Flashcards in LGD 3 Psychotherapy Deck (23)
What is goal of psychotherapy?
increase range of behaviors available to patient and relieve symptoms and alter problematic patters = talking and relationship based
What is psychotherapy used for?
- psychiatric symptoms/syndromes
- specific problems/stresses
- gen problems/self esteem
- augment treatment in non-psych conditions
How effective is psychotherapy?
75-80% of pts show benefit
What is principle of psychodynamic/psychoanalytic psychotherapy?
range of treatments based on freuds theories
use self-reflection on past experiences and unconscious to figure out how they inform current relationships = past is alive in the present
What are techniques of psychodynamic/psychoanalytic psychotherapy?
frequent sessions, unstructured therapy, free association, interpretations of transference and defense mech, exploration of fantasy life, therapeutic alliance
What pts are indicated for psychoanalytic/dynamic therapy?
- ability to tolerate neg emotions
- ability to delineate reality vs sessions
- maintain therapeutic alliance despite transference ebb and flow
- capacity to self reflect
- enough money to do multiple sessions/wk
What are goals of psychoanalytic/dynamic therapy?
increase insight/conscious awareness to fix maladaptive patterns beyond symptom remission
understand truth about oneself and motivations
What feat distinguish psychodynamic from other therapies?
- focus on affect/expression of emotion
- discussion of past experience
- focus on therapy relationship
- exploration fantasy life
- exploration of defense mech/transference
What are goals of CBT [cognitive-behavioral therapy]?
modify current cognitions-behaviors without regard to where they came from = unlearn and relearn adaptive behavior/thinking
typically short term
What are indications for CBT?
What is principle of CBT?
based on learning theory
What are techniques of CBT?
structured, psychoeducation, identify automatic thoughts
therapist = active teacher
What is dialectical behavior therapy [DBT]?
buddhist meditative practice combined with CBT = emotion regulation, distress tolerance and acceptance, mindfulness
What is aversive conditioning?
reduce appeal of undesired behaviors = associate behaviors with physical or psychological discomfort --> expose to unpleasant stimulus while engaging in targeted behavior
goal = create aversion to the behavior
use in: nail biting, sex addiction
What is exposure therapy?
exposure to feared stimulus to elicit pavlovian extinction of conditioned fear
technique = systemic desensitization, [gradual increase in exposure to stimulus], flooding [full exposure]
What are indications for exposure therapy?
specific phobias, PTSD, OCD
What are indications for DBT?
borderline personality disorder
What is exposure with response prevention?
indications = OCD, phobias
exposure to anxiety producing stimulus but can't perform associated anxiolytic ritual
What is token economy for?
increase target behaviors = reinforce the good not punish the bad via operant conditioning
What are the 2 levels of dysfunctional cognition targeted by CBT?
automatic thoughts = occur rapidly, often based on erroneous logic, accessible through therapist questioning [arbitrary inference, all-or-none thinking, magnification/minimization, personalization]
cognitive schema = deeper cognitive structs with basic rules for filtering info from environment
What distinguishes CBT vs psychodynamic therapy?
CBT = short [5-20 sessions wkly], for current problem, agenda driven
psychodynamic = long [mos-yrs 1-4x/wk], for general problem, free association
What is supportive psychotherapy?
- ameliorate symptoms while improving self-esteem and adaptive coping skills --> increase resilience, strengthen adaptive defenses
via therapeutic modeling, self-disclosure, reassurance, encouragement, advice, empathetic listening