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I.therapyR - THERAPY Bio-Psycho-Social talk therapy(CBT...

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Unformatted text preview: THERAPY Bio-Psycho-Social talk therapy (CBT) affects the front part of the brain Paxil works on primitive region, (back brain) (right, red) Psychopharmacology: 1. Antidepressants 2. Stimulants 3. Mood stabilizer 4.Antianxiety 5. Antipsychotics Antidepressants SSRI: (selective serotonin reuptake inhibitors) The SSRIs comprise 6 medications: Celexa Lexapro LuVox Paxil Prozac Zoloft SSRI: Clinical Effects Serotonin can also influence: Anxiety Impulsivity & Anger Affect Modulation SSRIs are often used to treat: Major Depression Dysthymia Generalized Anxiety Disorder Panic Disorder PTSD Social Anxiety Disorder Obsessive-Compulsive Disorder Borderline Personality Disorder Impulse Control Disorders Bulimia Nervosa SSRI: Side Effects SSRIs can cause: Nausea, diarrhea, constipation Headache, dizziness Insomnia or sedation Weight gain, weight loss Dry mouth, sweating, tremor Anxiety, restlessness Sexual side effects (function & libido) Suicidal ideation SSRI: Discontinuation Syndrome These symptoms include: Dizziness Lethargy Nausea Irritability Headaches 1B. Atypical Antidepressant The antidepressants in this class include: Cymbalta Effexor Remeron Wellbutrin SSRIs effect the neurotransmission of 1 neurotransmitter: serotonin medications effect the neurotransmission of 2 neurotransmitters These Wellbutrin Influence noreprinephrine & dopamine Wellbutrin is indicated for: Depression Smoking cessation ADHD but not anxiety disorders 2. Stimulants The psychostimulants include: Dexedrine Adderall Ritalin These medications are all forms of amphetamine, which result in the release of norepinephrine, dopamine & serotonin Resulting clinically in: Increased concentration Energy Interest Feelings of well being Due to these clinical effects they are used to treat: ADHD Depression These medications are controlled substances, since they have a high risk of abuse Tolerance & psychological dependence can also develop, ...abrupt discontinuation can cause fatigue & depression Side effects include: Increased blood pressure Cardiac issues Insomnia Decreased appetite Irritability Dry mouth Psychosis Another medication to be aware of is Provigil Provigil increases wakefulness & is helpful for ADHD & in antidepressant augmentation is well tolerated with few side effects It 3. Mood Stabilizers Mood stabilizers include: Lithium Tegretol Depakote 4. Antianxiety: Benzodiazepines Because they reduce anxiety they are used to treat: GAD Panic disorder Social phobia Anxious depression Alcohol withdrawal These medications work because they Bind to the GABA receptor located on certain neurons GABA turns off rewardpleasure system Which translates clinically into sedation, relaxation & decreased anxiety some benzodiazepines last for a few hours, & others last for 12 hours or more Short acting: Xanax Medium acting: Ativan Long acting: Librium Klonopin Valium 5. Antipsychotics Biomedical Therapies (cont'd) Electroconvulsive Mimics Therapy (ECT) an epileptic seizure & somehow gets the neurotransmitters to the right places Biomedical Therapies (cont'd) Psychosurgery Prefrontal lobotomy Psychodynamic Include: INSIGHT Transference & defenses Unconscious Early developments Neuroscience Empathy Mirror neurons fire when observing another The id (aggressive & libidinal drives) The superego (moral/ethical code) The ego (partially conscious mediator between the id and superego) Internal perspective What experiencing What is going on in head Let me `be in mind' craziness & understand together Classical Psychoanalytic THERAPY Case Study Johnny was apple of mother's eye Brother Billy Johnny comes to therapy because his girlfriend threatens to break up unless he gets help Jealous Too Competitive (sports and classroom) Psychoanalysis Key Can't understand problems today without understanding problems of early relationships (ex: with parents & siblings) Goal Bring whatever has been repressed (defense mechanisms too) into awareness By understanding the process (DYNAMIC) puts it under patient's control Insight Psychoanalysis: Freud we can discover mind's unconscious functioning via Psychoanalysis Psychoanalysis Free Association Method for probing the unconscious by having patients talk freely about self, feelings & motives One thing leads to another We can observe "subjectively" from inside a mind Anna O Psychoanalysis Dream analysis Another way of getting at what might be repressed Dream work Latent content Manifest content Condensation displacement Psychoanalysis Resistance The blocking from consciousness of anxiety laden material Exactly where you need to dig Psychoanalysis Transference The patient's transfer to the analyst of emotions linked with other relationships (such as love or hatred for the parent) Counter- transference: the entire body of feelings that the therapist has toward the patient History: Bad To be tolerated Useful Psychoanalysis Interpretation may be either focused on present issues intended to draw connections between the patient's past and the present or "dynamic" Psychoanalysis Working use Through the new understanding from interpretations to make changes in present life Self Psychology and many others that focus on insight I shape the world that is mine Behavior Therapies No insight Just change the behavior Opposite of psychoanalysis Behavior Therapies (cont'd) Behavior Modification 1. Identify target behavior 2. Monitor to establish baseline 3. Identify positive reinforces 4. Establish schedule of reinforcement 5. Enlist social support 6. Monitor & record progress Behavior Therapies (cont'd) Systematic A Desensitization type of counter conditioning that associates a pleasant, relaxed state with gradually increasing anxiety-triggering stimulus Behavior Therapies Averse A Conditioning type of counter conditioning that associates an unpleasant state (such as nausea) with unwanted behavior (such as drinking alcohol) Modeling A process of observing and imitating a specific behavior Virtual Reality exposure therapy With technology, exposes pt to vivid simulations of a feared stimulus Behavior Therapies (cont'd) Flooding Large exposure to thing feared all in 1 session Cognitive Therapy Beck negative slant (interpretation) : Self World Future Cognitive Model Trigger Event Auto Thought Behavior/Emotion Interpretations dictate mood Fired (I'm a loser) Depressed Fired ( YAY, free to find my passion) Joy Cognitive Therapy (cont'd) By changing the way you think, you can alter your brain chemistry beliefs to alter thoughts Refocus Cognitive Therapy (cont'd) Cognitive Beliefs Attitudes Expectations Interpretations Restructuring = reshaping thinking Focus on thinking & reasoning processes Cognitive Therapy (cont'd) Cognitive Black Distortions & White Thinking: all or none thinking Cognitive Therapy Personalization Cognitive Therapy (cont'd) Rational Emotive Therapy Developed by Albert Ellis Direct form of therapy; most radical of the cognitive therapies Therapist is the expert Rational Emotive Therapy GOAL--to Stop show how misinterpretations cause distress catastrophiz-ing Stop awful-izing Have the courage to be imperfect Stop blaming yourself!! Humanistic Therapy MOST Non-direct form of therapy of RET Opposite Client is the expert GOAL--become fully functioning person Humanistic Therapy (cont'd) Success depends on: 1. 2. 3. 4. Unconditional positive regard Openness & genuine respect Active listening Warmth & empathy Group Therapies Gives people the opportunity to explore their problem w/others who have the same problem Group Therapies (cont'd) Family Type Therapy of group therapy that helps families interact differently Group Therapies (cont'd) Marriage Tries Therapy to see the *dynamic* between the couple partners have to be willing to change themselves Both ECLECTIC In psychoanalysis, the therapist's feeling toward the patient is called: A) B) C) D) Counter-transference Transference Interpretation Working through SSRI stands for A. Student Savvy Recognition Investigation B. Serotonin Starvation Research Institute C. Selective Serotonin Reuptake Inhibitors D. Somatic Substitution Range Involvement ...
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