psy-p 102: introduction to psychology - Study Guide
psy-p 102: introduction to psychology - Study Guide psy-p 102
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Study Guide for Exam 5 Psychotherapy Chapter 15 gt Psychotherapy and Biomedical therapy differences between the two I psychotherapy the treatment of emotional behavioral and interpersonal problems through the use of psychological techniques designed to encourage understanding of problems and modify troubling feelings behaviors or relationships 0 Many different forms of psychotherapy but all believe psychological factors play a big role in a persons troubling feelings relationships or behaviors I Biomedical therapies the use of medications electroconvulsive therapy or other medical treatments to treat the symptoms associated with psychological disorders 0 Based on the assumption that the symptoms of many psychological disorders involve biological factors such as abnormal brain chemistry 0 Drugs that are used to treat psychological or medical disorders psychotropic medications gt Difference between a clinical psychologist and psvchiatrist I Clinical psychologist Holds an academic doctorate PdD psy D or EdD and is required to be licensed to practice Assesses and treats mental emotional behavioral disorders Has expertise in psychological testing and evaluation diagnosis psychotherapy research and prevention of mental and emotional disorders May work in private practice hospitals or community mental health centers 0 Until very recently only licensed physicians psychiatrist were legally allowed to prescribe psychotropic medications But that tradition may be changing Since the 1990 s a movement to allow specially trained psychologists to prescribe has achieved some success Began with the US department of Defense conducting a successful pilot program in which 10 military psychologist were given intensive training in prescribing psychotropic medications to treat psychological disorders The success of the department of the defense program was one of the factors that persuaded New Mexico lawmakers to enact it 0 Includes psychoanalytic humanistic behavioral and cognitive I Psychiatrist holds a medical degree MD or DO and is required to be licensed to practice Has expertise in the diagnosis treatment and prevention of mental and emotional disorders Often has training in psychotherapy May prescribe medications electroconvulsive therapy and other medical procedures gt Freudian Psvchoanalvsis Freudian view of the causes of psychological disorders I Psvchoanalvsis A type of psychotherapy originated by Freud in which free association dream interpretation and analysis of resistance and transference are used to explore repressed or unconscious impulses anxieties and internal conflicts O Believed that when early childhood memories result in unresolved conflicts and frustrated urges these emotionally charged memories are repressed or pushed out of conscious awarenessAlthough unconscious these repressed conflicts continue to in uence a person s thoughts and behavior including the dynamics of his relationships with others O Psychoanalysis is designed to attempt to help unearth unconscious con icts so the patient attains insight as to the real source of her problems Through the intense relationship that develops bw the psychoanalyst and the patient longstanding psychological con icts are recognized and reexperienced If the analytic treatment is successful the con icts are resolved gt Steps in psychoanalysis Free association resistance analysis of the resistance dream interpretation manifest and latent content of dreams and transference Freud developed several techniques to coax longrepressed memories Impulses and con icts to a patient s conscious Free association a technique used in psychoanalysis in which the patient spontaneously reports all thoughts feelings and mental images as they come to mind as a way of revealing unconscious thoughts and emotions while lying on a couch The psychoanalyst typically sits out of view occasionally asking questions to encourage the flow of association 0 Blocks in free association such as sudden silence or an abrupt change of topic were thought to be signs of resistance the patient s conscious or unconscious attempts to block the process of revealing repressed memories and con icts Resistance is a sign that the patient is uncomfortably close to uncovering psychologically threatening material Dream interpretation because psychological defenses are reduced during sleep Freud believed that unconscious con icts and repressed impulses were expressed symbolically in dream images Often the dream images were used to trigger free associations that might shed light on the dream s symbolic meaning Content of dreams is analyzed for disguised symbolic wishes meanings and motivations O The psychoanalyst sometimes makes carefully timed interpretations in which the psychoanalyst offers a carefully timed explanation of the patient s dreams free associations or behaviors to facilitate the recognition of unconscious con icts or motivations Timing of interpretations is important Transference One of the most important processes that occur in the relationship between the patient and he psychoanalyst Occurs when the patient unconsciously responds to the therapist as thought the therapist were a significant person in the patient s life often a parent the process by which emotions and desires originally associated with a significant person in the patient s life such as a parent are unconsciously transferd onto the psychoanalyst O The psychoanalyst encourages transference by remaining neutral as possible the psychoanalyst doesn t reveal personal feelings take sides make judgments or actively advise the patient The therapeutic neutrality is designed to produce optimal frustration so that the patient transfers and projects unresolved con icts onto the psychoanalyst 0 As the transference becomes more intense the patient relives unconscious emotional con icts that have been repressed since childhood Only now these con icts are being lived out in the context of the relationship between the psychoanalyst and the patient All of these techniques are designed to help the patient see how past con icts in uence her current behavior and relationships Once these kind of insights are achieved the psychoanalyst helps the patient work through and resolve long standing con icts As resolutions occur maladaptive behavior patterns that were previously driven by unconscious con icts can be replaced with more adaptive emotional and behavioral responses I The intense relationship bW the psychoanalyst and the patient takes time Typically meet 3 times a week Often for years Slow expensive process gt Short term Psychodynamic therapy Interpersonal Therapy Short tem psychodynamic therapy based on traditional psychoanalytic notions yet differs In that it is typically timed limited has goals and involves an active rather than neutral role for the therapist 0 Last for no more than a few months The patient s problems are quickly assessed at the beginning of therapy The therapist and the patient agree on specific concrete and attainable goals In the sessions most psychodynamic therapist are more direct than are traditional psychoanalysis actively engaging the patient in a dialogue 0 As in traditional psychoanalysis the therapist uses interpretations to help the patient recognize hidden feelings and transferences that may be occurring in relationships in their life 0 Interpersonal therapy IPT a brief short term psychodynamic psychotherapy that focuses on current relationships rather than past and is based on the assumption that symptoms are caused and maintained by interpersonal problems 0 0 Originally developed as a brief treatment for depression May be brief or long term but it is highly structured In the first phase of treatment the therapist recognizes the interpersonal problem that is causing difficulties In the interpersonal therapy model there are 4 categories of personal problems I Unresolved grief problems dealing with the death of a significant other I Role disputes repetitive conflicts with significant others persons partner family member friends I Role transitions problems involving major life changes such as going to college getting married divorced parenting retiring I Interpersonal deficits 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 Also effective in helping people deal with interpersonal problems such as martial conflict parenting issues and conflicts at work Also works in non western cultures Proven to be work in family and group therapy sessions gt Behavior Therapy principles of behavior therapy operant and classical conditioning and observational learning 0 Behavior therapy a type of psychotherapy that focuses on directly changing maladaptive behavior patterns by using basic learning principles and techniques also called behavior modification 0 In contrast to insightoriented therapies the goal is to modify specific problems in behavior not change the entire personality Focus on current behaviors rather than the past 0 Assume that maladaptive behaviors are learned just as adaptive behaviors are The basic strategy in behavior therapy is unlearning maladaptive behaviors and learning adaptive ones in their place Use techniques based on the learning principles of classical conditioning operant conditioning and observational learning 0 0 Techniques based on classical conditioning I Learned associations can be at the base of some maladaptive behaviors Including strong negative emotional reactions John Watson conditioning little albert to fear a lab rat and furry objects I Marv Cover J ones student of John Watson explored ways of reversing conditioned fears For her pioneering efforts in treatment of children fears she is widely known as the first behavior therapist She treated a 3 year old named Peter who was similar to little albert fearful of furry objects Bc he was especially fearful of a tame rabbit she tried eliminating the rabbit fear Used a procedure known as counterconditioning the learning a new conditioned response that is incompatible with a previously learned response 0 The caged rabbit was brought into Peter s view but kept far enough to avoid eliciting fear original conditioned response With the rabbit visible at a tolerable distance peter sat in his chair and ate his favorite snack His favorite food was used because the enjoyment of eating would naturally elicit a positive response the desired conditioned response Such a positive response would be incompatible with the negative response of fear 0 Every day for two months the rabbit was inched closer to Peter as he ate his snack As peter s tolerance for the rabbit s presence gradually increased he was eventually able to hold the rabbit in his lap petting it and eating with one hand His fear of rabbits was eliminated and he stopped being afraid of other furry objects too She also used social imitation or observational learning techniques to help eliminate his fear Peter observed other children petting the rabbit Eventually Peter imitated the actions of the nonfearful children Systematic Desensitization by Joseph Wolpe Based on the same grounds as counterconditioning a type of behavior therapy in which phobic responses are reduced by pairing relaxation with a series of mental images or reallife situations that the person finds progressively more fear provoking Involves learning a new conditioned response relaxation that is incompatible with the old conditioned response fear First the patient learns progressive relaxationwhich involves successfully relaxing one muscle group after another until a deep state of relaxation is achieved Second the behavior therapist helps the patient construct an anxiety Hierarchya list of anxietyprovoking 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 ex walking on the beach Third process of desensitization While deeply relaxed the patient imagines the least threatening scene on the anxiety hierarchy After they can maintain complete relaxation while imagining this scene move to next If the patient begins to feel anxiety the therapist guides him back to imagining the previous scene or the control scene Over several sessions the patient gradually and systematically works his way up the hierarchy imagining each scene while maintaining relaxation Each imagined scene becomes paired with a conditioned response of relaxation rather than anxiety and desensitization to the feared situation takes place If the technique is successful the feared situation no longer produces a conditioned response of fear It is often combined with other techniques such as observational learning ex showing someone fear of planes a video of people boarding and riding on planes Because relaxation and fear are incompatible relaxation essentially blocks anxiety Aversive conditioning John Garcia first showed how taste aversions could be classically conditioned after rats drank a sweet avored water Garcia injected them with a drug that made them ill The rats developed a strong taste aversion for sweet water avoiding it A relatively ineffective type of behavior therapy that involves repeatedly pairing an aversive stimulus with the occurrence of undesirable behaviors or thoughts Attempts to create an unpleasant conditioned response to a harmful stimulus like smoking drinking For substance abuse and addiction taste aversions are commonly induced with the use of nauseainducing drugs ex A med called Antabuse is used in aversion therapy for alcoholism Consuming alcohol while taking Antabuse creates nausea Aversive conditioning techniques have been applied to many problem behaviors But mental health professionals are cautious about using such techniques because of their potential to harm or produce discomfort for clients Generally not very effective 0 Techniques based on operant conditioning O Operant conditionin2 Skinner s model of learning is based on the simple principle that behavior is shaped and maintained by its consequences Behavior therapist have developed many techniques derived from operant conditioning Shaping involves reinforcing successive approximations of a desired behavior Often used to teach appropriate behaviors to patient who are mentally disabled by autism or mental retardation or severe mental illnessesex been used to to increase the attention span of hospitalized patients with schizophrenia Other techniques involve controlling the consequences that follow behaviors Positive cg neggtive reinforcement are used to increase the incidence of desired behaviors Extinction or the absence of reinforcement is used to reduce the occurrence of undesired behaviors Ex of operant techniques in therapy to treat girl s sleeping issues First identify specific problem behaviors and determine their baseline ratehow often each problem occurred before treatment began which allows the therapist to target each problem behavior individually and measure progress Next the parent s identify specific behavioral goals for daughter The parent s were taught operant techniques to decrease the undesirable behaviors and increase desirable ones ex to extinguish the girl s crying the parent s were taught to ignore her rather than continue to reinforce it with parental attention Desirable behaviors were to be positively reinforced with praise encouragement attention and rewards Operant conditioning techniques have been applied to many different psychological problems from habit and weight control to helping autistic children learn to speak and modify the behavior of people with retardation or mental disorders I Token economy another example of the use of operant conditioning techniques to modify behavior A form of behavior therapy in which the therapeutic environment is structured to reward desired behaviors with tokens or points that may eventually be exchanged for tangible rewards I A system of strengthening desired behaviors through positive reinforcement Tokens or points are awarded as positive reinforcers for desirable behaviors and withheld or taken away for undesirable behaviors I Token economies have been most successful in controlled environments where the behavior of the patient is under ongoing watch or supervision classrooms jails inpatient psychiatric units Been shown to be effective even with severely disturbed patients who have been hospitalized for years Although effective token economies are hard to implement esp in community based outpatient clinics so not widely used today 0 Contingency management modified version of the token economy that has been used in outpatients in treatment programs Like the token economy it involves carefully specified behaviors that earn that individual rewards However unlike token economies which cover many behaviors it is typically more narrowly focused on one or a few specific behaviors Proved to be esp effective in outpatient treatment ot people who are dependent on heroin cocaine alcohol gt ModelingObservational learning techniques gt Aversion therapyaversive conditioning ooding gt Systematic Desensitization In vivo desensitization gt Cognitive Therapies 0 A group of psychotherapies based on the assumption that psychological problems are due to faulty irrational illogical patterns of thinking treatment techniques focus on recognizingidentifying and alteringchanging these unhealthy thinking patterns to more adaptive healthy patterns of thinking Most people blame their unhappiness on external events and situations but the real cause of unhappiness is the way the person thinks about the evetns not the events themselves I Ellis ABC model for therapy Rational Emotive TherapyRET theoretical assumption of the causes of emotional and behavioral disorders 0 Ellis trained as psychoanalyst and psychologist but disappointed with psychoanalyst approach as patients had insights but never got better Believed you largely feel the way you think I Developed Rational emotive therapy RET Based on the assumption that people are not disturbed by things but rather by their view of things I The key premise is that people s problems are caused by their faulty expectations and irrational beliefs RET focuses on changing the patterns of irrational thinking that are believed to be the primary casue of the client s problems I Ellis argues that people mistakenly believe that they become upset because of external events But not external events that make you unhappy its their interpretation of those events Its not dans behavior that makes Ann miserable its Ann s interpretation of the meaning of Dan s behavior I In RET therapy problems are explained by the ABC model When an Activating event A occurs it is the person s Beliefs 1B about the event that cause emotional Consequences C I Identifyingbecoming aware of the core irrational beliefs that underlie personal distress is the first step in RET Often irrational beliefs reflect musts and shoulds that are absolutes such as I should be good at everything I do The consequences of such thinking are unhealthy negative emotions like extreme anger Not only does the person feel miserable but she also feels that she is unable to cope with or control upsetting situations These kind of irrational cognitive or emotional response interfere with constructive attempts to change disturbing situations The result is selfdefeating behaviors depression and other problems I The second step is for the therapist to dispute the irrational beliefs RET therapist tend to be direct and even confrontational Rather than establishing a warm atmosphere RET therapist rely on logical persuasion and reason to push people toward recognizing and surrendering his irrational beliefs blunt harsh language is sometimes needed to push people into helping themselves I From the client s view RET therapy requires a lot of effort First the person must admit her irrational beliefs and accept that they are irrational and unhealthy Old mental habits don t yield easily The client must also change her way of interpreting and responding to stressful events I The long term RET goal is to teach clients to recognize and dispute their own irrational beliefs in situations BUT responding rationally to unpleasant situations does not mean denying your feelings Ellis thinks it is perfectly rational to feel sad when you are rejected or make a mistake Appropriate emotions are the consequences of rational beliefs Such healthy emotional responses help people work to change or cope with difficult situations I Albert Ellis s ideas have been in uential in psychotherapy and is popular because its straightforward and simple Has been shown to be effective in depression social phobia and some anxiety disorders and helping people overcome self defeating behaviors gt Beck s Cognitive Therapy Becks emphasis on Irrational belief Cognitive Bias and distorted perceptions Becks development of Cognitive therapy grew out of research on depression Discovered that depressed people have a 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 selfdeprecating beliefs Beck s CT focuses on correctingchanging the cognitive biases maladaptive beliefs that underlie depression and other psychological disorders Much in common with Ellis Like Ellis Beck believes that what people think creates their moods and emotions And like RET CT involves helping patients identify fault thinking and replace unhealthy patterns of thinking with healthier ones In contrast with Elli s emphasis on irrational thinking Beck believes that depression and other mental issues are caused by distorted thinking and unrealistic beliefs The CT therapist encourages that client to empiricallv test the accuracv of his or her assumptions and beliefs 1 help the client learn to recognize and monitor the automatic thoughts that occur without conscious effort or control Automatic thoughts can control your mood and shape your responses to events Because their perceptions are shaped by their negative cognitive biases depressed people usually have automatic thoughts that reflect very negative interpretations of experience 2 the therapist helps the client learn how to empirically test the reality of the automatic thoughts that are so upsetting ex thinks always say the wrong thing therapist tells client to have convo and note how many times says the wrong thing initially the therapist acts as a model showing the client how to evaluate the accuracy of automatic thought By modeling techniques for evaluating the the accuracy of automatic thoughts they hope to teach the client to do the same on their own Goal accurate and realistic perceptions of self others and external events The CT therapist also tries to create a therapeutic climate of collaboration that encourages the client to contribute to the evaluation of the logic and accuracy of automatic thoughts CT shown to be effective in treating depression and other disorders Like anxiety borderline personality disorders eating disorders PTSD and relationship problems May even help prevent depression from recurring In study high risk patients that experienced several episodes of depression in past were much less likely to relapse when they continued CT after depression lifted gt Becks Cognitive Biases in Depression Arbitrary Inference Selective Abstraction and Personalization Depressed people think and interpret experience in very negative terms They are prone to systematic errors in logic which shape their negative interpretation of events Arbitrary interference drawing a negative conclusion when there is little or no evidence to support it ex When Jim calls Joe to cancel their lunch date bc he has a meeting at work Joe thinks that he doesn t like him Selective Abstraction Focusing on a single negative detail taken out of context ignoring the more important aspects of the situation during Lisa s annual review her manager praises her performance but notes that she could be more confident when dealing with customers She leaves the office thinking that her boss is on the verge of firing her because of her poor confidence skills Personalization taking responsibility blaming oneself or applying external events to oneself when there is no basis or evidence for making the connection ex Rich becomes upset when his teacher warns the class about cheating he thinks the teachers warning was aimed at him and thinks that the teacher suspects him cheating on parts gt CognitiveBehavioral Therapy CBT Combination of Cognitive and Behavioral techniques assumptions as to how thoughts moods and behaviors are interrelated CBT therapy that integrates techniques from both cognitive and behavioral approaches and is based on the assumption that thoughts moods and behaviors are interrelated Thus changes in thought patterns will affect mood and behaviors and changes in behaviors will affects thoughts and moods O Pragmatic approach to CBT therapist design an integrated treatment plan using the techniques that are most appropriate for specific problems Been used in children adolescents and eldery Very effective in treatment for many disorders and can help lower the incidence of delusions in patients with schizophrenia 0 Emerging approach in CBT involves mindfulness techniques mindfulnessa meditation technique that involves present centered awareness without judgment like CBT the mindfulness based therapies involve targeting both behavior and thoughts But they do not seek to challenge test or replace the content of thoughts Rather the goal is to change the context in which those thoughts are understood Decentering individuals are taught to notice label and relate to their thoughts and emotions as just passing events rather than to identify with them and allow them to shape experience By increasing mindful awareness of thoughts cravings impulses clients are less likely to act on them Mindfulness Based Stress Reduction MB SR first mindfulness based therapy to earn acceptance Involves a structured program of mindfulness meditation and yoga and group discussion Treatment of stress and anxiety Mindfulness Based Cognitive Therapy MBCT developed to treat depression although expanded to treat other disorders Mindfulness training has been incorporated in other CBT treatments like substance abuse and borderline personality disorder New approach promising MBSR and MBCT were effective treatments for mood and anxiety disorders with long lasting effects One study showed that MBCT was as affective as antidepressant meds in preventing relapse of depression gt Humanistic PsychotherapyClientCentered Therapy emphasis of this therapy Humanistic psychologists think that the most important factor in personality is the individual s conscious subjective perception of self See people as innately good and motivated by the need to grow psychologically and fulfill unique potential Client centered therapy person centered therapy developed by Carl Rogers Deliberately used the word client rather than patient Thought patient implied that people in therapy were sick and seeking authority figure to cure them Clientcentered therapy emphasizes the Client s subjective perception of himself and his environment rather than the therapist s perception of the patient Roger saw the therapeutic relationship as the catalyst that leads to insight and change Believed that the therapist should be nondirective not making judgment decisions or solutions for client change in therapy must be directed by the client The therapist s role is to create the conditions that allow the client to direct the focus of therapy What therapeutic conditions promote selfawareness growth and selfdirected change Roger s believed that the therapist must have 0 Genuineness the therapist honestly and openly shares her thoughts and feelings with the client By modeling genuineness the therapist indirectly encourages the client to exercise this capability more fully in self 0 Unconditional positive regard the therapist must value accept and care for the client whatever her problems or behavior Rogers thought people develop psychological problems because they have consistently experienced only conditional acceptance family Friends peers will accept them only if conform to their expectations thus the patient has cut off or denied unacceptable aspects of self distorting her self perception which have negatively affected thoughts and behaviors The therapist who successfully creates a climate of unconditional positive regard fosters the person s natural tendency to move toward selffulfilling decisions without fear of evaluation or rejection Allows the patient to be whatever feeling is going on at the moment 0 Empathetic understanding the therapist must do so by reflecting the content and personal meaning of the feelings being experienced by the client The therapist creates a psychological mirror reflecting the patient s thoughts and feelings as they exist in the client s private inner world The goal is to help the client explore and clarify feelings and thoughts In the process the client begins to see himself and his problems more clearly Requires the therapist to listen actively 0 These three conditions foster feelings of being psychologically safe accepted and valued In this atmosphere change is more likely to occur as the patient s self concept and worldview become healthier As client becomes more self aware more open finds freedom to grow and move toward selfactualization realization of unqiue potential gt Applications of clientcentered therapy Motivational interviewing designed to help clients overcome the mixed feelings or reluctance they might have about committing to change Usually last one session or two MI is more directive than traditional clientcentered therapy The main goal of MI is to encourage and strengthen the client s selfmotivating statement or change talk these are expressions of the client s need desire and reasons for change Using clientcentered techniques the therapist responds with empathetic understanding and reflective listening helping client explore own motivations for change When the client expresses reluctance the therapist acknowledges that mixed feelings and redirects the emphasis toward change Seeks to evoke client s motivation with confidence in the human desire to grow in positive directions Says you have what you need I Client centered therapy has also been sued in marital counseling parenting business education and even international relations gtFactors in Successful therapy gtGroup therapy family therapy and selfhelp groups 0 Group therapy a form of psychotherapy that involves one or more therapists working simultaneously with a small group of clients Often group therapy is an important part of treatment programs for hospital inpatients Groups may be small as 3 or 4 or large as 10 Typically held by a professional whereas self help groups typically are not 0 Any approach can be used in group therapy And just about any problem that can be handled individually can be dealt with in a group 0 Number of advantages over individual psychotherapy 1 O 1 group therapy is costeffective It is less expensive for the client and more time efficient for the therapist O 2 rather than relying on a client s self perceptions anout how she relates to others the therapist can observe her actual interactions with others May provide insight into their personalities and behavior patterns 0 3 The support and encouragement provided by the other group memebers may help a person feel less alone and understand that his problem are not unique Strength in numbers Group therapies in the aftermath of disasters have good support 0 4 members may provide each other with helpful Practical advice for solving common problems and can act as models for successfully overcoming difficulties 0 5 Working within a group gives people an opportunity to try out new behaviors in a safe supportive environment I Family therapy a form of psychotherapy that is based on the assumption that the family is a system and that treats the family as a unit 0 Focusing on the whole family rather than on the individual 0 Maj or goal Is to alter and improve the ongoing interactions among family members Typically involves many members of the intermediate family including children and adults and may include important extended family such as grandparents 0 Based on assumption that the family is a system An interdependent unit not just a collection of separate individuals A dynamic structure in which each plays a unique role 0 Every family has unspoken rules of interaction and communication rules revolved around issues such as members that have power and who makes decisions Etc As such issues are explored unhealthy patterns of family interaction can be identified and replaced with new rules that promote the psychological health of the family as a unit 0 Often used to enhance the effectiveness of individual psychotherapy For example patient with schizophrenia are less likely to experience relapses when family members are involved in therapy In many cases the psychotherapist realizes that the individual clients problems reflect con ict and disturbance in the entire family system For the client to become better The family as a whole must become psychologically healthier 0 Most family therapist also provide marital or couple therapymany different approaches Most couple therapist have the goal of improving communication reducing negative communication and increasing intimacy between couple I For example behavioral couple therapy based on the assumption that couples are satisfied when they experience more reinforcement than punishment in their relationship Thus it focuses on increasing caring behaviors and teaching couples how to constructively resolve conflicts and problems I Selfhelp groups Self help groups range from the familiar alcoholics anonymous to the obscure Abused by religion and from the general parents of teens to the specific black parenting There are also groups for people dealing with lifes transitions such as divorce or retirement 0 All organized and led by nonprofessionals They are either free of charge or charge nominal fees to cover the cost of materials 0 Typically made up by members who have a common problem and meet for the purpose of exchanging psychological support 0 Some are freewheeling but others are highly structured 0 Many follow a 12step approach patterned after the famous 12 step approach of Alcoholics Anonymous AA Including themes of admitting that you have a problem seeking help from a higher power confessing your shortcomings repairing your relationships with others and helping other people who have the same problem critiqued for its idea that people are powerless to cope with their problems on own and must depend on a higher power 0 Research has shown that self help groups can be as effective as therapy provided by a mental health professional at least for some psychological problems Self help groups may be a cost effective alternative to psychotherapy for some It is not known WHY selfhelp groups are effective gt Support and encouragement and the helper therapy principle on which all self help groups are based people who help other people are themselves helped 0 One study suggests that 12 step attendees who find sponsors and who have high motivation to change are more likely to stay involved gtUses of ECT effectiveness Electroconvulsive therapy a medical treatment for severe depression involves electrically inducing a brief brain seizure unconsciously shocked Seizure last a minute When conscious confusion and disorientation occur Typically receives two to three times a week for two to seven weeks In the short term Very effective about 80 improve relieves the symptoms quickly within days Low complication rate typically used when all other treatment have failed However effects are short lived relapses are common within 4 months today those treated with ECT often follow with antidepressant meds Not proven that shocks are necessary It is very controversial gtAntidepressants SSRI s and dual action antidepressants how they work in the brain different types of antidepressants 1st generation SSRI s DualAction antidepressants DualReuptake inhibitors I 1 generation antidepressants tricyclists and MAO inhibitors affect multiple neruotrasnmitter pathways in the brain Increase the availability of serotonin and norepinephrinebut takes up to 6 weeks before depression goes away 0 Tricyclists side effects can cause dry mouth weight gain dizziness O MAO side effects can interact with many foods with certain chemical I Selective serotonin reuptake inhibitors SSRI third group of antidepressants rather than acting on multiple neurotransmitter pathways the SSRI affect the availability of only serotonin Act more selectively First to be released was Prozac O Tend to produce fewer side effects But side effects headaches nervousness 10s of appetite difficulty sleeping O SSRIs are also used in the treatment of anxiety disorders 0 Prozac became most pop Antidepressant in the world I Dual action antidepressants also affect serotonin levels but different mechanism I Dualreuptake inhibitors Cymbalata affects levels of serotonin and norepinephrine gt Drugs for Bipolar disorder lithium tegretol and depakote I Lithium the medication most commonly used to treat bipolar disorder a naturally occurring substance It counteracts both manic and depressive symptoms in bipolar patients effectiveness recognized since l960 s 0 Can prevent acute manic episodes over the course of a week or two once under control the long term use 0 lithium can help prevent relapses into either mania or depression Majority respond well to lithium but some experience relapses 0 Potential side effects if lithium level too low manic symptoms persist If too high lithium poisoning can occur Blood level of lithium must be monitored 0 Lithium affects levels of an excitatory neurotransmitter called glutamate which is found in many areas of the brain Lithium stabilizes availability of glutamate within a nnormal range preventing highs and lows I Depakote anticonvulsant medicine originally used to counteract epileptic seizures Seems to be especially helpful in treating those who rapidly cycle through bouts of bipolar disorder several times a year and for patients who don t respond to lithium gt Antipsychotic drugs differences between typical and atypical antipsychotic drugs side effects how they work in the brain D1 and D2 neurons 0 Typical antipsychotic drugs prescription drugs that are used to reduce psychotic symptoms frequently used in the treatment of schizophrenia also called neuroleptics O Resperine discovered in India used to treat schizophrenia O Chlorpromazine found in France treat schizophrenia fewer side effects than Resperine now called thorazine 0 Both resperine and chlorpromazine reduce levels of dopamine in the brain The first antipsychotics reduced the positive symptoms of schizophrenia Reduced the number of hospitalized for schizophrenia I Drawbacks didn t actually cure schizophrenia positive symptoms often returned if stopped taking drugs 0 Second not effective in eliminating negative symptoms sometimes even made them worse 0 Third the antipsychotics often produced unwanted side effects dry mouth weight gain sleepiness 0 Fourth fact they globally altered brain levels of dopamine affected not only psychotic symptoms but also normal motor movements Could produce muscle tremors rigid movements Long term use of these meds can cause a motor disorder called tardive dyskinesia 0 Fifth the revolving door pattern of hospitalization many rehospitalized O Atypical antipsychotic drugs 1990 newer antipsychotic medications that in contrast to the earlier antipsychotic drugs block dopamine receptors in specific brain regions associated with psychotic symptoms rather than more globally throughout the brain which affect movement resulting in fewer side effects 0 Affect both levels of serotonin and dopamine 0 Many advantages over older antipsychotic drugs less likely to cause movement related side effects much more effective in treating the negative symptoms of schizophrenia apathy much less likely to relapse revolving door pattern and return to hospital 0 Side effects weight gain and cardiac problems increased risk of diabetes Large study suggest that the newer antipsychotic medications don t produce greater improvements than the old ones gt Antianxiety drugs how these drugs work and the problems in using these drugs sideeffects two classes of antianxiety drugs 0 Anti anxiety drugs prescription drugs used to alleviate the symptoms of anxiety 0 The best known meds are the benzodiazepines include Xanax and Valium These calm jittery feelings relax the muscles and promote sleep Used to be called tranquilizers because of this Take effect rapidly I Increasing the level of GABA a neurotransmitter that inhibits the transmission of nerve impulses in the brain and slows brain activity I Taken for a week or two can reduce anxiety levels I Dangerous side effects can reduce coordination alertness and reaction time Effects intensified with alcohol can cause death Can be physically addictive if taken long time If dependence occurs must gradually withdraw from it as abrupt withdrawal can cause threatening symptoms Because of addictiveness less widely prescribed today 0 Buspar newer antianxiety drug Fewer side effects How it works is unclear likely to affect brain dopamine and serotonin levels Relieves anxiety while allowing the person to maintain normal alertness Does not cause the drowsiness that benzodiazepines do Very low risk of addiction 0 Drawback must be taken two to three weeks before anxiety is reduced Decreases its effectiveness in treating acute anxiety For immediate shortterm relief from anxiety benzodiazepines are still regarded as most effective meds available gt Drugs used to treat OCD Anafranil etc gt History of Psychosurgery Egas Moniz Walter Freeman Transorbital lobotomy gtUses of Psychosurgery today
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