Clinical Interviewing Final Part 3 Flashcards
(64 cards)
What is Attachment Theory?
– The behavioral and emotional responses that keep young children in close proximity to caregivers (Bowlby, 1969, 1988).
- Optimal attachment, caregivers provide a comfortable presence that reduces anxiety and promotes security
- The attachment system is disrupted when the attachment figure is unavailable
- Repeated experiences with attachment figures become organized into internal working models: mental representation of self
- Patterns: secure, anxious-ambivalent, anxious-avoidant
What is existential Psychotherapy?
- Similar to other dynamic therapies in the belief that conflicting forces govern people and have varying levels of awareness (Yalom, 1980)
- Existential concerns cause anxiety, which is combatted by defenses
What are 7 features that distinguish psychodynamic treatment (Blagys and Hilsenroth, 2000)?
1) Affect and expression of emotions are emphasized
2) Attempts to avoid distressing thoughts and feelings are explored
3) Therapists help clients identify recurring themes and patterns
4) Empathies on discussing past experiences
5) Focus on interpersonal relationships
6) Focus on the therapy relationship
7) Focus on the fantasy life
What is transference?
- Placing on to the therapist characteristics that belong to other people with whom one has unresolved issues
What is countertransference?
- Helper reaction to the client originates in the unresolved issues of the helper.
What are challenges?
- Points out maladaptive thoughts, feelings, or behaviors
What is Awareness?
- Cognizance, mindfulness, or attentiveness about behaving, thinking, or feeling in a certain way
What is Insight?
- Understanding why we behave, think, or feel in a certain way
What is the rationale for challenges?
- Raise awareness so that clients can be more intentional in their lives
- Leads clients to want to understand themselves at a deeper level
- Help clients become aware of ambivalent feelings
- Enable clients to admit to having deeper feelings than they were previously able to acknowledge
What are markers for readiness?
1) Ambivalence
2) Contradictions
3) Discrepancies
4) Confusion
5) Feeling stuck
6) Being unable to make a decision
What are the 5 types of challenges?
1) Challenges of discrepancies
2) Two-chair work
3) Humor
4) Silence
5) Challenging clients to take responsibility by changing their language
What are the Challenges of Discrepancies?
- Juxtapose two things to make the client aware of the contradiction between them:
1) Two verbal statements
2) Words and actions
3) Two behaviors
4) Values and behaviors
5) Values and feelings
6) One’s perception of self and experience
7) One’s ideal and real self
8) Helper’s and clients opinions
What is Two-Chair Work?
1) Useful for helping clients become aware of conflicting feelings or unfinished business
2) Acting out feelings feels easier and has more impact than talking about feelings
3) Client sits in one chair and tries to experience and express feelings from one side of the client.
4) The client moves the chair and talks from the other side
5) One side becomes top dog; one becomes the underdog
6) The client allows both sides to emerge and exist equally and thus integrate them both.
What is Humor?
- Helpers can identify whether clients own responsibility by listening to their language
What are the difficulties in using challenges?
- Helpers not challenging enough
- Cultural issues
- Using challenges inappropriately
- Using challenges too harshly
What is the rationale for using interpretive skills?
- Direct way of trying to facilitate insight into how clients behave, think, or feel
- Goal: helper and client work together to construct meaning
What are interpretations?
- Goes beyond what a client has overtly stated or recognized and presents a new meaning, reason, or explanation for behaviors, thoughts, or feelings so clients can see problems in a new way.
What are Interpretation types?
1) Making connections between seemingly isolated statements or events
2) Pointing out themes or patterns in a client’s behavior, thoughts, or feelings
3) Explicating defenses , resistance, or transference
4) Offering a new framework or explanation to understand behaviors
What are the psychoanalytic theory of Interpretations?
- Interpretations are the “pure gold” of therapy
- They replace unconscious processes with conscious ones
- Early childhood serves as a template and is often the focus of interpretations
- Interpreting the transference
What did Levy (1963) argue?
-Interpretations reveal discrepancies between the therapist’s and the client’s views:
- The client can change the direction of the helper’s viewpoint
-The client can try to change the helper’s mind
- The client can discredit the helper
What did Strong and Claiborn (1982) Say?
- If clients view the helper as expert, attractive, and trustworthy, clients are more likely to change in the direction of the helpers interpretation.
What are the Cognitive Psychology perspective on Interpretations?
- All thoughts, feelings, memories, and actions are stored in schemas
- Helpers attempt to change the structure of schemas
- Action and behavior change may be necessary to consolidate the schematic changes
What is the Narrative Therapy perspective on Interpretations?
- We rewrite our stories in more productive ways in the helping process
- Helpers work with clients to tell their narratives
- Challenges used to disrupt problematic narratives
- Interpretations: help clients rewrite their narratives and think about concerns in new ways
What is Core Conflictual Relationship Theme (CCRT)?
- Clients have wishes/ needs (to control others)
- Clients expect consistent responses from others (Submission)
- Clients consequently have a response from the self (depressed)
