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1. Clinical psychology

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the area of psychology that integrates science and theory to prevent and treat psychological disorders

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psychotherapy

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used to treat psychological disorders-a nonmedical process that helps individuals with psychological disorders recognize and overcome their problems *strategies include talking, interpreting, listening, regarding, and modeling

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biological therapies (biomedical therapies)

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treatments that reduce or eliminate the symptoms of psychological disorders by altering aspects of bodily functioning

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psychological approach to therapy

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practiced by clinical psychologists, counselors, and social workers. Requires licensing and certification *must have one year of a clinical internship after graduate school to hone their therapeutic skills

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biological approach to therapy

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required to have completed training to become a medical doctor

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psychiatrists

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medical doctors who specialize in treating psychological disorders. Complete medical school plus a 4 year program in psychiatric residency program *diagnose and prescribe medications

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clinical psychologist

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requires both clinical and research training. Must have one year internship. PhD or PsyD; 5-7 years beyond bachelors degree

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psychiatrist

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four years of medical school, plus an internship and residency in psychiatry MD; 7-9 years beyond bachelors degree

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counseling psychologist

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similar to clinical psychologist but with emphasis on counseling and therapy 3-7 years after bachelors degree

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school psychologist

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training in graduate programs of education or psychology. Emphasis on school related problems. Training is at a masters or doctorate level 3-7 years beyond bachelors degree

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social worker

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graduate work in a school of social work that includes specialized clinical training in mental health facilities. 2-5 years after bachelors degree

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psychiatric nurse

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graduate work in a school of nursing with special emphasis on care of mentally disturbed individuals 0-5 yrs after bachelors

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occupational therapist

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emphasis on occupational training with focus on physically or psychologically handicapped individuals. Stresses them to get back into the mainstream of work; 0-5 yrs after bachelors

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pastoral counselor

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requires ministerial background and training also an internship 0-5 yrs after bachelors

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counselor

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graduate work in a department of psychology or education with specialized training in counseling techniques 2 yrs after bachelors

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central issues in psychology

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1. Does psychotherapy work? Yes 2. Does one therapy work better than others? Depends on the diagnosis

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empirically supported treatment

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an approach to treating psychological disorders that advocates making treatment decisions based on the body of research that has shown which type of therapy works best

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evidence-based practice

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decisions about treatment are made using the best available research and considering the therapist's clinical judgement and client's characteristics, culture, and preferences

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factors in effective psychotherapy

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1.The Therapeutic Alliance-the relationship between the therapist and client. When therapists and clients are engaged with a real working relationship characterized by trust, respect, and cooperation, the therapeutic alliance is strong. 2. The Therapist-therapists with high expertise are those who possess a great deal of knowledge and continue to learn, monitor client progress, and make changes when necessary. Therapist's style and client's personality determine if it is effective 3. The Client-quality of the client's participation

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How do psychotherapies differ?

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1.Insight versus symptoms and skill development-some treatments focus on gaining insight into the deeper causes of the problem, others focus on the person's immediate symptoms and developing skills to manage them 2.Directive versus nondirective- some treatments call the therapists to be outspoken in giving advice to the client, encouraging the therapist to play an active role in the client's life, others prompt the client to drive the interaction, with therapists taking less active role in treatment

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four main approaches of psychotherapy

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psychodynamic, humanistic, behavioral, and cognitive

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psychodynamic therapies

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stress the importance of the unconscious mind, extensive interpretation by the therapist, and the role of early childhood experiences in the development of an individual's problems *goal is to help individuals gain insight into the unconscious conflicts that underlie their problems

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psychoanalysis

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Freud's therapeutic technique for analyzing an individual's unconscious thoughts *believed that a person's current problems could be traced to childhood experiences, many of which involved unconscious sexual conflicts

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free association

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in psychoanalysis, a psychoanalyst person might ask a person to say aloud whatever comes to mind in response to the symptoms that have brought them to the treatment

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dream analysis

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a psychoanalytic technique for interpreting a person's dreams *from this perspective, dreams give us an outlet to express symbolically our unconscious wishes, a mental theater in which our deepest and secret desires can be played out

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Transference

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key aspect of therapeutic alliance-a psychoanalytic term for the client's relating to the analyst in ways that reproduce or relive important relationships in the individual's life

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humanistic therapies

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people are encouraged toward self-understanding and personal growth *emphasis on conscious rather than unconscious thoughts, present rather than past, and self-fulfillment rather than illness unlike psychodynamic therapies

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client-centered therapy

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a form of humanistic therapy, developed by Carl Rogers, in which the therapist provides a warm, supportive atmosphere to improve the client's self-concept and to encourage the person to gain insight into problems

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goal of client-centered therapy

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to help clients identify and understand their own feelings and become more congruent, bringing their actual self closer to their ideal self

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reflective speech

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a technique in which the therapist mirrors the client's own feelings back to the client ex: woman is expressing her grief over the loss of her husband in a car accident, therapist might suggest "you sound angry" to help her identify her feelings

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three essential elements to grow by Rogers

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1. Unconditional positive regard-therapist consistently recognizes the value of the client, providing context for personal growth and development 2. Empathy-Therapist strives to put himself in the clients shoes to feel emotions the client is feeling 3. Genuineness-therapist is a real person in his or her relationship with the client, sharing feelings

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behavior therapies

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use principles of learning to reduce or eliminate maladaptive behavior. *offer action-oriented strategies to help people change behavior, not underlying thoughts or emotions *focus on classical and operant conditioning

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systematic desensitization

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a method of behavior therapy that treats anxiety by teaching the client to associated deep relaxation with increasingly intense anxiety-producing situations *involves exposing someone to a feared situation *a classical conditioning technique

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operant conditioning technique

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therapy involves conducting a careful analysis of the person's environment to determine which factors need notification *unhealthy behaviors are replaced with healthier ones

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applied behavior analysis

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involves establishing positive reinforcement connections between behaviors and rewards so that individuals engage in appropriate behavior and extinguish inappropriate behavior

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cognitive therapies

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emphasize that cognitions, or thoughts, are the main source of psychological problems; these therapies attempt to change the individual's feelings and behaviors by changing cognitions *focus on symptoms and skill development

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foundations of cognitive therapies

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cognitive restructuring-a general concept for changing a pattern of thought that is presumed to be causing maladaptive behavior or emotion, it is central to cognitive therapies *first goal of therapy is to bring automatic thoughts into awareness so that they can be changed

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with the therapists assistance, clients learn to recognize logical errors in their thinking

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1.Precieving the world as harmful while ignoring evidence to the contrary 2.Overgeneralizing on the basis of limited examples 3. Magnifying the importance of undesirable events 4. Engaging in absolutist thinking

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cognitive-behavior theory (CBT)

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a combination of cognitive therapy, with its emphasis on reducing self-defeating thoughts, and behavior therapy, with its emphasis on changing behavior *in CBT, the therapist takes a directive role, engaging in dialogue to help the client identify automatic thoughts and the feelings they produce and working with the client to change those

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self-instructional methods

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cognitive-behavior techniques aimed at teaching individuals to modify their own behavior *change what they say to themselves

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reinforcing self-statements

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examples of constructive statements, which the client can repeat in order to take positive steps to cope with stress or meet a goal

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self-efficacy

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the belief that one can master a situation and produce positive outcomes *important aspect of cognitive behavior therapy

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integrative therapy

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a combination of techniques from different therapies based on the therapist's judgement of which particular methods will provide the greatest benefit for the client ex: therapist might use a behavior approach for a panic disorder and cognitive approach for depressive disorder

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COGNITIVE THERAPY TECHNIQUES challenge idiosyncratic meanings

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explore personal meaning attached to the client's words and ask the client to consider alternatives

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question the evidence

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systematically examine the evidence for the client's beliefs or assertions

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reattribution

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help the client distribute responsibility for events appropriately

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examine options and alternatives

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help the client generate alternative actions to maladaptive ones

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decatastrophize

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help the client evaluate whether he is overestimating the nature of a situation

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fantasize consequences

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explore fantasies of a feared situation

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examine advantages and disadvantages

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examine advantages and disadvantages of an issue, to instill a broader perspective

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turn adversity to advantage

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explore ways that difficult situations can be transformed into opportunities

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guided association

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help the client see connections between different thoughts or ideas

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scaling

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ask the client to rate her emotions or thoughts on scales to help gain perspective

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thought stopping

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provide the client with ways of stopping a cascade of negative thoughts

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distraction

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help the client find benign or positive distractions to take attention away from negative thoughts or emotions temporarily

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labeling of distortions

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provide labels for specific types of distorted thinking to help the client gain more distance and perspective

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Therapies summed up:

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1.Psychodynamic therapies-discover underlying unconscious conflicts and work with client to develop insight: cause-clients problems are symptoms of deep-seated, unresolved unconscious conflicts 2. Humanistic therapies-develop awareness of inherent potential for growth: cause-client is not functioning at an optimal level of development 3. Behavior therapies-learn adaptive behavior patterns through changes in the environment and rewards and punishments: cause-client has learned maladaptive behavior patterns 4. Cognitive therapies-change feelings and behaviors by changing cognitions: cause-individual has developed inappropriate thoughts

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3.Biological therapies

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drug therapy, electroconvulsive therapy, and psychosurgery

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drug therapy--anti anxiety drugs

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commonly known as tranquilizers, make individuals calmer and less excitable Benxodiazepines offer greatest relief for anxiety symptoms such as xanax, valium, and librium side effects: drowsiness, loss of coordination, fatigue, and mental slowing

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antidepressant drugs

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regulate mood. 4 main classes: 1. Tricyclics, increases the level of certain neurotransmitters, especially norepinephrine and serotonin. ex: elavil 2.Tetracylics,or NaSSAs, increase levels of both norepinephrine and serotonin in the brain. ex: avanza 3. Monoamine oxidase inhibitors (MAO), block monoamine oxidase, an enzyme that breaks down serotonin and norepinephrine in the brain. ex: nardil 4. Selective serotonin reuptake inhibitors (SSRIs), target serotonin and work mainly by interfering only with the reabsorption of serotonin in the brain

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medication for bipolar disorder

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lithium-widely used to treat bipolar disorder. It influences serotonin and norepinephrine

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antipsychotic drugs

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powerful drugs that diminish agitated behavior, reduce tension, decrease hallucinations, improve social behavior, and produce better sleep patterns in individuals who have a severe psychological disorder, especially schizophrenia

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Two types of antipsychotic drugs to treat schizophrenia:

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1. Neuroleptics (first generation antipsychotics)-block dopamine's action to the brain. ex: haldol (haloperidol), loxitane (loxapine), and thorazine (chlorpromazine) 2. Atypical antipsychotic medications (second-generation)-influence dopamine as well as serotonin. ex: clozaril (clozapine), and risperdal (risperidone)

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two serious side effects of antipsychotic medication:

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1. Tardive dykinesia- a neurological disorder characterized by involuntary random movements of the facial muscles, tongue, and mouth, as well as twitching of the neck, arms, and legs 2. Metabolic syndrome-a condition associated with obesity and risk for diabetes and heart disease

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antianxiety drugs used for

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everyday anxiety (and antidepressant drugs), generalized anxiety disorder, panic disorder, and specific phobias

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agoraphobia

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tricyclic drugs and MAO inhibitors

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depressive disorders

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tricyclic drugs, MAO inhibitors, SSRI drugs, and tetracyclic drugs

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bipolar disorder

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lithium

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schizophrenia

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neuroleptics, atypical antipsychotic medications

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electroconvulsive therapy (ECT) or shock therapy

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sets off a seizure in the brain to treat psychological disorders. Used if drug therapy and psychotherapy don't work. side effects: memory loss

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psychosurgery

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a biological intervention that involves the removal or destruction of brain tissue to improve the individual's adjustment *antonio Moniz developed this, used as a last resort

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sociocultural approaches

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group therapy, family and couples therapy, self-help support groups, and community mental health

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group therapy

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brings together individuals who share a psychological disorder in sessions that are typically led by a mental health professional

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six features that characterize group therapy

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1.Information-individuals receive info about their problems from the group leader or other group members 2.Universality-individuals are able to see that they aren't alone by others sharing experiences 3.Altruism-group members support each other with advice and sympathy and learn that they have something to offer 4.Experience of a positive family group-leaders representing parents and other members representing siblings. Helps old wounds heal 5.Development of social skills-corrective feedback from peers may correct flaws in the individual's interpersonal skills 6.Interpersonal learning-group can serve as a training ground for practicing new behaviors and relationships

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family therapy

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group therapy among family members

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couples therapy

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group therapy with married or unmarried couples whose problems lie within their relationship

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four most widely used therapy techniques:

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1. Validation-therapist expresses an understanding and acceptance of each family members feelings and beliefs and thus validates the person 2.Reframing-therapist helps families reframe problems as family problems, not an individual's problems 3. Structural change-therapist tries to restructure the coalitions in a family 4.Detriangulation-therapist tries to disentangle the scapegoat (ex, child) away from the conflict between the parents

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self-help support groups

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voluntary organizations of individuals who get together on a regular basis to discuss topics of common interest. A paraprofessional conducts the group

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paraprofessional

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individuals who have been taught by a professional to provide some mental health services but who do not have formal mental health training. Themselves could have had a disorder. ex: AA groups

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community mental health

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maintained that individuals with psychological disorders ought to remain within society with their families rather than being locked aways in institutions, they should receive treatment in community mental health centers

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deinstitutionalization

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when individuals with psychological disorders are transferred from a mental institution to a community-based facility

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empowerment

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assisting individuals to develop the skills they need to control their own lives

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cross-culture competence

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refers both to how skilled a therapist feels about being able to manage cultural issues that might arise in therapy and how the client perceives the therapist's ability

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culture issues in therapy factors:

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socioeconomic status, ethnicity, gender, country of origin, current culture, and religious beliefs and traditions

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