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AP Psychology – Therapy

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Therapy
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The treatment of dysfuntional behaviors
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Psychotherapy
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Application of psychological principals and techniques to the treatment of a disorder
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What are some things included in Psychotherapy?
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Discussion of the problem, and specific exercises or techniques that are designed to help the person to function better in everyday life.
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Biological therapy
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Medical based therapy
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Treatments in biological therapy?
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Medications and ECT
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What is ECT?
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Electro Shock Therapy
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Combination Treatment Therapy
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The combined use of medication and psychotherapy
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Who can provide psychological treatment?
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Psychiatrists (MD degree), Psychologist (PhD or PsyD), and/or psychiatric social worker or nurse
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Who pioneered the Psychoanalytic approach to therapy?
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Sigmund Freud
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Sigmund Freud
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Stage fixations; defense mechanisms; conflicts with id, ego, and super-ego
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What does the psychoanalytic approach to therapy emphasize?
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The importance of the subconscious mind and the unraveling of the past to understand the future
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About how long does psychoanalytic therapy take?
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Until the patient is cured – multiple sessions per week over a long period of time.
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What are some psychoanalytic techniques?
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Free association, dream analysis, tats, and Rorschach ink blots
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Evaluation of psychoanalytic therapy?
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Deterministic in nature; lacks scientific reference; takes forever; transference; extremely expensive; ineffective in the treatment of psychotic disorders with biological implications (<ex: schizophrenia)
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Humanistic therapy
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Group therapy/Family counseling – often simply called “client centered therapy”
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What is humanistic therapy based on?
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Based on Maslow’s ideas and developed by Carl Rogers – there was little to no experimentation – dependent upon case studies, Q sorts, etc. to gain insight
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What does humanistic therapy emphasize?
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The present and future – not the past
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Client centered
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(Humanistic therapy) Non-directed therapy – “insight” therapy – free will of the clients to choose their own destiny
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Humanistic therapy techniques
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Genuineness, unconditional positive regard, empathy, and active listening
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Genuineness
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(Humanistic therapy) Complete openness and honesty from therapist and expected from client
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Unconditional positive regard
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(Humanistic therapy) Therapist emphasizes the value of the client
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Empathy
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(Humanistic therapy) Emotional understanding of the client by the therapist
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Active listening
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(Humanistic therapy) Repeating what the client said in a way that sounds that the therapist listened
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Gestalt therapy
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(Humanistic therapy) Variation of humanistic – points out inconsistencies in statements made by clients, how they see themselves, and how they interact with others.
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Evaluation of humanistic therapy
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Frequently used one family or group therapy sessions (AA, NA, etc.); fairly ineffective in treatment of serious disorders
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Behavioral Therapy
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-Based on the general principles outlined by Pavlov, Watson, and Skinner. -Emphasizes changing in learned behaviors rather than understanding feelings. -Traditional techniques use conditioning to alter behavior. Tried and true experimentation of effectiveness in treating some disorders (phobias).
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Techniques for behavioral therapy
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Systematic desensitization, aversion therapy, extinction of reinforcement, flooding or exposure therapy, token economy, virtual reality therapy
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Systematic Desensitization
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(Behavioral therapy) A pleasant relaxation state is paired with the stimulus that brings fear
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Aversion therapy
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(Behavioral therapy) Unpleasant stimulus is introduced at the same time as the learned behavior
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Extinction of reinforcement
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(Behavioral therapy) Ex: Quit calling out the name of the bad student – instead, ask them to leave
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Flooding or exposure therapy
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(Behavioral therapy) Flooding the affected person with the unpleasant stimulus. Ex: little pieces of dirt near/around the neat freak
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Token economy
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(Behavioral therapy) Starts, tokens, and/or other rewards are given when good actions happen and can be exchanged later for rewards
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Virtual reality exposure therapy
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(Behavioral therapy) Effective in the treatment of phobias Ex: fear of flying
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Evaluation of behavioral therapy
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Very effective in the treatment of some anxiety disorders and helpful with some forms of depression
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Cognitive therapy
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Commonly known as: REBT – rational emotive behavior therapy; Helps people to look at their problems in a more rational way; therapist acts as a “teacher” to help people see where they are misguided in thought
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Cognitive therapy was introduced by…
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Albert Ellis – people engage in self talk that is false
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What was Cognitive therapy designed to do?
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Designed to help people change the way they think about their problems
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What is challenged in Cognitive therapy?
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Self defeating attitudes and thoughts and patterns are challenged
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Cognitive therapy and treatment
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Cognitive therapy is used to treat depression – it challenges irrational thought. It requires the person to explain the automatic response they have to themselves.
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Who was Cognitive therapy authored by?
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Aaron Beck
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Cognitive therapy techniques
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Examine evidence for and against, computer simulations, zen mediations, mindfulness
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Evaluation of Cognitive therapy
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Ineffective in cases where medicine is definitely the answer but can be combined with medications, Effective when dealing with anything where people need to talk it out.
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Medical (biological) therapy
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To examine the role of biochemistry and genetics
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Chemotherapy
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(Biological therapy) Any drug – advent of in the 70s has greatly reduced the number of people in mental hospitals
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Neuroleptics
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(Biological therapy) Anti-psychotic drugs: reduce hallucinations and paranoia
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Types of neuroleptic drugs
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Clozaril, haldol, and Thorazine
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Thorazine
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(Biological therapy) Blocks dopamine – used in the treatment of schizophrenia which seems to be overactive in these people
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Anti-anxiety drugs
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(Biological therapy) Tend to suppress CNS activity – quick fix drugs
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Types of anti-anxiety drugs
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(medical (biological) therapy) Valium and Xanax
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Anti-Depressants/Anti-anxiety drugs
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(Biological therapy) Longer term – increase neurotransmission of serotonin and nor-epinephrine — SSRIs and MAOIs elevate mood and arousal.
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Types of ant-depressants/anti-anxiety drugs
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(Biological therapy) Prozac, zoloft, Paxil, celexa, etc.
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Bipolar disorder and medical therapy
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In cases of Bipolar Disorder, it usually requires a “cocktail” of drugs. Many times they need an anti-convulsive drug like Depakote and an anti-depressant
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What is the usual the anti-depressant drug of choice for treating bipolar disorder?
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Lithium
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ECT
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(Electroconvulsive Therapy – medical therapy) An electric current is administered after affected patient is sedated.
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When is ECT used?
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Used in the treatment of severe depression when nothing else has worked. No one really understands why it helps… It can cause memory loss.
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What are other popular forms of shock therapy?
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(Biological therapy) Chest implants that stimulate the vagus nerve, or rTMS
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What does the chest implant do in medical therapy?
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(Shock treatment – Biological therapy) Sends message to the limbic system, has helped some with depression
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rTMS
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Wire coils are placed on top of the head and then pulse are sent through the coils = stimulation of the left frontal lobe seems to help
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ACT
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Action therapties
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EMDR
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(Form of ACT – Biological therapy) Gets people to focus on quick changing visual things while thinking of the thing that causes them anxiety – some think it is a sham
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How is EMDR used?
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(Biological therapy) Used in the treatment of some anxiety disorders
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Evaluation of medical therapy
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Some drugs cause side effects like tardive dyskinesia, dry mouth, weight gain
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Tardive dyskinesia
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Spastic movements of face and/or limbs
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What is a good alternative to antidepressant drugs?
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Aerobic exercise
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What is an issue with prescriptions and medical therapy?
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Some drugs are over prescribed for depression as most are environmentally induced depression subsides in three months even with out medication
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Eclectic (biopsychosocial) therapy
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A combination of all different types of therapies
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Methodologies of Biological therapy
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Experimentation on animals
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Causes of dysfunctional behavior in biological therapy
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Biologically based – genetic predisposition, hormone or neurotransmitter problem
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Treatment techniques in biological therapy
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Medications, ECT, surgical techniques, DBS, and rTMS
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DBS
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Deep Brain Simulation
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Criticisms and limitations in biological therapy
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The side effects (tardive dis.., weight gain, dry mouth); can be expensive; over prescribed (38% of college students on some form of therapeutic drug)
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Methodologies of behavioral therapy
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Experiments – mostly on non-human animals
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causes of dysfunctional behavior in behavioral therapy
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Learned – either through operant/classical conditioning or observation
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Treatment techniques in behavioral therapy
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Behavior modifications – anxiety disorders – (phobias); extinguish unwanted behaviors; Aversion therapy; Flooding; systematic desensitization; token economy; virtual reality – exposure therapy (PTSD)
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Criticisms and limitations of behavior therapy
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Ethical concerns,failure to identify causes of unwanted behavior
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Too much serotonin?
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Schizophrenia
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Too little serotonin?
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Parkinson’s
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Methodologies of humanistic therapy?
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Case studies; q-sorts – cards with words on them that describe patient
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Causes of dysfunctional behavior in humanistic therapy?
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Inability to know self – what you want or who you are; Inability to talk responsibility for self
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Treatment techniques for humanistic therapy?
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Client centered; client and therapist work together; active listening
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Criticisms and limitations for humanistic therapy?
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Idealistic; lacks scientific support; limited applications to real psychosis; rare to work
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Methodologies for cognitive therapy?
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Experiment; computer simuations
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Causes of dysfunctional behavior in cognitive therapy?
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Distortions in thinking
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Treatment techniques in cognitive therapy
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Changes the way people think; insight based; assertiveness training; modeling; relational-emotive therapy (Ellis); cognitive restructuring (Beck)
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Criticisms and limitations to cognitive therapy
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Proven to be most reliable and effective
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Methodologies for psychodynamic therapy
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Case studies
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Cause of dysfunctional behavior in psychodynamic therapy
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Unresolved conflicts in childhood; repressed feelings; id, ego, superego out of balance
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Treatment techniques for psychodynamic therapy
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Make the unconscious conscious; insight based – developed self understanding; psychoanalysis; free association; dream interpretation; ink blots; tats
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Criticisms and limitations to psychodynamic therapy
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Deterministic; expensive; time consuming; based on inference rather than; scientific evidence; transference to therapist