Psych ch. 13: Therapies – Flashcards
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use of psychological techniques to treat personality and behavior disorders
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psychotherapy
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variety of individual psychotherapies designed to give people a better awareness and understanding of their feelings, motivations, and actions in the hope that this will help them to adjust
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insight therapies
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theory of personality Freud develpoed as well as the form of therapy he invented
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psychoanalysis (Freud)
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psychoanalytic technique that encourages the person to talk without inhibition about whatever thoughts or fantasies come to mind
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free association
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result of free association that, according to Freud, provides insight into the person's unconscious
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"stream of consciousness"
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the client's carrying over to the analyst feelings held toward childhood authority figures
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transference
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when a client feels good about the analyst (therapist)
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positive transference
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crucial step in psychoanalysis- presumably reveals negative feelings toward authority figures and resistance to uncovering repressed emotions
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negative transference
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an analyst suggests alternative meanings for clients' feelings, memories, and actions
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interpret
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goal of interpretation; awareness of previously unconscious feelings and memories and how they influence present feelings and behavior
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insight
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analysis takes great motivation to change and an ability to deal rationally with whatever the analysis uncovers
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what leads to successful therapy?
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traditional analysis may take five or more years, with 3-5 sessions a week
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how long does it take for therapy to work?
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nondirectional form of therapy which calls for unconditional positive regard by the therapist with the goal of helping the client become fully functioning
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client-centered therapy (Carl Rogers)
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the therapist must express unconditional positive regard (true acceptance of clients no matter what they say) and they must be nondirective (do not suggest reasons for why clients feel a certain way, etc.)
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what were rogers' ideas about therapy?
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research shows that a therapist's warmth and understanding increase success, regardless of the therapeutic approach
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rogers' interest in the process of therapy resulted in important and lasting contributions to the field
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insight therapy that emphasizes the wholeness of the personality and attempts to reawaken people to their emotions and sensations in the here and now; designed to help people become more genuine or "real" in day-to-day interactions
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gestalt therapy (Frederick Perls)
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a person speaks to part of himself that they imagine to be sitting in an empty chair
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empty-chair technique
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insight therapy that is time-limited and focused on trying to help clients correct the immediate problems in their lives
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short-term psychodynamic therapy
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usually 25 sessions; 75% of people experience improvement in this time frame
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what time-limits does this short-term therapy have?
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therapeutic approaches that are based on the belief that all behavior, normal and abnormal, is learned, and that the objective of therapy is to teach people new, more satisfying ways of behaving
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behavior therapy
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behavioral technique for reducing a person's fear and anxiety by gradually associating a new response (relaxation) with stimuli that have been causing the fear and anxiety; helps with fears and phobias
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systematic desensitization
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a list of situations from the least to the most anxiety-provoking
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hierarchy of fears
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when clients gradually confront their fears in the real world rather than merely in their imaginations
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when is desensitization most effective?
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full-intensity exposure to a feared stimulus for a prolonged period of time
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flooding
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behavioral therapy techniques aimed at eliminating undesirable behavior patterns by teaching the person to associate them with pain and discomfort
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aversive conditioning
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a study of ~800 people who completed alcohol-aversion treatment found that 63% maintained continuous abstinence for at least 12 months
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numbers regarding aversive conditioning?
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form of operant conditioning therapy in which the client and therapist set behavioral goals and agree on reinforcements that the client will receive on reaching those goals
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behavior contracting
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an operant conditioning therapy in which people earn tokens (reinforcers) for desired behaviors and exchange them for desired items or privileges; usually used in schools and hospitals; proven to be effective in modifying the behavior of people who are resistance to other forms of treatment (schizophrenic patients)
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token economies
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behavior therapy in which the person learns desired behaviors by watching others perform those behaviors; successful in helping people with schizophrenia; used to teach people w/ mental retardation job skills and appropriate responses
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modeling
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psychotherapies that emphasize changing clients' perceptions of their life situation as a way of modifying their behavior
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cognitive therapies
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type of cognitive therapythat trains clients to cope with stressful situations by learning a more useful pattern of self-talk
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stress-inoculation therapy
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a directive cognitive therapy based on the idea that clients' psychological distress is caused by irrational and self-defeating beliefs and that the therapist's job is to challenge such dysfunctional beliefs
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rational-emotive therapy (Albert Ellis)
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therapy that depends on identifying and changing inappropriately negative and self-critical patterns of thought; cognitive therapists are must less challenging and confrontational than rational-emotive therapists
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Beck's cognitive therapy
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type of psychotherapy in which clients meet regularly to interact and help one another achieve insight into their feelings and behavior
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group therapy
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a good group offers social support, a feeling that one is not alone in their problems; it helps one to learn useful new behaviors such as how to express feelings, to disagree without antagonizing others, etc
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what makes group therapy good?
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40-45 million Americans suffer from a psychological problem and self-help groups are a low-cost form of treament
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self-help groups
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sees the family as at least partly responsible for the individual's problems and seeks to change all family members' behaviors to the benefit of the family unit as well as the troubled individual
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family therapy
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improving family communication, encouraging family members to become more empathetic, getting them to share responsibilities, and reducing conflict within the family
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primary goals of family therapy
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intended to help troubled partners improve their problems of communication and interaction; generally more effective than therapy for only one of them
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couple therapy
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individuals of a couple are taught to share inner feelings and to listen to and understand the partner's feelings before responding to them
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empathy training
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twice as many people improve with formal therapy than with no treatment at all; recovery rate for people who receive no therapeutic help is less than one-third
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effectiveness of psychotherapy
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best for relatively mild psychological problems and seems to provide greatest benefits to people who really want to change; long-term therapy is better than short-term
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who does psychotherapy work best for?
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1. provides people with an explanation for their problems 2. hope and the expectation for improvement 3. therapeutic alliance with a therapist
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what do all forms of psychotherapy have in common?
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people seeking profound self-understanding, relief of inner conflict and anxiety, or better relationships with others
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insight therapy is best for?
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treating specific anxieties or other well-defined behavioral problems
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behavior therapy is best for?
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individual counseling for the treatment of drug abuse
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family therapy is better than?
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treating depression
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cognitive therapy is most effective for?
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psychotherapeutic approach that recognizes the value of a broad treatment package over a rigid commitment to one particular form of therapy
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eclecticism
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group of approaches, including meds, ECT, and psychocurgery, that is sometimes used to treat psychological disorders in conjunction with, or instead of, psychotherapy
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biological treatments
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1. some people are too agitated for psychotherapy 2. biological treatment is virtually always used for disorders with a strong biological component 3. biological treatment is often used for people who are dangerous to themselves and to others
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why are biological treatments sometimes selected over other forms of treatment?
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1. development of several very effective psychoactive medications 2. less expensive than psychotherapy
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two major reasons for the widespread use of drug therapies
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used to treat very severe psychological disorders, particularly schizophrenia; include reserpine and phenothiazines; work by blocking dopamine receptors; not effective for treating "negative symptoms" like social withdrawal
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antipsychotic drugs
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blurred vision, constipation, tardive dyskinesia (permanent disturbance of motor control, particularly in the face; risk of this increases with length of time the meds are taken); these drugs only alleviate symptoms while the person is taking the drugs; they are of little value in treating problems of social adjustment
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side effects of antipsychotics?
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used to combat depression and reducing episodes of panic and alleviating OCD symptoms; two main types in the 1980s were monoamine oxidase inhibitors (MAO inhibitors) and tricyclics, both of which work by increasing the concentration of serotonin and norepinephrine in the brain
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antidepressant drugs
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came out in 1988; works by reducing amount of serotonin uptake by nervous system, increasing amount of active serotonin in the brain at any given moment; known as a selective serotonin reuptake inhibitor
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Prozac
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used to treat bipolar disorder or manic depression; effect in 75% of cases, but often prescribed along with antidepressants because it is slow to take effect
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lithium
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heighten alertness and arousal; commonly used to treat ADHD/ADD; a study in 2000 showed that children between 2-4 yrs who take stimulants and antidepressants has doubled recently
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psychostimulants
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quickly produce a sense of calm and mild euphoria; used to reduce general tension and stress; ex. Valium
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antianxiety medications
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produce both calm and drowsiness; used to treat agitation or to induce sleep
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sedatives
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most often used for cases of prolonged and severe depression that do not respond to other forms of treatment; electrodes are placed on each side of a person's head and amild current is turned on for 1.5 sec.; treatment consists of 10 or fewer sessions of ECT
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electroconvulsive therapy (ECT)
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electric current is passed through only one side of the brain; produces fewer side effects such as memory impairment and confusion; other modifications of ECT include shorter durations (0.4 sec)
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unilateral ECT
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it works; the fatality rate for ECT is markedly lower than for people on antidepressants; best considered as "last resort"
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how effective is ECT?
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brain surgery performed to change a person's behavior and emotional state; a biological therapy rarely used today
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prefrontal lobotomy
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hospitilization has been used for the past 150 yrs; state hospitals have often been little more than warehouses for victims of serious mental illness who were unwanted by their families
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how were mentally ill people cared for in the past?
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1. agitated people could not be sedated with drugs instead of physical restraints 2. widespread release of people with severe psychological disorders back into the community
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emergence of drug therapies in 1950s changed state hospitals
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policy of treating poeple with severe mental disorders in the larger community, or in small residential centers such as halfway houses, rather than in larger public hospitals
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deinstitutionlization
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1. discharged people often find poorly funded community mental health centers 2. social stigma of mental illness 3. health insurance discourages outpatient care
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600 regional mental health centers accounted for 1.6 million cases of outpatient care
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argued to shift away from hospitalization
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Charles Kiesler
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9 out of the 10 studies found alternative treatments to have more positive outcomes than expensive hospitalization
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Kiesler examined 10 controlled studies in which seriously disturbed people were randomly assigned to either hospitals or alternative programs
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requires finding and eliminating the conditions that cause or contribute to mental disorders and substitute conditions that foster well-being
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prevention
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techniques and programs to improve the social environment so that new cases of mental disorders do not develop (ex. family planning, genetic counseling)
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primary prevention
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programs to identify groups that are at high risk for mental disorders and to detect maladaptive behavior in these groups and treat it promptly (ex. intervention)
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secondary prevention
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programs to help people adjust to community life after release from a mental hospital; includes efforts to educate the community that a person is reentering the community
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tertiary prevention
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critics say that women in therapy are often encouraged to adopt traditional, male-oriented views of what is "normal" or "appropriate" because most therapists are male
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equal treatment
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70% of prescriptions written by psychiatrists are for women, even though women only account for 58% of their office visits; women receive 70-80% of antidepressant prescriptions even though they make up 2/3 of all cases
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women receive a disproportionate share of drugs for mental disorders
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"fear of people"; rarely found outside of Japan; example of American therapists requiring special training to recognize disorders of a different culture
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Taijin Kyofusho