Evidence-Based Therapies and Interventions – Flashcards
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Acceptance and Commitment Therapy
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An integrative approach that focuses on providing wrap-around services to clients whose functioning is severely impaired. A behavioral therapy based on Relational Frame Theory. Aims to change the relationship individuals have with their own thoughts, feelings, memories, and physical sensations that are feared or avoided. Acceptance and mindfulness strategies are used. Patients learn to clarify their goals and values and to commit to behavioral change strategies. "Proven effective" (evidence supporting use) for pain management, depression, anxiety, psychosis, and OCD.
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Applied Relaxation
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Type of behavioral training, specifically, exposure therapy using relaxation techniques. Proven effective for panic disorder and generalized anxiety disorder.
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Assertive Community Therapy
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A type of CBT, which is proven effective for schizophrenia. A multidisciplinary team approach to intensive case management in which the team members share a caseload, have a high frequency of patient contact (typically at least once a week), low patient to staff ratios, and provide outreach to patients in the community.
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Behavior Therapy
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Based on psychological research on classical and operant conditioning. Proven effective for depression, obesity, and alcohol use.
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Cognitive Behavior Therapy
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Basic premise that thoughts, feelings, and bxs are all connected, and that by changing thoughts feelings and bxs can be changed. Includes behavioral principals, and often used as an umbrella term for acceptance and commitment therapy, dialectical behavior therapy, reality therapy/choice theory, cognitive processing therapy, EMDR, and multimodal therapy. Evidence indicates it is effective for insomnia, anorexia, binge eating, bulimia, anxiety, OCD, OCPD, social phobia, and schizophrenia. Also recommended in the case of somatic disorders. Hotly contested by researchers and practitioners.
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Cognitive Therapy
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Basic premise that thoughts, feelings, and bxs are all connected, and that by changing thoughts and feelings, bxs can be changed. Proven effective for bipolar disorder and depression.
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Emotion-Focused Therapy
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Is a usually short-term (8-20 sessions) structured psychotherapy approach to working with individuals, couples, or families. It includes elements of Gestalt therapy, person-centered therapy, constructivist therapy, systemic therapy, and attachment theory. Intervention analysis specifies five types of tasks: empathizing tasks, relational tasks, experiencing, reprocessing tasks, and action tasks. Proven effective for depression. Recommended by developer for couples.
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Exposure Therapy
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Behavioral intervention. It involves the exposure of the patient to the feared object or context without any danger. Proven effective for OCD and phobias. Not recommended for PTSD (Van der Kolk).
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Eye Movement Desensitization and Reprocessing
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The therapy uses an eight-phase approach that includes having the patient recall distressing images while receiving one of several types of bilateral sensory input, such as side to side eye movements. Proven as effective for PTSD as CBT, AND medications (in one study).
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Family Therapy
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Systems-oriented modality, based on the assumption that disfunction is supported by the dynamic of close relationships. Proven effective for anorexia,bulimia, and bipolar disorder. Recommended for somatic disorders and BPD.
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Interpersonal Psychotherapy
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A time-limited tx that encourages the patient to regain control of mood and functioning. Based on the principle that there is a relationship between the way people communicate and interact with others and their mental health. Focuses on interpersonal stressors, w/o the personality work of other psychodynamic approaches. Proven effective for binge eating, and bulimia, and depression.
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Interpersonal & Social Rhythm Therapy
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A behavioral therapy based on the assumption that stressful events, disruptions in circadian rhythms and personal relationships, and conflicts arising out of difficulty in social adjustment often lead to relapses. Proven effective for bipolar disorder.
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Mentalization-Based Therapy
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A psychodynamic therapy based on the assumption that insecure attachments result in a decreased ability to understand the mental states underlying their and other's bx. Goals are: (1) better bx control, (2) increased affect regulation, (3) better relationships and (4) the ability to pursue goals. Proven effective for BPD.
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Motivational Interviewing
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A method that works on facilitating and engaging intrinsic motivation within the client in order to change behavior. It is a goal-oriented, client-centered counseling style for eliciting behavior change by helping clients to explore and resolve ambivalence. Proven effective for substance use.
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Multi-Component CBT
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Often includes the following components: (1) education about illness including the nature of the disorder and the role patients can play in its management, (2) Symptom self-management skills targeting pain, fatigue, sleep, cognition, mood, and functional status, and (3) Life style change promoting skills targeting barriers to change, unhelpful thinking styles, and long term maintenance of changeProven effective for fibromyalgia and rheumatic pain.
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Paradoxical Intervention
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Psychotherapeutic tactics that seem to contradict the goals they are designed to achieve. Proven effective for insomnia.
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Present-centered Therapy
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A non-trauma focused treatment for PTSD. The primary mechanisms of change from a present centered perspective are grounded in (a) altering present maladaptive relation patterns/behaviors, (b) providing psycho-education regarding the impact of trauma on the client's life, and (c) teaching the use of problem solving strategies that focus on current issues
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Prize-Based Contingency Management
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A structured behavioral therapy that involves: (1) frequently monitoring the behavior targeted for change, and (2) reinforcing the behavior each time it occurs using tangible and escalating reinforcers. Often, the behavior targeted for change is drug use behavior, but other behaviors such as attendance at treatment, can also be reinforced. Proven effective for substance use.
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Problem-Solving Therapy
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Therapy that increases adaptive problem-solving skills as a means of better resolving and/or coping with stressful problems. Goals include: To ID triggering stressors, to better understand and manage negative emotions, become more hopeful about capabilities, be more accepting of unsolvable problems, be systematic problem-solving, be less avoidant, be less impulsive about wanting a "quick fix" Proven effective for depression.
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Prolonged Exposure Therapy
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Two interventions: Imaginal exposure, revisiting the traumatic memory, repeated recounting it aloud, and processing the revisiting experience, and in vivo exposure, the repeated confrontation with situations and objects that cause distress but are not inherently dangerous. Proven effective for PTSD and eating disorders.
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Psychoanalytic Therapy
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Based on the observation that individuals are often unaware of the factors that determine their emotions and behavior. Explores how these unconscious factors affect current relationships and patterns of thought, emotion and behavior. Treatment traces these patterns back to their historical origins, considers how they have changed and developed over time, and helps the individual to cope better with the realities of their current life situation. Psychoanalysis is generally not an effective treatment for PTSD, unless the trauma occurred in childhood. May be effective for panic disorder. Recommended for Cluster C Personality Disorders.
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Psychoeducation
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Psycho-education refers to the education offered to people who live with a psychological disturbance. It can help the client understand that his physical complaints are symptoms and appreciate the value of counseling. Involves teaching the client about their problem, how to treat it and how to recognize signs of relapse so they can get treatment before their problem worsens or recurs. It also helps them avoid things or situations which may aggravate their disorder. Helpful for all; proven effective for bipolar disorder and anxiety disorders. Also called a "didactic session." Additionally recommended for somatic disorders and substance use.
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Psychological Debriefing
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Post-crisis tx. Research suggests short-term benefit, but possible detrimental long-term effects. Brief CBT has better support.
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Rational Emotive & Behavior therapy
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Early form of CBT developed by Eillis. Places focus on the present. Addresses attitudes, unhealthy emotions and maladaptive behaviors that can negatively impact satisfaction. Practitioners work closely with ind.s, seeking to help ID beliefs that frequently lead to emotional distress. One intervention called "disputing" teaches clients to challenge their own beliefs. Proven effective for depression.
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Relaxation Training
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Bx technique in which patients are taught formal exercises focused on reducing somatic tension (e.g., progressive muscle relaxation, autogenic training) or intrusive thoughts at bedtime (e.g., imagery training, meditation). Multiple weekly or biweekly sessions are typically required; practice at home is also encouraged. Proven effective for insomnia.
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Reminiscence/Life Review Therapy
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Patients reconstruct their life story and examine both positive and negative experiences, with the therapist as a coach. At times, materials such as music and photographs are used to trigger memories. The overall purpose is to provide perspective and acceptance of one's life, including the resolution of past conflicts. Proven effective for depression, recommended for older populations.
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Schema-focused Therapy
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A form of cognitive behavioral therapy, centers around repairing schemas and the effective moods and coping styles associated with them. This very active and work-intensive form of treatment encourages patients to confront cognitive distortions, such as black and white thinking and perfectionism, and has been shown to have promising results for the treatment of NPD. Proven effective for BPD.
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Safety-Seeking
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A present-focused, coping skills therapy to help people attain safety from trauma/PTSD and substance use disorder. It embodies a compassionate tone that honors what clients have survived and respects their strengths. It was designed for flexible use. It is a first-stage model that can be used from the start of treatment. Proven effective for PTSD and substance use.
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Short-term Psychodynamic Therapy
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The therapy's primary goal is to help the patient overcome internal resistance to experiencing true feelings about the present and past which have been avoided. The technique is intensive in that it aims to help the patient experience these warded-off feelings to the maximum degree possible; it is short-term in that it tries to achieve this experience as quickly as possible; it is dynamic because it involves working with unconscious forces and transference feelings. The developer, Davanloo, claims effectiveness for depression, somatic disorders, and personality disorders. Proven effective for depression.
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Social Learning, Token Economy
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System of behavior modification based on the systematic reinforcement of target behavior. The reinforcers are symbols or "tokens" that can be exchanged for other reinforcers. A token economy is based on the principles of operant conditioning and can be situated within applied behavior analysis (behaviorism). Proven effective for schizophrenia
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Social Skills Training
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Has been found helpful in addressing functional impairments in social or activities of daily living. The key elements of this intervention include behaviorally based instruction, modeling, corrective feedback, and contingent social reinforcement. Results of controlled trials indicate the benefit of skills training in improving illness knowledge, social skills, and symptom and medication management. Proven effective for schizophrenia.
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Stress Inoculation Therapy
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A cognitive-behavioral approach providing people with added psychological resilience against the effects of stress through a program of managed successful exposure to stressful situations. Developed by Donald Meichenbaum Three phases: The Conceptualisation Phase - learning to conceptualise and reconceptualise stress. Skills Acquisition & Rehearsal Phase - inc. problem solving, cog. restructuring & guided self dialogue. Application & follow through Phase - staff are encouraged to write 'coping contracts' and undertake homework in order to ensure responsibility for their own wellbeing. Proven effective for PTSD.
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Transference-Focused Therapy
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A highly structured, twice-weekly modified psychodynamic treatment based on Otto Kernberg's object relations model of borderline personality disorder. Proven effective for BPD.
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Dialectical Behavior Therapy
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Mindfulness training, interpersonal skills training, distress tolerance training, and emotion management. Proven effective for BPD.
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Diaphragmatic Breathing Training
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Relaxation technique. Proven to be effective for anxiety disorders.
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Contingency Management
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Applied behavioral technique. Patients' behaviors are rewarded (or, less often, punished) for adherence to or failure to adhere to program rules and regulations or their treatment plan. Effective for substance use and suicidality.
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Cognitive Restructuring
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A CBT technique; comprised of learning to dispute maladaptive thoughts. Useful for anxiety disorders.
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Cognitive Processing Therapy
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A varient of CBT designed for PTSD. The primary focus of the treatment is to help the client understand and reconceptualize their traumatic event in a way that reduces its ongoing negative effects on their current life.
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Biofeedback Training
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A supplement to relaxation training; the process of gaining greater awareness of many physiological functions primarily using instruments that provide information on the activity of those same systems, with a goal of being able to manipulate them at will.Some of the processes that can be controlled include brainwaves, muscle tone, skin conductance, heart rate and pain perception. Contraindicated for: severe psychosis or neurosis, individuals with a pacemaker or other implantable electrical device, debilitated patients, and patients with psychopathic personalities.
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Aversive Therapy
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A variant of classical conditioning. Negative stimuli are paired with the target bx. Recommended as tx for substance use, but not until after other methods are exhausted.
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Role play
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Including empty chair technique. Enacting of relational interactions. Recommended for interpersonal concerns.
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Family-focused Therapy
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A hybrid of behavioral and family therapy including communication training, problem-solving training, and psyched. Recommended for depression and bipolar disorder.
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Graded Physical Exercise
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Gradually increasing exercise. Recommended for individuals with a decreased tolerance for exercise, as in a somatic complaint.
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Group Therapy
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More a mode of therapy than a approach. Often based on the recapitulation of the FOO. Recommended for NPD and somatic complaints, as well as generally working on social skills.
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Hypnotherapy
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Recommended for uncovering traumatic memories. Self-hypnosis is also recommended for somatic complaints a/s a conversion disorder.
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Interpersonal Therapy.
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Focuses on the behaviors and interactions a client has with family and friends. The primary goal of this therapy is to improve communication skills and increase self-esteem during a short period of time. It is most effective with clients suffering from mental illness caused by loss, relationship conflicts, and role transitions
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In vivo exposure
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A final step in typical exposure therapy. Exposing a client to stressor in person. Recommended for anxiety disorders.
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Interoceptive Exposure
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Controlled exposure to sensations of autonomic arousal such as voluntary hyperventilation in order to decrease the fear of experiencing a panic attack. Suggested use for GAP and Panic disorder, possibly PTSD. Inconsistency in delivery may pose risk to client.
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Medication Compliance Counseling
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Recommended in any context in which psychiatric meds are necessary.
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Mirror Exposure
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A form of desensitization, used in anorexia or bulimia.
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Mood Tracking Graph
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A mood tracking strategy useful in depression.
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Multisystemic Therapy
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An ecological approach proven effective for youth with conduct disorder. It proposes that the youth's behavioral problem is a product of the interaction between the youth and the family, the school, and the peers and the community. By changing the ecological system, it eliminates the environment that leads to the negative behavior and facilitates positive behavior.
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Object Relations Psychoanalysis
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Variant of psychotherapy focused on early relationships, based on the assumption that early relationships shape our later perceptions of the world. Places the therapeutic relationship at the center of work. Recommended for NPD.
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Person Centered Therapy
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A non-directive therapy which emphasizes unconditional positive regard (help client feel free to express his emotion without fear of rejection). The goal of the therapy is to increase self-esteem.
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Play Therapy
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Play Therapy is generally used to help young children express their fears, desires, and emotions through the medium of play when conversation with an adult is impractical.
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Periodic Suicide Risk Assessment
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Suicide is the leading cause of premature death among clients with psychosis. Risk factors for suicide include young age, high socioeconomic status background, high IQ, high aspirations, early ager at onset. It is important to consider suicide risk at all stages of the illness and to perform an initial suicide risk assessment and regular evaluation of suicide risk as part of each client's treatment plan.
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Prodrome Detection
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In this form of psychotherapy, the clinician meets with the client regularly over a certain period to discuss the client's experience as well as signs preceding manic and depressive episodes. A plan of action can be created to address these symptoms should they reappear in the future. The therapist helps the client maintain a diary on the disorder. Effective for bipolar disorder.
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Psychodrama
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A powerful therapeutic tool, particularly to resolve emotional distress related to prior interpersonal conflicts. This is a form of psychotherapy, in which clients use spontaneous dramatization, role playing and dramatic self-presentation to investigate and gain insight into their own personalities, relationships, conflicts, and emotional problems, and to alter faulty behavior patterns.
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Exercise
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This recommendation in combination with other relaxation techniques can be effective at reducing stress.
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Self-Help Groups
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Can improve symptoms and increase client's social networks and quality of life. Additional studies of self-help groups have demonstrated other positive outcomes, including reductions in hospitalizations, improved coping, greater acceptance of the illness, improved medication adherence and illness management, improved daily functioning, lower levels of worry, and higher satisfaction with health
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Transactional Analysis
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A psychoanalytic therapy wherein social transactions are analyzed to determine the ego state of the patient (whether parent-like, child-like, or adult-like) as a basis for understanding behavior. The patient is taught to alter the ego state as a way to solve emotional problems. Script analysis is the last stage of therapy. Long-term versions of this therapy is proven more effective, research unavailable on specific disorders. Not recommended for substance abuse.
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Solution-Focused Therapy
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This th targets the desired outcome of therapy as a solution rather than focusing on the symptoms or issues that brought someone to therapy. This technique gives attention to the present and the future desires of the client, rather than focusing on the past experiences. It is useful in gambling addiction, domestic violence, school counseling and depression. SFBT focuses on what the clients want to achieve through therapy rather than on the problems that made them seek help. The approach does not focus on the past, but instead, focuses on the present and future. Not recommended for NPD or OCDPD
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Supportive Psychotherapy
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Aims at improving self-esteem, psychological functing, and adaptive skills. It focuses upon current, problematic relationships and maladaptive patterns of behavior and emotional responses. A number of specific interventions are used: praise, reassurance, encouragement, exhortation, naming the problem, rationalizing, reframing, minimization, clarification, confrontation, interpretation,, anticipatory guidance, and modeling. A number of studies have found it is either similar or inferior to other psychotherapies for treating depression. The available evidence suggests that it is inferior to standard treatments for panic disorder.
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Twelve Step Program
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12 steps program, such as AA, is a set of guiding principles outlining a course of action for recovery from addiction. It has been proven to be effective in treating substance abuse and in maintaining sobriety.
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Exposure and Responce Prevention Therapy
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A Cognitive Behavioral Therapy used for Obsessive Compulsive Disorder, in which the client is exposed to a trigger and refuses, with coaching, to engage in their typical rituals/compulsions. "Consistent findings suggest that [this therapy] procedures are highly effective in treating obsessive-compulsive disorder (OCD). However, the studies that have reported success with this intervention have employed numerous variations in treatment procedures...Our results suggested that therapist-supervised exposure was more effective than self-controlled exposure. Further, the addition of complete response prevention to exposure therapy was associated with better outcome than partial or no response prevention. In reducing symptoms of anxiety, the combination of in vivo and imaginal exposure was superior to in-vivo exposure alone. "
