Psychotherapy Flashcards
Psychotherapy def (3)
A process in which a professionally-trained therapist:
(1) Systematically uses techniques derived from psychological principles
(2) To relieve another person’s psychological distress
(3) Or promote growth
Major Schools include: (4)
(1) Psychodynamic
(2) CBT
(3) Humanistic-experiential
(4) Integrative/eclectic (not a single school)
-> EVIDENCE-BASED TREATMENT: All of those schools have their own evidence based behind them
How do we establish whether a therapy is effective?
Typically established through Randomized Control Trials (RCTs). (Similar to medical model)
Randomized Control Trials (RCTs)
E.g. Study for treatment of depression. Get a large group of pple with depression - randomly assign them to receive new treatment or already good treatment.
→ Have to prove that 1) it does better than a waitlist control 2) beat already established treatment
Issues with Randomized Control Trials (RCTs) (5)
(1) Wait-list control for people who are acutely ill? Ethical (BUT if not effective, might harm pple)?
(2) Unlike a pill, different therapists may give different “doses”
(3) Patients enrolled are usually relatively uncomplicated cases (e.g., single dx)
(4) Highly controlled treatments: In the real world, therapist don’t provide treatment in that way
(5) Effectiveness? Effective outside of these highly controlled artificial environments?
Empirically Supported Therapies/Evidence-Based Practice def
Criteria established by Diane Chambliss. Gold standard.
The integration of the best available research and clinical expertise within the context of patient characteristics, culture, values, and treatment preferences.
-> Not strict reliance on a single empirically supportive therapy but rather the integration of the best available research & clinical expertise within the context of patient characteristics, culture, values, treatment preferences…
Three Waves of Behaviour Therapy
First Wave: Classic behaviour therapies
Second Wave: Incorporation of cognitions
Third Wave: New Ideas and Approaches
Explain: First Wave of Behaviour Therapy
Classic behaviour therapies. Classical and operant conditioning; systematic desensitization, reward learning…
-> Focus on behaviors, not thoughts
-> Altering behaviors with the idea that feelings and thoughts will follow
Explain: Second Wave of Behaviour Therapy
Incorporation of cognitions. Acknowledge that cognition exists. Rise of mainline Cognitive-Behavioral Therapy.
Explain: Third Wave of Behavior Therapy
New Ideas and Approaches.
-> Acceptance and Commitment Therapy
-> Mindfulness-based Cognitive Therapy
-> Dialectical Behavior Therapy
Criticism of CBT
It localizes the problem IN the individual rather than on the individual’s circumstances.
-> Criticism of most Western medicine
CBT is NOT the solution to every problem. Developed specifically for specific forms of psychopathology.
_____________ are one of the early examples of therapies that rely very heavily on behavioral principles.
Exposure therapies
-> Exposure to the fear so they can habituate and develop new structures about the feared objects
The Vicious Cycle of Anxiety
After panic’s “peak”, you cope, and the anxiety goes down.
Exposure: try to experience the peak and the “go down”
=> Otherwise: go down BEFORE peak and maintain anxiety at a relatively high level (avoidance - failure to habituate…)
=> If Repeated exposure: master the peak - peak is lower and lower (habituation)
In Vivo Exposure
Before: Afraid of snakes? Put you with a bunch of snakes. Rly effective but patients didn’t like it.
Now: Typically gradual exposure. Build a hierarchy (least to most feared situation). Therapist does all of the things with the client.
-> Systematic desensitization through exposure to feared situations or locations, in order to produce extinction of the fear response.
-> Imaginal exposure used if the patient cannot be directly exposed to the feared stimuli.
Interoceptive Exposure
When the feared stimulus is not EXTERNAL, but instead INTERNAL (e.g. panic). Systematic exposure to feared bodily symptoms.
Again - therapist always doing it with the client.
E.g. breath through coffee straw - sensation of not having oxygen
