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Flashcards in therapy Deck (36):
1

Psychotherapy - means? aka? goal is to? don't confuse with?

  • psychological intervention meant to help resolve emotional, behavioural and interpersonal problems and to improve quality of life
  • Aka psychological therapy
  • Interaction b/w therapist and someone suffering from a psychological problem
  • Goal is to provide support or relief from the problem
  • Don’t confuse with psychodynamic (Freudian) approach

2

Goals of Psychotherapy? (4 steps)

  1. Forming a diagnosis: figure out what’s wrong, identifying illness, understand what’s going on
  2. Proposing an etiology: understand causes of illness
  3. Making a prognosis: what’s going to happen in a week, a month?
  4. Implementing treatment: change their thoughts/behaviour/emotions/coping skills

2

humanistic/existential - key beliefs? emergence? assumption about problems?

  • human beings are basically positive
  • something intrinsically good about people
  • all have a tendency towards self-improvement
  • emerged in middle of 20th century
  • reaction against negative views of Freudian psychoanalysis (Europe) and lack of introspection of behaviourism (US)
  • psychological problems stem from feelings of alienation and loneliness
  • feelings traced to failures to reach one’s potential (humanistic) or failure to find meaning in life (existential

3

Who seeks therapy - how many people? gender? race? ST vs LT?

c) Who seeks therapy?
- 1 in 5 people suffer from some type of mental disorder
- Men & women: women more likely to seek help
- Caucasians, Asians & Aboriginals: Caucasians more likely to seek than minorities
- ST vs. long-term problems: often wait a very long time before seeking help
o People suffer from depression of years before asking for help
o ST problems fare better than LT (aka respond better to therapy)
d) Why do some people not seek treatment?
- People might not realize that their disorder needs to be treated:
o Mental illness not taken as seriously as physical illness
o Origin of mental illness “hidden”, not diagnosable by blood tests, x rays
o Stigma of mental illness: can be solved with mind over matter aka it is a sign of weakness
- Barriers to treatment like beliefs/circumstances that keep people from getting help:
o Some believe they should be able to handle things themselves
o Families discourage seeking help because of embarrassment
o Financial obstacles, lack of medical insurance, long waiting lists at facilities, etc
- Even people who acknowledge they have  problem don’t know where to look for services
o And even when they seek and find help, they might not receive the most effect treatment
e) Would I be a good therapist?
- Warm & direct: honest and open to people
- Developing positive relationship with clients: respecting who they are, emphasizing with them, understanding them – if you’ve gone through your own problems = better empathy
- Your ethnicity: might think matching client’s ethnicity is important – study shows that it doesn’t matter
- Topic selection: choose most important for the session – session should have a focus
- Match treatment to needs of patient – most therapists don’t identify as one of the six kinds – they use whatever technique is most appropriate for patient
 Eclectic psychotherapy: drawing on techniques from different forms of therapy depending on patient and the problem

3

Client centered approach - h or e? started by who? assumes? non-directive?

  • humanistic approach
  • Carl Rogers in 1940’s, aka person centered therapy
  • assumes that all individuals have a tendency toward growth and that this growth can be facilitated by acceptance and genuine reactions from the therapist
  • each individual is qualified to determine own goals for therapy, frequency and length of therapy
  • Non directive treatment: Client is the centre/focus you are there as an aid
  • not to tell what is right/wrong, we’re here to facilitate patient’s learning, doesn’t provide advice or suggestions, but instead paraphrases client’s words

4

Why not seek treatment?

  • People might not realize that their disorder needs to be treated
  • Stigma of mental illness: can be solved with mind over matter aka it is a sign of weakness
  • Barriers to treatment like beliefs/circumstances that keep people from getting help - families, finances
  • Even people who acknowledge they have  problem don’t know where to look for services

4

Client Centered Approach - 3 components? overall goal?

5

Would I be a good therapist? qualities? realtionship? ethnicity? topics? ecletic?

  • Warm & direct: honest and open to people
  • Developing positive relationship with clients: respecting who they are, emphasizing with them, understanding them – if you’ve gone through your own problems = better empathy
  • Your ethnicity: doesn’t matter
  • Topic selection: choose most important for the session – session should have a focus
  • Match treatment to needs of patient – most therapists don’t identify as one of the six kinds – they use whatever technique is most appropriate for patient
  • Eclectic psychotherapy: drawing on techniques from different forms of therapy depending on patient and the problem

5

Gestalt Therapy - h or e? founded by? goal? focuses on? empty chair technique?

a) Gestalt Therapy  existential approach
- Founded by Frederick Perls in 40’s/50’s
- Goal of helping client become aware of his thoughts, behaviour, experiences, feelings and to own or take responsibility of them
- focuses on present experience and immediate awareness of direct sensations & emotions
- enthusiastic and warm towards clients (just like person centered)
- Focus on the gestalt  gestalt = whole  want to understand whole person, context, etc
- Empty chair technique: putting their feelings into action
o Client pretends that another person (spouse, parent, co-worker) is in an empty chair sitting directly across from client  roleplaying what he’d say and what the other person would respond
o practice things out in a safe environment

6

Therapyp - two categories: psychotherapy? Medical approaches? .. Insight Therapy?

  • P: person interacts with a psychotherapist
  • psychodynamic, cognitive-behavioural, humanistic/existential, groups
  • M: drugs or surgery = medications, other biological approaches
  • Goals are the same: relief and support to someone suffering
  • IT: People normal, but have learned some kind of maladaptive behaviour
  • Insight: you don’t know what’s bothering you, but that “ah-ha” moment provides relief

 

6

Group therapy - family/couples? group? community?

 

  • family and couples: people who live together, somehow related, etc
  • group: stragners with similar problems
  • community: after natural disasters, etc

7

Psychodynamic Approach - roots in? what is it? what unifies all approaches?

  • roots in Freud’s personality theory
  • Explores childhood events and encourages individuals to use this understanding to develop insight into their psychological problems
  • emphasis on the unconscious: huge part of the mind, and it is in here that the problem resides
  • Inadequately defended urges or incomplete development during psychosexual stages
  • path to overcoming problem is to develop insight into unconscious memories, impulses, wishes, conflicts underlying these problems

7

Group Therapy - advantages and disadvantages

  • Provide context in which clients can practice relating to others, they have people who they have to talk to/get along with on a regular basis
  • Attending group with others who have similar problems shows clients they are not alone
  • Group models model appropriate behaviours for another and share their insights about how to deal with problems, people can learn by observation - social learning
  • Group therapy often just as effective as individual therapy but cheaper
  • Can use peer pressure for positive outcome
  • CONS: hard to assemble group, some can undermine others, less attention

8

Beyond Freud - Alfred and Jung?

a) Beyond Psychoanalysis
- Broke away from Freud, developed their own approaches to psychotherapy
- Alfred Adler and Carl Jung: Agreed insight was key therapeutic goal, but disagreed that insight usually involves unconscious conflicts about sex/aggression
- Alfred Adler:
o Not as bleak as Freud: still believed unconscious important
o Didn’t reduce people down to single instances, looked at them in their entirety, context, how they’re connected to people around them, etc  Connectedness to family, environment very important Holist not a reductionist
o Believed emotional conflicts were result of perceptions of inferiority, and psychotherapy should help people overcome problems from inferior social status, sex roles, discrimination
o Pro-feminist: equality in relationships very important
o Recognized that we all have goals, driven goals
o While we have id, ego, etc they are a source of creativity
o Coined the term “inferiority complex”
o Talked about importance of self-esteem, self-esteem has important impact on mental health
- Carl Jung:
o Emphasize collective unconscious: culturally determined symbols and myths that are shared among all people that could serve as a basis for interpretation beyond sex or aggression
- Melanie Klein
o Primitive fantasises of loss and persecution like worrying about a parent dying or about being bullied, were important factors underlying mental illness
o Karen Jorney
 Disagreed with Freud about inherent differences in the psychology of men and women – traced differences to society and culture instead of biology
- All approaches: individual is part of a larger society, and conflicts can reflect the individual’s role in society

9

Alfred Adler?

- Alfred Adler:
o Not as bleak as Freud: still believed unconscious important
o Didn’t reduce people down to single instances, looked at them in their entirety, context, how they’re connected to people around them, etc  Connectedness to family, environment very important Holist not a reductionist
o Believed emotional conflicts were result of perceptions of inferiority, and psychotherapy should help people overcome problems from inferior social status, sex roles, discrimination
o Pro-feminist: equality in relationships very important
o Recognized that we all have goals, driven goals
o While we have id, ego, etc they are a source of creativity
o Coined the term “inferiority complex”
o Talked about importance of self-esteem, self-esteem has important impact on mental health
- Carl Jung:
o Emphasize collective unconscious: culturally determined symbols and myths that are shared among all people that could serve as a basis for interpretation beyond sex or aggression
- Melanie Klein
o Primitive fantasises of loss and persecution like worrying about a parent dying or about being bullied, were important factors underlying mental illness
o Karen Jorney
 Disagreed with Freud about inherent differences in the psychology of men and women – traced differences to society and culture instead of biology
- All approaches: individual is part of a larger society, and conflicts can reflect the individual’s role in societ

10

Carl Jung?

  • Emphasize collective unconscious: culturally determined symbols and myths that are shared among all people that could serve as a basis for interpretation beyond sex or aggression

11

Melanie Klein?

Karen Jorney?

  • MK: Primitive fantasises of loss and persecution like worrying about a parent dying or about being bullied, were important factors underlying mental illness
  • KJ: Disagreed with Freud about inherent differences in the psychology of men and women – traced differences to society and culture instead of biology

12

Psychodynamic these days - childhood/sex/unconsciousness/ego?

  • Childhood and sex important, but not as much as Freud said it was
  • Insight into unconsciousness: still as important
  • Role of ego: can also be a positive force
  • less interpretation of unconscious sexual or aggressive impulses
  • Other concepts are still important: transference, fostering insight into unconscious processes

13

Psychodynamic these days - length? IPT?

  • Interpersonal psychotherapy (IPT)
  • Focuses on helping clients improve current relationships
  • Treatment focused on person’s interpersonal behaviours and feelings
  • particular attention to client’s grief, role disputes, role transitions or interpersonal deficits
  • As interpersonal relations improve, assumed that symptoms will subside
  • IPT vs classical psychoanalysis: face to face, less intensive, lasts shorter and less often sessions

14

Psychoanalysis - assumes humans are? encourages clients to? focuses on? session takes place? what happens during sessions?

a) More textbook notes on psychoanalysis
- Assumes humans are born with aggressive and sexual urges repressed during childhood development through use of defense mechanisms
- Encourage clients to bring repressed conflicts into consciousness to understand them and reduce unwanted influences
- Focus on early childhood events (where urges/conflicts were likely to be repressed)
- Take place over an average of 3 – 6 years, with 4 or 5 sessions a week
- Client reclines on couch and faces away from analyst
o Client expresses whatever thoughts/feelings come to mind
Analyst comments but doesn’t express his values/judgements

15

Free Association

  • reporting every thought that enters the mind without censorship/filtering
  • therapist looks for themes that recur

16

Dream Interpretation/Analysis - dreams are? interpretation?

  • dreams are metaphors that symbolize unconscious conflicts/wishes that contain disguised clues
  • mainfest = what dream was about, latent = underlying true meaning
  • interpretation: therapist deciphers meaning (unconscious impulses/fantasies) underlying what the client says and does

17

Analysis of Resistance? Transference?

  • resistance if reluctance to cooperate with treatment for fear of confronting unpleasant unconscious material
  • could be interpreted that interpretation is correct
  • aka as soon as you get to source of problem, patient feels distressed, tries to find way out
  • Transference: analyst begins to assume major significance in clients life, client reacts to analyst based on unconscious childhood fantasies
  • unconscious redirection or urge/anger/desireonto therapist

18

Cognitive-Behavioural Therapy: what? unlike psychodynamic? emphasizes? learning?

  • In contrast to insight therapies, CBT argue that thinking and insight not enough – have to take action, do something
  • either change thinking or behaviour or both
  • Unlike psychodynamic, which emphasizes early developmental processes as source of problems, BCT emphasize current factors like maladaptive behaviours an dysfunctional thoughts
  • Have to relearn system of rewards – wrongly rewarded for maladaptive behaviour, which causes problems

19

CBT: causes of the problem?

  • Different than the cause in psychotherapy
  • Cause: maladaptive thinking, behaviour

20

Behavioural Therapy - inspired by? learning and behaviour? assumes? three approaches?

  • Inspired by behaviourism: focusing treatment on behaviour rather than unconscious
  • All behaviour is learned = Maladaptive behaviour is also learned = to correct maladaptive behaviour you have to relearn
  • disordered behaviour is learned and that symptom relief is achieved through changing overt maladaptive behaviours into more constructive behaviours
  • classical conditioning, operant conditioning, social learning

21

Classical Conditioning - Exposure therpy: what? works because? types?

  • reducing unwanted emotional responses
  • confronting an emotion-arousing stimulus directly and repeatedly, ultimately leading to a decrease in emotional response
  • Only way to remove anxiety is to have person experience it, so expose person to object of anxiety, but in a safe way
  • technique works because of habituation and response extinction (classical conditioning)
  • Systematic desensitization and flooding

22

Systematic desensitization?

  • classical conditioning
  • set up hierarchy of anxiety/fear causing events
  • Procedure in which a client relaxes all the muscles of his body wile imagining being in increasingly frightening situations

23

Flooding?

  • instead of going slow, flooding is all at once and faster to finish
  • Fear based on irrational thought, so fear isn’t actually dangerous
  • Only cure is to stick through that anxiety
  • Danger: has to be done with trained therapist, and has to be finished or else it will only amplify fear/anxiety

24

Aversion Therapy ?

  • classical conditioning, but opposite of exposure therapy
  • want to create a fear or anxiety – why? Some of our behaviours are maladaptive because they are harmful

25

Token economy - what type of conditioning? what? example? advantage? effectiveness?

  • operational
  • to promote desired behaviours
  • Giving clients tokens for desired behaviours, which they can later trade for rewards
  • Stickers on homework, employee of the month plaque  (no promotion or money or anything), chocolates, cookies as rewards
  • Rewarding for desirable behaviours = increases/decrease their emotional response
  • useful for people hard to communicate with like schizophrenic patients, young kids, works because kids want rewards
  • Effective while system of rewards in place, but learn behaviours aren’t usually maintained when reinforcements are discontinued

26

Extinction? Behavioural Self Control?

  • operational conditioning
  • E: let behaviour happen, don’t reinforcement it = response is extinguished
  • BSC: therapist teaches you to administer own punishment and reward

27

Social Learning Theory - what? modeling?

  • Can learn within social context
  • Modeling: therapist teaches you how to behave (vs conditioning where therapist changes behaviour, now therapist models the behaviour)
  • For people with low self-esteem, couples with problems communicating
  • Patient learns how to behave from model

28

Cognitive Therapy - vs behavioural? what? cognitive restructuring?

  • Helping a client identify and correct any distorted thinking about self, others or the world
  • vs behaviour which doesn’t take into account a person’s thoughts/feelings
  • Have to relearn how to think: identify then change distorted beliefs
  • Cognitive restructuring: correcting the mistaken, but automatic, beliefs, assumptions, predictions and expectations that cause illness and often lead to negative emotions, and replacing them with more realistic and positive beliefs 

29

CT - Mindfulness Meditation? Albert Ellis - maladaptive response from?

  • Teaches them to be fully present in each moment, to be aware of thoughts, feelings and sensations, and to detect symptoms before thy become a problem
  • Helpful for preventing depression relapse
  • AE: rational emotive therapy
  • Antecedent: stimulus in environment, what cases the problem = adversity
  • Belief: inside head, which produces some kind of emotional behaviour response = your evaluation of those thoughts
  • C: emotional/behavioural consequence

30

CBT? what unites it? (problem, action, structure, transparency) effective for?

- Therapist focuses on what patient needs  problem focus so approach based on problem and patient
- What unites CBT:
o Problem focus : you are at therapy for this reason, let’s only focus on this  veer off, refocus
 Focusing on a specific problem
o Action orientation: focus on solving problem by taking action, actually doing something
 Specific strategies to address problems, client is expected to DO things
o Structure: well defined structure to therapy session, patient knows exactly what will happens at each session
o Transparency: client always aware of what is going on (vs psychodynamic approach where patient is ignorant of true cause of problem)
- Very effective for: unipolar depression, generalized anxiety disorder, panic disorder, social phobia, post-traumatic stress disorder, childhood depressive and anxiety disorders
- Moderate effects for: marital distress, anger, somatic disorders, chronic pain