Therapy & Psychological Treatment

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Terms in this set (64)
Cognitive RestructuringRecognizing & altering maladaptive thought patternsRational-Emotive TherapyTherapist acts as a teacher to explain errors in thinking and suggest revisionsInterpersonal TherapyFocus is on circumstances, especially interpersonal relationshipsMindfulness-Based Cognitive TherapyClients become aware of maladaptive thought patterns and learn to disengage from themCognitive-Behavioral TherapyCorrects faulty cognitions & trains new behaviors Includes exposure, exposure & response prevention, systematic desensitizationGroup TherapyCan be structured or unstructured; allows for social interaction, support, and a more cost-effective way of undergoing therapyFamily TherapyUses a systems approach to understand an individual within the context of their family unitExpressed EmotionPattern of negative reactions including criticism, hostility, and emotional involvement that may occur in a client's family Family attitudes are key in avoiding relapse and in long-term recoveryPsychotropic MedicationDrugs that affect mental processes by changing brain neurochemistryAnti-Anxiety DrugsIncrease GABA activity to promote relaxation; can cause drowsiness & are highly addictive Best used to treat anxiety in the short-term Include benzodiazepinesAntidepressantsWork mostly with serotonin to treat depressionMAO InhibitorsAntidepressants that prevent enzymatic breakdown of serotonin in the synapse Can react lethally with amino acid tyramine and some drugsTricyclic AntidepressantsInhibit neurotransmitter reuptake Can cause weight gain, drowsiness, constipation, sweatingSSRIsInhibit serotonin reuptake Can cause insomnia, headaches, weight loss, sexual dysfunctionAntipsychotics (neuroleptics)Bind to dopamine receptors to treat schizophrenia and psychosisLithiumTreats bipolar disorder by modulating neurotransmitter levels Discovered by John Cade Can cause thirst, tremors, excess urination, memory problemsAnticonvulsantsSeizure medication that can be used to stabilize mood and treat bipolar disorderTrepanningHistorical attempt at biological treatment of mental illness Involves making holes in the skull to let evil spirits outElectroconvulsive TherapyElectrodes on the head produce seizures, while muscle relaxants confine seizures to the brain Effectively treats severe depressionTranscranial Magnetic StimulationUses electrical pulses to disrupt brain activity Repeated TMS used to treat depressionDeep Brain StimulationSurgical implantation of electrodes in the brain to treat Parkinson's, depression, OCDTreatments That Don't WorkBirth reenactment, scream therapy: no scientific basis "Scared straight", DARE, discussing trauma, suggestive hypnosis: can be counterproductive Self-help books: questionable claimsClinical PsychologistPh.D or Psy.D depending on research or clinical emphasis Works in an academic setting or a hospitalPsychiatristMD; can prescribe drugsCounseling PsychologistPh.D; deals more with stress & day-to-day problems than serious mental illnessPsychiatric Social WorkerMSW; works in a psychiatric hospital or makes house callsPsychiatric NurseBSN; works in a hospital or an inpatient facility with the mentally illParaprofessionalNo degree; works in outreach programs or community initiativesTechnology-Based TreatmentForm of therapy with little or no client-therapist contact Useful due to lack of therapistsEvidence-Based TreatmentsBarlow: should vary by disorder and symptoms shown, should be developed in a lab by psychologist, & should be supported by evidence of its effectivenessTreating AnxietyCBT is best in the long-term Anti-anxiety drugs & antidepressants that increase serotonin & norepinephrine can help in the short-termTreating Specific PhobiaUse behavioral systematic desensitization: make a fear hierarchy, learn relaxation, begin exposure Cognitive therapy is useful to make clients aware of irrationality Tranquilizers alleviate immediate fear SSRIs treat social phobiaTreating Panic DisorderCognitive restructuring can help prevent panic in response to physical symptoms, sometimes in conjunction with exposure Tricyclics like imipramine can also help CBT and drugs work best togetherTreating OCDExposure & response prevention is effective SSRIs, esp. clomipramine, work well Drugs and psychotherapy is the best approach DBS to caudate can also be used in extreme casesTreating DepressionCBT increases adaptive thinking, while drugs treat symptoms Both change brain activity & work well in combinationAlternative Treatment for DepressionPhototherapy for SAD Aerobic exercise, ECT, TMS to left frontal lobes, DBS to nucleus accumbensTreating Bipolar DisorderLithium works best for mania, while SSRIs treat depressive episodes Anticonvulsants also work CBT can help clients stick to a medication regimen, esp. when they miss the highs of their manic episodesTreating SchizophreniaPharmacology is necessary: early drugs caused Parkinson's type symptoms and tardive dyskinesia, but modern drugs have fewer side effects Psychosocial treatment helps with social skills and self care CBT can help patients to understand their disordered thoughtsTardive DyskinesiaMuscle & facial twitches that result from drugs like chlorpromazine, and are permanent once they appearSecond-Generation AntipsychoticsModern schizophrenia treatments that have fewer side effects & work as he first line of defense against the disorderClozapineA second-generation antipsychotic that has serious side effects including a potentially fatal decline in white blood cells Works in most sever cases of schizophreniaPrognosis for SchizophreniaBest for females, those with later onset, ad those in developing countries Episodes grow progressively worse until diagnosis, but the disorder generally improves over timeTreating Borderline Personality DisordersUse dialectical behavior therapy with SSRIs for depressive tendenciesDialectical Behavior TherapyPioneered by Marsha Linehan; combines cognitive, behavioral, & mindfulness therapy3 Stages of DBT1) Target extreme behaviors & provide coping mechanisms 2) Explore past experiences for the roots of problems 3) Develop self respect & independent problem solvingTreating ASPDStimulants can normalize arousal levels in the short-term, anti-anxiety drugs can decrease hostility, lithium treats impulsivity & aggression in violent psychopaths Behavioral therapy can reinforce appropriate behavior & cognitive therapy can attempt to encourage rule-following Group therapy works better than individual therapyPrognosis for ASPDNothing really works to treat ASPD Many patients improve naturally after age 40, but the egocentricity, callousness, & manipulative tendencies persist Psychopaths almost never improveTreating Adolescent DepressionSSRIs are used frequently: easier & less expensive than CBT, although CBT is quite useful SSRI Prozac can increase suicidal thoughts, but seems relatively safeTreatment for Adolescents with Depression Study (TADS)Showed the Prozac, esp. in combination with CBT, is effective Prozac patients are 2x more likely to have suicidal thoughts, but suicide attempts are rare & have generally declined since the advent of SSRIsTreating ADHDEarly treatment is key; stimulants like Ritalin & Adderall can increase arousal and decrease the tendency for hyperactivity Medication can cause sleep problems, loss of appetite, twitches, growth suppression: behavioral treatment is also an optionBehavioral Treatment for ADHDUsed to develop coping strategies as medication is phased out Can be intensive & time-consumingTreating AutismApplied behavioral analysis is best because it is highly structured & time intensive Antipsychotics can reduce repetitive self-stimulating behaviors Oxytocin injections may promote social functionApplied Behavioral AnalysisPioneered by Ivar Lovaas Minimum 40 hours per week of repetitive operant conditioning Can result in a 20 IQ point gain over 2 years Works best early & with children with some language skillsCase Study: James O'NeilDiagnosed with autism at 2.5; began 8-hour daily regimen of therapy to address problem areas Started school with one of his full-time instructors and was able to progress fairly normally Eventually succeeded in displaying some normal social behavior & making a friend