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APPsych Chapter 17 Alicia Quinones Hour 5.

Alicia Quinones

on 17 January 2013

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Transcript of Therapy

Therapy Chapter 17 Presentation. Evaluating Psychotherapies Biomedical Therapies Drug Therapies Psychosurgery Brain Stimulation Case Studies Effectiveness of Different Therapies Clients Perceptions Mental Health Psychological Therapies Cont. Two main categories:
Psychological Therapies
Biomedical Therapies Psychoanalysis Cognitive Therapy Clinicians' Perceptions Evaluating Alternative Therapies Case Study #1
Done by the Australian Music Therapy Association
Special Education kids use music instead of language to communicate. Aiden has severe autism and enjoys music but only by himself. With a therapist he works on interpersonal relationships through ballroom dancing. Antipsychotic Drugs Lobotomy Electroconvulsive Therapy (ECT) or psychotherapy - "a planned emotionally charged, confiding interaction between a trained, socially sanctioned healer and sufferer" (Frank, 1982). a prescribed medication or medical procedure that acts directly on the patient's nervous system. Eclectic Approach: the biopsychosocial approach using "psychotherapy integration" a blend of therapies where therapists, rather than picking and choosing methods, integrate to combine the methods into a single, coherent system. Eclectic Approach: the biopsychosocial approach using "psychotherapy integration", a blend of therapies where therapists, rather than picking and choosing methods, use integration to combine the methods into one single, coherent system. Freud's therapeutic technique. Freud believed the patient's free associations, resistances, dreams, and transferences- and the therapist's interpretations of them-released previously repressed feelings, allowing the patient to gain self-insight. Methods of Psychoanalysis. Free Association: the process of free association includes relaxing and then saying aloud anything that comes to mind when talking to the psychoanalyst Resistance: the defensive blocking from consciousness of anxiety-laden material Interpretation: the analyst's noting supposed dream meanings, resistances, and other significant behaviors and events in order to promote insight. Transference: the patient's transfer to analyst of emotions linked with other relationships (such as love or hatred for a parent) Psychodynamic Therapy Therapy in which therapists attempt to focus on and conceptualize a patients current conflicts and defenses by searching for themes common to many past and present important relationships. Interpersonal Therapy: brief variation of psychodynamic therapy that focuses primarily on relieving current symptoms (such as depression) rather than on an intensive interpretation of the origins of unconscious conflicts. Humanistic Therapy Focuses on client's present and future experiences, on conscious rather than unconscious thoughts, and on taking responsibility for one's feelings and actions. Client-Centered Therapy: focuses on the persons conscious self-perceptions rather than on the therapist's own interpretations. Active Listening: echoing, restating and seeking clarification of what the person expresses (verbally or non verbally) and acknowledging the expressed feelings. Behavior Therapy therapy that applies learning principles to the elimination of unwanted behaviors Classical Conditioning Techniques Counterconditioning: a behavior therapy procedure that conditions new responses to stimuli that trigger unwanted behaviors; based on classical conditioning. Includes exposure therapy and aversive conditioning. Exposure Therapies: behavioral techniques, such as systematic desensitization, that treat anxieties by exposing people (in imagination or actuality) to things they fear and avoid. Systematic Desensitization: a type of counterconditioning that associates a pleasant relaxed state with gradually increasing anxiety-triggering stimuli. Commonly used to treat phobias. Virtual Reality Exposure Therapy: an anxiety treatment that progressively exposes people to simulations of their greatest fears, such as airplane flying, spiders, or public speaking. Aversive Conditioning: a type of counterconditioning that associates an unpleasant state (such as nausea) with an unwanted behavior (such as drinking alcohol) Operant Conditioning Token Economy: an operant conditioning procedure in which people earn a token of some sort for exhibiting a disred behavior and can later exchange the tokens for various privileges or treats a therapy that teaches people new, more adaptive ways of thinking and acting; based on the assumption that thoughts intervene between events and our emotional reactions Cognitive Behavior Therapy Group and Family Therapy a popular integrated therapy that combines cognitive therapy (changing self-defeating thinking) with behavior therapy (changing behavior) Benefit to Group Therapy: the social context allows for people to both discover that others have problems similar to their own and to receive feedback as they try out new ways of behaving. Family Therapy: therapy that treats the family as a system. Views an individual's unwanted behaviors as influenced by or directed at other family members; attempts to guide family members toward positive relationships and improved communication. Outcome Research 3 reasons clients judge psychotherapy:
They tend to enter therapy in crisis
They need to believe their time and expense is being justified
They try to find something positive to say when asked to evaluate their therapist Reasons of overestimation:
Clients enter therapy when they're unhappy
Leave it when they are less unhappy
Stay in touch only if satisfied with the treatment they received
Because of these reasons clinicians are mostly aware of other therapists' failures, not their own. Placebo effect (the belief that the treatment will work) and the regression toward the mean (the tendency for extreme or unusual scores to fall back toward the mean) contribute to the clients' and clinicians' misperceptions of the effectiveness of psychotherapy. Outcome Studies: randomized clinical trials in which people on a waiting list receive therapy or no therapy. these studies reveal that 1. people who remain untreated often improve but 2. those who receive psychotherapy are morel likely to improve, and 3. people who receive psychological treatment spend less time and money later seeking other medical treatment, compared with their counterparts on waiting lists. Meta-Analysis: procedure for statistically combining the results of many different research studies Meta-Analyses indicate that no one type of therapy is most effective overall, nor is there any connection between effectiveness and a therapists' training, expirence, supervision, or licensing. Although some are well-suited to specific disorders, such as...
cognitive, interpersonal, and behavior therapies for depression
cognitive, exposure, and stress-inoculation therapies for anxiety
cognitive-behavior therapy for bulimia
behavior modification for bed wetting
behavior conditioning therapies for phobias, compulsions, and sexual disorders. EMDR Therapy: a therapist attempts to unlock and reprocess previously frozen traumatic memories by waving a finger in front of the eyes of a person imagining traumatic scenes. Hasn't upheld under scientific testing and its modest successes may be attributable to the placebo effect. Light Exposure Therapy: exposure to daily timed doses of light that mimics outdoor light. proved most successful in treatment for seasonal affective disorder (a form of depression linked to periods of decreased sunlight) 3 Benefits of All Psychotherapies New hope for demoralized people A fresh perspective An empathetic, trusting, caring relationship Therapeutic Alliance: the emotional bond between therapist and client. Important part of effective therapy. Physically changing the brain's functioning by altering its chemistry with drugs, overloading its circuits with electroconvulsive shock, using magnetic impulses to stimulate or dampen its activity , or altering its circuits though psychosurgery. Psychopharmacology: the study of drug effects on mind and behavior Double-Blind Studies: where neither the medical staff nor the patient knows whether the patient is taking the real drug or a placebo, eliminating the bias that can result from clinicians' and patients' expectation of improvement dampen responsiveness to irrelevant stimuli, and they have been used effectively to treat schizophrenia accompanied by positive symptoms ( the presence of hallucinations and delusions) The first generation antipsychotic drugs, which block D2 (dopamine) receptors, can produce Tardive Dyskinesia- involuntary movements of facial muscles, the tongue, and arms and legs. The second-generation of antipsychotics, which target D1 receptors, can affect metabolism, increasing the risk of obesity and diabetes. Antianxiety Drugs Depress central nervous system activity, often used in combination with psychotherapy for treatment of anxiety disorders. These drugs can be psychologically and physically addictive. Antidepressant Drugs increase the availability of norepinephrine or serotine, which elevate arousal and mood. They begin to influence neurotransmitter systems almost immediately, but their full psychological effects may not appear until weeks later. Mood Stabilizing Medications Few drugs such as lithium for bipolar disorder, have proven very effective in stabilizing moods. The understanding of how these drugs work is yet to be fully understood. biomedical therapy for severely depressed patients n which a brief electric current is sent through the brain of an anesthetized patient Last-resort treatment for many people with severe depression (its ineffective in treating other disorders) who have not responded to drug therapy Alternatives to ECT Repetitive Transcranial Magnetic Stimluation (rTMS): a painless procedure where pulses of magnetic energy sent through the skull to the surface of the cortex stimulate or dampen activity in various areas of the brain A crude procedure in which surgical instruments inserted through a patient's eye sockets were used to sever connections running to the frontal lobes of the brain. the intent was to calm uncontrollably emotional or violent patient, but instead it usually created lethargy and an impulsive personality. Case Study #3 Louisiana State University did a study on students with ADHD on the effects of stimulant medications in college students to see what improves with medication and what does not.
They repeatedly found that people with ADHD had lower grades, ACT scores, and dropped more classes than their peers.
However, these issues were not improved by the stimulants such as Adderall.
The students with good study habits did better overall than their peers who did not have good habits, even without the use of stimulants
Acquiring better study habits early on through behavioral therapy could be more beneficial than use of drugs.
Case Study #2

Done by St. John's Episcopal Hospital
Tested effectiveness of Saint John's Wort to treat depression
Used a double-blind, randomized format to study 19 women and 11 men with mild-to-moderate depression.
They found that 47 percent of those taking St. John's wort improved compared with 40 percent of those taking the sertraline which is a serotonin inhibitor
Case Study #4 State University of New York at Albany
Using Virtual Reality Exposure Therapy, they treated Klock who was deathly afraid of heights
Therapists accompany patients into feared situations such as glass walled elevators going down 20 stories
A true sense of reality is needed, immersion.
Patient had to stay in the situation, no matter how scared they felt. Gradually, over several sessions, they became used to the height.
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