chapter 17 psychology

describe the use of electroconvulsive therapy in treating severe depression, and discuss some possible alternatives to ECT

ECT is a biomedical therpay in which a brief electric current is sent through the brain of an anesthesized patient. although controversial, ECT remains an effect, last-resort treatment for many people with severe depression and is ineffective in treating other disorders, and is only for people who haven't responded to drug therapy. how ECT works is unknown. depression has also been alleviated by implanting devices that stimulate parts of the brain or the vagus nerve sending signals to the limbic system. clinical trials are under ways to study repetitive transcranial magnetic stimulation (rTMS), where pulses of magnetic energy sent through the skull to the surface of the cortex stimulate or dampen activity in various areas of the brain

psychoanalysis

Sigmund Freud's therapeutic technique. Freud believed the patient's free associations, resistances, dreams, and transferences-and the therapist's interpretations of them-released previously repressed feelings, allowing the patient to gain self-insight into unconscious origins, working through accompanying feelings, and take responsibility for their own growth

nondirective therapy

The therapist listens, without judging or interpreting, and refrains from directing the client toward certain insights

antianxiety drugs

Xanax or Ativan, depress central nervous system activity and should not be used with alcohol. often used with psychotherapy for treatment of anxiety disorders, and can be psychologically and physically addictive

counterconditioning

a behavior therapy procedure that conditions new responses to stimuli that trigger unwanted behaviors; based on classical conditioning. includes expose therapy and aversive conditioning.

electroconvulsive therapy (ECT)

a biomedical therapy for severely depressed patients in which a brief electric current is sent through the brain of an anest

interpersonal psychothereapy

a brief (12-16 session) variation of psychodynamic therapy, effective in treating depression, aiming to help people gain insight into the roots of their difficulties, but its goal is symptom relief in the present, not overall personality change.

client-centered therapy

a humanistic therapy, developed by Carl Rogers, in which the therapist uses techniques such as active listening within a genuine, accepting, empathic environment to facilitate clients' growth

lobotomy

a now-rare psychosurgical procedure once used to calm uncontrollably emotional or violent patients. the procedure cut the nerves that connect the frontal lobes to the emotion-controlling centers of the inner brain

cognitive-behavior therapy

a popular integrated therapy that combines cognitive therapy (changing self-defeating thinking) with behavior therapy (changing behavior)

meta-analysis

a procedure for statistically combining the results of many different research studies

systematic desensitization

a type of counterconditioning that associates a pleasant relaxed state with gradually increasing anxiety-triggering stimuli. commonly used to treat phobias.

aversive conditioning

a type of counterconditioning that associates an unpleasant state (such as nausea) with an unwanted behavior (such as drinking alcohol)

virtual reality exposure therapy

an anxiety treatment that progressively exposes people to simulations of their greatest fears, such as airplane flying, spiders, or public speaking

eclectic approach

an approach to psychotherapy that, depending on the client's problems, uses techniques from various forms of therapy

psychotherapy

an emotionally charged, confiding interaction between a trained therapist and someone who suffers from psychological difficulties

token economy

an operant conditioning procedure in which people earn a token of some sort for exhibiting a desired behavior that can later exchange the tokens for various privileges or treats

explain the rationale of preventive mental health programs

argue that many psychological disorders could be prevented. their aim is to change oppressive, esteem-destroying environments into more benevolent, nurturing environments that foster individual growth and self-confidence

bed wetting

behavior modification

exposure therapies

behavioral techniques, such as systematic desensitization, that treat anxieties by exposing people (in imagination or actuality) to the things they fear or avoid.

paraprofessionals

briefly trained people

antipsychotic drugs

chlorpromazine (Thorazine), clozapine(Clozaril). mostly helps with schizophrenia with positive symptoms, negative symptoms don't respond well to it. molecules of antipsychotic drugs are similar enough to molecules of dopamine to occupy receptors and block activity. first generation targeted D2 dopamine receptors, with sluggishness, tremors, and twitches. new generation ones target D1 with fewer side effects but not more effective with increased risk of obesity and diabetes. dampen responsiveness to irrelevant stimuli. dosage varies from person to person. new gernation can affect metabolism

give some reasons why clinicians tend to overestimate the effectiveness of psychotherapy, and describe 2 phenomena that contribute to clients' and clincians' misperceptions in this area

clients enter therapy when they are unhappy, leave it when they are less unhappy, and stay in touch only if satisfied with the treatment they received. so clinicians are mostly aware of other therapists' failures, not thier own. both the placebo effect (the belief that a treatment will work) and regression toward the mean (the tendency for extreme or unusual scores to fall back toward the mean) contribute to clients' and clinicians' misperceptions of the effectiveness of psychotherapy

explain why clients tend to overestimate the effectiveness of psychotherapy

clients judge psychotherapy to be effective for 3 reasons: they tend to enter therapy in crisis, they need to believe their time and expense justified, and they try to find something positive to say when asked to evaluate their therapist. but research has not generally upheld clients' estimates of therapy's effectiveness

psychotherapy integration

closely related to eclecticism, advocating aim to combine methods into a single, coherent system.

contrast cognitive therapy and cognitive-behavior therapy, and give some examples of cognitive therapy for depression

cognitive therapy attempts to teach people to think in more adaptive ways, on the assumption that thoughts intervene between an event and our emotional reactions to it. cognitive-behavior therapy attempts to teach people to think in more adaptive ways but also to practice thr new ways of thinking in everyday life. in aaron beck's cognitive therapy for depression, therapists try to change self-defeating thinking by training clients to look at themselves in new, more positive ways. in stress oculation training, another form of cognitive therapy, people with depression learn to dispute their negative thoughts and to restructure their thinking in stressful situations. depressed people also work to establish the attribution style of nondepressed people (taking credit for good events and not taking blame for, or overgeneralizing from, bad events)

anxiety

cognitive, exposure, and stress inoculation training

treatments for depression

cognitive, interpersonal, and behavior therapy

bulimia

cognitive-behavior

active listening

empathic listening in which the listener echoes, restates, and clarifies. a feature of roges' client-centered therapy

humanistic

emphasized people's inherent potential for self-fulfillment, aiming to help people grow in self-awareness and self-acceptance. focuses on the present and future more than the past, conscious rather than unconscious thoughts, taking immediate responsibility for one's feelings and actions, and promoting growth rather than curing illness. involves carl roger's genuineness, acceptance, and empathy, and unconditional positive regard.

describe the technique used in exposure therapies and aversive conditioing

exposure therapies train people to relax, a response that cannot co-exist with fear, and then gradually but repeatedly expose them to the things they avoid and fear. exposure therapies try to substitute a positive response, or relaxation, for a negative one, or fear. aversive conditioning uses counterconditioning techniques to pair an unpleasant state with an unwanted behavior. aversive conditioning tries to substitute a negative response, such as nausea, for a positive one, as pleasure, to a harmful stimulus.

identify basic characteristics of the humanistic therapies, identifying the goals and techniques of the client-centered therapy

humanistic therapists focus on the clients' present and future experiences, on conscious rather than unconscious, and taking responsibility for one's actions. rogers proposed that therapists' most important contributions are to function as a psychological mirror for the client through active listening, and to provide an environment with unconditional positive regard, characterized by genuineness, acceptance, and empathy. rogers believed clients would increase their own self-understanding and self-acceptance

evaluate the effectiveness of eye movement desensitization and reprocessing (EDMR) and light exposure therapies

in EDMR therapy, a therapist attempts to unlock and reprocess previously forzen traumatic memories by waving a finger in front of the eyes of a person imagining traumatic scenes. EDMR has not held up under scientific testing, and its modest successes may be attributable to the placebo effect. in people with seasonal affective disorder, a form of depression linked to periods of decreased sunlight, light exposure therapy (exposure to daily timed doses of light that mimics outdoor light) has been proven effective by scientific research

discuss the rationale and benefits of group therapy, including family therapy

in groups normally consisting of 6-9 people, therapists may be less involved with each members but 90-minute sessions can help more people and cost less than individual therapy would. clients may benefit from knowing others have similar issues and from getting feedback and reassurance. most forms of therapy can be adapted to a group setting. family therapy views a family as an interactive system and attempts to help members discover the roles they play and to learn to communicate more openly and directly. millions of people participate in self-help and support groups, such as Alcoholics Anonymous

interpretation

in psychoanalysis, the analyst's noting supposed dream meanings, resistances, and other significant behaviors and events in order to promote insight.

resistance

in psychoanalysis, the blocking from consciousness of anxiety-laden material

transference

in psychoanalysis, the patient's transfer to the analyst of emotions linked with other relationships (such as love or hatred for a parent)

tardive dyskinesia

involuntary movements of the facial muscles, tongue, and limbs; a possible neurotoxic side effect of long-term use of antipsychotic drugs that target D2 dopamine receptors

mood-stabilizers

lithium controls the manic episodes. very effective in stabilizing moods, but don't understand how it works

summarize the history of lobotomy, and discuss the use of psychosurgery today

lobotomy was a crude procedure, in which surgical instruments inserted through a patient's eye sockets were used to sever connections running to the frontal lobe. the intent was to calm uncontrollably emotional or violent patients, but created lethargy and impulsive personality. disappeared in the 1950s, when its harmful effects were known. neurosurgeons rarely perform brain surgery to treat psychological disorders, and are used as a last resort because its effects are irreversible.

summarize the findings on which psychotherapies are most effective for specific disorders

meta-analyses indicate that no one type of therapy is most effective overall, nor is there any connection between effectiveness and a therapist's training, experience, supervision, or licensing.

spontaneous recovery

natural recovery

state the main premise of therapy based on operant conditioning principles, and describe the views of proponents and critics of behavior modification

operant conditioning therapies are based on the principle that voluntary behaviors are strongly influenced by their consequences. behavior modification procedures thus enforce desired behaviors and withhold reinforcement for, or punish, undesired behaviors. therapists sometimes create token economies, in which people receive tokens for exhibitng a desired behavior and can later trade the tokens for a privilege or treat. critics object 1) on the practical grounds that these behaviors may disappear when the tokens are discontinued 2) on the ethical grounds that it is not right to control other people's behaviors. proponents argue that 1) social or intrisinc rewards can replace the tokens and continue to be reinforcing, and 2) reinforcing adaptive behavior is justified because, with or without behavior modification, rewards and punishments will always control people's behavior

describe the importance of outcome studies in judging the effectivenes of psychotherapies, and discuss some of these findings

outcome studies are randomized clinical trials in which people on a waiting list receive therapy or no therapy. statistical digests (meta-analyses) of hundreds of these studies reveal that 1) people who remain untreated often improve but 2) those who receive psychotherapy are more likely to improve and 3) people who receive psychological treatment spend less time and money later seeking other medical treatment, compared with their counterparts on waiting lists

free associate

pauses represent resistance

biomedical therapy

prescribed medications or medical procedures that act directly on the patient's nervous system, physically changing the brain's functioning by altering its chemistry with drugs, overloading its circuits with electroconvulsive shock, using magnetic impulses to stimulate or dampen activity, or altering its circuits through psychosurgery

antidepressant drugs

prozac (fluoxetine), zoloft, paxil. also called selective-serotonin-reuptake-inhibitors (SSRIs). they slow the synaptic vacuuming of serotonin. dual-action ones have more potential side effects. increases the availability of norepinephrine or serotonin, which elevate arousal and mood. dual-action antidepressants block reuptake or absorption of both norepinephrine and serotonin, but with greater side effects. are used to treat depression and with cognitive therapy, anxiety. suicide risk may have been overestimated.

contrast psychodynamic therapy and interpersonal therapy with traditional psychoanalysis

psychodynamic therapy was influenced by traditional psychoanalysis but is briefer and less expensive. a psychodynamic therapist attempts to focus on anc conceptualize a patient's current conflicts and defenses by searching for themes common to many past and present relationships, including childhood experiences and interactions with the therapist. interpersonal therapy is 12-16 sessions and is a form of psychodynamic therapy, focusing on relieving current symptoms rather than intensive interpretation of unconscious conflicts

discuss the role of values and cultural differences in the therapeutic process

psychotherapists may differ from each other and from clients in personal beliefs, values, and cultural background. such differences can affect the formation of a bond between therapist and client. people searching for a therapist should have preliminary consultations with 2 or 3 to gain an understanding of the therapists' values, credentials, and fees, and to find someone with whom they feel comfortable.

randomized clinical trials

randomly assigning people on a waiting list to therapy or no therapy

Describe the 3 benefits attributed to all psychotherapies

seem to offer new hope for demoralized people, a fresh perspective, and an empathic, trusting, caring relationship. the therapeutic alliance, the emmotional bond between therapist and client, is an important part of effective therapy and may help explain why some paraprofessionals can be as helpful as professional psychotherapists

psychosurgery

surgery that removes or destroys brain tissue in an effort to change behavior

stress inoculation training

teaching people to restructure their thinking in stressful situations

repetitive transcranial magnetic stimulation (TMS)

the application of repeated pulses of magnetic energy to the brain; used to stimulate or suppress brain activity

neurogenesis

the birth of new brain cells, perhaps reversing stress-induced loss of neurons

psychopharmacology

the study of the effects of drugs on mind and behavior

regression toward the mean

the tendency for extremes of unusual scores to fall back (regress) toward their averages

progressive relaxation

the therapist trains you to relax one muscle group after another, until you achieve a drowsy state of complete relaxation and comfort. you imagine scenes, and when you feel anxiety, you go back to deep relaxation. this imagined scene is repeatedly paired with relaxation until you feel no anxiety.

psychodynamic therapy

therapists try to understand a patient's current symptoms by focusing on themes across important relationships, including childhood experiences and the therapist relationship. helps patient explore and gain perspective on defended-against thoughts and feelings, talking to face to face in the line of vision only once a week for a brief amount of time.

behavior therapy

therapy that applies learning principles to the elimination of unwanted behaviors

cognitive therapy

therapy that teaches people new, more adaptive ways of thinking and acting; based on the assumption that thoughts intervene between events and our emotional reactions

family therapy

therapy that treats the family as a system. views an individual's unwanted behaviors as influenced by or directed at other family members; attempts to guide family members toward positive relationships and improved communication

explain how the basic assumption of bhavior therapy differs from those of traditional psychoanalytic and humanistic therapies

to help people alleviate current conflicts and problems, traditional psychoanalytic therapists attempt to explain the origin of behaviors, and humanistic therapist attempt to explain the origin of behaviors, and humanistic therapists attempt to promote self-acceptance and self-awareness. therapists assume the problem behaviors are the problem, and attempt to change them through new learning

behavior modification

to reinforce desired behaviors and to withhold reinforcement for undesired behaviors or to punish them

eye movement desensitization and reprocessing (EDMR)

triggered eye movements by waving her finger in front of their eyes, supposedly enabling them to unlock and reprocess previously frozen trauma memories