Meichenbaum

Self talk

CBT Levels of Thought

1. Core beliefs

2. Assumptions

3. Strategies

4. Automatic Thoughts and Images

Beck and the Cognitive Triad

1. Negative self esteem

2. Negative view of the world

3. Pessimistic view of the future

"I'm no good, the world sucks, and it's not going to get better"

Ellis' 3 types of irrational beliefs

1)I must be competent and achieving and I must win the approval of important people.  I am a rotten person when I don’t achieve and don’t win the approval of others.

Beck's Stages of Therapy

1. Initial stage-- build relationship, distinguish between thoughts and feelings, define problem. Therapist is involved

2. Middle stage-- get patient to identify automatic thoughts, examine underlying core beliefs or schemas, patient assumes responsibility for identifying problems and solutions

3. Later stage-- patient is able to solve problems without therapist and deal with setbacks

CBT is effective with...

Eating disorders, depressions, panic disorders, phobias, OCD, PTSD, marital problems, GAD & SUDs

Negative practice

Deliberately doing something so that it becomes under concious control. Ex. facial ticks

Metacognition

Thinking about your thinking

Albert Bandura

Social Cognitive Theory (ex. Bobo doll)

Behavioral Activation

Patient engages in behaviors to test negative cognitions (Ex. study abroad girl)

Cognitive Rehearsal

Thinking about and planning all needed steps to complete a goal

Integrative Behavioral Family Systems Approach

Teaches couples to make arguments less hurtful by helping partners accept differences

Major Goals of Couple Therapy

1. Reduce anger and blame

2. Increase communication

3. Facilitate problem solving skills

Diekurs

Opened child guidance clinics in 1952

Murray Bowen

Saw families as systems, having well self-differentiation is key, detriangulation, emotional cutoff, projection process, societal emotional process, genograms

Virginia Satir

Family members have roles and rules, self-esteem basis of family health, congruence--whether words accurately math feelings, 2 kinds of systems--hierarchal and organic & seed model, temperature taking

Satir's Defensive Stances

1. Placating

2. Blaming

3. Distracter

4. Rational analyzer

Carl Whitaker

Salvador Minuchin

Focus on the present, major dysfunctional family systems: disengagement & enmeshment, takes sides, intensity, unbalancing, complementarity, restatement

Learning

A relatively permanent change in behavior due to experience

Behaviorism

Emphasizes study of observable behavior and the role of the environment as a determinant of behavior

Conditioning

The association between environmental stimuli and responses to the organism's responses

Classical conditioning

The process by which a previously neutral stimulus elicits a response through association with a stimulus that already elicits a simular response

Higher order conditioning

A previously neutral stimulus with new reinforcing qualities, can condition another neutral stimulus

(ex. paystub and money)

Stimulus discrimination

Learn to inhibit responses from a similar stimuli (ex. dog only responding to owner's whistle)

Response generalization

Emit range of similar responses to one stimulus (ex. party)

Extinction

A non-reinforced response results in the weakening and eventual disappearance of the response

Habituation

Repeated exposure results in no response

Spontaneous recovery

After a period of time has passed after extinction, a relapse may occur which shows that the organism has not unlearned the response

Thorndike's Law of Effect

Behavior that is followed by a satisfying state of affairs is likely to be repeated

Reinforcement

A stimulus that follows a response strengthens the response or increases the probability of the response

Extrinsic Reinforcers

Reinforcers that are not inherently related to the activity being reinforced

Intrinsic Reinforcers

Reinforcers that are inherently related to the activity being reinforced

Exposure therapies use principles of:

1. Extinction

2. Prevention of escape or avoidance

3. Reciprocal inhibition

Systemic desensitization

Pairing of an anxiety provoking stimulus with a relaxation response. Idea is that you can't be scared and relaxed at the same time

Francine Shapiro

Developed eye movement desensitization and reprocessing (EMDR)

Flooding

Massive exposure to fear stimulus with no escape.

Wolpe demonstrated this by locking patient with a car phobia in a car and driving her around until her fear was gone.

Covert sensitization

Imagined punishment

Most commonly used illicit drug

Marijuana

Binge drinking/Heavy drinking

Men--5 or more drinks
Women--4 or more drinks

5 or more binge episodes in past month

# of new drug initiates a day

8,000

Dependence

Continued substance use despite knowledge of having a persistent or recurrent psychological or physical problem caused or exacerbated by use. Manifested by three or more of the following at any time in a year:

Tolerance

Withdrawal

Difficulty controlling use

Neglecting or postponing activities

Spending time getting/using/hiding drug use

Inability to quit

Experiencing negative consequences and can't stop

Abuse

• Continued use despite social or interpersonal problems

• Repeated use resulting in failure to fulfill obligations at work, school, or home

• Repeated use resulting in physically hazardous situations

• Use resulting in legal problems

Medications that help with withdrawal

Agitation and anxiety-- benzos (xanax)

Sleep-- antidepressants (trazodone & remeron)

Sleep & hypomania-- antipsychotic (seroquel) & anti sezuire (clonidine)

Primary, secondary, tertiary gain

Primary: Anxiety that converts to physical problem (ex. conversion disorder)

Secondary: sympathy, getting out of school or work, etc.

Tertiary: pleasing the doctor by being unusual case, giving them extra money, etc.

Munchausen syndrome & Munchausen syndrome by proxy

Pretending to cause illness or intentionally causing harm to oneself to fulfill deep emotional needs

By proxy: making child sick

Antidepressants

Tricyclics (TCA's)-- older & cheaper, can also work for OCD, ADHD, enuresis and pain

Monoanine oxidase inhibitors (MAOI's)-- older & rarely used, have to avoid foods such as meet, cheese, beer and wine which can elevate blood pressure

Selective serotonin reuptake inhibitors (SSRI's)-- Zoloft, paxil, prozac, celexa, lexapro. Minor side effects

Selective serotonin/norepinephrine reuptake inhibitors (SSNRI's)-- trazodone, remeron, cymbalta. Zyban is the same as wellbutrin but marketed for cigarette cessation

Anxiolytics

Benzos include valium, xanax, ativan and klonopin. Also help with alcohol withdrawal. However they are not preferred anti anxiety medication because they're less effective and higher abuse rates than SSRIs.

Antipsychotics

1st generation: haldol, prolixin (side effect-tardive dyskinesia) thorazine and mellaril (less side effects)

2nd generation: zyprexa and clozaril (reduces negative symptoms of psychosis)

3rd generation: risperdal, seroquel, geodon and abilify (few side effects)

Bipolar disorder treatment

Lithium (mood stabilizer), anticonvulsants which increase GABA in the brain (related to seizures and works on inhibitory synapses)

ADHD treatment

Amphetamines (concerta, adderall, dexedrine, focalin, strattera)

Electroconvulsive Therapy (ECT)

Electric currents are passed through brain triggering a brief seizure. Used for people with severe depression, psychosis, suicidal intent, refusal to eat, mania and schizophrenia. Side effects such as confusion, memory loss (may be desired effect) and physical issues such as nausea, headache or vomiting

Methadone

Used for treatment of heroin abusers