L12.2 - Disorder Treatment Flashcards

1
Q

Psychodynamic psychotherapy (Rooted in Freud’s psychoanalysis)

A

Focus on:

  • Recurrent themes and patterns in thoughts and feelings
  • Development
  • How repressed emotions influence current behaviours & thoughts
  • Interpersonal relationships (object relations, attachments)
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2
Q

Resistance

A

In psychoanalysis, a patient’s self-censorship or avoidance of certain topics

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3
Q

Person-centered therapy

A
  • Based on Humanistic Psychology (Carl Rogers)

3 components:

  • Unconditional positive self-regard:
    -> Therapist’s acceptance and support of the client without judgment or conditions fostering self-exploration and personal growth
  • Empathy:
    -> Therapist’s ability to understand and share the client’s feelings and experiences
  • Congruence (genuineness; authenticity):
    -> Transparency of therapist in interactions with the client. Therapist is real, and open about their own feelings and experiences
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4
Q

Person-centered relationship btw therapist and patient

A
  • No hierarchy
  • Non-directive, therapist does not guide advise client, who is considered being expert on themselves
  • Goal of treatment is to increase the insight of patients
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5
Q

Cognitive Behavioural Therapy - First Wave

A

First wave: Classic Behavioural therapies

  • Classical & operant conditioning
  • Systematic desensitization
  • Focus on behaviours, not thoughts
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6
Q

Cognitive Behavioural Therapy - Second Wave

A

Incorporation of cognitions

  • Rise of CBT
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7
Q

Cognitive Behavioural Therapy - Third Wave

A

Less about change, more about acceptance

  • Acceptance and commitment therapy
  • Mindfulness-based CBT
  • Dialectical Behavioural therapy
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8
Q

Basics of CBT

A

Central factors to consider in a client:

  • Thought
  • Emotion (hardest to change, but we can change this by changing how we think and act)
  • Behaviour
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9
Q

Critiques of CBT

A
  • Challenging the negative automatic thoughts of client can have paradoxical effects and can be ineffective
    -> Ex. not thinking has little effect on classically conditioned fear responses
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10
Q

Acceptance and Commitment Therapy

A
  • Fosters acceptance of unwanted thoughts and feelings
  • Stimulates actions that improve the circumstances of living
  • Discourages client’s avoidance to experience negativity
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11
Q

ACT hypothesizes that psychopathology

A

Stems from the client’s efforts to escape unpleasant feelings using avoidance behaviours like:

-> Substance use disorder
-> Eating disorders
-> Panic disoredrs
-> PTSD
-> OCD

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12
Q

ACT Components

A

Psychological flexibility at the focus

  • Acceptance: reducing the motivation for experimental avoidance
  • Cognitive De-fusion: Watching negative thoughts with the awareness that they are only thoughts
  • Self as Context: Realizing that one’s identity is separate from one’s thoughts
  • Being Present: mindful awareness of thoughts and feelings
  • Values: clarifying values
  • Committed Action: setting tasks to live in accordance with values
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13
Q

ACT Critique of CBT

A
  • CBT too mechanistic
  • Too focused on symptom change
    -> Attention should be on changing context and broadening focus of change
  • Few techniques in traditional CBT developed in basic science laboratories (not much evidence)
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14
Q

CBT Critique of ACT

A
  • ACT is reframing of CBT
  • Cognitive restructuring and de-fusion share similar processes
    -> Restructuring is incompatible with thought suppression
    -> Disputing decreases experimential avoidance and defusion of “thought as fact”
  • Exploring schemas and rule is similar to exploring “values” in ACT
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15
Q

Cognitive Distortions

A
  • All or nothing thinking
  • Over-generalising
  • Mental filter
  • Disqualifying the positive
  • Jumping to conclusions
  • Emotional reasoning
  • Magnifying (catastrophising) & minimization
  • “should” “must” “ought” make us feel guilty like we have already failed
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16
Q

Cognitive restructuring

A

Set of cognitive therapy techniques for challenging a persons’ maladaptive beliefs through persuasion/confrontation

CBT Thought Record

  • Where were u?
  • Emotion or feeling
  • Negative automatic thought
  • Evidence that supports thought
  • Alternative thought
  • Emotion or feeling
17
Q

Behavioural Activation

A

Used mainly in Depression

  • Aims to increase engagement in adaptive activities
  • Ex. jogging, movie, walking, exercise
  • Worksheets to keep track of how you feel after each acitivity
18
Q

Behaviour - Exposure

A

Used in treating Anxiety and OCD

  • Operates according to the principles of Pavlovian extinction
  • Fearful stimulus gets presented without the negative reinforcer that client expects with focus on NOT engaging in safety behaviours

Types:

  • In-vivo exposure (Systematic Desensitization)
  • Introspective exposure
  • Imaginal exposure
  • NEW: Reconsolidation-based exposure
19
Q

Dodo Bird Effect

A
  • Saul Rosenzweig (1936): All therapies produce equivalent outcome
20
Q

Testing the Dodo Bird effect

A

The DSM
- 295 studies comparing efficacy of multiple psychotherapies (are they equal)

  • Null hypothesis: If Dodo bird conjecture is true, effect sizes will be roughly equivalent
  • Alternate hypothesis: if Dodo bird conjecture is false, effect sizes will not be homogenous
  • Result: effect sizes very similar, null hypothesis NOT rejected
  • Conclusion: all therapies seem similarly effective
21
Q

Common Factors - Client Characteristics

A

Positive expectancies distress

22
Q

Common Factors - Treatment structure

A
  • Techniques/structures
  • Exploration of “inner world”
  • Adherence to theory
23
Q

Common Factors - Therapist qualities

A
  • Cultivates hope
  • Warmth/positive regard
  • Empathy
24
Q

Common Factors - Change processes

A
  • Opportunity for catharsis (releasing repressed emotions)
  • Practice of new behaviours
  • Foster insight/awareness
25
Q

Common Factors - Relationship Elements

A

Development of Alliance

26
Q

Effect Sizes for Common Factors

A

Alliance - 0.57
Empathy - 0.63
Coal consensus/collaboration - 0.72
Positive regard/Affirmation - 0.56