21. Psychotherapy Flashcards
(40 cards)
1
Q
Describe: Psychotherapy (3)
A
- treatment in which a person with mental or physical difficulties aims to achieve symptomatic relief through interactions with another person
- psychotherapy is delivered by a trained counsellor, social worker, nurse, psychologist, general practitioner, or psychiatrist
- various types of therapy exist based on diverse theories of human psychology and mental illness etiology
2
Q
Name Common Factors of Psychotherapy (3)
A
- good evidence that effective psychotherapy creates observable changes in brain circuitry and connectivity, but these changes are different from those observed with successful pharmacologic and other treatment modalities
- studies suggest that up to 60-90% of therapy outcome is due to common factors with only 10-40% due to specific factors
- common factors are: warmth (unconditional positive regard), accurate empathy, genuineness, goodness of fit, relationship with provider predicts positive outcomes
3
Q
Describe: Freudian Psyche (3)
A
- id: instinctual drives, unconscious
- superego: person’s conscience, formed by societal/parental norms
- ego: latin “I”, sense of self, conscious actions, attempts to satisfy drives of id within confines of reality and demands of superego
4
Q
Name indications: Psychoanalytic/Psychodynamic therapy (5)
A
- Anxiety
- obsessional thinking
- conversion disorder
- sexual dysfunction
- depression
5
Q
Describe approach, technique and theory: Psychoanalytic/ Psychodynamic therapy (3)
A
- Theory: Exploration of meaning of early experiences and how they affect emotions and patterns of behaviour
- Recollection (remembering), repetition (reliving with the therapist), working through (gaining insight)
- Techniques: free association, dream interpretation, transference analysis
6
Q
Name ideal candidates: Psychoanalytic/ Psychodynamic therapy (3)
A
- Psychologically minded, highly motivated, wish to understand selves and not just relieve symptoms
- Able to withstand difficult emotions without fleeing or self-destructive acts
- High level of function
7
Q
Describe duration: Psychoanalytic/ Psychodynamic therapy (2)
A
Time intensive:
- Psychoanalysis: 4-5 times/wk for 3-7 yr
- Psychodynamically oriented therapy: 2-3 times/wk for fewer years
8
Q
Name indications: Supportive Therapy (2)
A
- Adjustment disorders
- somatic symptoms and related disorders
- severe psychotic or personality disorders
9
Q
Describe approach, technique and theory: Supportive Therapy (2)
A
- Ameliorate symptoms through behavioural or environmental restructuring to aid adaptation and facilitate coping
- Help patients feel safe, secure, and encouraged
10
Q
Name ideal candidates: Supportive Therapy (2)
A
- Individuals in crisis or with severe symptoms in acute or chronic settings
- Low insight, low motivation, ”weak” ego systems
11
Q
Describe duration: Supportive Therapy (1)
A
Variable (single session to years, though often short-intermittent)
12
Q
Name indications: Interpersonal Therapy (1)
A
Mood disorders
13
Q
Describe approach, technique and theory: Interpersonal Therapy (3)
A
- Focuses on how interpersonal relationships impact symptoms
- 4 key problem areas addressed:
- 1 grief and loss
- role transitions
- conflict
- interpersonal deficits
- Break the interpersonal cycle: depression, self- esteem, social withdrawal
14
Q
Name ideal candidates: Interpersonal Therapy (2)
A
- Individuals with depression or bipolar disorder with some insight and difficult social functioning
- Absence of severe psychotic process, personality disorder, or comorbid substance abuse
15
Q
Describe duration: Interpersonal Therapy (1)
A
Weekly sessions, 12-20 sessions
16
Q
Name indications: Behavioural Therapy (1)
A
- Most mental health disorders benefit from specific application of behavioural therapy (i.e. behavioural activation for depression; exposure therapy for phobias; contingency management for anorexia nervosa and substance use disorder)
17
Q
Describe approach, technique and theory: Behavioural Therapy (6)
A
- Systematic Desensitization: mastering anxiety- provoking situations by approaching them gradually and in a relaxed state that limits anxiety
- Flooding: confronting feared stimulus for prolonged periods until it is no longer frightening
- Positive Reinforcement: strengthening behaviour and causing it to occur more frequently by rewarding it
- Negative Reinforcement: causing behaviour to occur more frequently by removing a noxious stimulus when desired behaviour occurs
- Extinction: causing a behaviour to diminish by not rewarding it
- Punishment (aversion therapy): causing a behaviour to diminish by applying a noxious stimulus
18
Q
Name ideal candidates: Behavioural Therapy (2)
A
- Individuals with motivation to change and specific symptoms that are amenable to change
- Absence of global areas of dysfunction such as personality disorder
19
Q
Describe duration: Behavioural Therapy (1)
A
Usually short term (weeks-months)
20
Q
Name indications: Cognitive Therapy (5)
A
- Depression
- anxiety
- panic disorder
- personality disorders
- and somatoform disorders
21
Q
Describe Approach, Technique and Theory: Cognitive Therapy (3)
A
- Moods/emotions are influenced by one’s thoughts and psychiatric disturbances are often caused by habitual errors in thinking
- Therapy helps patient make explicit their inaccurate automatic thoughts and correct assumptions with a more balanced perspective
- Uses thought records (often charts with column headings including “situation,” “feeling,” “thought,” “cognitive distortion”) to help monitor thoughts, the situations they occur in, and the feelings they might provoke due to underlying cognitive errors
22
Q
Name Ideal Candidates: Cognitive Therapy (1)
A
Motivated individuals who will comply with homework, openness to changing core beliefs
23
Q
Describe Duration: Cognitive Therapy (2)
A
- First course - weekly or twice weekly sessions, 12-20 sessions
- Maintenance therapy can be carried out over years
24
Q
Name indications: Cognitive Behavioural Therapy (7)
A
Most mental health disorders including;
- mood
- anxiety
- OCD
- personality
- eating
- substance use
- psychotic disorders
25
Describe Approach, Technique and Theory: Cognitive Behavioural Therapy (2)
* Combines theory and method from
* Cognitive and Behavioural therapies to teach the patient to change connections between thinking patterns, habitual behaviours, and mood/anxiety problems
26
Name Ideal Candidates: Cognitive Behavioural Therapy (1)
Individuals with motivation to change and are able to participate in homework
27
Describe Duration: Cognitive Behavioural Therapy (2)
* Typically weekly or twice weekly sessions, 12-20 sessions
* Maintenance therapy can be carried out over years
28
Name indications: Dialectical Behavioural Therapy (1)
Borderline Personality Disorder
29
Describe Approach, Technique and Theory: Dialectical Behavioural Therapy (3)
* Therapy that combines CBT techniques with Buddhist Zen mindfulness practices and dialectical philosophy
* Focuses on 4 types of skills: mindfulness, emotion regulation, interpersonal effectiveness, and distress tolerance
* Involves 4 components: individual therapy, group skills training, phone consultations, and a consultation team
30
Name Ideal Candidates: Dialectical Behavioural Therapy (1)
Individuals with borderline personality disorder or borderline personality trait and severe problems of emotional dysregulation, impulsivity, or self-harm
31
Describe Duration: Dialectical Behavioural Therapy (2)
* Typically 1 yr
* Weekly individual and group therapy
32
Name indications: Motivational Interviewing (MI)
and Motivational Enhancement Therapy (MET) (2)
* Substance use disorders
* Techniques can be applied to facilitate behavioural change in most psychological problems
33
Describe Approach, Technique and Theory: Motivational Interviewing (MI)
and Motivational Enhancement Therapy (MET) (3)
* Spirit of MI (CAPE): Compassion, Acceptance, Partnership, Evocation
* Principles of MI (RULE): Resist “righting reflex”, Understand client and their reasons for change, Listen, Empower by conveying hope and supporting autonomy
* Techniques of MI (OARS): Open-ended questions, Affirmations to validate client, Reflections (the skill of accurate empathy), Summaries to help client organize self
34
Name Ideal Candidates: Motivational Interviewing (MI)
and Motivational Enhancement Therapy (MET) (2)
* Individuals with problematic substance use
* maladaptive behaviour patterns (therapy disengagement, medication noncompliance, poor health habits)
35
Describe Duration: Motivational Interviewing (MI)
and Motivational Enhancement Therapy (MET) (3)
* Brief interventions (efficacy with as little as 15 min, single session), better result with more sessions
* Addiction is a chronic condition, often need boosters over time
* MET = 4 sessions
36
Describe: Group psychotherapy (1)
* aims to promote self-understanding, acceptance, social skills
37
Describe: Family Therapy (2)
* family system considered more influential than individual, especially for children
* focus on here and now, re-establishing parental authority, strengthening normal boundaries, and rearranging alliances
38
Describe: Mindfulness-based cognitive therapy (MBCT)/stress reduction (MBSR) (3)
* derived from Buddhist meditative and philosophical practices
* aims to help people attend to thoughts, behaviours, and emotions in the moment and non-judgmentally using guided breathing exercises.
* Emerging evidence for treating adjustment disorder, MDD, anxiety, pain disorders, insomnia, substance relapse prevention
39
Describe: Narrative psychotherapy (1)
* an integrative approach that attempts to understand the patient’s experience as a whole
40
Describe: Hypnosis (1)
* mixed evidence for treatment of pain, phobias, anxiety, and smoking cessation
