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Psychotherapy (Chapter 19)
Second Lecture Outline:
Drug therapiesBehavior therapy
Cognitive-behavioral approaches
Psychotropic drug therapies
• Antipsychotic drugs: Phenothiazines– Cloropromazine: Block’s dopamine reuptake
• Antidepressant drugs: MAO Inhibitors and tricylics (e.g., Prozac)– increase serotonin & norepinephrine in synapse
• Barbituates and Benzodiazepines– valium, librium: relax muscles and tranquilize– barbituates: CNS depressant, addictive, lethal
• Concerns: Side effects, toxicity, latency
Behavior therapy
• Treatment of symptoms, objective behaviors, scientific methods – single subject designs
• Counterconditioning: stimulus response is replaced by alternative response– Aversion therapy: e.g., anta-abuse – Systematic desensitization: Relaxation paired with
gradually more threatening images and experiences, e.g., dog phobia, sex therapy
Behavior therapy (continued)
• Extinction procedures– Flooding: Exposure to threatening stimuli, e.g., fear of
flying– Implosion therapy: Imagine you are confronted with
very threatening stimuli
• Operant conditioning– token economy: earned tokens based on a system of
rewards and punishers– behavioral contract: e.g., gain weight to earn privilege
Modeling
• People can learn adaptive behaviors by having them modeled
• Age, credentials, similarity of the model is important
• Example: Social skills training videotapes function by having appropriate behavior demonstrated
• Example: Parent training with “bug in the ear”
Behavior Therapy
Begin with comprehensive assessment, using BASIC ID diagnosis
Behavior - Overt behaviors and habitsAffect - Emotions, moods, strong feelingsSensation - The five senses, unpleasant sensations, aches,
pains, dizzinessImagery - how does client view self, dreams and memoriesCognition - Insights, philosophies, ideas judgments
Interpersonal relationships - interactions with other people Drugs / biology - Drugs, prescription, non-prescription,
health and nutrition, concerns about health
Cognitive-Behavioral Approaches
• Clients change their behavior by changing their cognitions
• Goal: change how people think about things
• Rational-emotive behavior therapy– Cognition precedes emotion and irrational
thoughts therefore cause emotional distress– “I need to be a perfect student”– Therapist needs to challenge irrational cognitions
Cognitive-Behavior (video 101)
• Cognitive Therapy of Beck– Maladaptive schemas need to be changed because
they interfere wth your life
• Stress Inoculation Training– Stress management., adaptive cognitions, how did I
do?
• Social Problem Solving – Identify problem, choose alternatives, choose,
implement, evaluate outcome