobes i brain are surgically cut from other brain areas. (2) Supposed to calm people who did not respond to other forms of treatment. (3) Was not very successful & has undesirable side effects.
    • Deep Lesioning: (1) Small target areas in the brain are destroyed by using an electrode. (2) Can help specific disorders.
  57. Deinstitutionalization
    • Reduced use of full-time commitment to mental institutions
    • Limited success:
    • (1) Done to save money
    • (2) Chronic patients discharged without adequate care
  58. Paraprofessional
    Individual who works in a near-professional capacity under supervision of a more highly trained person