Abnormals Psychology Chapter 16 notes

therapeutic alliance

1. Sense of working collaboratively on the problem 2. Agreement between patient and therapist about the goals and tasks of therapy 3. An affective bond between patient and therapist

It can be difficult for a person who identifies as a racial/ethnic minority to find a therapist who matches their racial/ethnic identity as only ________ of therapists are racial/ethnic minorities.

16.4%

Research suggests that about ________ of patients show clinically significant change after 21 therapy sessions and, after 40 sessions, about ________ of patients have improved.

50%; 75%

In vivo exposure

Exposure that takes place in a real-life situation as opposed to in a therapeutic or laboratory setting.

During psychotherapy, client progress is not always smooth or linear. At times, however, clients have been known to make big positive changes from one session to the next. It has been suggested that these changes are the result of _______.

cognitive changes that the patients experience in critical sessions

Efficacy

In a situation where treatment is tested under ideal conditions (usually in a controlled clinical trial), efficacy is how well a given treatment improves clinical outcome compared to a control or comparison condition.

Neurosurgery

Surgery on the nervous system, especially the brain

Traditional behavioral couple therapy (TBCT)

Widely used form of therapy that uses behavioral approaches to bring about changes in the marital relationship.

Hannah has been a patient of Dr. Jones for the past year. Dr. Jones often invites Hannah out for coffee or dinner and has been known to kiss Hannah on the cheek. Recently, he suggested that Hannah join him on a trip to the Caribbean. Dr. Jones's behavior is an example of _______.

a boundary violation

The three types of mental health professionals who most often administer psychological treatment in mental health settings are:

1. Clinical psychologists 2. Psychiatrists 3. Psychiatric social workers

A dream has two kinds of content ____ and ____

1. manifest content 2. latent content

What percentage of U.S. adults receives professional mental health care each year?

15%

Motivational interviewing

A brief form of therapy, often used in areas of substance abuse and addiction, that allows clients to explore their desires, reasons, ability, and need for change.

Randomized clinical trials (RCTs)

A clinical trial in which participants are randomly assigned to different treatments

Antidepressant drugs

Drugs that are used primarily to elevate mood and relieve depression. Often also used in the treatment of certain anxiety disorders, bulimia, and certain personality disorders.

T/F: There is now a national trend toward greater use of psychotherapy over psychiatric medications

False!

Give an example of what can help explain why men may be more reluctant to seek help and therapy?

Men may be less able to recognize and label feelings of distress than women.

Countertransference

Psychodynamic concept that the therapist brings personal issues, based on his or her own vulnerabilities and conflicts, to the therapeutic relationship.

Psychodynamic therapy

Psychological treatment that focuses on individual personality dynamics, usually from a psychodynamic or psychodynamically derived perspective

When treatments are __________, ethnic minorities are less likely to drop out of treatment and tend to do well.

culturally adapted

A questionable therapeutic technique called ________ involved having an individual guide an autistic child's hand over a computer keyboard with the assumption that the child was "talking" through typing on the keyboard.

facilitated communication

Maria is a successful financial analyst who has been married for 20 years and is the mother of two adolescent children. Although Maria feels loved by family and friends and is happy in work and marriage, she recently entered therapy. Maria's reason for entering therapy most likely is for ________.

personal growth reasons

Weisman and colleagues are developing culturally informed treatments for the families of patients with schizophrenia that consider _______.

the role of family cohesiveness as well as spirituality and religion in the therapy process.

Antianxiety drugs

Drugs that are used primarily for alleviating anxiety

Family therapy

A treatment approach that includes all family members, not just the identified patient.

Transcranial magnetic stimulation (TSM)

A treatment in which the clinician positions a pulsed magnet over a carefully selected area of the patient's scalp and uses it to create an electrical field that increases or decreases neuronal activity in the brain.

Flooding

Anxiety-eliciting therapeutic technique involving having a client repeatedly experience the actual internal or external stimuli that had been identified as producing anxiety reactions.

What instrument has become almost standard in pre- and post-therapy assessment of depression?

Beck Depression Inventory

Systematic desensitization

Behavior therapy technique for extinguishing maladaptive anxiety responses by teaching a person to relax or behave, while in the presence of the anxiety-producing stimulus, in some other way that is inconsistent with anxiety

Latent content

Consists of the actual motives that are seeking expression but are so painful or unacceptable that they are disguised

Administering the medication ________ has been a useful adjunct to exposure therapy with patients who have social anxiety. The medication assists the therapy by _______

D-cycloserine; Activating a receptor that is critical in facilitating extinction of anxiety

Dasia participated in a therapy session aimed at helping her overcome her fear of spiders. The therapy session consisted of Dasia being taken by her therapist into a room teeming with non-venomous spiders. She was instructed to confront her fear and to remain in the room with the therapist and spiders until she was no longer afraid. The technique used to treat Dasia's fear of spiders is called ____.

Flooding

Imaginal exposure

Form of exposure therapy that does not involve a real stimulus. Instead, the patient is asked to imagine the feared stimulus or situation.

Rational emotive behavior therapy (REBT)

Form of psychotherapy focusing on changing a client's maladaptive thought processes, on which maladaptive emotional responses and thus behavior are presumed to depend

Transference

In psychodynamic therapy, a process whereby clients project onto the therapist attitudes and feelings that they have had for a parent or others close to them.

Modeling

Learning of skills by imitating another person who performs the behavior to be acquired

Tardive dyskinesia

Neurological disorder resulting from excessive use of antipsychotic drugs. Side effects can occur months to years after treatment has been initiated or has stopped. The symptoms involve involuntary movements of the tongue, lips, jaw, and extremities.

Client-centered (person-centered) therapy

Nondirective approach to psychotherapy, developed chiefly by Carl Rogers, that focuses on the natural power of the organism to heal itself; a key goal is to help clients accept and be themselves

Response shaping

Positive reinforcement technique used in therapy to establish, by gradual approximation, a response not initially in a person's behavioral repertoire.

Give an example of a statement that is accurate regarding psychotherapy

Psychotherapy is often less expensive in the long-run than other forms of treatment, like medications.

Neuroleptics are used to treat ____

Psychotic disorders

_____ is a psychotherapy that works with the client to change irrational thinking patterns which consist of internalized "shoulds," "oughts," and "musts." These thought patterns are believed to prevent the client from having a more positive sense of self-worth.

Rational emotive behavioral therapy

______ was a questionable form of therapy for children with attachment problems that involved therapists wrapping children in blankets, sitting on them, and squeezing them.

Rebirthing

Token exonomies

Reinforcement techniques often used in hospital or institutional settings in which patients are rewarded for socially constructive behaviors with tokens that can then be exchanged for desired objects or activities

Psychopharmacology

Science of determining which drugs alleviate which disorders and why they do so.

Resistance

Second stage of responding to continuing trauma, involving finding some means to deal with the trauma and adjust to it. In psychodynamic treatment, the person's unwillingness or inability to talk about certain thoughts, motives, or experiences.

Manualized therapy

Standardizing of psychosocial treatments (as in development of a manual) to fit the randomized clinical paradigm.

What factor would limit the effectiveness of imaginal exposures (but not in vivo exposures) in reducing, for example, phobic anxiety?

The patient may be unwilling or unable to vividly imagine the phobic stimulus.

What pieces of evidence would most directly provide a therapist with evidence that their patient is showing reductions in symptoms of a specific phobia?

Their patient is now willing to hold insects of different types and sizes for extended periods.

Gestalt Therapy

Therapy designed to increase the integration of thoughts, feelings, and actions and to promotes self-awareness and self-acceptance.

What are boundary violations

This is when the therapist behaves in ways the exploit the trust of the patient or engages in behavior that is highly inappropriate.

_______ uses techniques such as clarification, confrontation, and interpretation to help the patient understand and correct the distortions that occur in his or her perception of other people.

Transference-focused psychotherapy

Couple therapy

Treatment for disordered interpersonal relationships involving sessions with both members of the relationship present and emphasizing mutual need gratification, social role expectations, communication patterns, and similar interpersonal factors.

Structural family therapy

Treatment of an entire family by analysis of interaction among family members

Psychotherapy

Treatment of mental disorders by psychological methods

T/F: Evidence-based psychological treatments can produce longer-lasting benefits than medication

True

T/F: It is sometimes necessary for patients to change medication during the course of treatment.

True

The use of lithium as a treatment for ________, aside from health risks and reported deaths associated with its use to treat hypertension, was delayed because ______

bipolar disorder; it is a naturally occurring substance that cannot be patented and therefore is not profitable to be produced by pharmaceutical companies

What three mental health professionals are most likely to administer psychological treatment services?

clinical psychologists, psychiatrists, and psychiatric social workers

Rhea has experienced severe and debilitating depression over the past 5 years keeping her from maintaining a job. Several treatments have been tried, but none of these treatments, including behavioral therapy and antidepressants, have been effective. What novel treatment, although very invasive, may help reduce Rhea's symptoms and get her back to work?

deep brain stimulation

Benzodiazepines work by _____.

enhancing the activity of GABA receptors

The focus of integrative behavioral couple therapy (IBCT) is to ________.

help each member of the couple come to terms with and accept some of the limitations of his or her partner

The goal of motivational interviewing is to _______.

help the client resolve ambivalence about change and make a commitment to treatment

Client-centered psychotherapy, as developed by Carl Rogers, emphasizes _______.

helping people remove constraints and restrictions that grow out of unrealistic demands that they place on themselves.

In recent years, psychosurgery has been used with patients who have severe obsessive-compulsive disorder (OCD). Although many of these patients obtain relief from clinical symptoms of OCD, on follow-up, a large percentage of these patients exhibit ______.

impaired executive functioning on cognitive tests, problems with apathy, and disinhibited behavior

Carol is involved in a time-limited therapy where she is encouraged to look at how she uses past schemas developed from her relationships with parents and others to understand her current relationships. Carol's therapist appears to be using ________ in her work with Carol.

interpersonal therapy

Medications are often used without including psychotherapy to treat psychological disorders. A downside of focusing only on treatment with medication is that _____.

medications may alleviate symptoms by inducing biochemical changes, but do not help the individual understand and change the personal or situational factors that may be creating or reinforcing maladaptive behaviors

Assessing the treatment needs and outcomes of minority groups is difficult to fully assess because _______.

minority groups are disproportionately underrepresented in treatment research studies

In order to make therapy a better fit for men, it has been suggested that _______.

new treatment approaches should be developed to recognize that many men see little value in talking about their problems and may respond more positively to action-focused treatments

Bupropion (Wellbutrin) is an antidepressant that inhibits the reuptake of both norepinephrine and dopamine. This medication has been shown to help reduce symptoms of depression and ______.

nicotine cravings and symptoms of withdrawal in people who want to quit smoking

Benzodiazepines are a widely-used antianxiety drug that helps reduce acute anxiety and agitation, and at high doses, help to treat insomnia. However, the use of benzodiazepines is associated with _______.

psychological and physiological dependence alongside high relapse rates after discontinuation of the drug

Pharmaceutical companies are required by the FDA to conduct studies measuring drug efficacy by using informed human subjects that are randomly assigned to either a group that receives the drug being investigated or a group receiving a placebo. These studies are referred to as _______

randomized clinical trials (RCTs)

Raquel started seeing a therapist to help her with her social anxiety. When her therapist suggested that she start completing exposures to feared social situations (e.g., public speaking), Raquel was not happy. She had no desire to complete the exposures and she felt that the therapist was pushing this technique on her, when she just wanted to talk about her anxiety with a therapist. In this situation, one key factor Raquel and her therapist need to work on is ________, a component of the therapeutic alliance, to make sure Raquel stays in therapy and completes treatment.

reaching an agreement about the goals and steps of the therapy

Treatment with conventional antipsychotic medications such as chlorpromazine can cause patients to develop ________, which is ________.

tardive dyskinesia; a movement abnormality

Researchers studying psychotherapy have attempted to apply methodology similar to that used in drug studies in order to evaluate effectiveness. One factor that makes using this model for evaluating therapies challenging is ______.

the difficulty of creating a placebo condition that will appear credible to patients

Manifest content

the dream as it appears to the dreamer

Contemporary therapists often describe their approach to treatment as "eclectic." By this term, therapists imply that _____.

they combine concepts and techniques from various schools of psychological thought in order to best meet the needs of the client.

Clinicians may not be the best judge of client success because ______.

they may be biased in favor of seeing themselves as competent and successful

Currently, there is no empirical evidence that racial discrepancies between clients and their therapists impact the efficacy of treatment. However, this lack of evidence should be interpreted with caution because _______.

treatment studies tend to include relatively small numbers of minority participants, making it difficult to know if a true effect exists