Terms in this set (25)

-one particularly influential short-term psychodynamic therapy is interpersonal therapy, abbreviated IPT.
-in contrast to other psychodynamic therapies, interpersonal therapy focuses on current relationships and social interactions rather than on past relationships.
-originally developed as a brief treatment for depression, interpersonal therapy is based on the assumption that psychological symptoms are caused and maintained by interpersonal problems.
-interpersonal therapy may be brief or long-term, but it is highly structured. In the first phase of treatment, the therapist identifies the interpersonal problem that is causing difficulties. In the interpersonal therapy model, there are four categories of personal problems: unresolved grief, role disputes, role transitions, and interpersonal deficits.
-unresolved grief refers to problems dealing with the death of significant others, while role disputes refer to repetitive conflicts with significant others, such as the person's partner, family members, friends, or co-workers. Role transitions include problems involving major life changes, such as going away to college, becoming a parent, getting married or divorced, or retiring. Interpersonal deficits refer to absent or faulty social skills that limit the ability to start or maintain healthy relationships with others. During treatment, the therapist helps the person understand his particular interpersonal problem and develop strategies to resolve it.
-IPT is used to treat eating disorders and substance abuse as well as depression. It is also effective in helping people deal with interpersonal problems, such as marital conflict, parenting issues, and conflicts at work.
-in one innovative application, IPT was successfully used to treat symptoms of depression in villagers in Uganda, demonstrating its effectiveness in a non-Western culture. Beyond individual psychotherapy, IPT has proven to be valuable in family and group therapy sessions.
-Watson's research inspired one of his students, Mary Cover Jones, to explore ways of reversing conditioned fears. With Watson acting as a consultant, Jones (1924) treated a 3-year old named Peter who "seemed almost to be Albert grown a bit older." Like Little Albert, Peter was fearful of various furry objects, including a tame rat, a fur coat, cotton, and wool. Because Peter was especially afraid of a tame rabbit, Jones focused on eliminating the rabbit fear. She used a procedure that has come to be known as counterconditioning-- the learning of a new conditioned response that is incompatible with a previously learned response.
-jones's procedure was very simple. the caged rabbit was brought into Peter's view but kept far enough away to avoid eliciting fear. with the rabbit visible at a tolerable distance, Peter sat in a high chair and happily munched his favorite snack, milk and crackers. Peter's favorite food was used because, presumably, the enjoyment of eating would naturally elicit a positive response. Such a a positive response would be incompatible with the negative response of fear.
-every day for almost two months, the rabbit was inched closer and closer to Peter as he ate his milk and crackers. As Peter's tolerance for the rabbit's presence gradually increased, he was eventually able to hold the rabbit in his lap, petting it with one hand while happily eating with his other hand. Not only was Peter's fear of the rabbit eliminated, but he also stopped being afraid of other furry objects, including the rat, cotton, and the fur coat.
-mary Cover Jone's pioneering studies in treating children's fears laid the groundwork for the later development of a more standardized procedure to treat phobias and other anxiety disorders.
-developed by South African psychiatrist Joseph Wolpe in the 1950s, the procedure is called systematic desensitization. Based on the same premise as counterconditioning, systematic desensitization involves learning a new conditioned response (relaxation) that is incompatible with or inhibits the old conditioned response (fear and anxiety).
-three basic steps are involved in systematic desensitization. first, the patient learns progressive relaxation, which involves successively relaxing one muscle group after another until a deep state of relaxation is achieved. Second, the behavior therapist helps the patient construct an anxiety hierarchy, which is a list of anxiety-provoking images associated with the feared situation, arranged in a hierarchy from least to most anxiety-producing. the patient also develops an image of a relaxing control scene, such as walking on a secluded beach on a sunny day. the third step involves the actual process of desensitization. while deeply relaxed, the patient imagines the least threatening scene on the anxiety hierarchy. After he can maintain complete relaxation while imagining this scene, he moves to the next. If the patient begins to feel anxiety or tension, the behavior therapist guides him back to imagining the previous scene or the control scene. If necessary, the therapist helps the patient relax again, using the progressive relaxation technique.
-over several sessions, the patient gradually and systematically works his way up the hierarchy, imagining each scene while maintaining complete relaxation. Very systematically, each imagined scene becomes paired with a conditioned response of relaxation rather than anxiety, and desensitization to the feared situation takes place. Once mastered with mental images, the desensitization procedure may be continued in the actual feared situation. If the technique is successful, the feared situation no longer produces a conditioned response of fear or anxiety. In practice, systematic desensitization is often combined with other techniques, such as observational learning.
-treatment involved placing the young man in a state of relaxation and then asking him to imagine low anxiety scenes (such as an unknown man touching a trough of water containing one drop of urine). As the patient's anxiety gradually dissipated, Wolpe gradually increased the imaginary concentration of urine. In addition, a real bottle of urine was presented at a distance and moved closer to the patient in gradual steps. Finally Wolpe could apply drops of diluted urine to the back of the patient's hand without evoking anxiety. A follow-up 4 years later revealed complete remission of the compulsive behaviors.
-ex: Wolpe (1964) successfully used the method to treat an 18 year old male with a severe handwashing compulsion. The disorder involved a fear of contaminating others with urine. After urinating, the patient felt compelled to spend 45 minutes cleaning his genitalia, two hours washing his hands, and four hours showering.
-the token economy is an example of the use of operant conditioning techniques to modify the behavior of groups of people. A token economy is a very structured environment, a system for strengthening desired behaviors through positive reinforcement.
-basically, tokens or points are awarded as positive reinforcers for desirable behaviors and withheld or taken away for undesirable behaviors. The tokens can be exchanged for other reinforcers, such as special privileges.
-token economies have been used in prisons, classrooms, and juvenile correction institutions, as well as with people diagnosed with psychiatric disorders or mental retardation in hospitals and group homes. They have been shown to be effective even with severely disturbed patients who have been hospitalized for many years. However, token economies proved difficult to implement, especially in community based outpatient clinics, so they are not in wide use today.
-after lunch, she passes out tokens in the first two minutes of class time. A student who his very disruptive during the after-lunch reading time can lose tokens. She estimates students can earn 20 tokens for reading immediately after lunch and can easily earn 4 reading books. Once a month, she opens her store, which contains the following items and more. Extra recess cost 45 tokens. Computer time cost 35 tokens
-ex: Mrs. Weir has a token economy set up in her second grade classroom. She uses poker chips as her tokens. She has set up a system to encourage students to read more books and to start reading immediately when they sit down after lunch. Each time a student reads a book, she gives them one token after they have answered a couple questions about the book orally.
-in the 1950s, Ellis began to take a more active, directive role in his therapy sessions. He developed rational-emotive therapy, abbreviated RET in the 1950s. RET is based on the assumption that "people are not disturbed by things but rather by their view of things." The key premise of RET is that people's difficulties are caused by their faulty expectations and irrational beliefs. Rational-emotive therapy focuses on changing the patterns of irrational thinking that are believed to be the primary cause of the client's emotional distress and psychological problems.
-ellis points out that most people mistakenly believe that they become upset and unhappy because of external events. But Ellis (1993) would argue that it's not external events that make people miserable-- it's their interpretation of those events. It's not David's behavior that's really making Carrie miserable-- it's Carrie's interpretation of the meaning of David's behavior. In rational-emotive therapy, psychological problems are explained by the "ABC" model.
-according to this model, when an Activating event (A) occurs, it is the person's Beliefs (B) about the event that cause emotional Consequences (C). Identifying the core irrational beliefs that underlie personality distress is the first step in rational-emotive therapy.
-the second step in rational-emotive therapy is for the therapist to vigorously dispute and challenge the irrational beliefs. In doing so, rational-emotive therapists tend to be very direct and even confrontational. Rather than trying to establish a warm, supportive atmosphere, rational-emotive therapists rely on logical persuasion and reason to push people into helping themselves.
-from the client's perspective, rational-emotive therapy requires considerable effort. First, the person must admit her irrational beliefs and accept the fact that those beliefs are irrational and unhealthy, which is not as easy as it sounds. Equally challenging, the client must radically change her way of interpreting and responding to stressful events.
-the long-term therapeutic goal of RET is to teach clients to recognize and dispute their own irrational beliefs in a wide range of situations. However, responding "rationally" to unpleasant situations does not mean denying your feelings.
-psychiatrist Aaron T. Beck was initially trained as a psychoanalyst. Beck's development of cognitive therapy, abbreviated CT, grew out of his research on depression.
-seeking to scientifically validate the psychoanalytic assumption that depressed patients "have a need to suffer," Beck began collecting data on the free associations and dreams of his depressed patients. What he found, however, was that his depressed patients did not have a need to suffer. In fact, his depressed patients often went to great lengths to avoid being rejected by others.
-instead, Beck discovered that depressed people have an extremely negative view of the past, present, and future. Rather than realistically evaluating their situation, depressed patients have developed a negative cognitive bias, consistently distorting their experiences in a negative way. Their negative perceptions of events and situations are shaped by deep-seated, self-deprecating beliefs, such as "I can't do anything right," "I'm worthless," or "I'm unlovable." Beck's cognitive therapy essentially focuses on correcting the cognitive biases that underlie depression and other psychological disorders.
-in contrast with Ellis's emphasis on "irrational" thinking, Beck believes that depression and other psychological problems are caused by distorted thinking and unrealistic beliefs. Rather than logically debating the "irrationality" of a client's beliefs, the CT therapist encourages the client to empirically test the accuracy of his or her assumptions and beliefs.
-beck's cognitive therapy has been shown to be effective in treating depression and other psychological disorders, including anxiety disorders, borderline personality disorders, eating disorders, postraumatic stress disorder, and relationship problems.
-about 100,000 patients a year receive electroconvulsive therapy, or ECT, as a medical treatment for severe depression. Also known as electroshock therapy, or shock therapy, electroconvulsive therapy involves using a brief burst of electric current to induce a seizure in the brain, much like an epileptic seizure. Although ECT is most commonly used to treat depression, it is occasionally used to treat mania, catatonia, and other severe mental disorders.
-ECT is a relatively simple and quick medical procedure, usually performed in a hospital. The patient lies on a table. Electrodes are placed on one or both of the patient's temples, and the patient is given a short-term, light anesthetic and muscle-relaxing drugs. To ensure adequate airflow, a breathing tube is sometimes placed in the patient's throat.
-while the patient is unconscious, a split-second burst of electricity induces a seizure. The seizure lasts for about a minute. After the anesthesia wears off and the patient wakes up, confusion and disorientation may be present for a few hours. It is common for the patient to experience a temporary or permanent memory loss for the events leading up to the treatment.
-in the short term, ECT is a very effective treatment for severe depression: About 80% of depressed patients improve. ECT also relieves the symptoms of depression very quickly, typically within days. Because of its rapid therapeutic effects, ECT can be a lifesaving procedure for extremely suicidal or severely depressed patients.
-ECT's biggest drawback is that its antidepressive effects can be short-lived. Relapses within four months are relatively common. About half the patients treated for major depression experience a relapse within six months.
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