Therapeutic Approaches in Psychology: A Comprehensive Overview, Exams of Nursing

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INDIVIDUAL THERAPIES & THERAPISTS: - ✅Psychoanalytical - FREUD Cognitive - AARON BECK Behavioral - ARNOLD LAZARUS Dialectical Behavioral - Marsha Linehan Existential - Victor Frankl Humanistic - Carl Rogers Psychoanalytic Therapy - Freud - ✅Originated by Sigmund Freud who believed that behavior is determined by unconscious motivations and instinctual drives

2. Promotes change through the development and psychodynamic factors which shape present behaviors Cognitive Therapy - Aaron Beck - ✅1. Events do not cause anxiety and maladaptive response are the individuals expectations, perceptions, and interpretations of these events that cause anxiety
3. Allows people to view reality more clearly through an examination of their central distorted cognitions
4. Goal is to change the clients irrational belief and faulty conceptions and negative cognitive distortions Behavioral Therapy - Arnold Lazarus - ✅focuses on changing maladaptive behaviors by participation in active behavioral techniques such as exposure, relaxation, problem solving and role playing Dialectical Behavioral Therapy - Marsha Linehan - ✅Used w/Borderline personality disorder Focus is emotional regulation, tolerance for distress, self-mgmt. skills, interpersonal effectiveness, mindfulness with emphasis on treating therapy interfering behaviors. Goals- decrease SI,decrease therapy interfering behaviors decrease emotional reactivity, self-invalidation, crisis-generating behavior, active passivity increase realistic decision making increase accurate communications of emotions Existential - Viktor Frankl - ✅Philosophical approach in which reflection on life and self- confrontation are encouraged. Emphasizes accepting freedom and making responsible choices. States that a basic dimension of humans includes finding meaning and purpose in life, "why am I here" and "what is my purpose" goals are to live authentically and to focus on the present and on personal responsibility.

Humanistic - Carl Rogers - ✅AKA person centered therapy (unconditional positive regard) concepts include self directed growth and self-actualization people are born with the capacity to direct themselves to self actualization. EMDR - Francine Shapiro - ✅eye movement desensitization and reprocessing is a form of behavioral therapy. It integrates the use of rhythmic eye movements to treat traumatic stress and memories common in PTSD 3 Phases: desensitization, installation, body scan. EMDR Desensitization - ✅visualize trauma, verbalize negative thoughts remain attentive to physical sensations. This process occurs for a limited time while the person maintains a rhythmic eye movement he or she is the instructed to block out negative thoughts to breath deeply and to verbalize what he or she is thinking, feeling, or imagining EMDR installation - ✅the person installs and increases strength of positive thought that her or she has declared as a replacement for the original negative thought EMDR body scan - ✅the person visualizes the trauma along with the positive thought and then scans his or her body mentally to identify any tension within Irvin Yalom Group therapy - ✅Was the first person to put theoretical perspective on group work and identified 10 curative factors Irvin Yalom group benefits - ✅Increase insight about oneself Increase social skills Is cost effective Develops a sense of community Irvin Yalom 10 curative factors - ✅1.Instillation of hope 2.Universality

3. Altruism
4. Increased development of socialization skills
5. Imitative behavior
6. Interpersonal learning
7. Group cohesiveness
8. Catharsis
9. Existential factors
10. Corrective refocusing Yalom- instillation of hope - ✅Participants develop hope for creating a different life. Members are at different levels of growth and thus gain hope from others that change is possible.

Yalom-Universality - ✅Participants discover that others have similar problems thoughts or feelings and that they are not alone Yalom-Altruism - ✅This results from sharing oneself with another and helping another Yalom-Increased development of socialization skills - ✅New social skills are learned and maladaptive social behaviors are corrected. The group can provide a natural laboratory Yalom-imitative behaviors - ✅Participants are able to increase their social skills by imitating others Yalom-Interpersonal learning - ✅Interacting with others increases adaptive personal relationships Yalom-group cohesiveness - ✅Participants develop an attraction to the group and members as a sense of belonging Yalom-Catharsis - ✅Participants experience catharsis as they openly express their feelings which were previously suppressed Yalom-existential factors - ✅Group enable participants to deal with the meaning of their own existence Yalom-Corrective refocusing - ✅Participants reexperience family conflict in the group which allows them to recognize and change behaviors that may be problematic GROUP THERAPY Irvin Yalom - ✅Group Phases Pregroup Forming Storming Norming Performing Adjourning Pregroup - ✅the leader considers the framework of the group: purpose goals membership criteria membership size pregroup interview informed consent Forming - ✅members are concerned about self disclosure and being rejected. Boundries established. Development of trust & rapport

Storming - ✅members are resistant and may begin to use testing behaviors. Issues related to inclusion, control, and affection begin to surface. Leaders task is to allow expression of both positive and negative feelings, assist the group in understanding the underlying conflict and examine non productive behaviors Norming - ✅resistance to the group is overcome by members. A strong attraction to the group and others emerges. Open and spontaneous communication occurs and the group norms are established Performing - ✅the group's work become more focused. There is creative problem solving, and solutions begin to emerge. Experiential learning takes place. Group energy is directed toward completion of goals Adjourning - ✅preparation is being made to end the group. Both members and leaders express their feelings about each other and termination. A discussion and overview of what has been learned as well as what issues will still need to be worked on take place. REMINISCENCE THERAPY - ✅Elderly, lets them search for meaning and get resolution of past conflicts (General) Family System Concepts (vs. Bowens Family Systems Therapy) - ✅System - any unit based on feedback - the family Family System - how members operate together Family System Theory based on idea that one can't understand a member/part w/o understanding how all family members operate together (system) Family rules could be overt or covert Boundaries - barriers that protect & enhance functional integrity of families, individuals & subsystems Boundaries types: Clearly defined - maintain individual separateness; emphasizing belongingness Rigid/inflexible - lead to distant relationship & disengagement Diffuse - blurred, indistinct, lead to enmeshment Circular Causality - ✅Family system concept Ongoing feedback loop; actions & reactions that maintain a problem Pts & problems best understood via relationships & interactions in entire family Family Homeostasis - ✅Family tendency to resist change to keep a steady state Morphogenesis - ✅Family tendency to adapt to change when change is needed Morphostasis - ✅Family tendency to remain stable in the midst of change. FAMILY SYSTEMS Therapy - Originator - ✅Murray Bowen

Family Systems Therapy Gist & Goal - ✅Pt's problematic behavior serves a purpose for the family or is a symptom of dysfunctional patterns. -Focus on chronic anxiety in family Goal: increase family member's awareness of their function w/in family and to increase self-differentiation. Self-differentiation (Family Systems Therapy) - ✅the level where ones sense of self worth is not dependent on external relationships or circumstances. Family Systems Therapy concepts - ✅Triangles Nuclear family emotional system Multitransmission process Family projection process Emotional cutoffs Sibling position STRUCTURAL FAMILY THERAPY Originator - ✅Salvador Minuchin Structural Family therapy Gist, & Tx Goals - ✅Focus on how members relate to each other in order to understand & then change family's structure. An individual symptoms are rooted in family transaction patterns and reflects on the health of whole family. Goal: Make structural change in family to manage problems - change transactional patterns & family structure. Family Structure - ✅invisible set of demands that set up how members react w/ each other Subsystems (marital, parental, siblings) Coalitions (2 members against 3rd) Boundaries Structural mapping - ✅Structural Family Therapy (Genogram) to represent over- involvement,conflict or coalitions Hierarchies - ✅Structural family Therapy Distribution of power EXPERIENTIAL THERAPY Originator - ✅Virginia Satir Experiential Therapy Gist & Goals - ✅Bx decided by personal experience - NOT by external reality Focus on being authentic, freedom of choice, human validation, experiencing the moment. Goals: to develop authentic, nurturing communication, increased self-worth of each family member Goal is overall growth vs. symptom reduction alone

No particular techniques Strategic Therapy Originator - ✅James Haley METAPHORS!!!! Strategic Therapy Focus, Interventions, Goals - ✅Sxs as metaphors; show problem in hierarchy;Sxs are way to communicate metaphorically Goal: help members behave so as not to perpetuate problem bxs Interventions problem-focused/sx focused (more than structural therapy which says to change the structure & transactional patterns) Techniques change the sequence of interactions that is maintaining the problem Strategic Therapy Straightforward Directives - ✅Tasks designed when the family member is expected to be compliant Strategic Therapy Paradoxical Directives - ✅Negative task assigned when members resist change and member is expected to be noncompliant Strategic Therapy Reframing Belief Systems - ✅Problem bxs relabeled w/ more positive meaning (jealousy to caring) Solution Focused Therapy - Originator - ✅deShazer, O'Hanlon, Berg Solution Focused Therapy Focus, Tx - ✅Rework for the present old solutions that worked Goal: Fix problems by cognition, personal strengths Solution-Focused Therapy Techniques/Questions (3) - ✅Miracle questions: If a miracle were to happened what will be different? Exception finding questions: Was there a time when the problem did not occur? Scaling (1-10) questions Omega-3 Fatty Acids - ✅ADHD, dyslexia, cognitive problems, cardi vascular disease, asthma, lupus, rheumatoid arthritis Interacts w/ Coumadin - increases anti-coagulant effect. stop b/4 surgery Sam-e - ✅Depression, OA, liver disease But - can cause hypomania, hyperactive muscles, possible serotonin syndrome Tryptophan - ✅Depression, insomnia, HA's, fibromyalgia, obesity High in turkey **More risk of serotonin syndrome w/ SSRI's, MAOI'S, SJW (St. John's Wort) Vitamin E - ✅Enhances immune system, protects against free radicals Use for neuro d/o's, premenstrual, diabetes Interacts w/ Coumadin - increases anticoag effect

Interacts w/ antiplatelets, statins - additive effect, rhabdomyolysis 2 herbals that interact w/ Coumadin and increase anti-coagulant effect - ✅Omega-3 fatty acids and Vitamin E (& maybe fish oil) Melatonin - ✅Insomnia, jet lag, shift work, cancer Sets circadium rhythm, seasonal responses Interacts w/ aspirin, NSAIDS, BB's, steroids, valerian, kava kava, ETOH Inhibits ovulation if take alot Fish Oil - ✅Bipolar, HTN, lower triglycerides, decrease blood clotting Maybe interact w/ Coumadin, ASA, NSAIDS, garlic, ginkgo Maybe change glucose regulation Herbals & pregnancy or lactation? - ✅Most herbals secreted in breast milk - avoid in pregnancy, CONTRAINDICATED in lactation Black Cohosh - ✅menopausal symptmos, premenstrual syndrome and dysmenorhea, Belladonna - ✅Anxiety Catnip - ✅Sedation chamomile - ✅Sedation and anxiety Ginkgo - ✅sexual dysfunction d/t SSRI; delirium/dementia Ginseng - ✅depression, fatigue Valerian - ✅A mild sedative Complementary and alternative therapies (CAMS) - ✅1.Complementary therapies: used in addition to traditional medicine

2. Alternative therapies: used in place of traditional medicine
3. Integrative therapies: term use to describe the use of traditional complimentary therapies. Complementary and alternative therapies (CAMS) - ✅meditation biofeedback & yoga. aromatherapy, herbals, vitamins massage and accupuncture