Sadock & Sadock Psychotherapies

Discussion question

A.
1). After reviewing chapter 35 of Sadock & Sadock Psychotherapies, pp 924-975, please pick 2 therapies you believe you?d be good at or feel aligned with, give a BRIEF description of them, tell us what they treat and why you?d be good at that style/technique/or setting. Name one you feel you may not be great at or need to improve on, describe it, and tell us what it treats and why you struggle with it.
2). Conceptualize relapse prevention from Beck?s CBT basics and beyond.
3). Do some basic Research and name 2 training institutes in NYC where we could further develop our therapeutic techniques post graduation. You do not have to stick with CBT for this one.
B.
1. Describe the four stages of treatment ?in Dialetical Behavioral Therapy
2. What is more effective in treatment of Borderline Personality Disorder: Pyschothearpy or Psychopharm? You must choose one and explain why.
3. Do mood stabilizers play a significant role in treatment of BPD?
4. What are the two primary traits found in a patient with underlying BPD (see article by Paris)
5. Explain why a patient with BPD should or shouldn’t be hospitalized by their outpatient care provider when self-harming behaviors are evident.
C.
Question #1
Can a person be diagnosed with both schizotypal personality disorder and borderline personality disorder at the same time? Is this possible? Explain your reasoning.
?Question #2
Carlat discusses two strategies for assessing personality disorders. Which strategy do you prefer? Give examples of some of the probing questions you would use for the particular strategy you prefer. ?
?Question #3
Review how conventional antipsychotics and atypical antipsychotics interact differently with D2 receptors, be sure to include in the terms teeth and hit-and-run!
D.
1.???? Please list the antidepressant classes and How do you choose an antidepressant? (Stahl, chapter 12)
?
2.???? What are the symptom-based algorithm for antidepressants (positive or negative affect)? (Stahl, chapter 12)
?
3.???? Please describe the presentation of anxiety and depressive disorders in elderly. What are the guiding principles for prescription to the elderly? What are the general non-pharmacologic treatment and interventions in the older population? (Journal of the American Psychiatric Nurses Association)
E.
1) Describe how the sleep/wake switch is regulated by the neurotransmitters Histomine from the tuberomammillary nucleus (TMN) and GABA from the ventrolateral preoptic (VLPO)?

2) Describe the difference between a)Primary Insomnia b)Psychophysiological Insomniac and c) Idiopathic insomnia.

3) What is an Automatic Thought? What are some of the characteristics of automatic thoughts? What do you feel are some of your own automatic thoughts?

F.
1) With anxiety disorder, the aim of cognitive-behavioral therapy is to help the client reframe and identify the negative thinking patterns (cognitive distortions) and irrational beliefs that contribute to their anxiety, restructuring them with functional realistic cognitions.Through the use of guided discovery, you as a therapist, will ask your client a series of questions that will guide them towards identifyingand challenging their maladaptive thoughts.
Please give (1) example of a question used during guided discovery for each of the following anxiety disorders.
PTSD:” Hearing loud noises reminds me of when I was in combat?
GAD: ? I worry about everything when my children go to school, what if they are in the playground and they get kidnapped, or they fall and have a head injury, or worst die?
Phobia (Public speaking):?I get so nervous that I can?t stop thinking about how nervous I feel and how everyone is staring at me, and how foolish I must look.??
Agoraphobia:”What if I drive to NYC and Then I get stuck in traffic on the GWB and I’m stuck there and I can’t get back home again.”
Panic disorder:?I’ve felt like I was going to have a heart attack?.
OCD: ?If I am not careful enough, I could contract AIDS at work and make my baby sick. I wash my hands repeatedly with hot water until it feels ?just right??.
2) As discussed in Judith Beck?s book, one of the principles of CBT is its structure. It is emphasized that adhering to the recommended therapy format will guide the therapist to meet the goals established and make the process of therapy understandable to the client. Understanding the process of CBT will facilitate the likelihood that the client will become competent and confident in becoming their own therapist.
Please briefly describe and give an example of the three structured components of the CBT therapy session.
?3)Describe why homework is essential for the success of CBT and give an example of a homework assignment that would be appropriate for client diagnosed with Social Phobia (anxiety).
?4) What are the components of the Cognitive-Behavioral Case Formulation?
G.
1) Panic disorder can have many differential diagnoses to rule out including medical and mental disorders. What are some of the specific characteristics of panic disorder that differentiates it from these other disorders?
2) How would you approach questioning in a psychiatric interview with a client who complained of experiencing excessive anxiety for the past 6 months? What information would be important to obtain to formulate a diagnosis?
3) What is the function of the HPA axis in PTSD? OR Discuss how alpha-1 antagonists are useful in clients with PTSD
H.
According to the readings an adjustment disorder is considered one of the subthreshold disorders which are less well defined and share the characteristics of other diagnostic groups.Does this appear to make the turmoil anguish and suicidal potential for these patients any less important?
The DSM IV describes adjustment disorder as a maladaptive reaction to an identifiable psychosocial stressor that occurs within 3 months after the onset of that stressor.Do you feel the definition of maladaptive reaction is potentially too broad? Could this maladaptive reaction differ depending on race,ethnic background,and culture of either the patient or psychiatrist?
According to Stahl do antidepressants work in the same way over the entire life cycle span?Why do adolescents need to be payed particular attention to?

I.
1 (A):? A high functioning (and highly educated) client you are treating for depression asks, “How do SSRI’s work?? I know they increase Serotonin levels, but I’m interested in learning more.”? Assume the client has a master’s degree in the science field.???
1 (B):? A low functioning client with no education and chronic??schizophrenia (disorganized type)?asks, how does?my?Risperdal work???Is it?changing my brain?? Isn’t that bad for me and my thinking????
2.? As Stahl discusses, the former hypothesis that abnormal genes (genotypes) cause specific phenotypes (i.e.- DSM disorders) is no longer considered valid.? Discuss why this hypothesis is no longer thought to be valid and what is meant by the new hypothesis regarding endophenotypes.? How might this impact our clinical practice/treatments?
3.? Describe the differences between agonist, partial agonist, antogonists, and inverse agonists.??Why is it important to understand this concept (clinically speaking)????

J.
1. Discuss why antihistamine medications can be useful in prescribed treatment and give some of its beneficial effects.
2. How can the sleep-wake cycle contribute to Mental Illness ?
3. Briefly describe how Dopamine receptor antagonists work and give an example of what they are used to treat.

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