lecture 3 Flashcards
(58 cards)
What is the underlying premise of western treatment?
people can change with how they interact with the world.
What kind of biological therapies are there? (3)
- Psychopharmacology (medication) - most common
- ECT (this is shock therapy and is mean for treatment resistant disorders like depression but its intense)
- TMS (this goes through the brain and is picking out different sections of the brain to either inactivate or knock out. This is generally for treatment resistant stuff but you have to be careful what you’re calling treatment resistant. It uses magnetic fields to stimulate nerve cells in the brain)
what kind of psychological therapies are there?
- psychotherapy (many forms)
either evidence based or not evidence based.
Note: know the difference between evidence based and not evidence based because if you get therapy it probably isn’t evidence based.
What does evidence based treatment mean?
- efficacy studies have found it efficacious. AKA it works better than what the study was comparing it to.
- this mean that treatment works to decrease symptoms
- treatment group is greater than or equal to the comparison group (placebo or other treatment type)
What does not evidence based treatment mean?
it means that this is still being tested and has not been figured our yet. It basically means we don’t have the data to say it doesn’t work. (even DBT is really complex and the person who designed it hasn’t done subtraction for each little piece. Due to this we aren’t sure what we can take out, what we can add.
What NT is related to psychosis and what drug is used to treat it?
for psychosis, dopamine is very important and antipsychotics work on that.
What NT is related to bipolar mood disorders and what drug is used to treat it?
bipolar mood disorders are highly influenced by GABA and lithium works on that.
What NT is related to anxiety disorders and what drug is used to treat it?
Anxiety disorders are highly influenced by GABA and benzodiazepines work on that/
What NT is related to depression and what drug is used to treat it?
depression is highly influenced by seratonin (5-HT) and SSRI’s work on that.
What are the 5 evidence based kinds of psychotherapy? other?
Evidence-based:
- behavioural
- cognitive
- cognitive-behavioural
- humanistic
- interpersonal therapy.
other:
- psychodynamic
- classic psychoanalysis
- contemporary psychodynamic
therapy
(some research underway)
note: on an individual level you can do pre-post studies with your client to see if they are or are not responding to the treatment but this isn’t necessarily the same as evidence based.
What are 2 psychodynamic therapies and what do they involve?
- classical (freudian) psychoanalysis
- free association, analysis of dreams, transference, resistance.
(transference is when the client is seeing the therapist as their mother or something else. This is not hugely studied but it is a phenomenon that happens. There is a whole piece called counter-transference. Meaning the client puts something on you and you respond to that and put something on them. Like if you respond to me like I’m your mom then maybe I start treating you like my kid. That can be bad and is important to keep track of/be aware of. Its not like the client actually thinks that the therapist is their mom but they are responding similarly to the therapist. in psychoanalysis the therapist wants transference to happen so they can identify that and they want to kind of rewire the system. Transference is basically an intense version of projection.Basically any time transference happens on the end of the therapist this is called counter-transference.
- psychoanalytically oriented psychotherapy
- object-relations, attachements
(she thinks that a lot of CBT trained folks are like ew attachment but it is a real thing and people are starting to examine this. We are seeing that parent attachment styles influence how they respond to parent interventions in DBT. Parenting styles are like authoritative etc. Attachemnt styles are like insecure attachement, anxious attachment etc. attachment styles happen in response to how the parent is so the parenting styles influence that and the parents own attachment styles go into that too. She will not talk about this in the exam)
What is the premise of behavioural therapy?
if you can modify the behaviour you can change the feelings.
what are 4 behavioural therapies? What are these therapies used for?
- exposure therapy
- modelling
- reinforcement
- behavioural activation
these therapies work well for decreasing symptoms of anxiety disorders and depression. For anxiety this is pretty much what we use.
What is the premise of cognitive therapy? What does it examine? What would be an example of cognitive therapy strategies?
thoughts cause feelings and moods which influence behaviour.
(the way you think influences behaviour which influences how you feel. The idea is that there are distorted patterns of thinking. Like you have a schema. If your schema activated at different times then that would be activated. We all have different schema bits in our heads. )
examines distorted patterns of thinking. The idea is that you can change a person’s behaviour by changing their thoughts.
Ex:
- modifying self-statements
- changing interpretation of events
What is the therapy that most people practice? What does it do? What does it work well with?
CBT
it incorporates thoughts and behaviours maintaining disorder.
works well with anxiety, mild-moderate depression, conduct disorder, and bulimia.
What is the three component model in CBT?
3 component model: ABC
Cognitions (thoughts) influence affect (feelings) which influence behaviour (actions) which influence cognitions (thoughts) etc.
its basically saying jump in where you want and its going to affect the others.
note: In DBT we are generally saying affect is hard to change, thoughts are very hard to change and behaviour is the easiest.
What is humanistic therapy? what are 2 examples? what is it good for? What can it treat?
humanistic therapy is client-centered.
this basically says I believe in you to heal yourself. I will be here and be like you can do it.
Ex: motivational interviewing and gestalt therapy
- motivational interviewing is goof for building commitment to treatment and is used for difficult to treat behaviours (like substance use)
Motivational interviewing is good in situations when you want to help them commit to doing the hard thing. It is usually used for difficult to treat behaviours. She has used this through domestic violence situations. You can help people identify what matters to you, what are your values etc. Can be used alongside any therapy.
What is interpersonal therapy (IPT)? What is it used to treat?
- “eclectic” (premise uses multiple paradigms)
addresses way the client relates to others (using therapist client relationships)
evidence of working with:
- borderline personality disorder, and depression
this is eclectic so it uses a lot of different paradigms. Basically it is based on the idea that where people are going askew in their lives is their relationships, how they relate to other people. This is empirically supported. What ends up happening is you use the client therapist relationship in a very specific way. Like if someon is really ocncerned about confronting peole. You will do something as a therapist that is worth confronting and see how they respond. Then be like okay what is going on here. Can you stand up for yourself etc. One kid that she is working with has a strong reaction to losing games. So she is playing games with the client and was using the fact that she was going to win and used that as an opportunity to get her to get through that. First working on what is the emotion you are feeling, what do you notice, do you have to react to the emotion.
this therapy is basically just the therapist giving the client practice with dealing with specific circumstances
what is important to keep in mind when thinking about psychotherapy and minoritized groups?
people in minoritized groups are less studied, use fewer services, fewer clinicians are also in minoritized group leading to lower access to empirically supported treatments. Minoritied don’t always feel safe going into therapy with someone who doesn’t have your lived experience and there could be micro aggressions it isn’t necessarily in a safe space.
REFER TO DIAGRAM DRAWN IN BOOK
- clinicians may have different cultural backgrounds than the clients. The disadvantages to this are:
the client may not view the therapist as someone who can relat to them which makes them wonder if thet understand and can help them.
theres lots of kinds of subtle differences between cultures that could lead to misinterpretation.
for her family as an example, the more manners she has the more its like there is distance between her and that person. Nonetheless if she is talking to a therapist she may think that you insulting someone is actually insulting them and she wont get it and the client will feel invalidated because the behaviour is misinterpreted.
- may be less access to empirically-supported treatments.
may be less likely to recieve mental health treatment then this will increase stigma and their struggles may be enhanced and then people in the non-minoritized groups will be like these people. It is a huge issue when you look at graduate schools because the most common psychology graduate student is white girls and often blonde girls. These are the people who are involved in the conversations and then is not adding to the conversation in ways that things that need to be acknowledged. what doesn’t get through because of this is insight from the non-dominant culture.
This can have an impact on individual mental health AND community
when you have disorders that are not being treated you end up developing more stress et
a lot of psychologists are women which can cause issues for men who are seeking therapy maybe.
Explain the relationship between stress and the HPA access.
You just need to know HPA axis for the exam. Basically what happens is in response to stress, the hypothalamus releases a hormone that goes to the pituitary gland that hits the adrenal glands and they are going to release cortisol epinepherine and norepinepherine. . JUST NEED TO KNOW THE CORTISOL, This is the rstress hormone. it is fairly toxic but its super helpful in the short term. What is the problem with chronic stress and what the stress response was developed for. Chronic stress is not sustainable.
What are the effects of severe stress?
- extreme or prolonged stress can lead to extensive physical and psychological problems.
- it increases reactivity in sympathetic nervous system
it reduces the efficacy of the immune system (in nature it is thought when in a survival situiation you wont need immune system)
and it reduces psychological self-efficacy (when ur super stressed you think you aren’t capable of anything. so it is harder to resist other stressors )
leads to personality deterioration
can lead to death
you end up depending on extreme, lengthy etc. you can heighton the HPA axiss response. You can make it more responsive so basically you are sensitizing the HPA axis. You are sensitivizing it so you get more stress in response to other crap that happens. Cortisol is toxic. It is toxic to different parts of your brain including the part that is involved in the negative feedback loop. There is a certain amount of cortisol let out in your sysrem and theres a part of your brain that is sensitive to how much cortisol is in tyour systwem and it sends different chemicals tyo the part that is experiencing too much. That part experiences neuro toxicity and can die a but. So you don’t have the negative feedback loop which means you don’t have anyone telling the HPA axis chill menaing you get more cortisol.
What are psychosocial contributing factors?
REFER TO DIAGRAM ON PAGE
you should know when things are cute, she is going to put this on the exam for sure. AKA THIS WILL BE TESTED
we want to look at the contributing factors to how we cope with a stressor. There areaa couple things here Crisis comes after the stressor. Being robbed is the stressor and the crisis is I no longer feel comfortable walking down that streat/ In terms of external stressor there are different qualities of each. Is it a chronic stressor, who is, is there betrayal involved. Is it an accident? less stressful when its an accident.. Internally what are the perceptions of the stressor is anything about it predictable or controllable. If its predicatable we are better able to cope with if than if it is like rando. If there is anything controllable about it then it is less stressful when it happens. That gives people some sense of self-efficacy or some sense of a locus of control. Life changes due to the crisis. Are those affected by my reaction to what happened. Internally have I been able to make any kind of meaning out of it. Is there anything internally where like okay I stood my ground or I took that robber out and now he can’t rob anymore. Is there anyway that I can make some meaning out of it to help me get through it. You can see this in the sense that this person hurts me a lot but at least they are not hurting my sister because of it. Resources… what helps you get through it? social support. With stress social support is critical. It is very easy to come up with all of the things like IO am not capable, I do not have the resourcers to manage this. external is also like do I have money for treatment? Internal resources. What is your stress tolerance like. What kind of biological things do you have going for you that help you get through stress. She will likely give you a case example and will ask us things about that. Is a diathesis an internal resource? it depends. If you have genes that withstand stress, yes it is an internal resource.
What are the criteria for PTSD?
pay attention to these categories for the exam. You have to have been exposed to an event that threatens death, serious injury, or sexual violence etc. YOU MUST HAVE CRITERION A o have a diagnoissi of PTSD. Even if they have everything else, you can’t have this. You can have this from witness others experience it, direct experience, or repeated/extreme exposure to aversive details of events. Therapists need to be extra attentive to this stuff so they can work through their own shit.
criterion A: exposure to event threatening death, serious injury, or sexual violence through:
- learning it happened to close friends/family (violent or accidental)
- direct experience
- witness others’ experience
- repeated/extreme exposure to aversive details of event (EMTs, police)
What are the PTSD Symptoms?
REFER TO DIAGRAM
- Intrusion (nightmares, flashbacks)
- avoidance (avoid things associated with trauma)
- negative cognitions and mood (detachment, shame, anger, distorted blame on self and others)
- arousal and reactivity (insomnia, difficulty concentrating, hypervigilance, high startle response)
there are intrusion symptoms: things that come to you uninvited and they make ur life difficult like nightmares and flasshbacks. Avoidance of things that are associated with the trauma. Could be like I wore a certain outfit that day. I was on the way to the movies that day etc. you could go into a flashback but these can look different. When some people with PTSD are goign through flashbacks, they can be experiencing the sounds, etc. With people who have like interpersonal trauma they may be more likely to freeze. Negative cognitions and mood: they may detach, may see distorded blame like blaming people who aren’t responsible like yourself. Maybe you are blaming the people who gave you the order even if they didn’t actually kill the people. Arousal and reactivity: insomnia is super common, difficulty concentrating, hypervigilance, and high startle response. You actually can’t stop the high startle response.
