textbook ALL

Stressful life circumstances (gain considerably in short time)

People with long-standing problems (initially motivated, then may generate resistance)

Reluctant clients (males)

People who seek personal growth (substantial growth)

Severely disturbed, psychotic clients

Motivation to change

Severity of symptoms

Physicians

Clergy

Clinical psychologists

Psychiatrists

Social workers

Clinic

Team approach

Medication
ECT
Biological approaches

Strong alliance

Clear, coherent and succinct account (expert)

Collaborate on problem

Agree about goals of therapy

Yes

Therapist impression - biased for self, dropouts

Client - please therapist, want it to be worth it

Reports of family - more accuracy

Clinical ratings/battery - yet have regression to the mean - high or low scores tend to drift to average of distributions

Overt behavior measures - HRSD, fMRI, number of obsessions - yet doesn't show how patient would function in real life

Psychotherapy more effective than no treatment

75% healed after 40 sessions

5-10% deteriorate

BPD, OCD

Rupture of therapeutic alliance

Boundary violations - expoit trust of patient or engage in behavior that is inappropriate, like selling things, giving gifts, being in a sexual relationship

Yes: Difficulty of creating a placebo condition

No: can't use for comorbid diagnoses

Integrate the two

Drugs do not cure, only alleviate symptoms

Don't help individual understand nchange factors that may create/reinforce maladaptive behaviors

Risk of relapse

Social anxiety disorder who receive exposure therapy of D-cycloserine before session

Severe disorders

Acute distress

Adding meds do not improve clinical efficacy for anxiety disorders

Systematic desensitization - slow confrontation with thing they fear

Flooding - full srength

in vivo - real (more superior to imaginal)

imaginal - not real

virtual reality exposure

Aversion therapy - punishments

Modeling - learns new skills by imitating another person

Reinforcement - response shaping, positive reinforcement

Token economies - paid for his/her work in tokens for desirable objects

Short time

For more specific things, except BPD

Behavioral activation - activities to help mood

REBT: change a client's maladaptive thought processes, increase self-worth

Beck's Cognitive therapy - change biased processing, gather information about self and think about why they have this belief

REBT - for more healthy people; inferior to exposure-based therapies in treating anxiety disorders and OCD

Yet Beck's - can alleviate many types of disorders, as it's comparable to drug treatment except most severe cases; can prevent relapse

Client-centered therapy - accept good and bad and no judgment

Gestalt therapy - recognize bodily processes and emotions blocked off "be the object"

Process-Experiential therapy - experience emotions more

Reduce people to abstractions

Freudian - free association (contents of preconscious), dream analysis(repressive defenses lowered, and manifest-as it appears, and latent content - actual motives), analysis of resistance (not talking about something), and transference (react to analyst as they did to earlier person and feel same way)

Therapist acts in accord with transferred attributions rather than objectively

Understand present in terms of past, ignore libinal energy drives

No rigorous controlled outcome studies

transference-focused therapy in Kernberg - works well with BPD

Traditional behavioral couple therapy - increase caring behaviors in the relationship and to teach partners to resolve their conflicts in a more constructive way

Integrative behavior couple therapy (accept differences), better

Structural family therapy - change family context (best for anorexia)

Borrow and combine concepts

interpersonal therapy - emphasis on present, not on past, current relationships

No, each time therapists decide that 1 behavior should be eliminated or substituted for another, they are making a value judgment

Little or no evidence that outcomes are diminishd when client and therapist are different in race

Economic disadvantage

Preference for similar ethnicity

Reduce delusions/hallucinations by blocking dopamine receptors

Tardive dyskinesia - movement abnormality

Inhibit reeuptake of serotonin following release into synapse

"safe" - not fatal in overdose, yet not considered more effecitve than classic tricyclic antidepressants

3-5 wks to work

Sexual problems

Rarely fully well

Inhibit reuuptake of serotonin and norepinephrine

Alter receptor functioning and synthesis of neutrotransmitters

Block reuuptake of both norephenephrine and serotonin

Safe for overdose, help for those who don't do well for many other drugs

Treatment of depression results in at least 50% improvement

Removal of all symptoms; first months = remission, and after 6-12 months, well/recovered

Inhibit activity of enzyme that breaks down monoamine neutrotransmitters

More for depression - hypersomina and overeating

Inhibits reuuptake of serotonin, heavy sedation

Inhibits reeuptake of norepinephrine and dopamine

REduces cravings, doesn't inhibit sexual functioning

Ehance GABA activity, an inhibitory neurotransmitter that inhibits anxiety

Work on serotonergic functioning rather than on GABA

Lower potential for abuse than benzodiazepines

Decrease manic state

Discontinuation risky

Maybe not as reliable to prevent future manic episodes

Toxic

Psychotic disorders and psychotic mood disorders

Tricyclics - can be fatan in overdose

More acceptable and can be better tolerated

MAOIs: can't take tyramine with it

Anxiety disorders, bulimia nervosa, BPD

For severely depressed people, pregnant, and elderly

Downregulate receptors for norepinephrine, increasing functioning availability of neurotransmitter

Bilaterial ECT > Unilateral, yet must weight memory problems and anterograde amnesia for about 3 months after ECT ends vs. clinical benefit

Do uni -> bilateral

Can't inhibit impulses, absence of feeling, shallowness