Chapter 14: Treatment – Flashcards
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Psychotherapy
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A unique, modern, healing relationship involving a client and a paid therapist. The relationship is temporary and focused entirely on the needs and problems of the client. Each meeting of therapist and client is time-limited, confidential, and conducted in a structured setting.
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Paraprofessional
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A person who has obtained a nonprofessional level of education in a field such as education, law, or psychology, but who has obtained a job performing some of the duties ordinarily carried out by professionals.
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Psychodynamic Psychotherapy
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A general approach to psychotherapy based on principles originating in psychoanalysis. Psychodynamic theorists share psychoanalytic beliefs that unconscious emotional and motivational processes exert important effects on a person, that the origins of personality are in childhood, and that human beings create symbolic mental representations of the self and important personal relationships.
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Behavior Therapy
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Techniques of therapy based on learning principles of behaviorism and social learning theory. The point of behavior therapy is to teach the client how to substitute adaptive patterns of behavior for maladaptive patterns. Behavior therapy techniques utilize classical and operant conditioning strategies.
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Systematic Desensitization
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A behavior therapy technique primarily used to treat phobias and certain other anxiety disorders. Systematic desensitization involves controlled, incremental exposure to phobic stimuli while simultaneously practicing relaxation techniques that are incompatible with anxiety.
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Flooding
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An exposure therapy technique used to treat phobia and other anxiety disorders. Flooding involves non-incremental, total immersion in anxiety-producing phobic stimuli for a prolonged period.
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Exposure Therapy
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Any technique of behavior therapy based on the idea that only through exposure to feared stimuli can the anxiety produced by that stimuli be lessened. Although exposure therapy technically refers to any such technique, the term is used most often to refer to contemporary therapies rather than earlier behavior therapies such as systematic desensitization.
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Operant Therapies
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A type of behavior therapy based on principles of learning that relies on operant conditioning, in which rewards or punishments for a person's spontaneous behaviors are used to shape desired behaviors.
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Contingency Management (CM)
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A type of operant treatment used in various types of institutions (e.g., substance abuse rehab, psychiatric wards, prisons). In CM treatment a person is rewarded with tangible, desirable goods, prizes, or privileges for engaging in desirable behaviors and avoiding undesirable behaviors.
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Rational-Emotive Behavior Therapy (REBT)
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A form of therapy devised by Albert Ellis and based on the idea that emotional distress is rooted in illogical, absolutist, and counterproductive ideas and beliefs. REBT is directive -- the therapist's job is to forcefully dispute the client's illogical and unrealistic beliefs.
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Cognitive Therapy (CT)
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The therapy principally devised by Aaron Beck that suggests that when people possess underlying dysfunctional core beliefs about the self, the world, and the future, they respond to events with automatic thoughts that are self-defeating and biased against the self. These thoughts trigger negative emotional experiences and can lead to disorders such as depression and anxiety. Unlike REBT, which which it shares a cognitive approach, the cognitive therapist does not forcefully dispute the client's unrealistic beliefs but helps the client to test these beliefs in the manner of a scientist testing a hypothesis.
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Cognitive Behavioral Therapy (CBT)
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A development of behavior therapy that attempts to unite traditional behavior therapy with Beck's cognitive therapy. CBT is based on the idea that cognition, emotion, and behavior are linked in a circle of mutual influence and reinforcement. Although CBT is not identical to CT, the term CBT is often used to refer to either therapy.
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Empirically Supported Treatment (EST)
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A psychotherapy EST is therapy that has demonstrated statistically significant superiority over no treatment (and in some cases also to a placebo therapy) in a series of randomized clinical trials. Psychotherapy ESTs are generally brief and consist of highly specific techniques that may be described in treatment manuals.
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Integrative Therapy
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Any therapy that draws from more than one current of psychotherapeutic theory and technique.
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Client-Centered Therapy
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The humanistic therapy founded during the late 1940s and 1950s by Carl Rogers. The goal of client-centered therapy is to promote personal growth in the client in a nondirective manner by treating the client with dignity, empathy and unconditional positive regard.
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Bibliotherapy
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The practice of using self-help books as adjuncts to psychotherapy or as therapeutic tools in the absence of psychotherapy.
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Group Therapy
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When groups of three or more people engage in therapy under the guidance of one or more therapists.
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Self-Help Support Group
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A therapeutic group based on mutual support that is generally not headed by a mental health professional (and is therefore not an example of psychotherapy). Also in contrast to psychotherapy, most self-help groups are free and ongoing indefinitely. They are generally organized around a particular issue -- for example, substance abuse, cancer survival, child abuse mental illness, and so forth
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Family Therapy
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A form of psychotherapy that involves an entire family (or other closely connected group) rather than a single individual. Family therapy emerged from family systems theory, which proposes that the problems of an individual in a family cannot be understood outside of the context of the family as an integrated, organic unit.
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Family Systems Theory
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The view that the family is an integrated, organic unit that may be analyzed somewhat the way systems analysts view computer systems in organizations.
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Couple Therapy
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A form of psychotherapy involving a married, cohabitating, or dating couple. Couple therapy may be used to treat relationship distress or the mental health problems of one member of the couple.
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Efficacy
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An efficacious treatment is one that has been shown to be superior to a placebo in randomized clinical trials (RCTs). Because it is difficult to construct a placebo psychotherapy, the term efficacious is often applied to therapies that have only shown themselves superior to no treatment.
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Randomized Controlled Trial (RCT)
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A randomized controlled trial is a research study used to evaluate a therapy or treatment where the research participants are randomly assigned to receive either the treatment of interest, a competing treatment, no treatment, or (if possible) a placebo treatment.
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Effective
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An effective treatment is one that has shown itself to have significant utility in the "real world" of practicing clinicians treating patients in clinics, hospitals, consulting rooms, and medical offices.
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Clinical Significance
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When a statistical effect in a treatment outcome study is large enough and meaningful enough to suggest that the treatment being tested would be effective in the world outside of the research study.
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Dodo Bird Verdict
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A phrase used to sum up the "take-home message" of outcome research in psychotherapy: No legitimate form of therapy is superior to any other general outcome. The dodo bird verdict applies only to legitimate forms of psychotherapy appropriate for a given condition.
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Common Factors
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Hypothesized factors common to all legitimate forms of psychotherapy that are responsible for actual therapeutic events.
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Dismantling Study
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A study that seeks to isolate the factors responsible for the efficacy of a form of therapy. The dismantling study compares outcome results of a form of therapy against that same therapy minus its "active ingredient."
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Therapeutic Alliance
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A hypothesized common factor of psychotherapy that refers to the positive emotions between therapist and client, the therapist's empathy for the client, and both parties' joint commitment to therapeutic work.
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Therapist Alliance
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The therapist's commitment to the specific type of therapy he or she has chosen to use.
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Therapist Competence
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The degree to which a therapist tends to produce good results regardless of client or therapy techniques.
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Potentially Harmful Psychotherapies (PHPs)
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Therapies that may result in iatrogenic (therapist-caused) harm to clients.
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Pharmacotherapy
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The use of drugs and other substances to treat psychological disorders or distress. Pharmacotherapy is based on psychopharmacology, the study of the effects of drugs and other substances on mood, emotion, and behavior.
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Anxiolytic
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Any drug or other substance whose primary use is the treatment of anxiety.
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Benzodiazepine
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The most common class of anxiolytic drugs.
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Antidepressant
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Any drug or other substance whose primary purpose is the treatment of depression.
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Selective Serotonin Reuptake Inhibitors (SSRIs)
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A relatively recently developed type of antidepressant drug that blocks the reuptake of the neurotransmitter serotonin, while having relatively little effect on other neurotransmitters -- in contrast to the tricyclics and MAO inhibitors.
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SSRI Discontinuation Syndrome
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A drug withdrawal syndrome associated with the use of at least some of the SSRI and SNRI antidepressants. The syndrome may consist of flu-like symptoms, dizziness, weakness, nausea, fatigue, feeling of "unreality," loss of balance, "electric-shock" sensations, and other symptoms.
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Third-Generation Antidepressants
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The most recent group of antidepressants to be developed, these drugs include serotonin-norepinephrine reuptake inhibitors (SNRIs) as well as drugs with unique chemical structures and physiological mechanisms.
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Mood Stabilizers
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A general term used to describe a number of classes of drugs used to treat bipolar disorders. These drugs include anticonvulsants, lithium, and second-generation antipsychotics.
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Second-Generation Antipsychotics
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Recently developed drugs designed to treat psychotic disorders such as schizophrenia, but also used as mood stabilizers in bipolar disorder.
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Ghostwriting
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The practice of having professional writers write up reports of studies in articles bearing the names of researchers who did not contribute to the writing of the article and may not have been involved in the design and conduct of the study.
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Publication Bias
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The systematic exclusion of certain types of results from publication in favor of other types of results. Publication bias can result from a number of different practices, including withholding certain types of results from submission to journals, editorial decisions on the part of journal editors, and submitting data from the same study multiple times to give the impression that more studies found a particular result than is actually the case.
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Electroconvulsive Therapy (ECT)
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A treatment for psychological disorders (primarily treatment-resistant depression) that consists of passing a low-voltage electrical current through a person's brain for a brief moment, resulting in seizure and convulsion. ECT is usually conducted multiple times for any given case.
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Repetitive Transcranial Magnetic Stimulation (rTMS)
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A technique being developed for treatment of depression that consists of sending short electromagnetic pulses through the cerebral cortex by means of a coil placed on the scalp.
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Deep Brain Stimulation (DBS)
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A relatively new technique of psychosurgery used to treat Parkinson disease and being tested for use in psychological disorders, particularly depression. In deep brain stimulation electrodes are implanted in various regions of the brain and coupled to an external device that sends out stimulating electrical pulses.
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Integrative Treatment Model
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A model of treatment that reflects the reality that most current mental health treatment involves multiple modalities (e.g., psychotherapy plus medication plus bibliotherapy).