Chapter 16 : Therapy

*What are the components of lifestyle change that have been shown to reduce experiences with depression?

- Aerobic exercise - Adequate sleep - Social connection - Anti-rumination replacing negative thoughts with positive thoughts - Nutritional supplements

Drug Therapies

- Are most widely used biomedical treatments - Include prescribed antidepressants for 27 million Americans - Involve placebo and double blind techniques to evaluate drug effectiveness

Is psychotherapy effective?

- Clients' and therapists' positive testimonials can't prove that psychotherapy is actually effective - Research indicates that those undergoing psychotherapy are more likely to improve more quickly, and with less chance of relapse

*List the three other biomedical therapies discussed in class

- Electroconvulsive Shock Therapy - Deep brain stimulation - Repetitive transcranial magnetic stimulation (rTMS)

*Identify APAs suggestions for when to seek a therapist

- Feelings of hopelessness - Deep and lasting depression - Self-destructive behavior - Disruptive fears - Sudden mood shifts - Thoughts of suicide - Compulsive rituals such as hand washing

*What are the three basic benefits of all psychotherapies?

- Hope for demoralized people - New perspective for oneself and the world - Empathic, trusting, caring relationship (therapeutic alliance)

3 general benefits of psychotherapy and the therapeutic alliance

- Hope for demoralized people - New perspective for oneself and the world - Empathic, trusting, caring relationship (therapeutic alliance)

Therapeutic Lifestyle Change

77% of those in lifestyle change condition experienced relief from depressive symptoms vs. 19% control

Cognitive therapies

-Teaches people new, more adaptive ways of thinking; based on the assumption that thoughts intervene between events and our emotional reactions Beck's therapy for depression - gentle questioning seeks to reveal irrational thinking and then to persuade people to change their perceptions of their own and others' actions as dark, negative and pessimistic - people trained to recognize and modify negative self-talk

Behavioral Therapies

Behavior therapies apply learning principles to the elimination of unwanted behaviors Counterconditioning: Uses classical conditioning to evoke new responses to stimuli that are triggering unwanted behaviors Aversive conditioning: associates an unpleasant state (EX: nausea) with an unwanted behavior (EX: drinking) Exposure therapies: Treat anxieties by exposing people (in imagination or actual situations) to the things they fear and avoid Systematic desensitization: Associates a pleasant, relaxed state with gradually increasing, anxiety triggering stimuli

*Humanistic or client-centered therapies use _____ listening techniques including echoing, thoughts, inviting clarification and reflecting feelings

active

*Cognitive therapies seek to implement new, more _____ ways of ______

adaptive (cognitive) ; thinking

*The compatibility between a client and a therapist, often referred to as a ______ _________ emphasizes the importance of _________ over __________.

therapeutic alliance ; ? ; ?

*Cognitive Behavioral Therapy seeks to address both unhealthy patterns of ______ and also to establish new ________.

thought ; action

*How do behavioral therapists use classical conditioning and operant conditioning techniques?

Consequences drive behavior - voluntary behaviors are strongly influenced by their consequences

Electroconvulsive Shock Therapy

Manipulates depressed brain via electrical current; AMA concluded that ECT methods among most positive treatment effects; reduces suicidal thoughts; several theories about efficacy

Deep brain stimulation

Manipulates depressed brain via pacemaker; stimulates inhibition activity related to negative emotions and thoughts

Behavioral Therapies cont.

Operant conditioning therapy: Consequences drive behavior - voluntary behaviors are strongly influenced by their consequences Behavior modification: Desired behavior reinforced, undesired behavior not reinforced and sometimes punished Token economy: People earn a token for exhibiting a desired behavior and can later exchange the tokens for privileges or treats

Client Centered/Humanistic therapy and active listening

Problems diminish as people gain insight/get in touch with their feelings Client Centered Theme: Emphasis on people's potential for self-fulfillment; to give people new insights Goals: To reduce inner conflicts that interfere with natural development and growth; help clients grow in self-awareness and self-acceptance promoting personal growth Techniques: Client-centered therapy; focus on taking responsibility for feelings and actions ; active listening and unconditional positive regard

Psychodynamic Therapy

Problems subside as people gain insight into their unresolved and unconscious tensions Goals: To help people understand current symptoms; to explore and gain perspective on defended-against thoughts and feelings Techniques: Face to face meetings; exploration of past relationship troubles to understand origins of current difficulties

Cognitive behavioral therapy (CBT)

Problems will diminish as people begin to alter the way they think AND act - Integrative therapy that combines cognitive therapy (changing self-defeating thinking) with behavior therapy (changing behavior) - Aims to alter the way they act AND the way they think - Helps people learn to make more realistic appraisals

*Different types of psychotherapies include what?

Psychodynamic : Unconscious conflicts from childhood experiences (reduce anxiety through self insight) Client-centered : Barriers to self-understanding and self-acceptance (enable growth via unconditional positive regard, genuineness, acceptance, and empathy) Behavior : Dysfunctional behaviors (learn adaptive behaviors; extinguish problem ones) Cognitive : Negative, self-defeating thinking (promote healthier thinking and self-talk) Cognitive - behavioral : Self-harmful thoughts and behaviors (promote healthier thinking and adaptive behaviors) Group and family : Stressful relationships (heal relationships)

Different Modern Psychotherapies

Psychodynamic : Unconscious conflicts from childhood experiences (reduce anxiety through self insight) Client-centered : Barriers to self-understanding and self-acceptance (enable growth via unconditional positive regard, genuineness, acceptance, and empathy) Behavior : Dysfunctional behaviors (learn adaptive behaviors; extinguish problem ones) Cognitive : Negative, self-defeating thinking (promote healthier thinking and self-talk) Cognitive - behavioral : Self-harmful thoughts and behaviors (promote healthier thinking and adaptive behaviors) Group and family : Stressful relationships (heal relationships)

*_________ involves psychological techniques derived from psychological perspective while ______ _______ involves treatment with medical procedures.

Psychotherapy ; Biomedical Theraphy

Repetitive transcranial magnetic stimulation (rTMS)

Sends magnetic energy to brain surface through coiled wire held close to brain; fewer side effects; modest effectiveness

*Biomedical therapy's most commonly used treatments are __________ ___________.

medical procedures

Psychopharmacology

Includes study of drug effects on mind and behavior, has helped make drug therapy the most widely used biomedical therapy

Psychotherapy

Involves psychological techniques derived from psychological perspectives; trained therapist uses psychological techniques to assist someone seeking to overcome difficulties or achieve personal growth

Biomedical therapy

Involves treatment with medical procedures; trained therapist, most often a medical doctor, offers medications and other biological treatments

Many psychologists believe it is best to use _______ therapies in conjunction with ________.

drug ; psychotherapies

*Many psychologists believe it is best to use ________ _______ in conjunction with __________ __________.

drug therapies ; psycho therapies