NSG 6440 Practice Test

NSG 6440 Practice Test Chapter Overview - ANS - Major types of psychotherapy include psychoanalytic, humanistic, behavior, cognitive, and individual, group, and family psychotherapy. Issues in psychotherapy include culture, gender, values, effective factors and types, and the evaluation of psychotherapy effectiveness. We'll also look at biomedical therapies such as drugs, brain stimulation, surgery, and lifestyle change. -Finally, we'll briefly consider the prevention of psychological disorders. Therapy - ANS Therapy refers to how mental disorders are treated, with the help of the knowledge base of psychology. Current Forms of Therapy - ANS Psychotherapy: an interactive experience with a trained professional, working on understanding and changing behavior, thinking, relationships, and emotions Combining Therapies - ANS Biomedical therapy: the use of medications and other procedures acting directly on the body to reduce the symptoms of mental disorders Combining Therapies - ANS -An eclectic approach uses techniques from various forms of therapy to fit the client's problems, strengths, and preferences. Combining Therapies - ANS Medications and psychotherapy can be used together, and may help the each other achieve better reduction in symptoms Noteworthy Schools of Psychotherapy - ANS Psychoanalysis, psychodynamic therapy _ Sigmund Freud's legacy carried on today. Noteworthy Schools of Psychotherapy - ANS - Humanistic, client-centered therapy Carl Rogers and Abraham Maslow Noteworthy Schools of Psychotherapy - ANS - Behavior therapy, using classical operant conditioning _ B.F. Skinner and Ivan Pavlov applied to people. Noteworthy Schools of Psychotherapy - ANS - Cognitive thereapy, changing thoughts Aaron Beck and Albert Ellis, reducing errors and distress Psychoanalysis - ANS - The first formal psychotherapy to emerge was psychoanalysis, developed by Sigmund Freud. - Sigmund Freud's famous couch Psychoanalysis: Aims - ANS - Since psychological problems originate from childhood repressed impulses and conflicts, the aim of psychoanalysis is to bring repressed feelings into conscious awareness where the patient can deal with them. - When energy devoted to id-ego-superego conflicts is released, the patient's anxiety lessens Psychoanalysis - ANS Resistance: the therapist notices times when the patient seems blocked in speaking about certain subjects Psychoanalysis - ANS Dreams: there may be themes or "latent content" behind the plot of a patient's dream Psychoanalysis - ANS Transference: the patient may have reactions toward the therapist that are actually based on feelings toward someone from the past Psychoanalysis: Criticisms - ANS 1. Psychoanalysis is hard to refute because it cannot be proven or disproven. 2.Psychoanalysis takes a long time and is very expensive. Psychodynamic Therapy - ANS - Influenced by Freud, in a face-to-face setting, psychodynamic therapists understand symptoms and themes across important relationships in a patient's life. - Interpersonal psychotherapy, a variation of psychodynamic therapy, is effective in treating depression. It focuses on symptom relief here and now, not an overall personality change. Humanistic Therapies - ANS - Humanistic therapists aim to boost self-fulfillment by helping people grow in self-awareness and self-acceptance. Style of the Client-Centered Therapist - ANS Let insight and goals come from the client, rather than dictating interpretations. Being non-directive - ANS Let insight and goals come from the client, rather than dictating interpretations. Being genuine - ANS Be yourself and be truthful; don't put on a therapist façade. Being empathetic - ANS Demonstrate careful attention to the clients' feelings, partly by reflecting what you hear the client saying. Showing Empathy Through Active Listening - ANS -Showing Empathy Through Active Listening -Client-centered therapists show that they are tuning in to clients' feelings and meanings. -Summarize, paraphrase "So your father wasn't around much?" -Invite clarification and elaboration -"When you say 'anxiety,' what does that feel like to you? What is going on in your body and thoughts?" Reflect Feelings "It seems like you are disappointed; am I right?" Behavior Therapy - ANS - Therapy that applies learning principles to the elimination of unwanted behaviors. - To treat phobias or sexual disorders, behavior therapists do not delve deeply below the surface looking for inner causes. Classical Conditioning Techniques - ANS - Counterconditioning is a procedure that conditions new responses to stimuli that trigger unwanted behaviors. - It is based on classical conditioning and includes exposure therapy (systematic desensitization) and aversive conditioning. Operant Conditioning - ANS - Operant conditioning procedures enable therapists to use behavior modification, in which desired behaviors are rewarded and undesired behaviors are either unrewarded or punished. - In institutional settings, therapists may create a token economy in which patients exchange a token of some sort, earned for exhibiting the desired behavior, for various privileges or treats. Cognitive Therapy - ANS - Teaches people adaptive ways of thinking and acting based on the assumption that thoughts intervene between events and our emotional reactions. Cognitive-Behavior Therapy - ANS - Cognitive therapists often combine the reversal of self-defeated thinking with efforts to modify behavior. - Cognitive-behavior therapy aims to alter the way people act (behavior therapy) and alter the way they think (cognitive therapy). Family Therapy - ANS - Having a session with the whole family, at home or in the office, allows the therapist to work on the family system, that is, the family's patterns of alliances, authority, and communication. A related modality is couples/marital therapy. Group Therapy - ANS - Group therapy assembles about six to nine people with related needs into a group, facilitated by a therapist, to work on therapeutic goals together. The benefits include: less cost per person. more interaction, feedback, and support. clients realize others share their problems and they are not alone. Self-Help Groups - ANS - Self-help groups are led by group members instead of a therapist. -They can be much larger than group therapy, with less interaction. -The focus is more on support rather than on working on goals during the group session. Outcome Research - ANS - How can we objectively measure the effectiveness of psychotherapy? - Meta-analysis of a number of studies suggests that thousands of patients benefit more from therapy than those who did not go to therapy. Outcome Research - ANS - Research shows that treated patients were 80% better than untreated ones. The Relative Effectiveness of Different Therapies - ANS - Which psychotherapy would be most effective for treating a particular problem? Disorder/Therapy - ANS Depression: Behavior, Cognition, Interpersonal. Anxiety: Cognition, Exposure, Stress Inculation. Disorder/Therapy - ANS Bulimia: Cognitive-behavior Phobia: Behavior Bed Wetting: Behavior Modification. Evaluating Alternative Therapies - ANS - 57% of those who have had anxiety attacks and 54% who have had depression have used alternative treatments such as herbal medicines, massage, and spiritual healing (Kessler & others, 2001). Do alternative therapies hold up under scientific scrutiny? Eye Movement Desensitization and Reprocessing (EMDR) - ANS - In EMDR therapy, the therapist attempts to unlock and reprocess previous frozen traumatic memories by waving a finger in front of the eyes of the client. EMDR has not held up under scientific testing. Light Exposure Therapy - ANS Seasonal Affective Disorder (SAD), a form of depression, has been effectively treated by light exposure therapy. This form of therapy has been scientifically validated. Commonalities Among Psychotherapies - ANS Three commonalities shared by all forms of psychotherapies are the following: 1. A hope for demoralized people. 2. A new perspective. 3. An empathic, trusting and caring relationship. Culture and Values in Psychotherapy - ANS - Psychotherapists may differ from each other and from clients in their personal beliefs, values, and cultural backgrounds. - A therapist search should include visiting two or more therapists to judge which one makes the client feel more comfortable. Therapists & Their Training - ANS Clinical psychologists: They have PhDs mostly. They are experts in research, assessment, and therapy, all of which is verified through a supervised internship. Therapists & Their Training - ANS -Clinical or Psychiatric Social Worker: They have a Masters of Social Work. Postgraduate supervision prepares some social workers to offer psychotherapy, mostly to people with everyday personal and family problems. Therapists & Their Training - ANS -Counselors: Pastoral counselors or abuse counselors work with problems arising from family relations, spouse and child abusers and their victims, and substance abusers. Therapists & Their Training - ANS Psychiatrists: They are physicians who specialize in the treatment of psychological disorders. Not all psychiatrists have extensive training in psychotherapy, but as MDs they can prescribe medications. The Biomedical Therapies - ANS These include physical, medicinal, and other forms of biological therapies. The Biomedical Therapies - ANS 1. Drug Therapies 2. Brain Stimulation 3. Psychosurgery Drug Therapies - ANS Psychopharmacology is the study of drug effects on mind and behavior. - With the advent of drugs, hospitalization in mental institutions has rapidly declined. - Photo Antianxiety Drugs - ANS - Antianxiety drugs (Xanax and Ativan) depress the central nervous system and reduce anxiety and tension by elevating the levels of the Gamma-aminobutyric acid (GABA) neurotransmitter. Antidepressant Drugs - ANS - Antidepressant drugs like Prozac, Zoloft, and Paxil are Selective Serotonin Reuptake Inhibitors (SSRIs) that improve the mood by elevating levels of serotonin by inhibiting reuptake. Mood-Stabilizing Medications - ANS - Lithium Carbonate, a common salt, has been used to stabilize manic episodes in bipolar disorders. It moderates the levels of norepinephrine and glutamate neurotransmitters. Brain Stimulation - ANS Electroconvulsive Therapy (ECT) ECT is used for severely depressed patients who do not respond to drugs. The patient is anesthetized and given a muscle relaxant. Patients usually get a 100 volt shock that relieves them of depression. Alternatives to ECT - ANS - Repetitive Transcranial Magnetic Stimulation (rTMS) - In rTMS, a pulsating magnetic coil is placed over prefrontal regions of the brain to treat depression with minimal side effects. Psychosurgery - ANS - Psychosurgery was popular even in Neolithic times. Although used sparingly today, about 200 such operations do take place in the US alone. - Psychosurgery is used as a last resort in alleviating psychological disturbances. Psychosurgery is irreversible. Removal of brain tissue changes the mind. Preventing Psychological Disorders - ANS "It is better to prevent than cure." Peruvian Folk Wisdom - Preventing psychological disorders means removing the factors that affect society. Those factors may be poverty, meaningless work, constant criticism, unemployment, racism, and sexism. Psychological Disorders are Biopsychosocial in Nature - ANS Photo