Ch. 16 - Treatment of Psychological Disorders

Question 1

What are the 3 most common reasons a person doesn’t seek treatment for a psychological disorder?

Answer 1

1. Not realizing they have a mental disorder that can be effectively treated
2. Attitudinal barriers (beliefs about being able to “handle it themselves”, the treatment would be ineffective, stigma, etc.)
3. Structural barriers (physically prevent access to treatment)

Question 2

What are the major types of therapists?

Answer 2

• Psychologist
• Psychiatrist
• Clinical/psychiatric social worker
• Counsellor

Question 3

What are the two broad types of treatments for psychological disorders?

Answer 3

Psychological treatment: the client interacts with a clinician in order to use the environment to change their brain and behaviour

Biological treatment: drugs, surgery, or other types of interventions directly treat the brain

Question 4

Define psychotherapy

Answer 4

an interaction between a socially sanctioned clinicians and someone suffering from a psychological problem, with the goal of providing support or relief from the problem

Question 5

What is eclectic psychotherapy?

Answer 5

a form of psychotherapy that involves drawing on techniques from different forms of therapy, depending on the client and the problem
• Allows therapists to apply an appropriate theoretical perspective suited to the problem at hand

Question 6

What are the top 5 orientations to psychotherapy?

Answer 6

Most to least popular:

1. Cognitive behavioural
2. Humanistic/existential
3. Psychodynamic
4. Interpersonal
5. Family systems

Question 7

What are psychodynamic psychotherapies?

Answer 7

explore childhood events and encourage individuals to use the understanding gained from the exploration to develop insight into their psychological problems

Question 8

What are the underlying beliefs/assumptions of humanistic and existential therapies?

Answer 8

• A reaction to the negative views that psychoanalysis holds about human nature
• Assumes human nature is generally positive
• Emphasizes the natural tendency to strive for personal improvement
• Assumes psychological problems stem from alienation, loneliness, failure to reach one’s potential, and failure to find meaning in life

Question 9

What is person-centred/client-centred therapy?

Answer 9

assumes that all individuals have a tendency towards growth and that this growth can be facilitated by acceptance by and genuine reactions from the therapist (Carl Rogers)

Question 10

What is Gestalt therapy?

Answer 10

has the goal of helping the client become aware of their own thoughts, behaviours, experiences, and feelings and to “own” or take responsibility for them (Frederick Perls)

Question 11

What is behaviour therapy?

Answer 11

assumes that disordered behaviour is learned and that symptom relief is achieved through changing overt, maladaptive behaviours into more constructive behaviours

• A variety of behaviour therapy techniques have been developed based on learning principles (operant conditioning, classical conditioning)

Question 12

How does behaviour therapy approach eliminating unwanted behaviours?

Answer 12

• Investigating what happens immediately before and after the behaviour
• Understanding that behaviour can be influenced by its consequences, and that adjusting these can change the behaviour (operant conditioning)

Question 13

How does the behaviour therapy approach promote desired behaviour?

Answer 13

Token economy: involves giving clients “tokens” for desired behaviours that they can later trade for rewards

Question 14

How does behaviour therapy approach reducing unwanted emotional responses?

Answer 14

Exposure therapy: an approach to treatment of the client that involves confronting an emotion-arousing stimulus directly and repeatedly, ultimately leading to a decrease in the emotional response

-Depends on the processes of habituation and response extinction

Question 15

What is cognitive therapy?

Answer 15

focuses on helping a client identify and correct any distorted thinking about self, others, or the world

Instead of pathology being the outcome of classical/operant conditioning, it is the outcome of a person’s interpretation of the event

Question 16

What is cognitive restructuring?

Answer 16

teaches clients to question the automatic beliefs, assumptions, and predictions that often lead to negative emotions and to replace negative thinking with more realistic and positive beliefs; clients are taught to examine evidence for-against a particular belief or to be more accepting of outcomes that may be undesirable

Question 17

What is cognitive-behavioural therapy, and what are its two main characteristics?

Answer 17

a blend of cognitive and behavioural therapeutic strategies
• Problem-focused (undertaken for specific problems)
• Action-oriented (the therapist tries to assist the client in selecting specific strategies that could help address those problems; client is required to do things like journaling, exposure exercises, behaviour-changing skill practice, etc.)

Question 18

What are some advantages of group therapy?

Answer 18

• Attending a group with individuals who have similar problems shows clients that they are not alone in their suffering
• Group members model appropriate behaviours for each other and share their insights about how to deal with problems
• Often just as effective as individual therapy

Question 19

What are some disadvantages of group therapy?

Answer 19

• May be difficult to assemble a group of individuals who have similar needs
• May become a problem if one or more members undermine the treatment of others group members (dominating discussions, threatening others, making others uncomfortable, having dual relationships with group members, etc.)
• Clients get less individualized attention

Question 20

How did the original antipsychotic drugs support the dopamine hypothesis?

Answer 20

The drugs both block dopamine receptors and work to decrease positive symptoms of schizophrenia, suggesting schizophrenia is caused by excess dopamine

Question 21

What is different about atypical antipsychotic medications?

Answer 21

Affect both the dopamine and serotonin systems; work well for both positive and negative symptoms

Question 22

How do benzodiazepines work?

Answer 22

facilitate the action of the neurotransmitter GABA, which inhibits certain neurons in the brain and produces a calming effect

Question 23

Why are doctors cautious when prescribing benzodiazepines?

Answer 23

• Potential for abuse
• Drug tolerance
• Risk of withdrawal symptoms
• Negative side effects
• Do not interact well with alcohol

Question 24

What are the 4 common types of antidepressants?

Answer 24

MAOIs: prevent the enzyme monoamine oxidase from breaking down neurotransmitters

Tricyclic antidepressants: block the reuptake of norepinephrine and serotonin

SSRIs: block the reuptake of serotonin in the brain

SNRIs

Question 25

What are the 3 illusions of psychological treatment?

Answer 25

1. Natural improvement: the tendency of symptoms to return to their mean or average level; causes the patient to mistakenly conclude that a treatment has made them better even though it would have gotten better anyways
2. Placebo effects: recovery that is the result of nonspecific treatment effects that are not related to the proposed active ingredient of the treatment; recovery may be attributed to the treatment, when in reality it was another factor (ex. simply believing you are getting a treatment)
3. Reconstructive memory: thinking you have improved or believing that your symptoms were much worse before treatment;
   “getting what you want by revising what you had”

Question 26

What are the two levels of empirical support developed by the APA for psychological treatments?

Answer 26

Well-established treatments (those with a high level of support, such as evidence from several randomized controlled trials)

Probably efficacious treatments (those with preliminary support)

Question 27

Define iatrogenic illness

Answer 27

a disorder or symptom that occurs as a result of a medical or psychotherapeutic treatment itself

May result from psychotherapy based in an incorrect diagnosis (being treated for a disorder causes symptoms of the disorder, even though the person didn’t have it in the first place), being influenced through hypnosis or repeated suggestion in therapy, “trading one symptom for another” with psychotropic medications, etc.

Question 28

What 4 principles are ethical standards for psychotherapy based on in Canada?

Answer 28

• Respect for inherent dignity of persons
• Responsible caring
• Integrity in relationships
• Responsibility to society

Question 29

What is agoraphobia?

Answer 29

Social isolation secondary to a fear of panic

Question 30

What are the 6 most common obsessive themes in OCD?

Answer 30

• Harm
• Contamination
• Sexuality
• Perfectionism
• Religion
• Loss of control

Question 31

What are the two most effective treatments for OCD?

Answer 31

• Exposure therapy

- Deep brain stimulation

Question 32

Which neurotransmitter(s) do MAOIs act on?

Answer 32

MAOIs inhibit the breakdown of norepinephrine, serotonin, and dopamine

Question 33

Which neurotransmitter(s) do SSRIs act on?

Answer 33

SSRIs block the reuptake of serotonin

Question 34

Which neurotransmitter(s) do SNRIs act on?

Answer 34

SNRIs block the reuptake of serotonin and norepinephrine

Question 35

Which neurotransmitters do tricyclic antidepressants act on?

Answer 35

Tricyclic antidepressants block the reuptake of serotonin and norepinephrine

Question 36

What are the two most effective treatments for bipolar disorder?

Answer 36

• Mood stabilizers (lithium, valproate)

- Electroconvulsive therapy

Question 37

What are some structural changes in the brain associated with schizophrenia?

Answer 37

• Enlarged ventricles

- Progressive tissue loss

Question 38

What are the names of some common antipsychotic medications?

Answer 38

• Zyprexa
• Seroquel
• Abilify
• Risperdal

Question 39

What is labelling theory?

Answer 39

Criminologists theorize that labelling (conduct disorder, APD, etc.) increases further criminality