FINAL PSY250 Study Guide
FINAL PSY250 Study Guide PSY 250
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This 9 page Study Guide was uploaded by Jacobi Johnson on Friday December 11, 2015. The Study Guide belongs to PSY 250 at Central Michigan University taught by Deskovitz, Mark in Fall 2015. Since its upload, it has received 102 views. For similar materials see Abnormal Psychology in Psychlogy at Central Michigan University.
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Date Created: 12/11/15
FINAL PSY250 Study Guide Chapter 17 Therapy • Most therapists rely on receptiveness, warmth, and empathy and try to take a nonjudgemental approach. However, there is more to therapy than just talking. Therapists introduce psychological interventions that are designed to promote new understandings, behaviors, or both. • The underlying idea behind psychotherapy is that people with psychological problems can change and learn more adaptive ways of perceiving, evaluating, and behaving. This does not mean it is easy though. Therapy takes time. • The goals of psychotherapy include changing maladaptive behavior, minimizing or eliminating stressful environment conditions, reducing negative affect, Improving interpersonal competencies, Resolving personal conflicts, modifying inaccurate assumptions about oneself, and fostering a more positive self image. • Therapy does not offer any sort of magical transformation, but is can be beneficial for even the most severe mental disorders. • A multitude of therapeutic approaches exist. • Why do people seek therapy? Stressful life circumstances, long standing problems, personal growth, etc, but some may be more reluctant and few may have been required to seek treatment by the courts. • Who provides services? It’s not just psychiatrists or psychologists with PhDs also physicians, counselors, social workers, religious clergy, etc. • The therapeutic relationship is crucial. Key elements include a sense of working collaboratively on the problem, agreement between patient and therapist about the goals and tasks of therapy, and an effective bond between patient and therapist. • The client’s major contribution is their motivation and if they expect to receive help. • Rapport must be established. • At estimating clients gains in therapy generally depend on one or more of the following sources of information: a therapist impression of changes that have occurred, a clients report of change, reports from the client family and friends, comparison of pretreatment and posttreatment scores on personality tests or other instruments, and measures of change in specific target behaviors. • Therapists cannot be the only judge of a clients progress because they are likely to be biased in favor of seeing themselves as successful, and only see a limited observational sample of the clients behavior (in session). • It is possible for therapy to be harmful. Problems in the therapeutic alliance account for some instances of treatment failure. Therapeutic Approaches • Evidencebased treatment • efficacy the drug does what it’s supposed to do in curing or relieving some target condition. • Randomized clinical trials (RCTs)–voluntary and informed patients test out the efficacy of drugs. Normally, half are given the actual drug and the other half are given a placebo. • A combination of medication and therapy is usually the best bet to treat the average patient. • Behavior therapy a direct and active treatment that recognizes the importance of behavior, acknowledges the role of learning, And includes thorough assessment and evaluation. • Exposure therapy a widely used behavior therapy used in the treatment of anxiety disorders this can be accomplished through systematic desensitization or a more extreme manner such as flooding. • Aversion therapy– Involves modifying undesirable behavior by the oldfashioned method of punishment. • Modeling– Learning new skills by imitating another person, such as a parent or therapist. • Response shaping positive reinforcement is used to gradually establish a response that was actively resisted or not initially in an individual's behavioral norms. • Token economies were used to teach people how to properly deal with a reinforcement based world at the beginning of behavioral therapy. • Cognitive and cognitivebehavioral therapy stems from cognitive psychology with its emphasis on the effects of thoughts on behavior • Rational emotive behavior therapy (REBT)– Developed by Albert Ellis, REBT attempts to change a client's maladaptive thought processes and emotional responses to thus change behavior. • Beck’s cognitive behavioral therapy– Originally developed for treatment of depression and later for anxiety disorders, but is now used for a broad range of conditions. CBT attempts to modify a persons self statements and construe all of the events in order to change his or her behavior. • Humanistic experiential therapy (client centered therapy) and Gestalt therapy (unity of mind and body) are two other approaches widely used. • Motivational interviewing – a brief form of therapy that can be delivered in one or two sessions. It was developed as a way to help people resolve ambivalence about change and make a commitment to treatment. • Psychodynamic therapy A broad treatment approach that focuses on individual personality dynamics, usually from a psychoanalytic or a psychoanalytically derived perspective. • It is the oldest form of psychological therapy and was developed by Sigmund Freud. • Psychoanalysis a combination of Freud’s techniques: free association, analysis of dreams, analysis of resistance, and analysis of transference. • Free association an individual must say whatever comes to mind regardless of how personal, painful, or seemingly irrelevant they may seem. • analysis of dreams Freud believed dreams were the road to the unconscious, as repressive defenses are sent to be lowered, and forbidden desires and feelings maybe revealed. • manifest content–the dream as it appears to the dreamer • latent content–the actual motives that are seeking expression disguised by the dream • analysis of resistance unwillingness or inability to talk about certain thoughts, motives, or experiences must be dealt with if an individual is to face the problem. • analysis of transference transference is the concept that people/patients carry over and unconsciously apply (to the therapist) attitudes and feelings that they have in their relationships with the parents or other person close to them in the past. • Countertransference (the same situation explained above but from therapist to patient) may also occur. • In addition to their use in treating individuals, psychological treatment methods can be applied to problematic relationships through couple or family therapy. • Traditional behavioral couple therapy (TBCT) is based on the social learning model and views marital satisfaction and distress in terms of reinforcement. The goal is to increase caring behaviors in the relationship and teach partners to resolve their conflicts in a more constructive way through training in communication skills and adaptive problemsolving. • Integrated behavioral couple therapy (IBCT) focuses more on acceptance and include strategies that help each member of the couple come to terms with an excess some of the limitations of his or her partner, although change is not forbidden. • Structural family therapy aims to change the family context so individual members will have alternate experiences and behave differently in accordance with the change requirements of the new family context. Sociocultural Perspectives • Although psychotherapy is a set of tools to be used in pursuit of a clients welfare, not an ethics system, therapists are often faced with moral dilemmas in the course of treatment. • Racial and ethnic minorities are currently under served by the mental health system, possibly because they are economically disadvantaged and do not have health insurance to seek treatment. Biological Approaches to Treatment • Multiple classes of medications are now routinely used to help patients with a variety of mental disorders. • These drugs work differently in every one, and finding the correct dosage is crucial. • Antipsychotic drugs are used to treat psychotic disorders such as schizophrenia. They alleviate or help reduce the intensity of delusions and hallucinations by blocking dopamine receptors. • Atypical neuroleptics are the most commonly used antipsychotics. They improve both positive and negative symptoms and has fewer side effects than conventional antipsychotics her. • Antidepressants are the most commonly prescribed psychiatric medications. • Some of the earlier antidepressants such as tricyclics and MAOIs have been replaced by SSRIs and SNRIs • Antianxiety medications (benzodiazepines) work via their effect on the GABA system. They're also widely prescribed. • Lithium is an important medication in the treatment of mania. However, some of the newer mood stabilizing drugs are more frequently prescribed. • Although not frequently used, electroconvulsive therapy is a safe and effective treatment for depression and other disorders. It causes some short term cognitive side effects, especially when administered bilaterally. • Neurosurgery is a treatment of last resort. Even when patients improve clinically, they may have permanent, adverse side effects. Chapter 18 Contemporary and Legal Issues • Many mental health professionals are trying not only to cure mental health problems but also prevent them and reduce their effects. • Prevention efforts can be classified into three subcategories. • Universal interventions efforts that are aimed at influencing the general population • These types of interventions preform two key tasks: altering conditions that can cause or contribute to mental disorders (risk factors) and establishing conditions that foster positive mental health (protective factors). • They reduce the long term consequences of having had a disorder. • Universal prevention is very broad and includes biological, psychosocial, and sociocultural effects. • biological strategies for universal interventions include promoting a healthy diet, establishing a routine of physical exercise, and developing overall good health habits in order to improve physical well being. • psychosocial strategies include developing skills for effective problem solving, expressing emotions constructively, engaging in satisfying relationships with others, and developing a sense of identity and preparedness for any problems life may bring • sociocultural strategies involve creating social conditions that will foster healthy development and functioning in individuals including public education, Social Security, economic planning, and social legislation that advocates health care for all. • Selective interventions efforts that are aimed at a specific subgroup of the population considered at risk for developing mental health problems such as minorities or adolescents. • These are aimed at reducing the possibility of a disorder and fostering positive mental health efforts in subpopulations that seem to be at high risk. • The book uses the example of stopping drug use in teens and the different tactics the government, school system, and parents nationwide have used to try and do just so. • Indicated interventions efforts that are directed toward high risk individuals who are identified as having minimal but detectable symptoms of mental disorder but who do not meet criteria for clinical diagnosis for example, individuals forced from their home from a natural disaster. • emphasizes early detection and prompt treatment of maladaptive behavior Inpatient Mental Health Treatment in Contemporary Society • An estimated 26.2% of American adults age 18+ will develop a mental health disorder within a given year. • Some go to outpatient treatment (therapy and counseling) and some go to inpatient or residential treatment (intake into a mental hospital or mental health community). • In cases where individuals might be considered dangerous to themselves or others or where symptoms are so severe the patient is unable to take care of themselves, hospitalization may be necessary to prevent further deterioration • Milieu therapy involves the environment and all ongoing activities as a crucial part of the treatment setting. • In this approach, staff expectations are clearly communicated to patients, both positive and negative feedback are given, patients are encouraged to become involved in their decision making and actions, and patients belong to social groups within the ward to enhance cohesiveness and support. • Social learning programs such as token economies (mentioned earlier) may help shape more socially acceptable behavior. • Deinstitutionalization efforts made to reduce the population of inpatients by closing hospitals and treating less severe cases as outpatients. It has been a source of considerable controversy. • Readjustment into the community after removal from an inpatient treatment setting may be difficult, and thus leads into the importance of after care programs, or live in facilities that serve as an adequate home base for patients who cannot adequately function in normal society. • Some patients may not function well in these programs. • It has been proven that as we deinstitutionalize mental hospitals, prison populations go up. Controversial Legal Issues and the Mentally Ill • Forensic psychology and psychiatry is dedicated to centering on the rights of members of society to be protected by disturbed individuals. • Being mental ill is not considered sufficient grounds for involuntary commitment the patient must be considered dangerous to themselves or others, incapable of providing for their basic needs, are unable to make decisions about hospitalization themselves, and seem to be in need of treatment or care. • After civil commitment procedures, people who are judged to be potentially dangerous due to their psychological state may be confined to a mental institution or other sentencing depending on the extent of the issues. • Attempts to assess dangerousness often stems from past behaviors. This can be incredibly difficult to assess accurately. • Tarasoff decision held that a therapist has a duty to protect potential victims if his or her patient has threatened to kill them. • The insanity defense (not guilty by reasons of insanity) is used often to escape the legally required consequences of a crime. • Historically, there have been multiple different legal precedents that have existed prior to the insanity defense. This includes the M’Naghten rule (knowing right from wrong), the irresistible impulse rule, the Durham rule, the American Law Institute Standard, and the Federal Insanity Defense Reform Act. • The defendant must be ruled competent to stand trial. • A plea of guilty but mentally ill (GBMI) may also be used in some states. Organized Efforts for Mental Health • Federal agencies such as the National Institute for Mental Health (NIMH), the National Institute on Drug Abuse (NIDA), and the National Institute of Alcohol Abuse and Alcoholism (NIAAA) are devoted to promoting research, training, and services in the mental health community. • A number of professional organizations exist as well, such as the American Psychological Association (APA), National Association of Social Work (NASW), etc. • These may function to establish and review training qualifications for professional personnel, to set standards and procedures for the accreditation of undergraduate and graduate level programs, to set standards and procedures for the accreditation of clinics, hospitals, and other service operations, to carry out inspections to make sure these procedures are followed, and to investigate reported cases of unethical or unprofessional conduct and to take action when necessary. • International organizations suck as the World Health Organization (WHO) and the World Federation for Mental Health (WFMH) have contributed to mental health programs worldwide. • The challenges for the future include more effective planning on a community, national, and international levels and the job of the client to accept their role and contribution to bettering society. Actual answers to the exam’s questions! 8. B, DARE programs 21. A, Rational emotive behavior therapy (REBT) 28. C, Deinstitutionalization Exam topics • why do people seek therapy • therapeutic rapport • big names in medications antipsychotic and antidepressant • different types of exposure and behavior therapy REBT, client centered, gestalt, psychoanalysis • not guilty by reason of insanity • tarasoff decision
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