Download - Cognitive Therapies
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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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Rational-Emotive Therapy “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
Social Skills Training
Token Economies
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Theoretical Orientations
Clinician's Theoretical Orientations
0 5 10 15 20 25 30 35 40 45
Eclectic
Psychodynamic
Cognitive
Client-Centred
Other
Behavioral
Existential
Family
Gestalt
% of Respondents
• 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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PsychosurgeryWalter Freeman1936 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 2/3rds 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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Efficacy of Different Therapies
0 20 40 60 80 100
% Improved More Than Control
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Evaluating Therapeutic Outcomes
Sloane et al, (1975)
0
0.5
1
1.5
2
2.5
3
3.5
Behavioural Psychodynamic Wait List Control
Seve
rity
Of S
ympt
oms
Pre Tx4 Month
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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
deinstitutionalizationAdvantages:
more cost effective improved tx in hospitals
Disadvantages: increased re-admissions lack of appropriate alternatives
results in increased # of homeless