Section 2: Therapy
Section 2: Therapy PSYCH 3830
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This 6 page Class Notes was uploaded by Margaret Bloder on Sunday January 31, 2016. The Class Notes belongs to PSYCH 3830 at Clemson University taught by Pam Alley in Winter 2016. Since its upload, it has received 14 views. For similar materials see Abnormal Psychology in Psychlogy at Clemson University.
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Date Created: 01/31/16
Section 2: Therapy Biomedical Approaches A. Drug Therapy (Psychopharmacology): psychoactive drugs work on the brain 1. Antipsychotics (Abilify, Seroquel, Risperdal) Treat psychotic disorders (most significant: schizophrenia) Used when a person shows psychotic features Helps to reduce the frequency and intensity of delusions and hallucinations Works by blocking some of the dopamine receptors About 60% of people diagnosed with schizophrenia and take medication have reduced symptoms within 6 weeks 2. Anti-Depressants (Zoloft, Paxil, Celexa, Prozac, Lexapro) Most widely prescribed “ndassical anti-depressants” 2 generation anti-depressants are more effective (SSRI: selective serotonin reuptake inhibitors) - Individuals have too much reuptakemore serotonin - Safe, fewer side effects, overdoes less likely to be fatal Prozac is the most widely prescribed/used drug Anti-depressants treat depression as well as bulimia nervosa 3. Anti-Anxiety Drugs (Xanax, Klonopin, Valium, Ativan…all forms of benzodiazepine, which is the most widely used) “Treatment of choice” Anxiety, agitation Biggest problem: can become dependent on them Relatively high relapse rate (return of symptoms) On part, act on GABA 4. Mood-Stabilizing Drugs (Lithium) Lithium is the most common known as the “wonder drug”, treats bipolar disorder 70-80% of people will start to get better within 2-3 weeks B. Electroconvulsive Therapy (ECT) Passes through a person’s brain Alleviate depressive and manic episodes About 100,000 people a year are treated Bad reputation back then, but today people are put to sleep and given muscle relaxers Relatively safe and effective Typically going to be used if a person is severally depressed (highly suicidal) Not the first choice of treatment Electro current, works better using 2 electros to the same side of the head Amnesia when they wake up, may experience memory loss Not a one time deal (usually 12 sessions) C. Neurosurgery Surgery on the brain Treatment for psychological problems Most common: prefrontal lobotomy (frontal lobe severed from inner part of brain) Drug therapy began to increase and overtake neurosurgery because of all the negative side effects Last resort Not as dramatic a procedure today Psychotherapy A. Psychodynamic therapy 1. Psychoanalysis: Freud’s psychoanalysis is perhaps the most widely known example of psychodynamic therapy and focuses on identifying the individual’s unconscious feelings, impulses, and conflicts and bringing them into conscious awareness Therapist is mostly passive, patient talks most Not an approach we use a lot today Long, hard & expensive (takes years) The processes: Free Association (Primary way at getting at the unconscious): Process in which patients are encouraged to talk freely about whatever comes to mind Catharsis: Release of strong and repressed emotions Interpretation: Explanation of the patient’s remarks/actions so that they can understand their own unconscious motives Resistance: Unwillingness of client to cooperate with therapist in uncovering unconscious material Negative Transference: Displacement of one’s negative feelings towards one’s parents onto the therapist Insight: Client’s awareness of what underlies their behavior patterns, motivations, or illness (why they do what they do) Personality Restructuring: Restructuring of client’s personality so that they can develop more adaptive behaviors Behavior Change: Change of client’s behavior in light of insight gained through therapy B. Behavior therapy Symptoms are the problems Learning principles: get rid of unwanted behaviors and replace with healthy behavior 1. Systematic Desensitization: type of behavior therapy in which patients learn to relax in anxiety-provoking situations Developed by Wolpe, who believed individual cannot be relaxed & anxious at the same time Most widely used method Before Therapy: Stimulus or situation Undesired Response: Fear During Therapy: Learn relaxation techniques + Create hierarchy of anxiety-provoking situations Use relaxation techniques while imagining anxiety-provoking situations After Therapy: Stimulus or situation Alternative Response: Relaxation C. Cognitive Therapy Focuses on thoughts Assumes our feelings and our behavioral responses to events are strongly influenced by our cognitions Cognitive therapist distinguishes between an observed causal relationship and an actual causal relationship (which considers the individual’s intervening cognitions) EXAMPLE: an individual who has recently lost his job becomes depressed. The observed causal relationship is losing job depression. But the actual causal relationship is losing job cognitions: “I am worthless” Depression 1. Rational Emotive Behavior Therapy (REBT): one type of cognitive therapy in which irrational or unrealistic cognitions about life events are replaced with more constructive cognitions Most common in treating depressed individual Very confrontational, active therapist The REBT therapist helps the depressed individual replace his unhealthy cognitions with more adaptive thoughts EXAMPLE: new causal relationship becomes losing job cognitions: “I am talented”, “I will get another job” feelings of self-efficacy and contentment Makes them learn to think in a certain way D. Humanistic Therapy Very positive Focuses on strengths 1. Person-Centered (or client-centered) Therapy (AKA non-directive therapy): type of humanistic therapy introduced by Carol Rogers that emphasizes people’s potential for self-fulfillment and facilitates this by helping people grow in self-awareness and acceptance Person-Centered Therapists use active listening in order to help the individual feel more comfortable and grow in self- awareness and acceptance During active listening the therapist attempts to clarify the client’s thoughts and feelings by echoing and restating his or her words EXAMPLE: -Client: “I have been wondering why I worked so hard to try to make other people comfortable. I don’t understand why I have such a strong need for everything to go without a hitch.” -Therapist: “In other words, it is important to you to help other people feel more at ease. You put in a lot of effort in trying to make everything go along smoothly and as planned.” E. Marital Therapy (AKA couple therapy) 1. Traditional Behavior Couple Therapy (TBCT) More change focused 10-26 sessions (relatively short term) Goal is to help couples learn how to resolve conflicts, communication Effective About 2/3 people show improvement 2. Integrative Behavioral Couple Therapy (IBCT) Relatively short term Focuses on acceptance, not as much change Effective About 70-80% show improvement F. Family Therapy 1. Structural Family Therapy: Minuchin Helps family become more supportive of each other, reduce tension Child that brings family into therapist is usually the healthiest child that doesn’t cause problems G. Eclectic Therapy Draw techniques from different approaches About 50% of therapists practice this Pull in more holistic/ natural remedies more and more popular today Get people to change their lifestyle physical and mentally healthier Effectiveness of Therapy A. Outcome Research Studies: used to determine the efficacy of different treatment options for individuals experiencing psychological symptoms. Some of the more common conditions used in these studies include: Untreated Control Group: Individuals who do not receive treatment Placebo Group: Individuals who are led to believe that they are receiving the treatment but are not Paraprofessional Led Group: Individuals who receive treatment from someone who has received a limited amount of informal training Professional Led Group: Individuals who receive treatment from someone with a masters or Ph.D. in some field of counseling -Results are inconsistent so we use meta-analysis, which is a procedure for statically combining the results of many different studies as if they came from one huge study with thousands of participants B. Measuring Therapeutic Effectiveness 1. Client testimonials Problems: Crisis will go away themselves; hard to say whether it was therapy or passage of time that helped Patient needs to feel that their money and time was well worth spent Clients are likely to like their therapist, so they will listen to them 2. Clinicians’ perceptions C. Results of Outcome Research 1. Spontaneous remission of untreated individuals 40% of individuals start to get better within 3 month period Start to get better on their own 2. Effects of placebo and paraprofessional treatment Tend to show more improvement than the untreated controls 3. Treatment by professionals More likely to show improvement and more quickly *5-10% of individuals who get treated are going to deteriorate either from a bad therapist or being more troubled than others, etc. D. Variables Impacting Therapeutic Effectiveness Nature of Problem: Certain kinds of problems are harder to treat (always easier to treat someone with a clear and specific problem) Fit between disorder and therapeutic intervention: Some approaches are certain to a specific problem Client Characteristics: Therapy is most effective for people who need it the least (individuals who are young, intellectual, successful, motivated are more likely to experience improvement) Clinician Characteristics: Fit between client and therapist matters, more effective if there is a good relationship, warm, empathetic, actively involved, non-judgmental therapists tend to be more effective
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