Psychotherapy Exam One

• who are the Hellenistic physicians?

  -hippocrates

  -leibniz

  -mesmer
• who are the clinical researchers/scientists?

  -Freud

  -carl jung
• what do clinical researchers/scientists focus on?


  focus on bridging the gap between lab research and everyday practice. We need to think of impacts of biological science conducting. Brought about analytical
• Neuroplasticity


  the brain is malleable and can adapt to different things. The brain in constantly changing due to experiences
• epigenetics


  how the environment affects our genes. Ex: addictions run in your family and you start drinking a lot. This might trigger the addiction gene
• Cultural Factors


  deals with the historical considerations at the time of the creation and will dictate how you interact/choose to treat a client. Demographics, culture, and language shape experience. Also dictates if there is a stigma surrounding mental health
• client/therapist rapport


  thought up by Mesmer; effects how one responds to therapy or treatment. this is establishing a relationship with your clients and getting to know them and making them trust you
• client's confidence in the therapeutic procedure


  the client has to trust that what the therapist is doing will help because if they don't then no change will occur. Need to have hope it will work.
• spontaneous recovery


  thought of my Mesmer. Occurs when patients just get better because some disorders wax and wane
• what is the great chain of being?


  places everyone into hierarchy (some people are better than others)
• Problematization


  we say part of the population (for whatever reason) is a problem and we discriminate)
• Explain the ways that the fields of psychiatry/psychology/psychotherapy were intertwined with eugenics, slavery, and institutionalization


  different disorders were made up to call women crazy (hysteria) and were also used to justify slavery saying black people needed to be punished and tortured for their own good. Also justified slavery by saying that slaves couldn't take care of themselves. Doesn't get abolished until the 13th amendment. Psychiatric institutions were only white and then they allowed in blacks in segregated intuitions (1800s)
• Eugenics


  certain races are better than other races. We should control reproduction so we can limit inferior races. This includes the mentally disabled. Can affect who has medical care and who doesn't, the legal justification for forced treatment, etc. also used IQ as a form of discrimination
• Drapetomania


  runaway slave disorder that should be treated with violence
• diasthesia aethiopica


  poor work ethic that should be treated with violence and forced labor
• Explain how the civil rights movement impacted psychiatric diagnoses

  Before the 60s, schizophrenia was considered a docile disorder that plagued white house wives. After the 60s, it was considered a violent disease that affected black men (hostile feelings and anti-whiteness). There was a big push to deinstitutionalize so mental health problems were now criminalized. Black men received harsher punishment, were not released on probation, more likely to b
• What is the DSM and what is it used for? How is it both necessary and limiting?


  The DSM is the diagnostic manual used by psychiatrists and others in the field to make diagnoses. The DMS allows for people in the field to easily refer to something and everyone else knows what they are talking about, like a code. However, this is limiting because disorders can look different for everyone and the DMS is like a checkbox without much wiggle room.
• diagnosis


  a collection of experiences that exist on a continuum. A product of financial situations and can affect one's autonomy
• what are other ways we can think of disorders?

  Theoretic orientation; Different reasons why people have certain distress
• How might these diagnoses be influenced by culture, and how might they impact people?

  they are influences about what is going on at the time like homosexuality was a disorder at one point because being gay was frowned upon in the 50s but now it is no longer a disorder because the LGBTQ community is more accepted in our culture. Influenced by culture and background of people writing, society at the moment, depends on who is in power, financial decisions, etc.
• Why is it important to be aware of and avoid perpetuating the stigma around mental health?


  people will not get help for their mental health disorders if there is a stigma around mental health and no one would get better
• efficacy-effectiveness gap


  efficacy describes how well something works in a perfect lab setting with few variables other than the IV and DV. The effectiveness of a product is how it will actually work in the real world and this rating will be much lower
• efficacy


  treatment worked in a controlled environment, homogeneous group (everyone is the same), narrow inclusion criteria, put through tasks you wouldn't in the real world, show cause and effect with treatment
• effectiveness


  implementation science, how do we take what works in the lab and apply it to the real world, how do we get treatments into a clinic, less rigorous than in a study, doesn't disclose anyone, priority on external validity, won't be monitored as much
• what is the difference between experimental and observational research methods?

  experimental research involves manipulation while observation is watching without manipulation
• prospective treatment assignment


  the 1st step in the research study; decide which group participants go into. Done to reduce bias
• empirically support treatments


  very strict criteria, treatment has to be tested by different research groups. Must have active control (test against another treatment), large sample sizes, support from more than one study conducted by different research groups. Need more than just a waitlist control. Subject to limitations of RCTs. May be difficult to adapt to a wide range of patients.
• manualized interventions


  details what you do at each step. ex: at step 1, you do this. In step 2 you do this.
• observational study


  watching without manipulation. you don't decide which treatment everyone gets. don't see cause and effect because you can't account for confounding variables.
• descriptive study


  only 1 group of people. Tell us if a phemonmenon is occurring in the 1st place. 1st step for research in a new area. Allows you to see prevalence and to see the natural course of something. Also allows us to see correlation. Ex: depression and when it waxes and wanes.
• analytical study


  type of observational study. Analyzes and compares one group of people to another. There is a comparison group, not control group
• cohort study


  type of analytical observational studies. treatment happens before outcomes are assessed. Useful because it shows long term effects, shows temporal precedence (what come before the other), less prone to recall bias (any bias that would make you answer something different then you would have in the moment). There are two groups: treatment and control group. Follow the groups forward in time to determine if they experience different outcomes. Limitations are cost, rare outcomes are hard to observe (hard to get a lot of people of a rare disease), and occur over a very long period of time. People may leave because it is so long, people may move away, and change their phone numbers or addresses. Ex: these people are using the call quit line for smoking, lets see how many people it works for.
• case-control study


  a type of analytical observational stuys. see the outcome then give treatment. Two groups: one with identified outcomes and one without. Start with the outcome of interest. Then get two groups of people within that outcome. Ex: people who tried to quit smoking, one who did successfull,y and one who didn't. see what treatment worked on the group that quit. Sometimes in these studie,s it is unethical to not give treatment and sometimes it is unethical to give "treatment". Assess whether there were differences in treatment exposure retrospectively using chart reviews (medical records), self-reports (ask what they did), and interviews (asking more in-depth questions). Good for rare outcomes and to save time and money since there are no long-term follow-ups. Limitations: difficult to select appropriate control groups because you want the groups to match, recall bias (make people think back on what they did), and you can not see the prevalence of the outcome, only the odds of experiencing both because ther'es no control group.
• cross section study


  type of analytical observational studies. studying different groups across time. Use one time point to assess both outcome and treatment exposure, can provide estimates of the frequency of an outcome or treatment, cannot tell you which came first, and is subject to recall bias. At one time, you ask all the questions. No temporal precedence, you just know it happened. Allows you to see the correlation between two variables but no cause and effect.
• rate


  frequency of an event in the population over a defined period of time. Ex: # of people with depression in the US who saw a therapist last year/total # of people in the US who had depression last year
• proportion


  frequency of an event without a defined time period. Ex: # of adults in the US who see a therapist/total # of adults in the US
• ratio


  number of people in one condition, relative to the number in another. Does not need to be in terms of time. Ex: # of people who attended therapy in 2022/number of people who did not attend therapy in 2022
• absolute risk


  probability of an outcome. What are the odds this happens?
• relative risk


  ratio representing how often the outcome happens in the treatment group, relative to the untreated group. Does not tell you the actual size of the risk for each group, just the amount of risk relative to one another. Just tells you something will happen, but not how much in general. Ex: people with chronic pain are 3x more likely to relapse than people without chronic pain, not overall
• odds ratio


  likelihood of membership in one group, given membership in another (also relative). Ex: if you belong to NA what are the odds you are also in AA