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14 Cards in this Set
- Front
- Back
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what is the definition of psychotherapy? who can practice it?
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- psychological treatment for a mental disorder, behavioural disturbance or other problem resulting in psych suffering or distress, and has as its purpose to foster sig changes in cog emotional or behavioural functioning, interpersonal relations, personality or health. It goes beyond help aimed at everyday difficulties and beyond a support or counselling role
can be practise by:- psychologists, med doctors, permit can be obtained by councillors PTOT etc. |
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Evidence-based treatment training
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Looked at psychologists (PhD and PsyD), psychiatrists, and social workers
- are they getting training in evidence-based therapy? (shown more effective than placebo at least twice in RCTs) - found that PsyD and social work programs have the most amount of people and least evidence based training - psychiatrist is first, psych is second |
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Psychiatrists and psychotherapy; commonalities among psychotherapies?
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- psychiatrists less likely to do psychotherapy now than before
- patients who paid out of their own pocket were more likely to receive psychotherapy then those who used insurance - minorities less likely to receive psychotherapy - unique setting - activities based on rational- now way relationship |
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What are some common things paid attention to in psychodynamic therapy?
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- free association,
- dream analysis (manifest and latent content), - resistance (like coming late, this is stupid I don’t want to talk), - transference (client takes feelings about a person in their life and projects it onto the therapist) |
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what are humanistic therapies based on? types?; What are interpersonal therapies focused on?
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- psychopathoogy arises from alienation, loneliness, failure to fins meaning
- power is within each person to be happy - person centred: about the persons ideas not the therapists - Gestalt therapy: helps client take charge of choices and decisions Interpersonal- emphasis on relationships and roles |
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What is the basis of behavioural therapy? what are some examples?
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- behaviours associated with the disorder ARE the problem not the symptom
- behaviours are learned so they can be unlearned - exposure treatments: systematic desensitization, implosion therapy - aversive conditioning - social learning theory - watch desirable behaviours - use of reinforcement- add something to enviro |
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What is the basis of CBT? What are some common cognitive distortions?
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- rationale of cog therapy is that the situation doesn’t determine how you feel, it is your thoughts
- cog restructuring- evidence common cognitive distortions: - all or nothing - mind reading - personalization - shoulding and musting - overgeneralization - mental filter (filter out good) |
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what are third wave therapies built upon? 3 common features?
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Third wave therapies
- built upon principles of CBT - common features: mindfullness, patient values, therapist-patient relationship |
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What is NOT psychotherapy? what are some potentially harmful therapies?
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- support meetings like AA
- psych education alone - readaptation (like after stroke) - clinical follow-up - coaching - crisis intervention Potentially harmful therapies - attachment therapies - has known to cause death and serious injury (rebirthing)- facilitated communication- harm to friends and families (false accusations of sexual abuse)- critical incident stress debriefings- have the people immediately relive the event, get feelings out, but actually increases risk for PTSD- scared straight+ bootcamp interventions for CD |
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Neural changes in psychotherapy vs drugs (3 studies)
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OCD: SSRI vs behavioural therapy, scanned at baseline and after 10 weeks of treatment. They only looked at the responders, about equal in both groups. Decrease in glucose met in right head of caudate nucleus in both groups, equivalent
MDD: drug vs CBT: difference in response was seen. Increase in metabolism in hippocampus and decrease in frontal areas. Drug showed decrease in hippo metabolism and increases in frontal MDD: Psychotherapy vs Fluoxetine : found that patients who receive psychotherapy had increase density of serotonin receptors, but not in the fluoxetine |
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Depression: how do drugs vs psychotherapy work?
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Depression inked to overactive amygdala and underactive frontal cortex. There are reciprocal links between them, in that PFC inhibits the amygdala. Thought restructuring increases PFC functioning, top-down effect, allows it to inhibit the amygdala. Drugs are thought to act on the amygdala directly, decreasing activity- bottom-up.
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Dodo-effect of psychotherapy. Two sides?
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Dodo-effect: all psychotherapies work from all different places but all have positive effects
Does therapy make a difference? - common factors across psychotherapies will make the difference- qualitative reviews agree - other side: the nonspecific elements do matter but there are specific interventions that are most effective for specific diagnoses |
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Some issues with research on psychotherapy
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- in RCTs, independent variables diagnosis and type of treatment, and these people are highly selected, no comorbidity
- not very generalizeable to real world- treatment in RCTs is tricky for providing the psychotherapy - what is DV? just reduction in symptoms or quality of life improvement? what is most helpful? for dif patients dif outcomes can be equally good - when you have a control group they are often waitlist group, but in active therapy vs nonactive therapy, the person administering the therapy knows and may effect the outcome - looked at those who entered and didn’t complete psychotherapy as well as those who completed. Those who didn’t complete had slightly worse improvement, but not by a whole lot |
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Is the dodo hypothesis true?
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Yes
- common factors across psychotherapies- therapist allegiance is key - you being aligned to the intervention makes a difference- therapeutic alliance with patient is key - effectiveness of therapist - treatment rationale - why engaging in this treatment is good No - some methodological flaws in meta-analyses - superiority has been shown for specific disorder/treatment pairings - just because they both work well does it mean there is no difference? |
