Abnormal Psych Final

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Biological treatments (6)

Back 1

Trephining, Insulin shock treatment, ECT, Prefrontal Lobotomy, Deep Brain Stimulation, Transcranial Magnetic Stimulation

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Transcranial Magnetic Stimulation

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sends short, strong magnetic pulses into the cerbral cortex
via a coil placed on the scalp,

has varying effects depending on location of coil on scalp,

researchers still don't understand how it affects brain activity,

can be used to treat depressed people where medication hasn’t worked, can also reduce symptoms in a variety of disorders.

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Off Label Use

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medications prescribed that have not been approved for treating the given disorder

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Anti-Psychotic Medication

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medications that can get through the frantic and calm them down, an reduce hallucinations

doesn’t take the psychosis away just calms them down,

are less upset by certain things, reduce hallucinations

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Deinstitutionalization

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people don’t go to institutions as much as they used to and they don’t stay for very long

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Medication Side Effects

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Sometimes the side effects are bad enough that a person will want to stop taking their medication

side effects lower sexual drive, tiredness, jumpyness

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Anti-Anxiety Medication

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work very nicely, someone who is very jumpy can get some relief,
but can get dependent, hooked on it if you take it everyday

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Target Dosing

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start medication at lowest possible effective dose,

what is the lowest dose that you can possibly get an effective dose.

A little poison in your system as possible

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Anti-Depressant Medication

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SSRIs
not as addictive as anti anxiety meds,
can be prescribed for various anxiety disorders or eating disorders

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SSRIs

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selective serotonin reuptake inhibitors – medications that slow the reuptake of serotonin from the synapse used for depression

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Stimulants

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increase attention and reduce general activity level and impulsive behavior

help people to focus,

feel to many kids are on, they really just need to be challenged

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Anti-Manic Medication

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something to try to keep the person form going sky high, bipolar disorder might have anti depress and anti manic,

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Placebo Effect

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when a person has not been givin a active medication and they get better,

when you believe you have a medication you sometimes get better, very powerful in our country today, 2/3s of hit is placebo

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Psychotherapy Dosage Effect

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there is evidence, more psychotherapy the better,

people did better if they went to more sessions, the more the better, point of dimins

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Effectiveness

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assessed in nonresearch settings when something like a treatment or medication works in the real world but it can have problems

Where most clinicians treat patients in the real world not the lab

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Efficacy

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in pure forms, the treatment shows to have success in testing in the lab

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Clinical Significance

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Does the decrease in symptoms from the treatment improve her daily functioning or other aspects of her quality of life?

Can be based on patients own perceptions, on observations of friends and fam, or on the therapists judgment.

Because of treatment a bulimic may have gone from purging every day to 3 times a week, statistically its an improvement but its it clinically meaningful.

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Statistical Significance

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the condition in which the probability of obtaining the value of a statistical test is greater than what would be expected by chance alone.

The observed result is unlikely to be a quirk or random variation in the data. Not the same as importance

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Dodo Bird Verdict

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Certain therapies are all effective, no one type of therapy appears to be more effective than another

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Common Factors (4)

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Helpful aspects of therapy that are shared by virtually all types of psychotherapy.

Therapeutic Alliance
Plausible Narrative
Instillation of Hope
Rogerian Triad

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Therapeutic Alliance

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the positive relationship between the therapist and the patient.

Good collaboration will provide the trust and good will needed to take on the challenging work of the therapy.

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Plausible Narrative

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opportunities to express problems

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Instillation of Hope

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therapist who is hopeful about their work, encouragment

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Rogerian Triad

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foundation for good therapeutic alliance, proposed by Carl Rogers

a. Unconditional Positive Regard
b. Empathy
c. Congruence

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Unconditional Positive Regard in the Rogerian Triad

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expressing positive feelings for the client, regardless of the clients emotions,

continually showing that the client is inherently worthy as a human being.

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Empathy in the Rogerian Triad

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does not interpret but reflects back key parts of the client feelings and reactions to situations.

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Congruence in the Rogerian Triad

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helps client achieve congruence between real self and ideal self, whether this is modifying ideal self or realizing the real self is actually closer to the ideal self

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3 MAJOR SYMPTOMS AREAS OF AUTISM

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Deficits in language and communication, Social skills, Excessive behavior

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Deficits in language and communication in Autism

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speak and understand languagae most important part of communication

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Social skills

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Autistic babys tend to focus more on objects than on faces
dont look you in the eye

involves so many diff behaviors
See this as early as 4 month yr olds

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Excessive behavior in autism

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behavior that we see too much of,
flapping hands, look at objects form perferey, jumping up and down, shrieking,

some are body focused some are object focused

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ECT

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treatment for severe depression

an electric current is passed through the head via electrodes that are placed on the scalp which causes a controlled brain seizure

The patients receives a muscle relaxant and is under anesthesia.

It is not understood why it works but is effective in treating depression.

loose hundred brain cells, memory loss afterward

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Trephining

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drilling a hole into the skull, used on people who had mental disorders in century they thought they were filled used to let evil spirits

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etiology of autism

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neurobiological cause of autism

genetic factors, but not in all cases
there might be traits in features in relatives
multi modal

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Seven families of therapy

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Experiential, Behavioral, Cognitive, Psychodynamic, Interpersonal, Family Systems, Meaning based Therapy.

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Experiential Therapy (2 parts)

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getting in touch with the experience by reflection

a. Non-Directive – letting the person talk about whatever they want and letting them reflect

b. Directive – direct the person what to talk about or think, can help them face their fears

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Behavioral Therapy (2 parts)

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new learning can allow patients to develop more adaptive behaviors, cognitions, and emotions

closest to research methodology,
like the ABA treatment for autism, child is taught how to behave and live in society,

a. Behavioral Activation – like for depression, direct them and get them to do something.

b. Stimulus Control – like for binge eating, have them get rid of the junk food

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Cognitive Therapy

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conscious thoughts infuence a person feelings and behavior,

correcting such thoughts and beliefs leads to more rational thoughts and accurate beliefs and therefore will lead to a better mood.

Collaborative Empiricism

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Collaborative Empiricism in Cognitive Therapy

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with the clients assistance, taking what they think or believe and break it apart, looking at it as a hypothesis

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Psychodynamic Therapy

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Therapy based on psychoanalysis but involves less frequent sessions,

Attention to present experiences, which is compared to psychoanalysis which focuses on past experiences.

ess emphasis on aggressive and sexual drives, and more.

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Interpersonal Therapy

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trying to understand how you impact other people,

learning how you interact with other people,

if people are uncomfortable in your presence or do not gravitate towards you, why is that?

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Family Systems Therapy

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Designed to change the communication or behavior patterns of one or more family members.

Goals are to identify and then change maladaptive patterns of interaction and communication among family members.

Family is systems that strives to maintain homeostasis, so a change in one family member can affect other family members.

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Exceptions to Confidentiality (5)

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a) If there is danger to self or others, Duty to Warn, Tarasoff – said he was going to kill the person and the therapist warned the campus police but not the person and the person was killed

b) Child or Elder Abuse – must report child or elder abuse even if it is not currently happening

c) Written Consent – a patient can give the therapist written consent to talk about their sessions like to speak to the spouse

d) Sued for Malpractice – you can defend yourself and break confidentiality

e) Patient claims insanity – you can testify for or against his claims

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Dual Relationship

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a therapist is not allowed to have any sort of relationship outside of therapy

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Barter

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no bartering to pay for therapy, a girl was babysitting for the therapist which is bad. The therapist should reduce the fee for the client can pay.

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Abandonment

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you cannot fire a client or abandon them even when you don’t like them or are not getting along.

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Satiation in autistic treatment

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when the child gets used to reinforcers

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How to avoid satiation

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vary reinforcers, object reinforcers, social reinforcers, praise,

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High probability task in autistic treatment

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there is a high prob that they are going to to do it, and then reinforce

Front 50

Insulin shock treatment

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used mainly on schizophrenia patients. Overdose of insulin, in order to induce a coma, injection of glucose to bring out it, they don’t use it any more, dangerous, didn’t seem to work beyond palcebo

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Prefrontal Lobotomy

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separate frontal lobe form rest of brain, to control and calm people, really severe mental illness

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Deep brain stimulation

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used for ocd or parkinsons, insert something brain that can activate it

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What is needed for a technique to be considered “Empirically Supported?”

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research results support the treatments beneficial effect. Has to better than 2 other studies

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Least Restrictive Alternative

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St E’s – can she do as well in a half house?