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PSY 108 (52)

Beck Experiments

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PSY 108
Franklyn Prescod

- Beck gives his patients activity assignments to provide them with successful experiences and allow them to think well of themselves. But the overall emphasis is on cognitive restructuring, on persuading the person to think differently. Behavioural change by itself is not expected to alleviate depression. Mindfulness-Based Cognitive Therapy: - MBCT: been developed specifically to prevent relapse among clinically depressed people. - combines relaxation and related techniques designed to increase awareness of changes in the body and the mind with standard cognitive intervention techniques. - The key component is developing meta-cognitive awareness (i.e a sense of how cognitive sets are related to emotional feelings and vice versa.) - MBCT reduces the overgenerality of autobiographic memory. - The NIMH Treatment of Depression Collaborative Research Program: a large three site study of Beck’s CT, comparing it with IPT and pharmacotherapy, called the Treatment of Depression Collaborative Research program. - The pharmacological therapy imiparmine (tofranil) a well tested tricyclic drug widely regarded at the time as a standard therapy for depression, was used as a reference treatment against which to evaluate the two psychotherapies, the second and third treatments. - Some of the complex findings are summarised here: (** GO TO PAGE 305, read dotted points**) Social Skills Training: - Evidence supports the effectiveness of a focus on enhancing overt social behaviour by such techniques as assertion and social skills training. Psychological Treatment of Bipolar Disorder: - One problem in getting bipolar patients to take their medication regularly is that they lack insight into the self-destructive nature of their behaviour. Studies show that careful education about the disorder and its treatment can improve adherence to medication which is helpful in reducing the mood swings, bringing more stability. - Patients relapse more quickly if they return from hospital to family settings characterized by high levels of hostility and over-involvement (called ‘expressed emotion’) than if they returned to a less-charged emotional climate. - This points to the need for interventions aimed at the family and no merely at the patient. - A problem-solving approach called interpersonal and social rhythm therapy is designed to help the patient deal better with life events that trigger stress and manic episodes. - Lam outlined the common features in psych treatments for relapse prevention in BD:  Psychoeducation  Promotion of medication adherence  Promotion of regular daily routines and sleep  Monitoring of mood  Detection of early warnings and relapse prevention strategies  General coping strategies and problem-solving techniques BIOLOGICAL THERAPIES: Electroconvulsive Therapy:  ECT is being used with increased frequency in Canada and elsewhere. One reason is that when it works, it is faster than antidepressants and psychotherapy.  ECT entails the deliberate induction of a seizure and momentary unconsciousness by passing a current between 70 and 130 volts through the patient’s brain.  Electrodes were formerly placed on each side of the forehead, allowing the current to pass through both hemispheres, a method known as bilateral ECT.  Today, unilateral ECT, in which the current passes through the non-dominant (right) cerebral hemisphere only is more commonly used.  The mechanism through which ECT works is unknown. It reduces metabolic activity and blood circulation to the brain
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