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Cognitive Therapies

Cognitive Therapies. Albert Ellis. Rational-Emotive Therapy catastrophic thinking ABC model activating event belief system consequence. Rational-Emotive Therapy. Rational-Emotive Therapy. “D” component of the model detecting instances of catastrophic thinking

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Cognitive Therapies

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  1. Cognitive Therapies

  2. Albert Ellis • Rational-Emotive Therapy • catastrophic thinking • ABC model • activating event • belief system • consequence

  3. Rational-Emotive Therapy

  4. Rational-Emotive Therapy • “D” component of the model • detecting instances of catastrophic thinking • disputing irrationality of this thinking

  5. Beck’s Cognitive Theory depressives: • blame setbacks on themselves • focus on negative events • unduly pessimistic • make overly negative evaluations

  6. 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

  7. Anxiety Hierarchy

  8. Behavioural Therapies • Social Skills Training • Token Economies

  9. Theoretical Orientations • eclecticism

  10. Biomedical Therapies • Psychosurgery • Golz - 1890 • Burkhardt - 1892 • Jacobsen - 1935 • lobotomy (lobe-cutting) • Dr. Antônio Egas Moniz - 1936 • leukotomy (white matter cutting)

  11. Psychosurgery Walter Freeman 1936 initial procedure • Freeman-Watts Standard Procedure • prefrontal lobotomy • “ice-pick” lobotomy (1945) • 18,000+ between 1939 & 1951 • 1949 Nobel Prize • cingulotomy

  12. Psychopharmacotherapy • Antianxiety drugs • e.g., Valium, Xanax, BuSpar

  13. Psychopharmacotherapy • Antipsychotics • e.g., Thorazine, Haldol • side effects • tardive dyskinesia • Antidepressants • tricyclics • MAO inhibitors • selective serotonin reuptake inhibitors (SSRIs) • Prozac, Paxil, Zoloft

  14. Psychopharmacotherapy • Lithium • tx for bipolar mood disorder

  15. Electroconvulsive Therapy (ECT) • 70-120 volt AC • 1-3 times/week • 2-4 weeks • side-effects • total amnesia • retrograde amnesia • anterograde amnesia

  16. 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

  17. Evaluating Therapeutic Outcomes

  18. Changes in Treatment of Disorders • Community Health Movement • local, community-based care • reduced reliance on hospitalization • focus on prevention • deinstitutionalization

  19. Changes in Treatment of Disorders deinstitutionalization Advantages: • more cost effective • improved tx in hospitals Disadvantages: • increased re-admissions • lack of appropriate alternatives results in increased # of homeless

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