1
Q
historical context (western society)
A
- Bedlam/St. Mary of Bethlehem (1700’s): patients tortured, mistreated, and put on public display
- Philippe Pinel, Dorothea Dix (1800’s): first to see psychological problems as mental illness
- Asylums (1900’s): protection, treatment, (and containment?)
- Deinstitutionalization (1960’s): rapid decline in mental hospital residents from the 60’s onwards
2
Q
cultural context
A
- Western views: disease/illness something that happens inside someone
- Non-western views: can focus on cooperation, interdependence, community (not removing someone from community)
- Cultural symbols and rituals of curing: shamanism, ritual healing, dissociation of consciousness
3
Q
harmful therapies that still exist today
A
- Recovered memory therapy
- Critical incident stress debriefing
- Rebirthing therapy
- “Scared Straight”
- Alcoholics anonymous
- These treatments are reminders that we need to continue to apply the scientific method, even in treatment
4
Q
why is Alcoholics Anonymous problematic?
A
- 50% drop out first month
- 95% drop out first year
- Problematic because if people see this as their only option and then they’re unsuccessful, they might believe they’re hopeless, when in reality the program just isn’t very effective
5
Q
goals of major therapies
A
- Reaching a diagnosis
- Proposing a probable etiology (cause)
- Making a prognosis -> what’s going to happen if we treat this, what’s going to happen if we don’t treat it?
- Treatment planning
- Often a theory-driven enterprise -> depend on your view of the world
6
Q
biomedical therapies
A
- Alter brain functioning via chemical or physical interventions
- ex. Surgery, Electric shock (electroconvulsive therapy), Magnetic stimulation (used to make brains more active), Drugs, etc.
7
Q
psychotherapy
A
treatment involving psychological techniques; consists of interactions between therapist and person seeking to overcome psychological difficulties, achieve personal growth, and treat faulty behaviours, thoughts, perceptions and emotions
8
Q
Psychological therapies
A
- psychodynamic
- behavioural
- cognitive
- humanistic (humanism usually underlies all the other therapies)
9
Q
types of therapists
A
- Clinical psychologists (have PhDs plus internship and training)
- Psychiatrists (Have MDs and can prescribe meds, but may not have extensive training clinical psychologists do)
- Counselling psychologist (have Master’s degrees)
- Clinical social worker (have Master’s degrees and post-grad supervision)
- Pastoral counselor
- Psychoanalyst
10
Q
therapeutic settings
A
- Patient: used in biomedical approach to treatment
- Client: used by clinicians who think of psychological disorders as problems in living
- Therapeutic alliance: relationship between patient and therapist – one of strongest predictors on how successful treatment will be
11
Q
psychoanalysis
A
- Freud’s technique
- He believed the patient’s free associations, resistances, dreams, and transferences – and the therapist’s interpretations of them – released previously repressed feelings, impulses, and conflicts allowing the patient to gain self-insight
- Patient talks, analyst interprets
- Historical reconstruction to shed light on the present
- dream analysis
12
Q
free association
A
disclosing thoughts, wishes, physical sensations, and mental images as they occur
13
Q
catharsis
A
expressing strongly felt but usually repressed emotions
14
Q
countertransference
A
when the therapist assigns qualities to their client based on the therapist’s interactions with previous clients
15
Q
behaviour therapies/modification
A
- Applies principles of learning to increase or decrease the frequency of behaviours
- counter-conditioning, desensitization, contigency management
- Ex. Un-conditioning the woman’s fear of snakes
16
Q
counter-conditioning
A
- Systematic desensitization: Swap (-) for (+)
- Ie. making public speaking a more pleasant experience
- Aversive conditioning: swap (+) for (-)
- Ie. making alcohol less pleasant
17
Q
desensitization
A
- Relaxation: CS becomes paired with relaxation, not anxiety
- Prolonged exposure: habituation to conditioned stimulus
- Using virtual reality to expose people to their fears
18
Q
contingency management/token economy
A
- believes behaviours are influenced by their consequences (operant conditioning technique)
- Ie. Rewards (attention, praise, food)
- Ex: childhood ADHD -> reward-based token systems used to influence their behaviour (tokens to be redeemed for desirable items like candy, TV, trips, etc.)
19
Q
Cognitive therapies
A
- changing thinking to change feelings
- Assumes that our emotional reactions aren’t produced by events, but by our thoughts -> you can’t directly change the way you feel or control event, but you can control what you think
- aims to change unhelpful beliefs and tendencies to see things negatively (ex. belief that because you can’t tell jokes, you don’t fit into social situations)
- ex. lost job -> thought: I’m worthless -> depression; lost job -> thought: I’ll find a better job -> no depression
20
Q
rational-emotive therapy
A
Same premise as cognitive-behavioural therapy, but uses a confrontational style
21
Q
person-centered therapy/client-centered therapy
A
- humanistic therapy developed by Carl Rogers
- uses active listening, non-directive approach, listening in a non-judgemental way, having unconditional positive regard, and being empathetic to facilitate client’s growth
22
Q
Gestalt therapy
A
- Getting in touch with oneself
- “owning” feelings and fantasies
- Making client “whole”
23
Q
group therapy
A
- ex. Marital and family therapy (couples counseling, family therapy) and community support groups (ie. self-help groups, AA)
24
Q
psychopharmacology
A
study of the effects of drugs on mind and behaviour
25
anti-depressants
- used to treat depression, anxiety disorders, OCD, ad PTSD
| - Increase availability of norepinephrine or serotonin
26
anti-anxiety drugs
- Work by depressing CNS activity (increases GABA)
- Ex. Valium, Librium
- Using these meds can increase your psychological dependence (this effect isn't seen with anti-depressant drugs though)
27
therapies of last resort
- Electroconvulsive therapy (ECT) -> Limited to severely depressed patients
- Brain surgery -> Ex. Cutting corpus callosum in epilepsy
28
does therapy work?
- rather than asking which one is best, ask which one works best for which problem and which group of people
- ie. Medication is better for schizophrenia than therapy, for example
- Many therapies work (over 100 research-supported treatments to date)
- Depression: behavioural activation, interpersonal, cognitive-behavioural
- Anxiety disorders: exposure, behavioural/cognitive-behavioural
- Borderline personality disorder: dialectical behaviour therapy
29
the role of "common factors"
- common factors: therapeutic alliance, empathy, instilling hope that treatment will help the client, active listening skills (humanistic techniques)
- the better the therapist is at these common factors, the better the client will do regardless of which treatment is being used
30
how do we know if a therapy works?
- use research methods that identify cause and effect
- ex. Randomized controlled trials, Experimental case designs
- Randomly assigning the treatment to time intervals instead of to people (on-off-on-off-on-off)
- simply using on-off designs is problematic because of placebo effects, spontaneous (natural) remission, and regression to the mean
31
eclectic approach
an approach to psychotherapy that uses techniques from various forms of therapy
32
resistance
in psychoanalysis, the blocking of anxiety-laden material from consciousness
33
interpretation
in psychoanalysis, the analyst's noting supposed dream meanings, resistances, and other significant behaviours in order to promote insight
34
transference
in psychoanalysis, the patient's transfer to the analyst of emotions linked with other relationships (such as love or hatred for a parent)
35
psychodynamic therapy
- derives from psychoanalysis
| - views individuals as responding to unconscious forces and childhood experiences, and seeks to enhance self-insight
36
insight therapies
variety of therapies that aim to improve psychological functioning by increasing a person's awareness of their underlying motives and defenses
37
active listening
- empathetic listening in which the listener echoes, restates, and clarifies
- A feature of Rogers' client-centered therapy
- Uses paraphrase, invites clarification, and reflects the feelings of the client
38
unconditional positive regard
a caring, accepting, non-judgemental attitude, which Carl Rogers believes would help clients develop self-awareness and self-acceptance
39
exposure therapy
behavioural techniques, such as systematic desensitization and virtual reality exposure therapy, that treat anxieties by exposing people (in imagination or actual situations) to the things they fear and avoid
40
cognitive-behavioural therapy (CBT)
a popular integrative therapy that combines cognitive therapy (changing self-defeating thinking) with behaviour therapy (changing behaviour)
41
evidence-based practice
clinical decision-making that integrates the best available research with clinical expertise and patient characteristics and preferences
42
therapeutic alliance
a bond of trust and mutual understanding between a therapist and a client, who work together constructively to overcome the client's problem
43
antipsychotic drugs
used to treat schizophrenia and other forms of severe thought disorder
44
electroconvulsive therapy
biomedical therapy for severely depressed patients in which a brief electric current is sent through the brain of an anesthetized patient
45
Repetitive transcranial magnetic stimulation (rTMS)
the application of repeated pulses of magnetic energy to the brain; used to stimulate or suppress brain activity
46
lobotomy
- psychosurgical procedure once used to calm uncontrollably emotional or violent patients
- cuts nerves connecting the frontal lobes to the emoton-controlling centers of the inner brain
47
resilience
the personal strength that helps most people cope with stress and recover from adversity and even trauma
48
post-traumatic growth
positive psychological changes as a result of struggling with extremely challenging circumstances and life crises
Psych 102
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