Abnormal psychology: implementing treatment – Flashcards

cause of the disorder

biomedical, individual, or group therapy. However, a multifaceted approach to treatment is believed to be the most efficient.

biopsychosocial

drug treatment, individual therapy (e.g. cognitive therapy), or group therapy (e.g. family therapy) as well as help to handle risk factors in the environment such as a stressful relationship.

-Based on the idea that biological factors are associated with changes in brain chemistry (neurotransmitters and hormones). -Number of drugs used in effect -there is not a full understanding of how neurotransmitters and symptoms are linked, or why drugs work only sometimes.

- therapist works one on one with a client. - may include cognitive therapy to change negative thought patterns -Seen as more personal (person feels like less of a patient...and more like a client than in drug therapy) -More individualised

- group of clients meet with one or more therapists. - allows talk of very private matters...initiates healing process. - less expensive - more than one client are analysed - less dependancy on the therapist by client...client has a support group - Gives feeling of not being alone (great stressor for many...worry they are outside the norm or have insurmountable feelings) - Allows development of social skills

- Some individuals may not want to disclose their problems - Issue of confidentiality -

- Therapy success is decided by culture - Sometimes a combination of western psychotherapy and indigenous healing practices are used for success -

- therapeutic beliefs and practices that are rooted within a given culture -non-western practices include heavy reliance on family and community networks, and incorporation of traditional, spiritual, and religious beliefs. - In Malaysia, religion has been incorporated into psychotherapy for example (integration of prayer and focusing on verses of the Koran that address "worry," have made psychotherapy culturally relevant)

A indigenous healing practice. - verses from Taoist writings that highlight main principles, such as restricting selfish desires, learning how to be content, and learning to let go, are read and reflected on by the client. - was more effective in the long-term reduction of anxiety disorders than medications.

go beyond the traditional focus of responding to a person's distress on an individual level and include analysis of psychological health at the community level.

emphasizes the relationships between people and the settings they live in; the identification of naturally occurring resources within the community that can promote healing and healthy adaptation.

an approach that incorporates principles or techniques from various systems or theories whilst recognizing the strengths and limitations of the various therapies, and tailors sessions to the needs of the individual client or group.

drug therapies alone often have significant relapse rates, that is the client begins to show symptoms of the disorder after having been symptom-free.

even if the individual did not have therapy, he or she would have improved, simply through a natural process of recovery, just as with a common cold.

● For how long must a person show a relief from his or her symptoms to be categorized as a treatment success? ● Is a total absence of symptoms the only criterion that should be used? ● Should only observable behavioural change be used to assess success? ● Is it possible to gather quantitative data on the effectiveness of therapy, or only qualitative data? however...who decides whether the treatment was successful ? Therapists are unlikely to state that their therapy was ineffective, especially if the client has spent a lot of time and money on the sessions. Another issue is self-reporting by the client.

Used to evaluate effectiveness of therapy: focus on results. Implications to consider: - Even if all participants had depression, the degrees may vary. - Therapy is not standardised but rather personalised

MDD is the serotonin hypothesis, which suggests that there is an inadequate amount of serotonin available in the synaptic gap between neurons for effective transmission to occur... medication for MDD increases serotonin...SSRIs, (selective serotonin reuptake inhibitors) such as Prozac are commonly utilised.

it treats the symptoms, but does not cure the disorder, and the medication needs to be continued for the effect to be maintained.

psychiatric therapy that uses short electrical stimulus to the brain through tiny electrodes in the temples.

Strengths (MDD scope): - in many cases there is an alleviating of symptoms, especially when used in tandem with psychotherapy Limitations: - The anti-depressants prescribed for any of these disorders can be physically and/or psychologically addictive. -Many side-effects -Medication mostly takes long until it works -ECT can have, usually temporary, impacts on memory

Cognitive-behavioural therapy (CBT) is the most common individual treatment for MDD.

Strengths: - it puts control in the hands of the client, rather than the psychologist or psychiatrist. Limitations: -The maladaptive cognitions seen in psychologically disturbed people could be a consequence of their mental disorder, rather than a cause. The cognitive model is narrow in scope - thinking is just one part of human functioning, and maybe broader (biological and/or sociocultural) issues need to be addressed. - May be impossible for people who have poor verbal expression skills.

Cognitive-behavioural therapy: As the name suggests, cognitive-behavioural treatments incorporate both cognitive and behavioural strategies.

Strengths: -Good outcomes recorded -. The skills learnt are useful, practical and helpful strategies can be formed and incorporated into everyday life -Person can feel less isolated Limitations: -risk of one patient monopolizing therapy, confrontation between group members, and the development of subgroups -Some disturbing cognitions may be left unsaid

an eclectic approach has a broader theoretical base, and therefore may be more sophisticated than an approach using only one theory. • there is greater flexibility offered to the client, and individual therapy needs may be met. • there is more chance of finding an effective treatment if two approaches are used in tandem. • this approach is suitable for a wider range of clients than a single approach. • a therapist using an eclectic approach is not biased towards one treatment theory and method, and therefore may be more objective. • a therapist using an eclectic approach can revise and rebalance treatment according to which approach appears to be most effective.

Claim made by Eysenck in 1961 hypothesising that an individual, with or without psychotherapy, would have naturally recovered.

●For how long must a person show a relief from his or her symptoms to be categorized as a treatment success? ● Is a total absence of symptoms the only criterion that should be used? ● Should only observable behavioural change be used to assess success? ● Is it possible to gather quantitative data on the effectiveness of therapy, or only qualitative data? ●who decides if the treatment was successful?

- based on the assumption that problems are cause by biological malfunctions. Can be restored by drug use. - Drugs first used in the 19th century to treat disorders - Drugs impact neurotransmitters such as dopamine, serotonin, noradrenalin, or GABA

Precursor of adrenaline; regulates emotional response

-relays signals from one part of the brain to the other -Includes brain cells that control mood, sexual desires, appetite, sleep, memory, and learning.

It increases blood pressure by constricting the blood vessels. The main purpose of Noradrenaline is to normalize life threatening low blood pressure (acute hypotension).

Distorted cognitions of a depressed individual can be treated with cognitive restructuring. The principle are to: ● identify negative, self-critical thoughts that occur automatically ● note the connection between negative thought and depression ● examine each negative thought and decide whether it can be supported ● replace distorted negative thoughts with realistic interpretations of each situation.

According to Beck, a person's beliefs contribute to "automatic thoughts" based on schemas. In depression, negative self-schemas bias a person's thinking.

-Based on the assumption that interpretations of events impact thinking and behavioural patterns. - Brief form of psychotherapy - Based on Becks cognitive therapy - Used in treatment of adults and children with MDD - CBT focuses on current issues and symptoms...not the past - approximately 12-20 weekly sessions - Aim is to identify and correct faulty cognitions - Encourages increase of activities that can be rewarding

When the client associates negative thoughts with depression and corrects them.

● Arbitrary (unreasonable thoughts) inference: drawing wrong conclusions about oneself by making invalid connections—for example, when it rains on the day that you have organized a picnic, you think that only you have bad luck and that the world is against you. ● Personalization: assuming that others' behaviour is done with the intention of hurting or humiliating you—for example, when someone does not greet you when he or she passes by, and you assume that person is angry with you or hates you. ● Overgeneralization: applying a single incident to all similar incidents—for example, assuming that a relationship problem with a friend means that you are unsuccessful in relationships and have no true friends. ● Selective abstraction: drawing conclusions by focusing a single part of a whole—for example, focusing on a single bad grade and ignoring the fact that you actually have an A in the class; or thinking that because you have fat thighs, you are a fat person, as is often the case with bulimics. ● Exaggeration: overestimating the significance of negative events—for example, when shortness of breath while exercising is seen as a sign of major illness and imminent death. ● Dichotomous thinking: an all-or-nothing approach to viewing the world—for example, you either love me or you hate me. APOSED

● Help the client to change faulty thinking patterns and underlying schemas. ● Help the client to develop coping strategies and problem solving skills, and to engage in behavioural activation

The ability to think about ones own thoughts...this is taught in CBT

- cognitive therapy, including CBT, effectively treats patients with depression (e.g. Rush et al. 1977) however, CBT has also been found to not be superior to any treatment or to a placebo (e.g. Dobson 1989) - Elkin et al. (see page 173) found that the two therapies were slightly less effective than the drug but more effective than placebo. - Riggs et al. (2007) studied effectiveness of CBT. Found 67 per cent of the patients in the CBT group + placebo group and 76 per cent of the patients in the SSRI drug + CBT were judged as "very much improved" or "much improved" after 4 months of treatment. -Cognitive therapies have been criticized for focusing on symptoms rather than causes. It has also been argued that by providing clients with strategies for self-help, they are less manipulative than other treatments.

- Often this is "couples" therapy - Jacobsen et al. (1989) have found that this form of group therapy has shown to be just as effective as other forms in treating the symptoms of depression - Group treatment was found to be as effective as individual treatment in 75 per cent of these studies and more effective in the remaining 25 per cent. (Toseland and Siporin (1986) - In no case was individual treatment found to be more effective - Group treatment was more cost-effective than individual therapy in 31 per cent of the studies. - McDermut et al. (2001) provide a meta-analytic review of the effectiveness of group psychotherapy in the treatment of depression.

Group cohesion. No one person should be different from the rest. There needs to be a sense that all people "belong" in the group. For example, there should not be five males and one female. Exclusion. Are there any characteristics that should be excluded from the group? For example, current substance abusers, married men, or people with a certain health condition? Confidentiality. People must trust that they can speak freely in the group. Relationship with therapist. Group therapy compensates for the fact that the therapist is not "one of us." The therapist must show empathy for the members of the group and attempt to understand their reality

Antidepressants and tranquilizers are prescribed to treat people suffering from PTSD.

A line of intervention based on knowledge from how people react in traumatizing situations.

According to Weine, traditional treatment is said to work by deactivating "networks of fear" in the psyche. Testimony is based on theories that consider collective traumatization to be at least as significant as individual traumatization. B

e.g. All testimonies were conducted in Bosnian, translated into English, and then translated back into Bosnian. Could pose issue of reliability

Since people suffering from bulimia often suffer from depression, different drugs such as tricyclic antidepressants and SSRIs have been investigated.