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What are some of the personal, social and financial costs of mental illness?
- Stigma, makes it harder to have/keep relationships
- Costs a lot of money to get treatment
- Self esteem issues
- Impairment to carry out daily activities
- Disability leave
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What are the obstacles to treatment for the mentally ill?
- 1. People may not realize they have a mental disorder that could be effectively treated
- 2. There may be barriers to treatment, like beliefs and circumstances that keep people from getting help
- 3. Structural barriers prevent people from physically getting to treatmetn
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Psychotherapy
An interaction between a socially sanctioned clinician and someone suffering from a psychological problem with the goal of providing support or relief from the problem
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Eclectic psychotherapy
A form of psychotherapy that involves drawing on techniques from different forms of therapy, depending on the client and the problem
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Psychodynamic psychotherapies
Therapies that explore childhood events and encourage individuals to use this understanding to develop insight into their psychological problems
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Mental illness is often
Misunderstood and because of this it often goes untreated
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Untreated mental illness can be extremely
Costly, affecting an individual's ability to function and also causing social and financial burdens.
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Many people who suffer from mental illness do not get the help they need
They may be unaware that they have a problem, they may be uninterested in getting help for their problem or they may face structural barriers to getting treatment
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Treatments include
Psychotherapy, which focuses on the mind, and medical and biological methods, which focus on the brain and body
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What might a client's resistance signal to a psychoanalyst?
That the idea might not be correct but it is on the right track
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In what common ways do other Psychodynamic theories differ from Freudian analysis?
- Procedures used, sitting face to face instead of one person laying down, less intensive
- Content, rather than free association, therapists using IPT talk to clients about their interpersonal behaviors and feelings
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Resistance
A reluctance to cooperate with treatment for fear of confronting unpleasant unconscious material
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Transference
An event that occurs in psychoanalysis when the analyst begins to assume a major significance in the client's life and the client reacts to the analyst based on unconscious childhood fantasies
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Interpersonal psychotherapy (IPT)
A form of psychotherapy that focuses on helping clients improve current relatinships
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Person-centered therapy (or client-centered therapy)
Assumes that all individuals have a tendency toward growth and that this growth can be facilitated by acceptance and genuine reactions from the therapist
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Gestalt therapy
Has the goal of helping the client become aware of his or her thoughts, behaviors, experiences and feelings and to "own" or take responsibility for them
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Behavior therapy
A type of therapy that assumes that disordered behavior is learned and that symptoms relief is achieved through changing overt maladaptive behaviors into more constructive behaviors
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What primary problem did behaviorists have with psychoanalytic ideas?
They had a problem with theories that were based on "invisible" mental properties that were difficult to test and impossible to observe directly.
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How does a humanistic view of human nature differ from a Psychodynamic view?
Humanistic view saw all humans as good and trying to improve
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How might exposure therapy help treat a phobia or fear of a specific object?
It depends on the processes of habitation and response extinction.
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Token economy
A form of behavior therapy in which clients are given tokens for desired behaviors, which they can later trade for rewards
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Exposure therapy
An approach to treatment that involves confronting an emotion-arousing stimulus directly and repeatedly, ultimately leading to a decrease in the emotional response
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Cognitive therapy
Focuses on helping a client identify and correct any distorted thinking about self, others, or the world
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Cognitive restructuring
A therapeutic approach that teach clients to question the automatic beliefs assumptions and predictions that often lead to negative emotions and to replace negative thinking with more realistic and positive beliefs
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How might a client restructure a negative self image into a positive one?
Cognitive restructuring to question the beliefs held about themselves and to change them and make them better
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Mindfulness meditation
Teaches an individual to be fully present in each moment; to be aware of his or her thoughts, feelings, and sensations; and to detect symptoms before they become a problem
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Cognitive behavioral therapy (CBT)
A blend of cognitive and behavioral therapeutic strategies
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Why do most therapists use a blend of cognitive and behavioral strategies?
The technique acknowledges that there may be behaviors that people cannot control through rational thought, BTU also that there are ways of helping people think more rationally when thought does play a role
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When is group therapy the best option?
When people might be Abel to recover from disorders in the same way they got them, not as an individual effort but through social process
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Group therapy
A technique in which multiple participants (who often do not know one another at the outset) work on their individual problems in a group atmosphere
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What are some of the pros and cons of group therapy?
- Pro: You're not alone, group members model appropriate behavior, can share insight
- Cons: Difficult to assemble a group with similar needs, problems with members undermining each other, particular members dominate conversation, less attention than they could have gotten in one on one sessions
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What are the pros and cons of self help support groups?
- Pro: Support from a community, cost effective,
- Con: Disruptive or aggressive or encourage bad behavior, oversensitive to symptoms they might not have otherwise had
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Humanistic approach and existential approaches
Focus on helping people to develop a sense of personal worth
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Behavior therapy applies
Learning principles to specific behavior problems
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Cognitive therapy is focused on helping
People to change the way they think about events in their lives, and teaching them to challenge irrational thoughts.
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Cognitive behavior therapy which merges
Cognitive and behavioral approaches has been shown to be affective for treating a wide range of psychological disorders
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Group therapies target couples, families, or groups of clients
Brought together for the purpose of working together to solve their problems
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Self help and support groups
Such as AA are common in the US and around the world but not well studied
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Psychodynamic therapies, including psychoanalysis, emphasize helping clients gained insight into their unconscious conflicts.
Traditional psychoanalysis involves 4-5 sessions a week with a client lying on a couch free associating, whereas modern Psychodynamic therapies involve one session per week with face to face interactions in which therapists help clients solve interpersonal problems
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Antipsychotic drugs
Medications that are used to treat schizophrenia and related psychotic disorders
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Psychopharmacology
The study of drug effects on psychological states and symptoms
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Antianxiety medications
Drugs that help reduce a person's experience of fear or anxiety
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Antidepressants
A class of drugs that help lift people's moods
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What do antipsychotic drugs do?
They block dopamine receptors in parts of the brain like the mesolimbic area, an area between the tegmentum (in the Midbrain) and various Subcortical structures. It reduces dopamine activity in these areas
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What are the advantages of the newer, atypical antipsychotic medications?
They appear to affect both dopamine and serotonin systems, blocking both types of receptors.
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What are some reasons for caution when prescribing Antianxiety medications?
Benzodiazepines have a potential for abuse, are associated with drug tolerance and risk withdrawal symptoms
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What are the most common antidepressants used today? How do they work?
- Selective serotonin reuptake inhibitors (SSRIs) are among the most common.
- They block the reuptake of serotonin in the brain, which makes more serotonin available in the synaptic space between neurons. The greater availability of serotonin in the synapse gives the neuron a better chance of recognizing and using this neurotransmitter in sending the desired signal.
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Why aren't antidepressants prescribed for bipolar disorder?
In the process of lifting one's mood, they might actually trigger a manic episode in a person with bipolar disorder. They are treated with mood stabilizers instead
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Why are herbal remedies used? Are they actually effective?
They are easily available over the counter, less expense and perceived as "natural" alternatives. They aren't considered medications by regulatory agencies so they are more likely to get away with crap but there is research support for the effectiveness of some herbal and natural products-though it's not overwhelming.
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Where do people turn if psychological treatment and medications are unsuccessful?
Electroconvulsive therapy is used primarily to treat severe depression that hasn't responded to antidepressant medications, it may also be useful for treating bipolar disorder.
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Electroconvulsive therapy (ECT)
A treatment that involves inducing a brief seizure by delivering an electrical shock to the brain
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Transcranial magnetic stimulation (TMS)
A treatment that involves placing a powerful pulsed magnet over a person's scalp, which alters neuronal activity in the brain
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Phototherapy
A therapy that invokes repeated exposure to bright light
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Psychosurgery
Surgical destruction of specific brain areas
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Medications have been developed to
Treat many psychological disorders, including antipsychotic medications (for schizophrenia and psychotic disorders), Antianxiety (for anxiety disorders) and antidepressants (for depression and related disorders)
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What are medications often combined with?
Psychotherapy
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Biomedical treatments other than medication are
Electroconvulsive therapy, transcranial magnetic stimulation and psychosurgery- the last used in extreme cases, when other methods of treatment have been exhausted.
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What are three kinds of treatment illusions?
- Maybe you would have gotten better despite taking a pill
- Maybe the pill wasn't the active ingredient in your cure
- Maybe after you're better you mistakenly remember having been more ill than you really were.
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Three potential illusions of treatment
- Natural improvement
- Placebo effects
- Reconstructive memory
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Natural improvement illusion
The tendency of symptoms to return to their mean or average level, the illusion happens when you conclude mistakenly that a treatment has made you better when you would have gotten better anyway
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What is the placebo effect?
Nonspecific treatment effects can produce recovery. Just knowing you are getting a treatment can be a nonspecific treatment effect
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Placebo
An inert substance or procedure that has been applied with the expectation that a healing response will be produced
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Why is a double blind experiment so important in assessing treatment effectiveness?
So that nobody is affected by the placebo effect
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Iatrogenic illness
A disorder or symptom that occurs as a result of a medical or psychotherapeutic treatment itself.
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Observing improvement during treatment does not
Necessarily mean that the treatment was effective, it might instead reflect natural improvement, nonspecific treatment effects and reconstructive memory processes
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Treatment studies focus on
Both treatment outcomes and processes, using scientific research methods such as double blind techniques and placebo controls
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Treatments for psychological disorders are generally more effective than no treatment at all but
Some are more effective than others for certain disorders, and both medication and psychotherapy have dangers that ethical practitioners must consider carefully.
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