EPPP Treatment, Intervention, Prevention, & Supervision

Two Highlights in Early History of Behavioral Therapy Based on Classical Conditioning

1) In 1924, psychologist Mary Cover Jones document the first use of behavioral therapy based on classical conditioning. She treated Peter, a little boy presenting with extreme fear of furry things, such as rabbits. She used successive approximations, bringing a rabbit a little closer to Peter during each session over several weeks. He gradually became less fearful until he could pet the rabbit on his lap. Despite Jones' success with this patient, the use of behavior therapy was not reported again until 1938, when psychologists Mowrer and Mowrer used it to treat bedwetting. 2) In 1938, Mowrer and Mowrer used behavior therapy to treat bedwetting. During this treatment, an alarm triggered by wetness would wake the patient. This prototype of the enuresis alarm had a 75 percent success rate, whereas psychodynamic therapy discussing the symptom's meaning failed abysmally.

Examples of Behavioral Techniques Used to Treat Diagnosed Psychological Conditions

1. Lee has been diagnosed with depression. The therapist has him self-monitor for a week by keeping a daily activity log. This log shows he goes to work in the morning, comes home in the evening, and watches TV until bedtime, allowing no time for social interactions. The therapist helps Lee identify activities he is willing to do that afford positive social experiences. They agree he will join a bowling team and eat dinner out with a friend weekly. The therapist discovers that Lee is shy and does not know how to initiate conversations with strangers. 2. Through role playing, Lee practices these skills with the therapist. 3. Common techniques used in behavioral therapy are behavioral contracts and reinforcement. If Lee wants to buy a new MP3 player, he and the therapist might agree to a contract. This contract could state that when Lee reduces his television-watching to three hours daily and engages in three new activities, he can reward himself by buying the player.

Underlying Principle of Aversion Therapy

A principle of classical conditioning, a behavior model, is that when a neutral stimulus is paired with another stimulus and a certain response is elicited, the neutral stimulus becomes conditioned to elicit the same responses as the other stimulus through association. This principle underlies both systematic desensitization, wherein the individual learns to extinguish undesirable responses to previously conditioned stimuli, and the converse- aversion therapy, wherein clients actually learn to associate unpleasant responses with particular stimuli.

Problems that Respond Well to Behavioral Therapies

A principle of classical conditioning, a behavior model, is that when a neutral stimulus is paired with another stimulus and a certain response is elicited, the neutral stimulus becomes conditioned to elicit the same responses as the other stimulus through association. This principle underlies both systematic desensitization, wherein the individual learns to extinguish undesirable responses to previously conditioned stimuli, and the converse- aversion therapy, wherein clients actually learn to associate unpleasant responses with particular stimuli. This is used with harmful stimuli, such as tobacco, alcohol, other abused drugs and substances, violent behaviors, etc. For example, a smoker might have to chain smoke cigarettes while a noxious odor is blown in his or her face until he or she associated smoking with nausea. The drug Antabuse, which causes nausea upon drinking alcohol, employs the same principle. Non-harmful but unpleasant electric shocks have also been paired with target stimuli in aversion therapy. Other than probation court orders, the most common reason clients voluntarily submit to aversion therapy is for problematic addictions that have proven unresponsive to other treatments.

Potential Advantages of Immunization Over Treatment

A vaccine could prevent heroin use for several months or longer. This would give addicts more freedom, and could possibly allow them to completely quit using heroin for good.

Example of Changing Behavior Through Contingency Management

A young child goes grocery shopping with his parents. He asks for candy and they buy it for him, reinforcing his behavior. When they refuse to buy him candy, he throws a screaming temper tantrum. To end his tantrum behavior, which is punishing to them, the parents give in to his demands, further reinforcing his behaviors. If they ignore his demands and tantrums, they may eventually extinguish these behaviors. They can also reward him whenever they observe him behaving well so that he gets attention for this instead of for misbehavior.

Explain How Beck's Practice of Psychotherapy Originally Relied on Freudian Psychoanalysis

Aaron Beck originally practiced Freudian psychanalysis. However, in doing so, he observed that when his patients with depression used the Freudian techniques of free-association and recounting their dreams, they expressed a lot of negative ideas. For example, they might say, "If they really knew me, nobody would like me." Beck began to think depression resulted from such negative beliefs and "self-talk." He concluded that the job of the therapist was to help the client identify these negative thinking habits and learn habits of thinking more positive thoughts to replace the self-defeating negative ones. The cognitive therapist works with depressed patients by helping them identify, face, and examine the self-destructive beliefs or thoughts that contribute to and perpetuate their depression. For the obsessive thoughts characteristic of obsessive-compulsive and other disorders, cognitive therapy would help clients focus on challenging the irrationality of their obsessive beliefs and their assumptions that catastrophes will occur without their compulsive actions. Research studies find Beck's approach to treating depression can be as effective as medication.

Basic Principle of Cognitive Psychotherapy Example of Selective Abstraction

According to cognitive theory, unhappy feelings are caused by inaccurate thinking. Faulty beliefs that we entertain about ourselves, others, situations, and life lead us to feel badly. Changing out thoughts so they are more realistic can therefore make us feel better. Selective abstraction is thinking only about selected aspects of a situation, typically the most negative ones. Karen presents a proposal at work for solving a particular workplace problem. All meeting members are very interested in her solution, and many praise a number of her ideas. Her supervisor mentions only one negative point: that her budget for the solution seems extremely insufficient. Karen construes this single comment as her supervisor's lack of support, and believes the supervisor intended to embarrass her in front of the group. She forgets all the positive feedback and obsesses over the single negative response.

Recent Statistics Regarding Prevalence of Co-Existing Mental Illness & Substance Abuse (highlight prevalence by employment status)

According to the 2004 (reported in 2006) National Survey on Drug Use and Health (NSDUH, formerly NHSDA), 4.6 million adults had dual diagnoses of substance abuse and mental disorders and/or serious psychological distress. Within this group, six percent received treatment for both substance abuse and mental health problems. Five percent received treatment for substance abuse only. An estimated 41.4 percent received treatment for mental health problems only, and 47.5 percent received no treatment at all. Of full-time employed adults between the ages of 18 and 64, 10.6 percent had exhibited the symptoms of a substance abuse disorder within the past year, 10.2 percent had serious psychological distress within the past year, and 2.4 percent had both. Roughly 13.2 percent of males in this group versus 6.9 percent of females had experienced substance abuse problems over the past year. Roughly 14.2 percent of females versus 7.3 percent of males had problems with serious psychological distress over the past year. Among 2.9 million full-time employed adults between the ages of 18 and 64 with dual diagnoses of substance abuse and serious psychological distress, almost 60 percent received no treatment, and less than 5 percent received treatment for both diagnoses.

History of Dr. Aaron Beck's Development of Cognitive Behavioral Therapy

As a psychotherapist, Aaron Beck, observed that his patients often seemed to have "internal dialogues" taking place in their minds, as if they were silently talking to themselves (this parallels Vygotsky's concept of inner speech). They reported very little of this thinking to him. For example, a patient might think, "The doctor isn't saying much today. Maybe he's mad at me." This could engender feelings of anxiety or anger. If the patient then thought, "Maybe I'm avoiding my main problems by talking about more trivial things," or, "Maybe he's just tired today," these thoughts could change the patient's feelings. Beck realized that thoughts and feelings are significantly connected. He coined the term "automatic thoughts" to describe thoughts laden with emotions that pop into people's minds. People are often unaware of these thoughts, but they can learn to recognize and report them. Beck found that identifying negative, unrealistic, unhelpful thoughts enabled people to understand and overcome their problems.

Example of Participant Modeling

Athletic coaches have long used participant modeling. If a client has a phobia of cats (ailurophobia), for example, the therapist could model successive approximations by approaching a cat in a carrier first, then touching the cat, etc. The client would the imitate the therapist's model at each level until he or she could perform the task without anxiety.

Research Findings About Participant Modeling

Bandura's research compared participant modeling to systematic desensitization therapy; symbolic modeling, wherein participants were indirectly exposed to fearful stimuli via videos; and a control group with no treatment. Participant modeling was found to be the most effective.

Aspects of Behavioral Theory Approach to Psychotherapeutic Treatment

Behaviorism does not address internal states since they are not observable, but works to change outward behaviors. Desired changes in behavior lead to changes for the better in how the patient feels. In the structured approach of behaviorism, the therapist first obtains information from the client through interviews, and by asking the client to keep records. The therapist can observe from the client's responses and records what the client is doing that perpetuates the presenting problem(s). The therapist and client then work together to select some behaviors or activities the client can engage in that will result in positive reinforcement. Therapists will often develop a schedule of activities that the client will engage in during the week. If a client lacks the confidence and/or social skills for social activities, the therapist can help by conducting role playing exercises to practice things like starting conversations, making friends, etc. Behavioral contracts involve committing to specified behaviors or activities. Something rewarding to the client is provided as reinforcement if the client displays the behaviors or participates in activities he or she committed to in the contract.

Differences Between Freud's and Neo-Freudian Theorist's Psychodynamic Therapy Models

Both focused on motivation. However, their treatments were shorter. They might conduct weekly sessions for several months rather than conducting sessions several times a week for several years as Freud did. Neo-Freudian psychodynamic therapies tend to focus more on conscious motivations than unconscious ones, which eliminates much time spent delving into repressed memories and unconscious conflicts. They place more emphasis on the importance of the ego or self instead of on the id. they are also concerned with the influences of life experiences beyond childhood influences. While Freud concentrated on sexual and aggressive drives as the fuel for motivation, neo-Freudian psychodynamic therapists place more important on the roles of social needs and interpersonal relationships. Freudian psychanalysts would probe early childhood memories, seeking clues about a patient's depression. Neo-Freudian psychodynamic therapists, on the other hand, would more likely examine current relationships for clues, attributing depression more to social than sexual sources.

What Problems Has CBT Found To Effectively Treat

CBT has been found effective for a wide range of problems, including: anxiety, panic attacks, anger management, issues of childhood and adolescence, chronic fatigue syndrome, chronic pain, depression, drug, alcohol, and substance abuse, eating disorders, general health problems, facial tics, habits, mood swings, obsessive-compulsive disorder, phobias, PTSD, relationship problems, sexual problems, and sleep problems. A new, quickly burgeoning trend in psychotherapy is combining medications with CBT to treat hallucinations and delusions caused by schizophrenia, cocaine toxicity, some cases of bipolar disorder, long-term difficulties with social interactions and other disorders and issues.

Application of CBT to Groups v. Individuals

CBT is often used in individual counseling sessions. However, it is also effective for family therapy and group therapy, particularly in their earlier stages. Although it is normal for many clients to feel intimidated about sharing personal problems with groups, especially strangers, most find the results of group therapy beneficial if and when they can surmount this trepidation. They can discuss various problems with other people who share similar experiences and understand how they feel. They receive valuable advice and support from peers rather than just from the therapist. Another advantage of using CBT in therapy groups is that service providers are able to meet with more than one client at a time. If there are 10 people in a therapy group, then help is offered to 10 times as many people than in an individual session. Ultimately, more people can get help sooner.

Describe Techniques Involving Games & Puzzles Used in Cognitive Remediation Therapy (CRT) for eating disorders

CRT, originally developed for treating schizophrenia, has been adapted to treat eating disorders. Both disorders are characterized by cognitive inflexibility, and CRT is designed to develop cognitive flexibility. In the map game, patients find one route between two places on a map, then another, then a third one, and so on. Through completing this task, they realize there are multiple approaches to problem solving. In the letter game, patients start reading all words in a list starting with F. Halfway through, they start reading all words starting with P. This exercises flexible thinking. In the summary game, patients read a letter or short story, and then summarize it in a single sentence. They learn to stop obsessing over details and grasp the "big picture," which alters their perspective. In the visual illusion game, patients examine illusions or deceptive images, such as the dual images of young and old women in the Thematic Apperception Test. Patients practice perspective-taking, learning to see others' points of view, including love ones' perceptions of their illness. These techniques work because they are simple, and because they do not focus on food and/or emotions.

How Does CRT Modify Disorder Symptoms

CRT, originally developed for treating schizophrenia, has been adapted to treat eating disorders. Both disorders are characterized by cognitive inflexibility, and CRT is designed to develop cognitive flexibility. In the map game, patients find one route between two places on a map, then another, then a third one, and so on. Through completing this task, they realize there are multiple approaches to problem solving. In the letter game, patients start reading all words in a list starting with F. Halfway through, they start reading all words starting with P. This exercises flexible thinking. In the summary game, patients read a letter or short story, and then summarize it in a single sentence. They learn to stop obsessing over details and grasp the "big picture," which alters their perspective. In the visual illusion game, patients examine illusions or deceptive images, such as the dual images of young and old women in the Thematic Apperception Test. Patients practice perspective-taking, learning to see others' points of view, including love ones' perceptions of their illness. These techniques work because they are simple, and because they do not focus on food and/or emotions.

Two Reasons Why CRT is Effective

CRT, originally developed for treating schizophrenia, has been adapted to treat eating disorders. Both disorders are characterized by cognitive inflexibility, and CRT is designed to develop cognitive flexibility. In the map game, patients find one route between two places on a map, then another, then a third one, and so on. Through completing this task, they realize there are multiple approaches to problem solving. In the letter game, patients start reading all words in a list starting with F. Halfway through, they start reading all words starting with P. This exercises flexible thinking. In the summary game, patients read a letter or short story, and then summarize it in a single sentence. They learn to stop obsessing over details and grasp the "big picture," which alters their perspective. In the visual illusion game, patients examine illusions or deceptive images, such as the dual images of young and old women in the Thematic Apperception Test. Patients practice perspective-taking, learning to see others' points of view, including love ones' perceptions of their illness. These techniques work because they are simple, and because they do not focus on food and/or emotions.

Neo-Freudian Therapy Theorists

Carl Jung, Alfred Adler, Karen Horney, and Anna Freud Their theories maintained Freud's focus on motivation, however, their treatments were shorter.

Carl Roger's Client-Centered Therapy

Carl Rogers developed a humanistic type of therapy he called client-centered or person-centered therapy. Rogers assumed, as humanistic psychologists do, that healthy development and motivations are the norm. He also assumed these developments and motivations could be disrupted by conflicts between a person's need for a positive self-image and criticisms from oneself and others, which could lead to unhappiness and anxiety. Rogerian therapy aims to create a nurturing environment wherein clients can work through their individual issues to attain feelings of self-respect, and to self-actualize, or realize complete potential. Rogers identified key qualities of empathy, genuineness and what he termed "unconditional positive regard" - acceptance and respect of the client without judgement- as major contributors to therapeutic success. Providing these qualities in therapy enables clients to clarify feelings impeding personal growth. An important technique is reflective listening, wherein the therapist listens and then mirrors or reflects back the client's expressed feelings by paraphrasing them. Research by an APA task force found that effective therapies commonly share exactly the qualities Rogers defined: unconditional positive regard, feedback, genuineness, and empathy.

Identify New Treatment for Schizophrenia Adapted for Anorexia Nervosa & Explain the Connection

Cognitive remediation therapy (CRT), a new treatment for schizophrenia, takes advantage of neural plasticity. Neural plasticity refers to the fact that our brains can establish new synapses and pathways, and thus can be retrained to respond differently. Those diagnosed with schizophrenia tend to become fixated on minute, trivial details, and often harbor delusions. Those with the eating disorder anorexia nervosa have distorted body images (seeing their normal or thin bodies as fat), starve themselves, obsess over diet and food, exercise compulsively, and rigidly follow unusual routines and rituals. Those diagnosed with anorexia display the same cognitive inflexibility as schizophrenics. Both are incapable of changing or widening their perspective. CRT trains people to change their thinking by practicing tasks that develop the ability to shift perspective, or even broaden it. These are often low-stress tasks, such as taking a different route to work. CRT is considered an add-on to therapy and dietary management. No single treatment can effectively treat all eating disorders. However, preliminary research suggests CRT significantly enhances patients' capacities to change their behaviors, and initiatives the recovery process in a non-threatening manner.

Basic Principle of Cognitive Psychotherapy Example of Magnification-minimization

Cognitive theory holds that faulty beliefs and thinking are the sources of negative affective states, and hence mental disorders. Cognitive therapy replaces inaccurate or unrealistic thoughts with more appropriate ones to improve corresponding emotions and moods. Magnification-minimization involves having a distorted view of the importance of particular events that take place in one's life. Depressed individuals magnify negative events so that they are disproportionate to their true influences on a situation, and minimize positive events so they seem less influential than they really are. Ken is a pre-med college student who usually gets straight A's. He knows his GPA will be considered for admission to medical school. He receives a D in one American civilization class. He despairs that he will never achieve his dream of being a doctor. He has magnified one low grade in a course not essential to his major into the destruction of his entire future. At the same time, he has minimized the importance of the straight A's he got in all other courses.

Basic Principle of Cognitive Psychotherapy Example of Personalization

Cognitive therapy is based on the basic principles that our thoughts cause our feelings. According to this approach, psychological disorders are caused by incorrect thinking and beliefs. Therefore, correcting these faulty ideas improves the individual's perception of events, and hence his or her emotional state. Psychological research into depression in particular has found that people with depressed moods often have inaccurate beliefs about themselves, their circumstances , and the world in general. Personalization is taking negative events personally without having an objective reason to do so. Gina passes the boss in the hall at work and says hello, but the boss does not return her greeting. Gina construes this as meaning the boss dislikes her, and feels hurt, rejected and discouraged. However, the boss might have been preoccupied with things unrelated to Gina, such as a major work problem or personal issues. By considering that the boss's behavior might have nothing to do with her, Gina could avoid her own negative feelings.

Basic Principle of Cognitive Psychotherapy

Cognitive therapy maintains that feelings result from thinking, and that much of our thinking is inaccurate. Oftentimes, if our false beliefs are corrected, our feelings improve. Cognitive psychotherapeutic theory identifies some common cognitive mistakes.

Common Cognitive Errors

Common cognitive mistakes include personalization, dichotomous thinking, selective abstraction, and magnification-minimization.

Explain the Delayed Emergence of Behaviorism in Psychotherapeutic Practice

Despite successful uses in 1924 by Mary Cover Jones and 1938 by Mowrer and Mowrer, behavior therapy was not accepted in psychotherapy until 20 years later. This was because the Freudian concept of unconscious underlying causes for symptoms was so strong that therapists feared "symptom substitution." They thought attacking symptoms without eliminating root causes could result in a worse symptom replacing the treated one.

Identify Status of Research and Development Toward Vaccine Against Addictive Effects of Methamphetamine

Development of a vaccine against methamphetamine, which would be administered directly to addicts without the animal intermediary, is in its infancy. Scientists have not yet even reached an agreement about which carrier protein to try.

Basic Principle of Cognitive Psychotherapy Example of Dichotomous Thinking

Dichotomous thinking results when someone has a black-and-white/all-or-nothing viewpoint. People demonstrate this when they are only able to identify two choices in a given situation. Guy feels that one particular supervisor at work is treating him unfairly. He sees the only alternatives for resolving this situation as "telling off" this supervisor or quitting. Since the first option could result in Guy being fired, either of these choices could result in unemployment. Guy has failed to realize the existence of many other options, such as approaching the supervisor with a constructive attitude to discuss the situation, asking a superior supervisor for guidance or advice, speaking to the employee relations department, etc.

How Does CBT Identify and Address the Source of Negative Thoughts (provide an example)

Dr. Aaron Beck, originator of CBT, suggested that negative thought patterns begin in childhood, and then become automatic and somewhat fixed. The following is an example of the development of negative thought patterns. A child received few demonstrations of affection from his parents, but they praised him for schoolwork. He came to think, "I must always perform well; otherwise, people will reject me." Beck called this type of thought a "dysfunctional assumption." As a life rule, this assumption might work most of the time and motivate the person to work hard. However, encountering failure due to forces outside the person's control activates the dysfunctional assumption, and it can become automatic. The person might think, "I failed; nobody will like me; I can't face them." CBT helps the client understand this process, detach from the automatic thoughts, and test them. The therapist invites the client to consider what happened to him or her and others in similar real-life situations, affording a more realistic perspective. The client can then test others' opinions by asking friends what they think. Their responses will almost certainly contradict the client's exaggerated beliefs about rejection.

Basic Principles of Ellis's Rational-Emotive Behavior Therapy (REBT)

Ellis's REBT is a variation of CBT. CBT proposes our feelings are caused by our thoughts (cognitive). It also states that maladaptive behaviors are learned, and can therefore be unlearned and/or replaced by learning more adaptive ones (behavioral). Ellis identified the irrational beliefs of maladjusted people as unattainable goals and unrealistic values. He opined that such people base their lives on goals they cannot achieve and values they cannot realize. Because they are incongruent with reality, Ellis termed these goals and values "neurotic." Examples of irrational beliefs are: believing that people should always like you, that you should always be successful, that others should always approve of you and your actions, that everybody should always approve of you and your actions, that everybody should always treat you fairly, and/or that your life experiences should always be pleasant. According to Ellis, telling yourself you "should" exercise daily, get all A's etc. is "neurotic self-talk." He called it "should-ing on yourself." REBT involves identifying assumptions, questioning their rationality, and replacing faulty beliefs with more realistic ones.

Characteristics of Family Therapy, Including Approach, Benefits, and Therapist's Roles

In family therapy, the family, rather than an individual member, is the client. Each family member is regarded as part of the system of relationships. Family therapists help family members identify the behavior patterns or concerns that are causing problems in the family system. Changing the interpersonal dynamics of family interactions is the goal of family therapy. Its benefits include not only decreasing tensions within the family, but also helping individual family members identify their roles within the group. This allows each member to enhance their individual functioning. Research has found that family therapy is particularly effective in treating the eating disorder anorexia nervosa, depression and other mood disorders. It even benefits families trying to cope with schizophrenia in a family member. Psychotherapist Virginia Satir, a pioneer in family therapy, remarked that family therapists play the roles of interpreting and clarifying family session interactions, mediating, refereeing and advising. Rather than blaming one member for problems, therapists show families how they interact and help them solve problems collaboratively and constructively.

Contrast Client-Therapist Relationship in CBT with Other Psychotherapeutic Approaches Used

In some psychotherapies, the client develops a dependence on the therapist, which is encouraged to facilitate the treatment process. For example, in psychodynamic therapies, the client may come to regard the therapist as a parent substitute, which is important to the psychodynamic process of transference that allows the client to work our unresolved child-parent issues. The client may view the therapist as an omniscient, omnipotent authority for a time. Other therapies require the therapist to be very didactic and directive with the client. In CBT, the client-therapist relationship differs in that the relationship is much more equal. Some also consider it more businesslike in that is is practical and focused on problems and solutions. CBT founder Aaron Beck coined the term "collaborative empiricism" to describe how the client and therapist work together with real-life evidence to test how CBT's principles apply to the client's individual problems and circumstances.

Example of Positive Psychotherapy (PPT)

In the "three good things" exercise, the therapist instructs the client to write down three things that went well that day and why they went well before going to bed. PPT therapists also teach their clients to respond constructively to others, to concentrate on positive emotions, and to pursue pleasure more at home and work.

General Issues Related to Addiction (e.g. matching treatment to individual's occupational, financial, and mental health)

In the USA, over 25 million people have addictions, but only 10 percent seek treatment annually. Many are not motivated to recover. Others are, but do not know where to look. Many fear stigmatization or insurance issues. Additionally, information regarding the probabilities of treatment success is contradictory and confusing. Experts note this does not happen with a broken leg. Hospitals efficiently triage physical problems, end experts state addiction treatment should be more like this. Specific medications, CBT, behavioral contingency management, motivational interviewing, social support, exercise and meditation are all effective techniques. The addiction treatment industry, however, is not well-managed or organized. Moreover, legislation for parity in addiction and mental health treatment progresses slowly. Addiction researchers advocate incorporating addiction treatment into medical care, with increased standardization to reflect increased resources. They are testing a criteria system to guide addicts to appropriate treatments. For example, someone working fulltime with a limited budget should not consider residential facilities, providers without serious mental health services admitting

Contrast the Approach of Behavioral Therapies with Insight-Oriented Therapies

Insight-orientated therapies include psychodynamic, humanistic, and cognitive therapies. Behavioral therapies include those based on classical conditioning, operant conditioning, and observational learning. Insight-oriented therapies seek to understand inner thoughts, feelings, and motivations. In contrast, behavioral therapies seek only to understand problematic behaviors, not inner states. Behavioral theory holds that maladaptive behaviors are learned, and can therefore be unlearned. More adaptive behaviors can then be learned to replace the maladaptive ones. Behaviorism also maintains that only observable behaviors that can be measured or behaviorally described can be changed. Behavioral therapies have been found to be very effective for treating such problems as bedwetting, shyness, overeating, or antisocial behavior. Behavioral therapists also report successful treatment of such psychological issues as depression, aggression, compulsions, fears, delinquent behaviors, and addictions.

Implementation of Passive Immunization

Meanwhile, they are investigating passive immunization, which could ameliorate overdose effects, but would not confer ongoing protection. Passive immunization is currently approved for treating cancer, but not addictions to commonly abused substances.

Pros & Cons of Methadone Treatment

Methadone and buprenorphine both rapidly relieve heroin overdoses, and they prevent withdrawal symptoms by imitating heroin and occupying the same neuroreceptors. However, patients remain dependent on these drugs of treatment. They help many heroin addicts live normal lives, but addicts must still make frequent trips to clinics for injections. A psychiatrist researching and developing vaccines against addictive drugs found that preventing heroin addiction from developing in the first place would be preferable to methadone clinic treatments. A vaccine could prevent heroin use for several months or longer. This would give addicts more freedom, and could possibly allow them to completely quit using heroin for good.

How Neuroimaging Tech Has Been Used to Document Results of CBT

Newer imaging techniques show increased activity in specific parts of the brain, allowing scientists to see which areas are associated with certain drives, feelings, and thoughts. For example, neuropsychologists conducted a study with patients who had obsessive thoughts typical of obsessive-compulsive disorder, such as constantly worrying after leaving home that they had left the stove turned on or the door unlocked. They were given CBT training to reframe their worries as being obsessions, not rational concerns, and to distract themselves by doing other things for around 15 minutes instead of compulsively rushing home to check on things. During the study, the researchers took positron emission tomography (PET) scans of their brains. They found that the areas of the participants' brains that showed higher activity levels in connection with their obsessive worries gradually showed less activity over time with CBT training. This proves not only that CBT helps people change their thinking, but also that when people change their thinking it actually changes their brains.

Preliminary Research on Immunological Treatments for Drug Abuse

Normally, drugs of abuse pass the blood-brain barrier and excite the brain's reward circuits, making them addictive to users. Until now, drugs such as methadone, behavioral therapy, and quitting "cold turkey" have been among the few available treatment methods. However, some scientists now regard addictive substances as introduced toxins, and thus seek to treat them like the flu - immunologically, with vaccines. Related experiments have involved combining an immune-stimulating foreign protein with an addictive substance, and then using this combination to make a vaccine. Vaccination makes the patient's immune system respond by producing antibodies, which eliminate most of the substance from the system before it reaches the brain. This process can also stimulate immune memory: the body recognizes future drug doses, even without the added protein, and mounts the same immune responses, diluting the user's high. Scientists have found that users do not compensate by increasing drug dosage, but instead decrease their use or quit altogether. Vaccines could become available in 15 to 20 years.

Identify Characteristics of Individuals Who Would & Would Not Benefit from CBT

People who feel vaguely unhappy or dissatisfied, but have no specific symptoms and cannot identify any specific problems in their lives that they would like to solve would not benefit from CBT since it focuses on solving specific problems and setting and meeting specific therapeutic goals. People who agree with CBT's ideas and prefer practical solutions, rather than making their first priority the attainment of deep insights, would benefit from CBT.

Operant Conditioning & Contingency Management

Operant conditioning is a behavioral process whereby behaviors that are rewarded or reinforced become more frequent. Contingency management manipulates rewards and punishments to increase or decrease the frequency of targeted behaviors. In contingency management, then, consequences are controlled and contingent upon specific behaviors.

Define Basic Characteristics of Cognitive Behavioral Therapy (CBT)

Originally developed by Dr. Aaron T. Beck, CBT combines principles of cognitive therapy (the theory that our thoughts determine our emotions, and that correcting inaccurate or unrealistic thoughts determine our emotions, and that correcting inaccurate or unrealistic thoughts causing our negative emotions can improve affect) and behavioral therapy (the theory that internal affect can be improved by changing external behaviors through changing their antecedents and consequences). CBT is a structured, short-term approach that is goal oriented, practical, and espouses hands-on problem solving. It aims to change patterns of both thinking and behavior thought to be responsible for psychological problems. The treatment duration of CBT for most emotional difficulties is four to seven months of weekly 50-minute sessions. The therapist and client collaborate to find more effective strategies for coping with problems. Because the client learns a set of principles through CBT that he or she can then apply to future situations throughout life, the results can last indefinitely even though the therapy is brief.

Goals of Positive Psychotherapy (PPT)

PPT is humanistic in orientation in that it emphasizes balancing the negative focus on mental disorders typical of psychology with a positive focus on mental health, personal growth, and happiness. However, its methods are mainly cognitive behavioral, and emphasize research.

Preliminary Research Findings Regarding Effectiveness of Positive Psychotherapy (PPT)

PPT is humanistic in orientation in that it emphasizes balancing the negative focus on mental disorders typical of psychology with a positive focus on mental health, personal growth, and happiness. However, its methods are mainly cognitive behavioral, and emphasize research. Preliminary findings of Seligman's research team show PPT more effective in alleviating depression than antidepressant drugs or conventional therapy.

Two Main Influences of Positive Psychotherapy (PPT)

PPT's main influences are humanistic psychology and CBT.

Three Theoretical Influences of Participant Modeling

Participant modeling incorporates behavioral principles of classical conditioning, operant conditioning, and the observational learning described by Albert Bandura's social learning theory.

Participant Modeling

Participant modeling incorporates behavioral principles of classical conditioning, operant conditioning, and the observational learning described by Albert Bandura's social learning theory. Bandura proved people learn not only from direct experience, but also from observing others' behaviors and how they are rewarded or punished. People will then behave accordingly based on these observations. People can learn maladaptive responses like fears and phobias through observing and imitating others' behavior. They can also learn adaptive responses in the same way.

Current Application of Passive Immunization

Passive immunization differs from vaccination in that it produces only short-term rather than lasting immunity. Currently, it is used to temporarily stimulate patients' immune systems to treat cancers such as lymphoma. One method of passive immunization is combining the pathogen with a carrier protein, and then injecting an animal with this combination. The antibodies produced in the animal are then extracted and injected into human patients to combat the disease. It's expected this same process could be used with substances of abuse, not just disease-causing organisms. Development of a vaccine against methamphetamine, which would be administered directly to addicts without the animal intermediary, is in its infancy. Scientists have not yet even reached an agreement about which carrier protein to try.

Joseph Wolpe & Systematic Desensitization

Psychiatrist Joseph Wolpe challenged the Freudian concept of symptom substitution, which predicted that attacking symptoms by changing behaviors without eliminating underlying causes would result in worse symptoms replacing the presenting ones. According to the classical conditioning model, new, previously unrelated or unconditioned stimuli become conditioned to evoke the same responses as other stimuli through their association. Wolpe theorized that irrational emotional responses like fear could become associated with crowds, insects, lightning, etc. through this process. He also found that the nervous system cannot be simultaneously agitated and relaxed. Wolpe combined these two concepts to form the basis of systematic desensitization, wherein the association of stimuli with undesirable responses is unlearned. The extinction process begins with relaxation training. Patients are then instructed to imagine situations that are progressively more anxiety-provoking. The therapist and patient rank situations in order of severity to develop an "anxiety hierarchy." Through visualization and/or direct exposure, clients confront progressively more fearful circumstances, gradually developing desensitization to one at a time until they can confront the most severe, anxiety-provoking circumstances without experiencing anxiety.

General Summary of Principles & Methods of Psychodynamic Model of Psychotherapeutic Treatment

Psychodynamic treatment models are based on Freud's psychoanalytic theory. One general principle is that the client's problems originate in unresolved inner childhood conflicts, unconscious motivations, and early child-parent interactions. Another principle is that three personality structures are at work in any individual. The id energizes the personality by generating impulses to act, the ego governs the person's sense of reality, and the superego provides a conscience or moral sense. An additional principle is that the ego generates defense mechanisms to protect the individual from threatening thoughts, feelings, and impulses. Psychodynamic treatments focus on relating current problems to unresolved conflicts, exploring these, and seeking and finding solutions. Methods include free association, wherein the client speaks freely about whatever comes to mind that is related to the presenting problems. Transference, wherein the patient relates to the therapist as a parental figure, is a key therapeutic process. Therapists typically listen a lot, make notes, ask questions, and analyze the client's feelings. This is an in-depth type of therapy that is neither brief nor time-limited. It can take years, and affords many valuable insights into a client's motivation and behavior.

Positive Psychotherapy (PPT)

Psychologist Martin Seligman is the founder of PPT, a newer variation of CBT. PPT's main influences are humanistic psychology and CBT. PPT is humanistic in orientation in that it emphasizes balancing the negative focus on mental disorders typical of psychology with a positive focus on mental health, personal growth, and happiness. However, its methods are mainly cognitive behavioral, and emphasize research. PPT techniques are didactics in the sense that therapists assign clients homework.

History of Research & Development Regarding a Vaccine Against Heroin Addiction

Researchers first began research and development for a vaccine against heroin's addictive effects in the 19702. However, when the drugs methadone and buprenorphine were found to block brain receptors responsible for heroin's stimulation of the brain's pleasure centers and reward circuits, they came into widespread use. Methadone and buprenorphine both rapidly relieve heroin overdoses, and they prevent withdrawal symptoms by imitating heroin and occupying the same neuroreceptors. However, patients remain dependent on these drugs of treatment. They help many heroin addicts live normal lives, but addicts must still make frequent trips to clinics for injections. A psychiatrist researching and developing vaccines against addictive drugs found that preventing heroin addiction from developing in the first place would be preferable to methadone clinic treatments. A vaccine could prevent heroin use for several months or longer. This would give addicts more freedom, and could possibly allow them to completely quit using heroin for good.

Research & Development Work on Vaccine Against Cocaine Addiction

Some scientists are beginning to approach substance abuse and addictions as processes analogous to viral diseases in the sense that they believe they can be prevented rather than merely treated after a problem has developed. This reasoning has led them to begin working on vaccines to address these issues. A vaccine for cocaine addiction is presently being tested in clinical trials. It caused strong immune responses in some cocaine users, and these individuals subsequently gave high proportions of urine samples that were free of cocaine. However, this experimental vaccine produced these results in only one-third of participants. Researchers suspect that genetic influences may be involved, and are investigating this further. Another separate research team combined a chemical similar to cocaine with the parts of a cold virus that stimulate immune response, and created a vaccine that produced long-term drug immunity in mice. Clinical trials to test this vaccine are expected to begin in a few years.

Token Economy (identify how it works, and its main principle)

The behavioral method of the token economy is a variation of positive reinforcement. The main principle is that reinforcements (rewards) for desired behaviors are received immediately following the display of those desired behaviors. However, unlike simple reinforcement, it involves tokens, which are then exchanged for rewards. This way, participants can accumulate a number of tokens to earn a reward. For the trainer, this facilitates teaching multiple instances, longer durations, and/or higher frequencies of desired behaviors. It motivates the trainee to engage in more desired behaviors to accrue enough tokens. It also helps trainees identify the desired behavior since it is immediately with that behavior, and with a certain amount of it.

Example of an Anxiety Hierarchy Using Systematic Desensitization

The behavioral technique of systematic desensitization uses classical conditioning to help clients unlearn undesirable conditioned responses to stimuli. For example, if a client has an extreme fear of public speaking, the client and the therapist would construct an anxiety hierarchy. The client would list fearful situations relevant to public speaking. The therapist and client would rank the following situations in order, from least anxiety-provoking to most: 1. viewing a picture of someone else making a speech 2. seeing someone else make a speech 3. preparing one's own speech 4. introducing oneself to a big group 5. waiting to be called to speak during a meeting 6. being introduced to a group as a public speaker 7. walking to a dais, podium, or stage to speak; and 8. actually giving the speech to a big group. The client imagines and/or actually performs each item until he or she can do it without anxiety before proceeding to the next item, working from the least anxiety-provoking task to the most anxiety-provoking item.

Extinction Process in Systematic Desensitization

The extinction process begins with relaxation training. Patients are then instructed to imagine situations that are progressively more anxiety-provoking. The therapist and patient rank situations in order of severity to develop an "anxiety hierarchy." Through visualization and/or direct exposure, clients confront progressively more fearful circumstances, gradually developing desensitization to one at a time until they can confront the most severe, anxiety-provoking circumstances without experiencing anxiety.

How do Group Therapies Relate to Individual Therapies

The majority of theoretical orientations used for individual therapy are also used in group therapy.

Characteristics of Group Therapies, Applications, Benefits & a Few Types of Group Therapy

The majority of theoretical orientations used for individual therapy are also used in group therapy. Some therapy programs, especially ones designed to treat addiction in adolescents, for example, primarily stress the importance of the group therapy experience. Individual sessions can also be conducted as needed. Group therapy approaches most often embrace a humanistic theoretical orientation. The second most common approach to group therapy is the psychodynamic orientation. Group therapy is valuable for treating issues related to interpersonal interactions, relationships, and social behaviors. Groups are beneficial for people sharing the same diagnoses, symptoms, or issues, such as substance abuse, depression anxiety disorder, etc. Clients not only find others who have similar experiences in common, but also receive support from fellow members within a non-judgmental environment. Additionally, they can observe, learn, and practice new and improved social kills in this safe atmosphere. Another benefit of group therapy is that more clients receive therapy at one time. Some group therapy types include couples/marital therapy, family therapy, and self-help groups.

Recent Phencyclidine (PCP) use Trends, Abuse Symptoms, & Development of Treatment v. Prevention

The recreational use of phencyclidine (PCP), popularly known as "angel dust," has recently increased. Those who use this drug chronically develop symptoms that mimic the symptoms of schizophrenia, a very serious mental illness characterized by hallucinations, delusions, paranoia, disorganized thinking and behavior, and loss of cognitive and adaptive skills, among other things. PCP toxicity can be extremely dangerous. Scientists have recently been working on developing vaccines to prevent abuse of and addiction to various substances. By combining immune-response-stimulating carrier proteins with addictive substances, vaccines can cause users' immune systems to generate antibodies against the substances. Such a vaccine for PCP is in the very early stages of development. However, before continuing work on a vaccine, researchers may want to develop a treatment for PCP overdose first because overdoses of this particular drug are so dangerous.

Development, Benefits, & Characteristics of Self-Help Support Groups as a Type of Group Therapy

The self-help concept was pioneered in the 19302 by Alcoholics Anonymous (AA). AA's 12 steps to recovery from addiction were based on the experiences of its earliest members. In the 1960s, the feminist movement's emphasis on raising consciousness expanded the self-help concept to target a broader range of recipients. Since then, interest in self-help support groups has continued to grow. Support groups that are not directed by paid healthcare professionals are often free of charge, and can therefore benefit people with limited financial means. Another benefit is sharing experiences and ideas with others who have similar issues, including those who are coping very well, in a non-threatening atmosphere. In addition to substance abuse, today's self-help groups address other behavior control issues like overeating, gambling, and sexual addictions. They also help attendees manage life crises or transitions such as divorce or a child's death; physical disorders such as heart attack, stroke, and diabetes; mental disorders such as depression and anxiety; coping with the stress of having a loved one who is dealing with addiction; and coping with terminal illness.

Outline Advantages of Using CBT in Group Situations

They can discuss various problems with other people who share similar experiences and understand how they feel. They receive valuable advice and support from peers rather than just from the therapist. Another advantage of using CBT in therapy groups is that service providers are able to meet with more than one client at a time. If there are 10 people in a therapy group, then help is offered to 10 times as many people than in an individual session. Ultimately, more people can get help sooner.

Examples of Aversion Therapy

This is used with harmful stimuli, such as tobacco, alcohol, other abused drugs and substances, violent behaviors, etc. For example, a smoker might have to chain smoke cigarettes while a noxious odor is blown in his or her face until he or she associated smoking with nausea. The drug Antabuse, which causes nausea upon drinking alcohol, employs the same principle. Non-harmful but unpleasant electric shocks have also been paired with target stimuli in aversion therapy. Other than probation court orders, the most common reason clients voluntarily submit to aversion therapy is for problematic addictions that have proven unresponsive to other treatments.

Settings & Populations Wherein Contingency Management has Worked

This technique has been found effective when used in families, workplaces, schools, psychiatric hospitals, the military, and prisons. It has also been found to decrease self-injurious behaviors in autistic children.

Disorders Responsive to Systematic Desensitization

This technique has been found particularly helpful when used to address specific phobias and other anxiety-related issues such as agoraphobia, social phobias, stage fright, and sexual performance anxiety.

Identify Status of Research & Development of Vaccines to Prevent Nicotine Addiction

Through first-hand experience or observations of others, most of us are familiar with how difficult it is for most users to quit using tobacco, even if they are motivated to quit. Currently, some scientists are looking at substance abuse in a different way. While the disease model of addiction has existed since AA was founded, treatment has been mostly behavioral and/or has involved the use of effect-blocking drugs like methadone or naltrexone. Now, some researchers are working to develop preventive vaccines comparable to those used to prevent polio, influenza, or pneumonia. Vaccines work by stimulating the immune system to produce antibodies to a pathogen. Current research aims to develop vaccines that produce immune responses against addictive substances. Clinical tests of three different nicotine vaccines are ongoing; one is expected to be available within the next few years. One researcher admitted that this vaccine needs to be improved to have the desired level of effectiveness. However, he also predicts it will serve as a good model for immunization against other abused substances.

How and Why Does CBT Differ from Other, Less Structured Forms of Psychotherapy

Unlike psychoanalytic and psychodynamic therapies, wherein the patient is encourage to free-associate (speak freely about whatever comes to mind), CBT is structured. The client and therapist first meet to identify specific problems the client is experiencing, and to set goals they will try to achieve through therapy. Based on these problems and goals, they jointly plan session content. They begin each session by deciding which main topics they will address that week, reviewing and discussing the conclusions made during the previous session, and reviewing the progress the client made with the homework he or she self-assigned during the previous session. At the end of the session, they plan another homework assignment. The structure of CBT maximizes the efficiency of the short therapy course. It prevents the client and therapist from overlooking important information, such as homework results. It also helps the client and therapist consider new assignments that naturally proceed from each new session. CBT therapies actively structure early therapy. As clients learn helpful principles and make progress, they take increasing responsibility for session content. By the end of therapy, they feel empowered to continue independently.

Populations wherein Token Economies can be Used

When this system is used in schools and with children, tokens are often stickers, gold stars, marks on a chart, points, or play money. Token economies can also be adapted effectively for use with developmentally disabled children psychiatric patients and correctional inmates.

How is CBT Combined with Computer Technology in Treatment of Phobias & Anxiety Disorders via Systematic Desensitization

While cognitive therapy focuses on identifying and changing irrational beliefs and thoughts t hat cause undesirable emotions, and behavior therapy focuses on identifying and changing undesirable learned behaviors, CBT does both. Behaviorism uses systematic desensitization to help individuals unlearn the association of fearful or anxious responses with conditioned stimuli. Behaviorists believe this process of classical conditioning is responsible for specific phobias. They use the same process in systematic desensitization to dissociate those responses from the target stimuli. Recently some CBT therapists have been using the computer technology for virtual reality environments for systematic desensitization. They create virtual environments, which are safe for clients. In these environments, they expose them to their specific feared stimuli, which could be snakes, spiders, small spaces, heights, etc. This virtual exposure can be more visually real than mental imagery for some clients. It is also less threatening than real-life exposure, facilitating desensitization.

Benefits & Features of Couples/Marital Counseling or Therapy as A Group

While individual therapies help clients address individual issues, group therapies are especially useful for clients who need to learn about social relationships and improve their own relationships. Couples' counseling sometimes involves one couple meeting with a therapist; it can also be a group couples' therapy, in which several couples participate in a session. In addition to resolving relationship issues, the focus is on clarifying interpersonal communications and improving the quality of interactions. Typically, couples' therapy does not concentrate on individual personalities, but on the relationship's processes, especially ones related to conflicts and communicating. Therapists teach couples non-directive listening skills to help them clarify their emotions and thoughts and express them. They help couples identify the ways, both verbal and nonverbal, that each member confuses, controls or dominates the other. Then, they assist them in withdrawing from conflicts and reinforcing more desired responses in one another.

Main Principles of Humanistic Therapies & How They Differ From Psychodynamic Therapies

While psychodynamic therapies focus on motivations and conflicts among them, humanistic therapies focus on such influences as low self-esteem, misdirected goals, and unsatisfying relationships as the sources of mental disorders or difficulties. Humanistic therapies aim to resolve "existential crises," which are problems related to the purpose and meaning of existence that produce feelings of alienation, difficulties in and/or lack of fulfillment in relationships, and overall dissatisfaction with life. A basic tenet of humanistic therapies that sets them apart from psychodynamic approaches is that, generally, people are motivated by healthy needs for psychological well-being, growth, and self-actualization. The idea of the whole person who is continuously changing and growing is emphasized. Negative self-evaluations and criticisms from others can create unhealthy environments that interfere with normal growth and development. Humanistic therapies regard such negative influences as the causes of mental disorders. They seek to help clients realize their own freedom, improve their self-esteem, and realize their full potential.

Two Main Concepts of Systematic Desensitization

Wolpe theorized that irrational emotional responses like fear could become associated with crowds, insects, lightning, etc. through this process. He also found that the nervous system cannot be simultaneously agitated and relaxed. Wolpe combined these two concepts to form the basis of systematic desensitization, wherein the association of stimuli with undesirable responses is unlearned.