ICL 10.7: Psychotherapy Flashcards
(40 cards)
which therapies are biological therapies?
- medication therapy
- electroconvulsive therapy
- psychosurgery/psychostimulation
which therapies are psychotherapies?
- self-help/online mobile app
- psychodynamic/behavior/cognitive/humanistic
- hospital/residential assistance
how is psychotherapy different than talking to the bartender or the barber?
they don’t help resolve problems
venting makes you feel good for a few hours but it’s not lasting
what are psychotherapies?
all psychotherapies involve:
- a helping relationship –> there has to be relationship between the patient and physician
- systematic interaction based on a theoretical viewpoint ( which could be exploring unconscious, facilitating insight, action oriented, applying learning principles and more . . .)
- use of behavioral science/psychological principles from personality, learning, developmental, and abnormal psychology to treat emotional, behavioral, social and cognitive problems
what brain changes happen after psychotherapy for depression, anxiety, borderline personality disorder?
therapies change the brain just as much as medications!!
what are the 2 psychodynamic approaches?
psychodynamic approaches stem from hidden inner conflicts –> conflict between what we want and the constraints placed on us by others and the self; conflicts originate in childhood and if not resolved, lead to adult dysfunctional behavior
psychodynamic theory talks about how the unconscious has a very powerful effect on our behaviors and emotions
there’s no behavior without a cause –> psychodynamic approaches say the cause is always internal: id, ego, superego or childhood traumas
psychodynamic approaches try to uncover those unconscious feelings, thoughts, events, etc. –> what are defending against? what is the conflict going on inside you?
- psychoanalysis
- psychodynamic
what is psychodynamic therapy?
understanding conflict area and particular defense mechanisms used, making unconscious, conscious
provide insight into hidden conflicts by bringing them to the surface
every 1-2 weeks for 4-12 months
what is psychoanalysis?
resolution of symptoms and major reworking of personality structures related to childhood conflicts
psychoanalysis tears things down and takes a slow time to build things back up; it’s very intense
2-3 x week, 3-10 years
what do you do during psychodynamic therapy?
- identify defense mechanisms
- identify patient resistance
- free association/projection
“when i say mom, you say…”
- dream analysis
- interpretation of the patient’s problems by the therapist –> if the patient says their boss is demanding you could say it reminds you of his demanding relationship from his dad
- transference/counter transfers
what is is the rorschach test?
the inkblots!!
you ask the patient what they see and interpret what they see so you can try to understand their unconscious so you can understand their problems
the problem is there aren’t a lot of empirical findings but people still use it
a type of psychodynamic therapy
what is the thematic apperception test?
TAT is again what do you see in a picture/scene?
again, there isn’t a ton of empirical evidence but it can reveal unconscious thoughts/problems of the patient
a type of psychodynamic therapy
what is the behavioral approach?
it stems from faulty learning: inappropriate/dysfunctional emotional and physiological conditioned responses
the goal of the behavioral approach is dysfunctional behavior is learned through conditioning/ reinforcement so treatment is based on unlearning inappropriate behaviors/emotional responses and learning appropriate behaviors/emotional responses
something in the environment is triggering a behavior; if someone is struggling with alcohol withdrawal, driving past his favorite bar will trigger a relapse – so this is an environmental trigger that’s a conditioned response and if you can figure out the links then you can work towards breaking them!
what are the strategies used during behavioral therapy?
you are trying to accomplish extinction of classically and operantly conditioned responses; you can do this through:
- aversion therapy: reduce unwanted behavior by pairing it with an unpleasant stimulus
- exposure, flooding: alleviating fears and phobias (conditioned responses) by using extinction
- systematic desensitization: reducing fear and anxiety through planned, systematic exposure to fear but also include some level of relaxation/calming strategy –> associate fear with relaxation!
- observational learning: use of modeling
- relaxation/biofeedback
what is exposure?
it’s a type of behavior therapy
extinguish behavior/ emotional response (e.g., fear) by “exposing” one to the stimulus, long enough to learn nothing bad happens
usually “gradual” exposure (systematic desensitization)
what is flooding?
it’s a type of behavior therapy
exposure is all at once and person “flooded” with emotion (e.g., fear)
what is habituation?
it’s a type of behavior therapy
the result of exposure
it’s a decreased response to a stimulus; this means one is habituated (has adapted) to feared stimulus and begins to associate arousal with calmness or relaxation
what is exposure therapy used to treat?
- phobias (flying, elevators, needles, MRI’s, dentist drill, thunder, public spaces etc.)
- PTSD
- OCD
- social anxiety
what is systematic desensitization used to treat?
- sensitive to physical sensations, i.e. panic
2. use of relaxation with exposure to feared sensations
what are the goals fo behavior therapy?
- remove reward for unwanted response
ex. tantrums (children/adults) or pain behavior (grimacing, groans, posture) - sometimes a “new” response must be taught/rewarded to replace inappropriate response
- selectively reinforce appropriate behavior
- biofeedback: systematic positive feedback (operant conditioning)
- token economy
how is behavioral therapy different from psychodynamic therapy?
behavioral therapy:
- does not emphasize insight and self awareness; it’s not looking at your childhood, it’s looking at now and what needs to change now to alter the current behavior you’re struggling with
- emphasis on external/environmental factors; what’s going on in the environment that’s reinforcing my behaviors and how can i break this association
- emphasizes the influence of external stimuli as rewards/punishments or conditioned responses (classical conditioning)
what is cognitive therapy?
it’s about your thoughts; it stems from distorted patterns of thought, irrational, incorrect beliefs about self, future and the world (Cognitive Triad) which all result in dysfunctional behaviors and emotions
the goal of cognitive therapy is to change feelings and behaviors by changing self-defeating thoughts, beliefs
if i go around saying the material is too hard and you can’t do it, you won’t have a good day and emotionally you won’t do well – the question is, is that thought an honest, realistic thought?
so cognitive therapy looks at your thinking and try to decide how realistic or helpful is that thinking?
what is the general strategy used by physicians during cognitive therapy?
the general strategy is to encourage expression of “thoughts” along with feelings when negative life events occur
distinguishes between feeling appropriately and helpfully concerned, sorry, sad, frustrated and feeling inappropriately and destructively panicked, depressed, enraged and self-pitying
what are the strategies used during cognitive behavior?
- question the evidence for patient’s thoughts, beliefs (never question the feelings/emotions)
- label distortions; cognitive errors/bias, catastrophize, black or white all-or-nothing thinking, defense mechanisms
- socratic questioning, collaboration
- explain how thoughts can precipitate feelings; the thoughts that elicit certain feelings are called into question (are you reallyyyy going to die?)
- distinguish thoughts from facts
- rate the degree of emotion and the strength of the related belief; how much do they really believe what they’re thinking?
- categorize the distortion in thinking; emotional reasoning, catastrophizing, perfectionism
what is the cognitive triad?
people think unrealistically about themselves, their world and their future = cognitive triad
they need help to see their distortions
so cognitive therapy does not focus on origins but on the here-and-now
