Chapter 15 - Treatment of Psychological Disorders Flashcards Preview

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Flashcards in Chapter 15 - Treatment of Psychological Disorders Deck (113):
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All forms of psychotherapy involve interactions between the practitioner and client

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Biological therapies

Treatment based on medical approaches to illness and disease. These therapies are based on the idea that mental disorders are the result of abnormalities in neural and bodily processes - like an imbalance of neurotransmitters

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Types of biological treatments?

Drugs, electrical stimulation of the brain, surgical intervention

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Psychopharmacology

The use of medications that affect brain or body function. They are affective in the short term.

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Nonbiological treatments are more effective for some disorders in the long term

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For many disorders, the recent focus has been on combining biological therapies with other approaches to find the best treatment for each patient

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Each theory about a mental disorder includes treatment strategies that are based on the theory's assumptions about the causes of mental disorders

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Treatment is based on what?

What we think are the CAUSES of mental disorders

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Etiologies

The causes of mental disorders

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Psychotherapy is aimed at what?

Changing patterns of thought or of behavior

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Eclectic approach

Using a variety of techniques that seem appropriate for a given client

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Free association

Freud came up with this. You basically talk about whatever comes to mind and the therapist looks out for signs of unconscious conflicts, especially when the client seems resistant to talking about certain subjects. Eventually as you talk, unconscious desires and fears will come out

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Dream analysis

Freud came up with this. You interpret the hidden meaning of the client's dream

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Insight

The goal of psychoanalysis: a patient's awareness of his or her own unconscious psychological processes and how these processes affect daily functioning

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Psychodynamic therapy

Examining the patient's needs, defenses, and motives as a way of understanding why the patient is distressed

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Most proponents of psychodynamic theory embrace what?

Freud's talking therapy - however, the talking tends to be more conversational

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Some features of psychodynamic therapy?

Examining client's avoidance in distressing thoughts, looking for recurring themes and patterns in thoughts and feelings, discussing early traumatic experiences, focusing on interpersonal relations and childhood attachments, examining dreams, emphasizing relationship between therapist and client

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Weak evidence that psychodynamic therapy works. What's a problem with it?

It takes many years... It may help people with borderline personality disorder, it's not effective

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A study found that it makes people feel positive to express their emotions and emotional events

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Talking about emotions and emotional events help boost immune function

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Client-centered therapy

An empathetic approach to therapy; it encourages people to fulfill their individual potentials for personal growth through greater self-understanding. The therapist creates a safe and comforting setting, accepts the client with unconditional positive regard, and takes the client's perspective. Helps people access their true feelings.

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Reflective listening

The therapist repeats the client's concerns to help the person clarify his or her feelings

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Motivational interviewing

Uses a client centered approach over a very short period of time (like 1 or 2 interviews) motivational interviewing is helpful for drug and alcohol abusers

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Behavior therapy

Treatment based on the premise that behavior is learned and therefore can be unlearned through the use of classical and operant conditioning. Desired behaviors are rewarded. Unwanted behaviors are ignored or punished.

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Social skills training

The therapist will model appropriate social behavior and the client is encouraged to imitate the behavior, rehearse it in therapy, and later apply the learned behavior to real world situations

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Modeling

The therapist acts out an appropriate behavior. The client is encouraged to imitate the observed behavior, rehearse it in therapy, and later apply the behavior to real world situations. It's a form of observational learning

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Cognitive therapy

Treatment based on the idea that distorted thoughts produce maladaptive behaviors and emotions; treatment strategies attempt to modify these thought patterns

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Cognitive restructuring

A therapy that strives to help patients recognize the maladaptive thought patterns and replace them with ways of viewing the world that are more in tune with reality

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Rational-emotive therapy

Through this approach, a therapist acts as a teacher, explaining the client's errors in thinking and demonstrating more adaptive ways to think and behave

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Interpersonal therapy

Focuses on circumstances - namely relationships the client attempts to avoid. This approach integrates cognitive therapy with psychodynamic insight therapy. Interpersonal therapy developed out of psychodynamic ideas on how people relate to one another, but it uses cognitive therapy with psychodynamic insight therapy. Involves exploring interpersonal experiences and relationships

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Mindfulness based cognitive therapy

Mindfulness based cognitive therapy is based on principles derived from mindfulness meditation; it helps clients be aware of their negative thoughts and feelings and help people disengage from ruminative thinking through meditation. It's effective for depression sufferers

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Cognitive Behavioral Therapy (CBT)

Incorporates techniques from cognitive therapy and behavior therapy to correct faulty thinking and change maladaptive behaviors

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Exposure

A cognitive-behavioral therapy that involves repeated exposure to an anxiety producing stimulus or situation... Most cognitive behavioral therapies have people engage in exposure

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Exposure and response prevention

If the client is not permitted to avoid the stimulus they fear and have to be exposed to the fear, the client's avoidance response is eventually extinguished

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Systematic desensitization

The therapist exposes the client to increasingly anxiety producing situations by having the client imagine them and then teaching the client to relax at the same time. Exposure and systematic desensitization are reliable treatments for phobias

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Group therapy

Less expensive, helps ppl share emotions and learn social skills and learn from each other

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How many client's is ideal in group therapy

About 8

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What types of group therapy are best when structured??

Bulimia and OCD

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Systems approach

An individual is part of a larger system. Any change in that individual will affect the system they're part of (especially family)

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Recovering alcoholics = family therapy is good because when the alcoholic gives us drinking thy will be irritable and the family should be aware of that

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Family therapy is good for whom?

Schizophrenics

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Expressed emotion

A pattern of negative actions by a client's family members. The pattern includes critical comments, hostility directed towards the client by family members, and emotional overinvolvement

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Some cultures like China are less accepting of psychotherapy

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Psychotropic medications

Drugs that affect mental processes. They act by changing brain neurochemistry. They can inhibit action potentials or alter synaptic transmission to increase or decrease the action of particular neurotransmitters

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Psychotropic medications fall into what categories?

1. Anti-anxiety drugs
2. Antidepressants
3. Antipsychotics

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Anti-anxiety drugs

A class of psychotropic medications used for treatment of anxiety. They are used in the short-term treatment of anxiety and can be highly addictive and make you drowsy. They DO help you feel more relaxed though. This includes Benzodiazepines. These drugs increase the activity of GABA.

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Antidepressants

A class of psychotropic medications used for the treatment of depression. They are often used for anxiety disorders too. Some antidepressants are monoamine oxidase inhibitors - they create MORE serotonin and increase dopamine. Tricyclic antidepressants - result in more neurotransmitters. Selective serotonin reuptake inhibitors (SSRIs) - best known is Prozac. They inhibit the reuptake of serotonin - so they INCREASE serotonin

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Antidepressants typically do what?

INCREASE SEROTONIN

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Criticism of SSRIs

They have side effects

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Antipsychotics

Used to treat schizophrenia and other disorders that involve psychosis

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What do antipsychotics do?

Reduce hallucinations and delusions

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Side effects of antipsychotics?

Tardive diskinesia

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Tardive diskinesia

The involuntary twitching of muscles which can be irreversible. Antipsychotics are not good at treating the negative effects of schizophrenia and can actually make them worse

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Lithium

Most effective drug for bipolar disorder

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Anticonvulsants

Stabilize bipolar disorder

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What about people that don't respond to treatment - not psychotherapy nor medication

They use alternatives like brain surgery, the use of magnetic fields, and electrical stimulation

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Trepanning

Making a hole in someone's head to let spirits out

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Psychosurgery was a thing in the early 1900s

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Lobotomy

Removing parts of prefrontal cortex which makes people listless and have flat effect

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Electroconvulsive therapy

A procedure that involves administering a strong electrical current to the patients brain to produce a seizure. It is effective in some cases of severe depression.

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What is Electroconvulsive therapy helpful for (ECT)?

SEVERE DEPRESSION

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Transcranial magnetic stimulation (TMS)

Delivering an electrical current that produces a magnetic field - may be useful for depression

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There is single pulse TMS and repeated TMS

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Deep brain stimulation (DBS)

Implanting electrodes surgically into the brain. It's used to treat Parkinson's disease and was relatively effective with few complications - we may be able to use this to treat OCD and depression!!

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Additional methods of therapy?

Scream therapy, reenacting your own birth, using hypnosis to remember bad memories,

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Types of psychologists who provide treatment

Clinical psychologists, psychiatrists, counseling psychologists, physiatrist social workers,

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Technology-based treatments

Use minimal contact with therapists and rely on smartphones; computer programs, or the Internet to provide some form of psychological treatment

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Specialized practitioners who help with psychological problems?

Clinical psychologists, psychiatrists, counseling psychologists, psychiatric social workers, psychiatric nurses, and paraprofessionals

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What disorders are their highly effective treatments for?

Anxiety disorders, mood disorders, and sexual dysfunction

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Few treatments for alcoholism are helpful

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People who experience depression after death of a loved one usually can resolve the depression on their own over time without treatment

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Randomized clinical trials

Good research to establish whether a particular treatment is effective

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Evidence based treatments

Psychological disorders should always be treated in ways that scientific research has shown effective

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What are evidence based treatments vs just any treatment?

Psychological treatments = evidence based treatment

Psychotherapy = any form of therapy

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What characterize psychological treatments?

1. Treatments vary according to the particular mental disorder and the client's specific psychological symptoms
2. The techniques used in these treatments have been developed in the laboratory by psychologists, especially behavioral, cognitive, and social psychologists.
3. No overall grand theory guides treatment.. Instead, treatment is based on evidence of its effectiveness

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What kind of therapy is best for anxiety disorders?

Cognitive-behavioral therapy (CBT)

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What drugs are useful in anxiety?

Generalized anxiety is treated well with drugs that block reuptake of serotonin (and therefore increase serotonin)

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What treatments don't treat anxiety well??

Anxiety reducing medications only decrease anxiety in the long term - and they make you drowsy and they're addictive

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What's the best treatment for phobia?

Behavioral therapy

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What else helps treat phobias?

Systematic desensitization

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Fear hierarchy

When client makes a list of situations in which fear is aroused in ascending order

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Exposure to feared objects defeats the phobia rather than relaxation techniques

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Virtual environments

Exposing the client to their phobia virtually thru like a computer

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Cognitive therapy for phobia

Help the client realize it's irrational

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Medical treatments for phobia?

Tranquilizers- they only work in short term tho

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Panic disorder treatment?

Cognitive therapy helps - it teaches you how to stop anticipating danger

Cognitive behavioral therapy is VERY helpful

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Exposure treatment to the trigger also helps panic disorder

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Legit definition of agoraphobia

Being afraid of enclosed spaces OR open spaces

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What's the BEST treatment for panic disorder?

Cognitive behavioral therapy

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What are good treatments for OCD?

SSRIs
Cognitive behavioral therapy (especially exposure and response)
Clomipramine (drug of choice for OCD)
*** the use of exposure and response cognitive behavioral therapy IS MORE EFFECTIVE Than clonipramine, the drug of choice for OCD**
Deep brain stimulation is a possibility of helping people with OCD

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What are good treatments for depression??

Iproniazid (a MAO inhibitor) initially a treatment for tuberculosis but ended up increasing energy levels and appetite and gave people an overall sense of well being... Problem with iproniazid is that it can be lethal if you eat or drink something with tyramine in it

Tricyclics - very effective - but they have bad side effects like drowsiness, weight gain, sweating, constipation, heart problems, dry mouth, etc.

Prozac (an SSRI) - it sometimes causes weight loss, sexual dysfunction, headaches, etc.
Prozac and SSRIs are more often prescribed because they don't have as severe side effects as tricyclics and MAO inhibitors

Bupropion - less side effects


Cognitive behavioral therapy - just as effective as drugs for treating depression... Depression happens because people have automatic, irrational negative thoughts

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Why is medical treatment of depression controversial?

People believe it helps treat symptoms of depression without treating the underlying cause of the depression

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The issue is not drugs vs psychotherapy.. It's which treatment is best for the individual!

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seasonal affective disorder (SAD)

They experience bouts of depression during winter

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What can treat SAD?

Phototherapy - exposure to a high-intensity light source for part of each day

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Aerobic exercise helps depression

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ECT

Effective treatment for severe depression

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Electroconvulsive therapy side effects?

A high relapse rate, memory impairments,

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TMS vs ECT

TMS is effective even for patients who have not responded to treatment with antidepressants

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Deep brain stimulation is good for

Depression and OCD

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What's the most effective for bipolar disorder?

Lithium!!! Side effects include thirst, hand tremors, excessive urination, and memory problems.

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Schizophrenia treatments

Reserpine - a toxic herb - effective antipsychotic

Chlorpromazine - major tranquilizer, reduces anxiety, sedated

Haloperidol -

Extx

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Social skills training

An effective way to address some deficits in patients with schizophrenia- helps patients recognize social cues and predict the effects of their behavior in social situations

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Cognitive behavioral therapy is helpful in schizophrenia

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Schizophrenics get better as they get older

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Most effective treatment for schizophrenia?

The use of both drugs and psychosocial interventions

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People with personality disorders are super difficult to treat

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Dialectical Behavior Therapy

A form of therapy used to treat Borderline Personality Disorder - combines elements of the behavioral and cognitive treatments with a mindfulness approach based on Eastern meditative practices

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Conduct disorder

A childhood condition known to be a precursor to antisocial personality disorder

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SSRIs make increased suicidal thoughts in kids and adolescents

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ADHD is treated by

Methylphenidate or Ritalin

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Applied behavioral analysis

An intensive treatment for autism based on operant conditioning

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Psychotherapy

The generic name given to formal psychological treatment