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Psychotherapy
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clients
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Marital Status
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Age
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Education
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Insurance
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Type of Disorder
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Psychotherapy therapistssts psychologist PhD with clinical training clinical vs counselling psychiatrist MD with clinical internship others
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Insight Therapies Psychoanalysis free association dream analysis interpretation resistance transference Modern Psychodynamic Therapy
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Client-Centred Therapy Carl Rogers non-directive incongruence therapeutic climate genuineness unconditional positive regard empathy therapeutic process
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Gestalt Therapy Fritz Perls developed 1950s figure-ground relationships skillful frustration role playing
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Cognitive Therapies
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Albert Ellis Rational-Emotive Therapy catastrophic thinking ABC model activating event belief system consequence
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Rational-Emotive Therapy
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“D” component of the model detecting instances of catastrophic thinking disputing irrationality of this thinking
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Beck’s Cognitive Theory depressives: blame setbacks on themselves focus on negative events unduly pessimistic make overly negative evaluations
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Behavioural Therapies General Principles behaviour is the product of learning what has been learned can be unlearned Systematic Desensitization Wolpe, 1950’s based on classical conditioning phobias relaxation training anxiety hierarchy
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Anxiety Hierarchy
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Behavioural Therapies Exposure Therapies Flooding Implosion Aversion Therapy UCS (Drug in Alcohol) UCR (Nausea) CS (Alcohol) CR (Nausea)
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Behavioural Therapies Social Skills Training Token Economies
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Theoretical Orientations eclecticism
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Biomedical Therapies Psychosurgery Golz - 1890 Burkhardt - 1892 Jacobsen - 1935 lobotomy (lobe-cutting) Dr. Antônio Egas Moniz - 1936 leukotomy (white matter cutting)
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Psychosurgery Walter Freeman 1936 initial procedure Freeman-Watts Standard Procedure prefrontal lobotomy cingulotomy “ice-pick” lobotomy (1945) 18,000+ between 1939 & 1951 1949 Nobel Prize
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Psychopharmacotherapy Antianxiety drugs e.g., Valium, Xanax, BuSpar
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Psychopharmacotherapy Antipsychotics e.g., Thorazine, Haldol side effects tardive dyskinesia Antidepressants tricyclics MAO inhibitors selective serotonin reuptake inhibitors (SSRIs) Prozac, Paxil, Zoloft
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Psychopharmacotherapy Lithium tx for bipolar mood disorder
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Electroconvulsive Therapy (ECT) 70-120 volt AC 1-3 times/week 2-4 weeks side-effects total amnesia retrograde amnesia anterograde amnesia
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Evaluating Therapeutic Outcomes Eysenck’s (1952) criticism 2/3 rds spontaneous remission same as success rate later spontaneous remission revised to 30% meta analysis (Smith, 1980) people who were treated were better off than 80% of non-treated
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Evaluating Therapeutic Outcomes
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Changes in Treatment of Disorders Community Health Movement local, community-based care reduced reliance on hospitalization focus on prevention deinstitutionalization
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Changes in Treatment of Disorders deinstitutionalization Advantages: more cost effective improved tx in hospitals Disadvantages: increased re-admissions lack of appropriate alternatives results in increased # of homeless
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