Psychology of Stress and Health, Exams of Psychology

Download Psychology of Stress and Health and more Exams Psychology in PDF only on Docsity! 1 Psyc 110 unit 5 notes 2023 update pass guaranteed Chapter 14: Stress & Health 1. Stress: a response that consists of tension, discomfort, or physical symptoms that arise when a stressor strains our ability to cope effectively. 2. Stressor: a situation that strains our ability to cope effectively. a. Example: an exam i. Traumatic Event: a stressor so severe that it can produce long-term psychological or health consequences. 1. Example: like a car accident 3. Hassles: minor nuisances that strain our ability to cope a. Can actually contribute more to the experience of stress than major life events b. We define hassles differently (on average) depending on our life circumstances and age. 4. What is the purpose of stress? a. Survival! b. Stress activates the sympathetic nervous system c. Fight-or-flight response: body reaches optimal physical performance & alertness i. Prepares body to respond physically 1. Example: blood pressure increases, heart rate increases, sweating 2. Optimized for survival in a physically challenging situation 5. Types of Stress: a. Eustress: good stress that motivates us and is 2 tolerable & manageable i. Example: moderate amount of stress over an upcoming final b. Distress: bad stress that is too much to bear or cope with i. Example: a lot of stress over an upcoming final paper that is interrupting your sleep & eating. 6. Yerkes-Dodson Law: a. Yerkes-Dodson Law: an empirical relationship between arousal & performance i. Performance increases with physiological or mental arousal, but only up to a point ii. When levels of arousal become too high, performance decreases iii. Inverted U-shaped relation where there’s an optimal point of arousal at the middle of the curve 7. Other Reasons Stress is Adaptive: a. Signals something is wrong with an aspect of our lives i. Example: a bad relationship, career choice, or circle of friends b. Warns us we need to slow down to avoid injury or illness c. Produces the arousal/endurance required to respond to a physical threat d. Provides sense of challenge, which may be less harmful than boredom & apathy 8. Physiological Reactions: a. Constant stress = multiple poor health outcomes b. Fight-or-Flight Response: physical & psychological reaction that mobilizes people & animals to either defend themselves (fight) or escape (flee) a 5 i. Caffeine directly stimulates several systems in the body 1. Keeps us in a chronically tense, aroused condition 6 2. Best to limit caffeine to 100mg a day d. Minimize alcohol consumption i. In excess, can lead us to more stressful situations ii. Interferes with quality of sleep e. Eat a healthy diet i. Relationship exists between diet, stress, and mood 1. What we eat can actually increase stress ii. Limit sugar & salt intake 1. Can impact blood sugar levels and blood pressure, affecting how stressed we feel f. Exercise regularly i. Reduces skeletal muscle tension that comes with stress ii. Reduces adrenaline in bloodstream (arousal) iii. Discharge pent-up frustration iv. Produces endorphins in the brain = improves mood v. Aerobic exercise 4-5 times a week = most beneficial g. Practice good sleep hygiene i. Too much sleep, not enough sleep, and/or irregular sleep schedule can affect mood & efficiency 12. Promoting health: Why do we fail to follow through? a. Personal Inertia: resistance to trying new things i. Trying new things is hard ii. Many unhealthy behaviors relieve stress in the moment iii. They do not have immediate consequences b. Misestimating Risk: often underestimate our likihood of dying due to some health behaviors vs. others i. Example: people are more afraid of flying than smoking 7 c. Feeling powerless to change habits get so deeply ingrained that we feel unable or powerless to make changes d. Prevention Programs: to prevent unhealthy behaviors often start too late-- need to start during adolescence or earlier 10 6. Mindfulness: a form of meditation bringing one’s complete attention to the present experience on a moment-to-moment basis 7. Progressive Muscle Relaxation: a technique for learning to monitor & control muscular tension by deliberately inducing & releasing tension in specific muscle groups. a. Pay attention to the contrast between the tension & relaxation b. Biofeedback: a modification of progressive muscle relaxation using external measuring devices to indicate how successful one is in relaxing 8. Ruminating: focusing on negatives & endlessly analyzing what caused problems a. Can lead us to become depressed b. Seen more frequently in women, in part due to early socialization i. Parents encourage girls to analyze & talk about their problems 1. Discourage boys from expressing feelings- encourage them to take action. ii. Men tend to focus more on pleasurable distracting activities instead iii. Mean have a more direct approach to solving their problems than women do iv. Could contribute to why women have higher rates of depression 9. Hardiness: a set of attitudes in which you… a. View change as a challenge rather than a threat b. Are committed to your life and work c. Believe you control events 11 d. Related to low levels of anxiety proneness and a general tendency to react calmly to stress 10. Optimism: hopefulness & confidence about the future 12 a. Optimistic people are: i. More productive ii. More persistent iii. More focused iv. Better at handling frustration b. Has also been related to certain physical benefits: i. Lower mortality ii. Better immune response iii. Better surgical outcomes iv. Fewer physical complaints 11.Defensive Pessimism: strategy of anticipating failure & compensating for this by mentally over-preparing for negative outcomes a. Can be helpful for people with high anxiety b. Can improve performance by encouraging one to work harder i. Example: anticipate that you are going to fail an exam so that you study harder 12. Spirituality & Religion: a. Higher levels of spirituality/religion relate to better coping b. People of faith have… i. Lower mortality rates ii. Improved immune system functioning iii. Lower blood pressure iv. A greater ability to recover from illness c. Protective against depression, anxiety, drug and alcohol abuse, sexual risk-taking behaviors, and other psychological issues d. Mechanisms: i. Prohibit risky behaviors 15 b. More options = easier to imagine that you could have made a better choice (regret) c. Too much choice can produce paralysis (don’t choose any) d. Differences in responding to large # of choices: 16 i. Satisfiers = people who pick the first option that meets a reasonable threshold ii. Maximizers = people who strongly desire picking the “best” option 1. Maximizers may become paralyzed by trying to find the best option 2. May be more prone to depression & less happy overall 17. The Hedonic Treadmill a. Out mood quickly adjusts to our life circumstances i. May expect a positive change to make us happier, but soon after we revert back to our baseline way of being 1. Example: win the lottery but feel the same after a couple of months ii. Proposes that we actually begin life with a happiness “set point” to which we will return after most events 18. Affective Forecasting: predicting our own & others’ happiness a. We’re markedly bad at guessing what is going to make us happy b. Durability Bias: overestimating the long-term impact of events on our moods such that we expect good & bad moods to last longer than they do 19. What DOES Make People Happy? a. Genetic influences b. Marriage c. friendship /Social Connections d. College e. Exercise 17 f. Gratitude g. Giving h. Religion 20. Benefits of Being Happy: 20 1. Who in society gets to define hat violations are “abnormal” in a bad way? a. Those in power a. Example: drapetomania = disorder of slaves who tried to escape from their masters 2. Norms can change over time c. Causes significant distress or impairment i. Distress = individual is concurred about the behavior or thought ii. Impairment = the behavior or thought causes problems in the person’s life 1. Functioning is impacted d. Biological Dysfunction: i. Variations in biology are seen among people with certain mental illnesses 1. Example: too little or ineffective GABA in the amygdala might be involved in anxiety disorders e. Summary: i. Clearly, there are multiple ways we define “abnormal” ii. Sometimes you know it when you see it, but other times it may be more subtle iii. “Abnormal” can vary by culture 1. The Demonic Model: odd behavior is attributed to evil spirits invading the body a. View of mental illness during Middle Ages in Europe & later America b. Treated mental illness with exorcism (still performed in Italy & Mexico) 21 2. The Medical Model: mental illness viewed as due to a physical disorder requiring medical treatment. 22 a. View of mental illness during the Renaissance i. Mentally ill housed in asylums--overcrowded & caged & chained b. Barbaric Treatments i. Bloodletting: based on idea that excessive blood caused mental illness ii. Fear: scare disease out of them 3. The Moral Treatment: approach to mental illness calling for dignity, kindness, and respect for those with mental illness a. Late 1700’s: view of mental illness in Europe and America following reform 4. The modern era a. 1950’s medication made treatment of severe symptoms possible for first time i. Deinstitutionalization: government policy in 1960’s and 1970’s releasing hospitalized psychiatric patients into the community & closing mental hospitals 1. Led to many becoming homeless & unable to function 5. Mental Disorder: A Working Definition a. Mental Disorder: behaviors or mental processes (symptoms) that cause significant distress or impairment in social, occupational, or other important areas of functioning. i. Definition ties together multiple conceptions of “abnormal” ii. No firm definition b. psychopathology: = “mind” “disease” “study of” 6. DSM: Diagnostic & Statistical Manual of Mental Disorders a. Published by the American Psychiatric Association 25 a. Tajin Kyofusho 26 i. Fear-based responses to various interpersonal situations found in Japanese cultures ii. Avoidance of social situations or extreme anxiety in social situations iii. Person fears offending others with blushing, eye contact, body deformity, or body odor iv. Somewhat similar to social anxiety disorder b. Ataque De Nervios i. “Attack of Nerves” ii. Specific to some Latino/a cultures, especially those in the Caribbean iii. Symptoms include screaming uncontrollably, crying, seizure-like behavior iv. Some overlap with panic disorder in the DSM c. Koro i. Belief that one’s penis or testicles are disappearing & receding into their abdomens & that they will die ii. Women also experience fear of receding vulva & nipples iii. Typically, in Asian countries, although occurs worldwide iv. Also known as shrinking penis & genital retraction syndrome d. Bulimia Nervosa i. Characterized by: 1. Recurrent episodes of binge-eating a. binge-eating: consumption of large quantities of food in a short period of time 2. Recurrent episodes of purging 27 a. Purging: inappropriate compensatory behaviors to prevent weight gain i. Self-induced vomiting ii. Misusing laxatives, diuretics, or enemas 30 2. Unable to appreciate wrongfulness of the act 3. Defendant must provide convincing evidence 4. “Insanity Plea” rarely works 10. Labeling Effects: a. Labeling theory: psychiatric diagnoses expert powerful negative effects on people’s perceptions of behavior i. Sometimes equated with “stigma”, but they are not the same. ii. In one study, 8 people reported hearing a voice 1. Were hospitalized for an average of 3 weeks without further symptoms 2. Normal behavior (note taking, saying they needed to go read the news) was misinterpreted as delusional iii. Different from bias people with disorders (not a myth) 11. Stigma: a discrediting attitude towards people with mental illness (form of prejudice and often discrimination) a. Perceived Stigma: experiences of actual discrimination that a person recognizes as related to their mental illness b. Stigma can lead to: i. Anticipated discrimination ii. self-stigma = internalized attitude iii. Decreased help-seeking behavior iv. Increased treatment noncompliance c. Thornicroft Et Al. (2009) i. Cross-sectional survey of experienced and anticipated discrimination against people with 31 schizophrenia in multiple countries ii. Negative Discrimination: 1. In making or keeping friends, from family members, in finding a job, in keeping a job, and in intimate or sexual relationships 32 iii. Anticipated Discrimination: 1. In applying for work, training, or education & looking for a close relationship 2. Most felt the need to conceal their diagnosis 12. Myth: Mental Illness & Violence a. Myth: people with severe mental illness are much more prone to violence i. Most patients with psychosis are not violent ii. People with severe mental disorders are more likely to be victims of violence iii. Certain symptoms may increase risk 1. Paranoid thoughts & specific command hallucinations iv. Substance abuse increases risk of perpetration among those with mental illness v. Myth is example of confirmation bias Chapter 15: Anxiety Disorders 1. Anxiety: apprehension about possible future danger. a. Cognitive i. Rumination (running through worries over & over in one’s head) b. Behavioral i. Shaking, avoidance of certain situations/stimuli c. Physical i. Sweating, heart racing, dizziness, shortness of breath 2. Panic Attacks: brief, intense episodes of extreme fear characterized by these physical symptoms & cognitions: i. Increased heart rate ii. Sweating 35 1. The excessive anxiety & worry occurs more days than not for at least 6 months AND… 2. Must have 3 or more of the following symptoms: a. Restlessness or feeling “edgy” b. Being easily fatigued c. Difficulty concentrating or mind going blank d. Irritability e. Muscle tension f. Sleep disturbance 3. Social Anxiety Disorder: a. Social anxiety disorder: fear in situations where you are exposed to possible judgement by others i. Fear of being humiliated, embarrassed, or rejected b. Common feared situations: i. Having a conversation ii. Meeting unfamiliar people iii. Being observed eating or drinking iv. Speaking or performing in front of others c. 12-month prevalence: 7% 4. Phobias: a. Phobia: an unrealistic, excessive fear of a specific object or situation that almost always immediately provokes fear i. Avoidance: object or situation is actively avoided or endured only with intense fear or anxiety ii. 12-month prevalence: 7-9% iii. Not uncommon to have multiple phobias 36 iv. 5 Categories: 1. Animal a. Example: insects, snakes 2. Natural Environment a. Example: thunderstorms 37 3. Blood-Injection-Injury a. Example: needles 4. Situational a. Example: airplanes, elevators 5. Other a. Example: Getting hair in one’s mouth 5. Post-Traumatic Stress Disorder: marked distress after exposure to a traumatic event such as a life-threatening event such as a life- threatening event, serious injury, or sexual violence i. Women at greater risk ii. Very common among veterans iii. Not everyone who experiences a traumatic event develops PTSD a. Symptoms: i. Flashbacks, dreams, intrusive memories ii. Avoidance of both external & internal reminders iii. Distorted cognitions & mood iv. Heightened physiological arousal 1. For example, exaggerated startle symptoms, sleep disturbance, reckless behavior, irritability, angry outbursts v. Symptoms must last for more than 1 month 6. Obsessive-Compulsive Disorder: a. OCD: condition marked by repeated & lengthy obsessions, compulsions or both i. At least 1 hour a day b. Obsessions: unwanted thoughts, images, ideas or impulses that cause distress or anxiety c. Compulsions: repetitive behaviors or mental acts used to manage or reduce anxiety 40 b. Initial response - classical conditioning i. Fear response classically conditioned c. Avoidance behavior - negative reinforcement i. Negative reinforcement from avoiding anxiety provoking stimulus 41 1. For example, if you avoid the bee, you remove the unpleasant stimulus (bee), reducing your anxiety a. Makes you more likely to continue to avoid bees in the future d. In PTSD, initial response is so intense that repeated pairing of the US & CS is not needed i. A stimulus is paired with a traumatic event 1. Future experiences with this event lead to the same physical, mental, and emotional response e. For example, listening to a song at the time of a car accident i. The next time you hear that song, you feel nauseous & scared (classical conditioning) ii. Turn the song off when it plays & the fear goes away (negative reinforcement) iii. Start to avoid the song & experience fewer symptoms (in the short term) iv. Remove the stimulus (the song) and feel better = more likely to avoid song in the future 8. Other Casual Theories: a. Observational Learning: people learn to develop anxiety by watching the way others react i. For example, someone is afraid of thunder storms, then the person they live with develops phobia (even the dog!) b. Misinformation: people are falsely told to be fearful of something i. For example, people used to say you could catch STIs from toilet seats & could contract HIV from 42 touching someone with the virus c. Catastrophic Thinking: predicting terrible events despite their low probability i. For example, “If I fail this exam, I’ll fail at life.” 45 3. Racing thoughts 4. Disconnected ideas 5. More talkative than usual (can’t stop talking) 6. Increased goal-oriented activity 7. Increased self-esteem or grandiosity 8. Decreased need for sleep (may stay awake for days) ii. Impulsivity: excessive involvement in activities with a high potential for bad consequences 1. Excessive shopping sprees a. For example, buying 3 cars in one day 2. Sexual indiscretions a. For example, have unprotected sex with 5 people in one week 3. Foolish business investments a. For example, invest life savings into a sudden idea they think will make them rich 4. Excessive gambling a. For example, gamble entire life savings in one day 2. Bipolar Disorder: condition marked by a history of at least one manic episode i. AKA bipolar I disorder ii. Most severe form of bipolar b. Bipolar II Disorder: condition marked by a history of hypomanic and full depressive episodes i. Hypomania = sub-manic, less intense than full manic episode c. Cyclothymia: condition marked by a history of 46 hypomanic & mild depressive episodes i. Most mild d. Multiple Causes: 47 i. Strong genetic component 1. Up to 85% heritability a. But remember that heritability refers to differences among people in a population ii. Intersection of biological, psychological, and social factors 1. Increased activity in brain structures related to emotion (amygdala) 2. Decreased activity in brain structures associated with planning (prefrontal cortex) 3. Stressful life events = increased risk of manic episodes e. Treating Bipolar Disorder: i. Medication = core element of treatment 1. Particularly mood stabilizers to stabilize mood & treat depressive symptoms 2. Often compliance is a problem. Why? a. Manic episodes can be like a high- feels so good that they don’t want it to end & don’t think anything is wrong ii. Cognitive -Behavioral Therapy 1. Can help person cope with symptoms & recognize signs of mood shift 2. Address thoughts, feelings and behaviors iii. Family - Focused Therapy 1. Teach family members about symptoms & warning signs iv. Interpersonal & Social Rhythms Therapy 50 don’t try to escape from a bad situation ii. Way people view negative events that happen to them can have an impact on whether they feel helpless or not 2. Interpersonal Factors 51 a. Excessive reassurance seeking = rejection = depression iv. Precipitating Causes (triggers) 1. Life Events a. Particularly loss - of a person, role, or self- esteem i. Can tax someone’s ability to cope & lead to depression v. Maintaining Causes 1. Same as predisposing causes: a. Biological factors b. Cognitive Factors c. Learning history/behavioral factors d. Interpersonal factors i. Therapies may target these 4. Suicide: a. Women attempt suicide 3x more than men i. however, men are 4x more likely to die by suicide. Why? 1. Man choose more violent/lethal means (guns) than women (pills) b. Suicide is a public health concern i. In 2013, 10th leading cause of death in the U.S. ii. 30,000 deaths by suicide in U.S. per year iii. Leading cause of death among college students c. Suicide risk factors i. Previous attempts ii. Depression iii. Hopelessness iv. Substance abuse v. Schizophrenia 52 vi. Loss of a loved one 55 d. Delusions: strongly held beliefs that have no basis in reality and are difficult to change i. Psychotic = reflect serious distortions in reality ii. Various Delusion themes: 1. Persecution (very common) belief you will be harmed a. For example, believe the government is reading your thoughts 2. Grandiosity belief you have exceptional abilities, wealth or fame a. For example, believe NASA wants to hire you because of your special abilities 3. Love - belief that another person is in love with you a. Can lead to stalking or performing extreme acts to impress i. For example, John Hinckley’s assassination attempt on Ronald Reagan to impress Jodie Foster iii. Delusions can occur on a continuum 1. For example, someone may begin with the pronouncement that they created a new type of YouTube video that will make them millions (grandiosity) a. Then, the same person may begin to fear people are stalking them for their technology (persecution) b. Then, they may fear people are reading their thoughts through their 56 eyeglasses (persecution) e. Hallucinations: sensory experiences without external stimulation 57 i. Psychotic = reflect serious distortions in reality ii. Cannot tell the difference between real sensory experiences and sensory experiences created internally iii. Can involve any of the 5 senses 1. Auditory is the most common iv. Command hallucinations = tell a person what to do 1. Possible risk of violence f. Disorganized Thinking: inferred from a person’s speech i. “Word salad” = when speech becomes disorganized ii. Person jumps from topic to topic without clear organization g. Abnormal Motor Behavior: i. Can be any of the following: 1. Unpredictable Agitation 2. Emotions that do not match the situation 3. Lack of self-care 4. Catatonia: motor problem that may involve the following a. Decrease in reactivity to the environment b. Rigid posture c. Holding the body in an unusual position h. Negative Symptoms: refers to a decrease in normal behaviors i. Mostly associated with schizophrenia rather than other psychotic disorders i. Decreased emotional expression ii. Decreased goal-oriented behavior iii. Decreased speech iv. Decreased social engagement 60 1. For example, traumatic event 61 b. Biological influences i. Brain abnormalities 1. Smaller volume in certain limbic structures a. Hippocampus, amygdala, thalamus 2. Enlarged Ventricles a. May be deterioration of the brain areas surrounding the ventricles i. Ventricles = fluid-filled cavities that produce cerebrospinal fluid 3. Decreased frontal lobe activation 4. Not localized to a single area a. Genes and environment lead to small changes in brain development 5. Dopamine a. Excesses associated with positive symptoms b. Deficits associated with negative symptoms c. Maintaining Causes i. Marijuana Use 1. May increase risk of disorder in the first place 2. In associated with more severe symptoms in people with the disorder ii. High expressed emotion in the family 1. More specifically, criticism, hostility, and over- involvement 2. Especially perceived lack of emotional warmth 3. May increase risk of relapse d. Common Misconception i. Schizophrenia does not mean multiple personalities 62 1. “Schizophrenia” = “split mind” NOT true 2. Multiple personalities actually refer to dissociative identity disorder 65 2. Sociocognitive Model = skeptical of the disorder & states that cultural factors or learning from psychotherapy/media about DID lead to this presentation 5. Personality Disorders: a condition in which personality traits, are inflexible, stable, expressed in a wide variety of situation, and lead to distress or impairment i. First appears in adolescence ii. Highly comorbid with other disorders b. Borderline Personality Disorder: condition marked by extreme instability in mood, identity, and impulse control i. Often self-destructive: drug abuse, sexual promiscuity, overeating, and self-mutilation common ii. Can be manipulative to draw attention & receive energy from it iii. High risk for suicide c. Psychopathic Personality: conditioned marked by superficial charm, dishonesty, manipulativeness, self- centeredness, and risk-taking i. Not a disorder d. Antisocial Personality Disorder: condition marked by a lengthy history of irresponsible and/or illegal actions i. Not overly concerned with the impact they have on others Chapter 16: Psychotherapy Treatments 1. Psychotherapy: a psychological intervention based in theory, designed to help people resolve emotional, behavioral, and interpersonal problems and improve 66 their quality of life. a. Can take different forms: i. Individual: 1 client & a therapist ii. Couple: 1 couple & a therapist iii. Family: 1 family & a therapist 67 1. Address communication, boundaries, relationships iv. Group: 2 or more people (often with a similarity in problems) with 1 or more therapists 1. Allows clients to learn from one another and to hear about other people going through similar experiences b. Differences in Approaches to Therapy i. Each theoretical approach differs mostly in what the therapist is focusing on 1. Differ in what they see as the cause of the problem 2. Differ in how they believe we can treat a problem c. Common features of Psychotherapies i. All therapies have the common features: 1. Clinical interview (intake): the therapist begins to get to know the client and what they would like to do in counseling 2. Therapeutic Alliance: the therapist is warm, empathetic, nonjudgement, and focuses on the needs of the client a. Help client gain insight into their problems b. Provide suggestions (often not directly but help explore options) c. Use of techniques to instill change 3. Most therapists integrate now (draw from many theories) 2. Basic therapy techniques: a. Attending Behavior 70 ii. Interpersonal Therapy 1. Aims to increase insight into our interpersonal patterns, conflicts, and life transactions with focus on current events 71 iii. Humanistic Therapy (Person-Centered Therapy) 1. Aims to increase insight into own emotional experience, goals and self-actualization needs with focus on current thoughts and feelings 4. Psychoanalytic Therapy: a. Cause of problem = unconscious conflicts & adverse childhood experiences i. ID and Superego are entirely or partially unconscious 1. This battle of impulses, wishes, drives, and moral edicts leads to problems in functioning ii. Also focuses on how we act in our relationships b. Focus of treatment = bring about insight using 6 key ingredients c. 6 Key Ingredients: i. Free Association: saying whatever comes to mind so that we are not censoring ourselves and can give voice to unconscious needs and desires ii. Interpretation: therapists from hypotheses from the string of free associations iii. Dream Analysis: dreams represent unconscious drives that are reflected in the client’s conscious life iv. Resistance: clients become more aware of previously feared aspects of the self and try to avoid confrontation. v. Transference: clients project intense unrealistic feelings & expectations from their past onto the therapist 72 1. Therapist may take on the role of a parent, child, or sibling 2. Considered the mechanism of change in psychoanalytic therapy vi. Working Through: therapists help clients process their problems and confront ineffective coping in real life 75 c. Qualities of the therapist: i. Genuineness ii. Non-judgmental acceptance 1. People often suffer because they learn to tie their self-worth to certain conditions (conditions of worth) 2. Therapist provides unconditional positive regard so that the person’s worth is not evaluated in relation to the situation or meeting certain conditions iii. Empathetic understanding iv. Therapist qualities are necessary and sufficient for change 7. Behavioral Therapies: therapies that focus on current problem behaviors and variables that maintain problematic thoughts, feelings and behavior a. Cause of problem = learning history b. Focus on treatment = learning new behaviors i. Uses principles of classical conditioning, operant conditioning, and observational learning to change current behaviors ii. Idea that changing behavior leads to changes in thoughts and feelings c. Systematic Desensitization: clients are taught to relax as they are gradually exposed in a stepwise manner to what they fear d. Treatment of phobias: client needs to extinguish the fear response they experience in the phobic situation and stop avoiding the feared situations i. Hierarchy of fear-produced situations 8. Cognitive-Behavior Therapies: therapy that attempts to 76 replace maladaptive or irrational thinking and behaviors with more adaptive, rational ones. a. Cause of problems = irrational or maladaptive thoughts & behaviors 77 b. Focus of treatment = replacing irrational & maladaptive thoughts & changing behaviors c. Note: these are now the most commonly practiced form of therapies. d. CBT: interplay between thoughts, behaviors, emotion e. Common Cognitive Distortions: i. Polarized Thinking: thinking in either/or extremes 1. For example, “I can either make the best cake ever for my friend’s birthday or I might as well not even try!” ii. Overgeneralization: applying one negative experience to other contexts 1. For example, “because I couldn’t win the game the first time I played, it means I am a failure without any athletic ability whatsoever.” iii. Catastrophizing: exaggerating or dwelling on the worst possible outcomes 1. For example, “if I do poorly on this exam, my life is over.” iv. Personalization: thinking that everything that others do or say is somehow directly related to you 1. For example, “that student just turned to whisper something to someone. They must be talking about something stupid I just said!” v. Shoulds: a list of rules we have about how others and we should behave or think 1. For example, “I should have given a better lecture! The students should have liked 80 a. Half of people who need therapy don’t get it i. Practical reasons 81 1. Financial (including health insurance) 2. Time ii. Stigma 1. Gender Norms: men are less likely to go to therapy 2. Religion: some religions do not believe in therapy 3. Race: people of color are more likely to be wary of therapy 5. What to Expect: Triage Appointment a. paperwork - questions about yourself on a computer b. Meet for 15 min. With a therapist to learn about your needs i. Explain confidentiality 1. No one will know that you were or anything you expect for 3 exceptions a. You may hurt yourself or someone else b. Suspected child or elder abuse c. Court order ii. Will ask about what’s been going on c. Course of treatment i. Assessment ii. Active treatment iii. Termination 6. Medication a. Medication is effective i. Works best with therapy 1. Medication does not help you change thoughts or learn to cope with situations b. Medication is safe c. Medication does not numb feelings--goal is to get you to a normal state of functioning 82 d. Works by targeting problems in brain chemistry e. Can be short-term or long-term if someone has a mental illness