Lecture 16 (chapter 15)

Question 1

Psychological Therapies

Answer 1

Whereas the biological therapies view mental
disorders through the medical model, psychological therapies view the roots of
abnormal behavior in mental states
– Each therapy has its own view as to the cause of mental disorder
– Each therapy has its own approach to the treatment of mental disorder

Question 2

Insight-Oriented Therapy

Answer 2

E.g. psychoanalysis, humanistic, gestalt
* Help person understand the basis of their thinking, behavior, emotions and perceptions
* Insight into the cause will lead to change
* Emotion focused therapy or process experiential

Question 3

Action-Oriented Therapy

Answer 3

• E.g. Cognitive-Behavioral therapy, Rational-Emotive therapy
• Encourages individuals to change behavior or thinking
• Multifaceted and individually tailored
• Strong therapeutic relationship
• Behavioral techniques and cognitive restructuring

Question 4

Varieties of Psychological
Treatment

Answer 4

Psychodynamic
* Humanistic
* Cognitive-behavioral
* Biological/Biomedical
* Group therapy
* Family and marital therapy

Question 5

Psychodynamic Approach to therapy

Answer 5

The psychodynamic approach was created by S. Freud
– Mental symptoms reflect unconscious conflicts that
induce anxiety
– Insight refers to the situation in a person comes to understand their unconscious conflicts
– Therapeutic change requires an alliance (relationship) between the patient and therapist

Question 6

Psychodynamic Techniques

Answer 6

• The goal of psychodynamic therapy is to achieve insight into unconscious conflicts

– Free Association refers to a technique in which the patient is encouraged to say whatever comes to mind to reveal the unconscious processes of the
patient

– Interpretation: Therapist interprets the thoughts,
and feelings of the patient in order to reveal the hidden conflicts and motivations

– Analysis of transference: Patients bring into therapy their past troubled relationships; these are
transferred to the therapist

Question 7

Humanistic Therapy

Answer 7

• Roger’s Client-centered therapy
• Therapeutic Climate
  1) Genuineness
  2) Unconditional Positive Regard
  3) Empathy
• TherapeuticProcess
  Guidance, clarification, become more comfortable
  with genuine self

Question 8

Behaviour therapies

Answer 8

• Classical conditioning techniques can alter emotional responses
  – Systematic desensitization: Patient is encouraged
  to confront a feared stimulus (snake) while in a relaxed state
• Therapist trains relaxation
• Patient constructs an image hierarchy
• While relaxing, patient imagines the least fearful of
  the images in their hierarchy (e.g. being on the planet as a snake)
  – Exposure: Patient is exposed to the stimulus that they fear (locked in a room full of snakes)

Question 9

Cognitive Therapies

Answer 9

Focus of cognitive therapies is on changing dysfunctional thought patterns

• Rational Emotive Therapy focuses on the hurtful thought patterns of the patient
  – Ellis’s theory suggests that pathology results when persons adopt illogic in response to life situations
  – Therapist notes illogical and self-defeating thoughts and teaches alternative thinking that promotes rational thought

Question 10

Cognitive-Behavioral Therapies

Answer 10

Cognitive-behavioral therapies focus on the current behaviors of a person
– Emphasis is on the present rather than the past
– Cognitive-Behavioral therapists are very directive
– Therapy duration is short-term rather than years long
– Initial focus is on a detailed behavioral analysis: focus is on the problem behavior and the stimuli associated with it

Question 11

Cognitive Restructuring: Beck and ellis

Answer 11

Beck: approach emphasizes the cognitive triad and how automatic thoughts (often negative or distorted) shape our emotional experiences and behaviors.

Elis: founder of Rational Emotive Behavior Therapy (REBT), which is also a cognitive therapy that focuses on identifying and challenging irrational beliefs. REBT is built around the premise that irrational beliefs lead to emotional and behavioral problems, and changing these beliefs can result in improved mental health.

Question 12

ABCD of Rational Emotive Therapy

Answer 12

A – activating event
B – belief
C – consequences (emotional)
D – disputing beliefs

Question 13

Receiving psychotherapy is considerably more effective than

Answer 13

no treatment

Question 14

CBT shows a

Answer 14

slight but consistent advantage with regards to effectiveness compared to insight-oriented therapy

Question 15

People who do best in therapy are those

Answer 15

who have the least problems

Question 16

Medical model

Answer 16

views abnormal behavior
as reflecting a biological disorder
– Usually localized within the brain
– Involving either brain damage or a disruption of
the neurotransmitter processes of the brain
– Person is viewed as a patient, treated by doctors in a mental hospital
– Therapies tend to be physical in nature
* Drugs (Pharmacotherapy)
* Surgical alteration of brain (Psychosurgery)

Question 17

Pharmacotherapy

Answer 17

• Psychotropic medications are drugs that act on the brain to alter mental function
• Prior to 1956, schizophrenia was virtually untreatable with many patients confined for
  life in mental hospitals
  – Chlorpromazine (Thorazine) was found to reduce severity of psychotic thought, allowing people to live outside of mental institutions
• Reduced size of institutions
  – The psychotropic actions of many drugs are often accidentally discoveries

Question 18

Antipsychotic Medications

Answer 18

Refer to drugs that alleviate schizophrenia
– Antipsychotic medications are more effective for the positive symptoms than for negative symptoms of
schizophrenia

Question 19

Schizophrenia can be viewed as composed of:

Answer 19

– Positive Symptoms: Presence of hallucinations
– Negative Symptoms: Absence of affect

Question 20

Dopamine and Schizophrenia

Answer 20

• The positive symptoms of schizophrenia reflect too much brain dopamine activity

– Antipsychotic drugs are effective antagonists of dopamine receptors (block the action of dopamine)
– Drugs such as amphetamine release dopamine from terminals; too much amphetamine exposure
can induce a psychotic state in humans

• Negative schizophrenic symptoms may reflect brain damage enlarged ventricles)

Question 21

Antidepressant Medications

Answer 21

Psychotropic antidepressant drugs can lift depression (require 3-4 weeks for effect)

Question 22

3 types of antidepressant medications

Answer 22

– Tricylic antidepressants: Act by blocking the reuptake of norepinephrine and serotonin

– Monoamine oxidase (MAO) inhibitors: MAO degrades transmitters; drugs that inhibit MAO allow the transmitter to work for longer periods
– Selective serotonin reuptake inhibitors: Prozac blocks the reuptake of serotonin

Question 23

Depression reflects a

Answer 23

disturbance of mood,
sleep, and appetite

Question 24

Antianxiety Medications

Answer 24

• Drugs such as Valium increase the activity of the transmitter GABA to dampen the neural activity of the brain
  – Valium is useful in the short-term treatment of anxiety
• Antianxiety medications can result in drug dependence

Question 25

Anxiety reflects an

Answer 25

Intense emotional state of dread and apprehension

Question 26

Electroconvulsive Therapy

Answer 26

Electroconvulsive shock therapy (ECT) refers to the intentional induction of a brain seizure by shock administered to either or both hemispheres – ECT produces immediate improvement in mood (explanation is unknown) – Side effects of ECT include memory loss

Question 27

Con of antidepressant drugs

Answer 27

drugs require 3-4 weeks to take action on mood; the person may be at risk for suicide or is not responding to drug treatment

Question 28

Common Factors in Psychotherapy

Answer 28

* Development of a therapeutic alliance * Providing a rationale * Opportunity for catharsis or venting * Acquisition and practice of new behaviors * Beneficial therapist qualities (objective, confidential, professional) * Patient positive expectations and hope

Question 29

Eclecticism

Answer 29

* Involves using different treatments for different clients with different problems * Using a reasonable combination of various treatments for the same client (technical eclecticism) - all populations can receive different types of group therapy

Question 30

Advantages of groups in therapy

Answer 30

1. Efficiency 2. Universality 3. Empathy 4. Interaction 5. Acceptance 6. Altruism 7. Modeling 8. Pressure 9. Practice 10. Reality testing 11. Transference

Question 31

Suicide Risk Factors

Answer 31

Diathesis * psychological disorder (90%) * substance use and abuse (25-50%) * family history of suicide * family breakdown * societal breakdown * past suicide attempts

Question 32

Suicide risk factor: Stress

Answer 32

Stress - changes in relationships, academic/work, or financial situation - life event that is shameful or humiliating - significant loss - homosexuality - recent suicide

Question 33

Suicide warning signs

Answer 33

Warning Signs - withdrawal - change in eating, sleeping, friends - writing and talking about death - telling statements - agitation followed by calm resignation - giving away valued possessions

Question 34

What to do as a friend in terms of suicide

Answer 34

* Take suicide threats seriously * Don’t be afraid to discuss suicide * Recognize the warning signs and the risk factors * Don’t leave the person alone * Get help

Question 35

What to do as a therapist in terms of suicide

Answer 35

* Ask directly about suicide * Find out if they have a plan * Do they feel like they are in control of their behaviour? * Develop a safety plan * Make a contract * Treat the psychological disorder Crisis situation – break confidentiality Grief after suicide...