Clinical Psych Flashcards
(112 cards)
1
Q
Assumptions of Psychodynamic therapies
A
- behavior is motivated by unconscious processes
- emphasis on early development
- universal principles explain personality devel
- increasing insight into unconscious processes
2
Q
Freud’s Theory of Personality
A
based on 2 theories
- structural theory-personality has 3 structures-id, ego, superego
- developmental theory-emphasizes the sexual drives of the id and personality is formed in childhood and is the result of 5 psychosexual stages of development
3
Q
id, ego, superego
A
id
- source of all psychic energy
- present at birth
- pleasure principle
ego
- at 6 months in response to id’s inability to gratify all needs
- operates on reality principle
superego
- between 4-5 yo.
- internalization of society’s values and standards as conveyed by parents via rewards and punishments
4
Q
characteristics of defense mechanisms
A
- operate on an unconscious level
2. serve to deny or distort reality
5
Q
types of defense mechanisms
A
- repression-underlies all other defense mechanisms; id’s drives and needs are excluded
- reaction formation-expressing the opposite (hate mother but lavish with praise)
- projection-threat is attributed to another person or source
6
Q
psychodynamic therapy goal and techniques
A
- bring unconscious into conscious
- analysis-free associations, dreams, resistances, and transferences
7
Q
Difference between Adler and Freud
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- Adler-teleological approach: behavior is motivated by future goals rather than past events
- less emphasis on sexual forces
- more attention on societal factors
8
Q
Key concepts of Adlerian theory
A
Inferiority
-result of real or perceived weaknesses
Striving for superiority-inherent tendency
Style of life
- how someone compensates for inferiority and achieves superiority), and social interest
- healthy style vs. mistaken style
- affected by early experiences with family and is established by 4-5 y.o.
9
Q
Adler’s view of maladaptive behavior
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-disorders represent a mistaken style of life
10
Q
Adlerian Therapy goals and techniques
A
- help client identify and understand his/her style of life and consequences
- use a life style investigation
11
Q
Jung’s Analytical Psychotherapy-theory
A
Personality is the consequence of conscious and unconscious factors
- conscious is directed toward external world & governed by the ego
- unconscious-made up of personal unconscious and collective unconscious
- personality results from striving to unite different parts of the personality (public mask, the shadow, and animia & animus (feminine & masculine traits)
- personality consists of extraversion and introversion
12
Q
Jung’s collective unconscious
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- latent memory traces that have been passed down from generations
- contains archetypes-primordial images that cause people to experience and understand certain phemonena
13
Q
Jung contrast to Freud
A
development continues throughout the lifespan and most interested in growth after mid 30’s
14
Q
Individuation
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- Jung
- integration of conscious and unscious
15
Q
Jung’s view of maladaptive behavior
A
symptoms are unconscious messages to the individual that something is awry
16
Q
Jung Therapy goals and techniques
A
- goal is to bridge gap b/t uncon & con
- rely on interpretation, dreams, transference, countertransference
- more focus on here and now
17
Q
Object Relations
A
Klein, Fairbairn, Mahler, & Kernberg
-consider object seeking (relationships with others) to be a basic inborn drive and emphasize a childs early relationships with objects
Most concerned with issues related to attachment, safety, and security
18
Q
Object Relations view of maladaptive behavior
A
- Maladaptive behavior results from abnormalities in early object relations
- In infancy there is a natural tendency to split mental representations of “good” and “bad”
19
Q
Object Relations therapy goals and techniques
A
-provide support, acceptance, and conditions to restore the client’s ability to relate to others
focus on splitting, projective identification
20
Q
Key Concepts of Humanistic psychotherapies
A
- to understand a person you must understand their subjective experience
- focus on current behaviors
- belief in inherent potential for self-determination and self actualization
- therapy is an authentic, collabor, and egal relationship
- rejection of dx and assessment
21
Q
Person Centered therapy-personality theory
A
Rogers
-the organized self-composed of perceptions of “I” and as “I” relates to the world
-belief that each person can become self-actualized
22
Q
Person-centered view of maladaptive beh
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- result of incongruence between self and experience
- a person may attempt to resolve incongruence through perceptual distortion or denial
23
Q
Person-centered goals and techniques
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- help achieve congruence
- techniques: unconditional pos regard, genuineness, accurate empathic understanding
24
Q
Gestalt Therapy-overall premise
A
Founded by Perls
-each person is capable of assuming personal responsibility for thoughts, feelings, beha, actions
- incorporates psychoananlysis, phenomenology, and extentialism
- Gestalt-reflect current needs
- people tend to seek closure
- behavior represents a whole that is a sum of parts
- behavior can only be understood in context
- a person experiences the world in accord with the principle of figure/ground
25
Gestalt Personality theory
personality is composed of the self and self-image
- self: creative aspect of personality that promotes inherent tendency for self-actualization
- self-image: hinders growth and self-actualization by imposing external standards
26
Gestalt view of maladaptive behavior
boundary disturbances:
1. Introjection: when someone accepts concepts, facts, and standards from the envir without understanding or fully assimilating
2. projection: disowing aspects of the self by assigning them to others
3. retroflection: doing to oneself what one wants to do to others
4. confluence: absence of a boundary between self and envir
27
Gestalt therapy goals and techniques
- focus on awareness of thoughts, feelings, and behaviors in the here and now
- use of imagery, empty chair
28
Existential Therapy
- emphasis on personal choice and responsibility for developing a meaningful life
- maladapt beh-results from inability to cope authentically with concerns of existence (death, freedom, maninglessness)
- goal-help clients live in a more committed, self-aware, authentic, and meaningful way
- paradoxical intention is used
29
Reality Therapy
Glasser
- based on choice theory-ppl are responsible for choice (I choose to be depressed)
- motivation comes from survival, love, power, freedom, and fun
- success vs. failure identity
- rejects medical model and biology-focus is on current behaviors and beliefs to develop more realistic plan of action
30
Personal Construct Therapy
kelly
- focuses on how the client experiences the world-people chose ways to experience the world
- psychological processes develop from the way you perceive, interpret, and predict events by using personal constructs (dimensions of meaning-happy/sad) and operate on conscious and uncon levels
- help client to replace maladapt constructs
- use the repertory grid (people who have various roles)-ways person is similar and different
- fix role therapy-client "try on" different ways of being
31
Interpersonal Theory
- brief therapy
| - probs in social roles and interpersonal relationships and -prob attachment styles
32
Interpersonal Therapy goals
improve functioning in 4 prob areas
1. unresolved grief
2. interpersonal role disputes
3. role transitions
4. interpersonal deficits
33
Solution Focused Therapy
focuses on problems rather than problems
34
role of therapist in solution focused therapy
to act as the collaborator/consultant who poses different types of questions (miracle question, exception question, scaling question)
35
Transtheoretical Model
-focuses on factors that facilitate behavior change
| identifies decisional balance, self efficacy, and temptation as mediating variables
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Stages of change
- Precontemplation-low insight; no change necessary
- Contemplation-aware of need to change; wants action soon
- Preparation-plans to take action
- Action-takes steps to change
- Maintenance
- Termination
37
Motivational Interviewing
stresses empathy, reflective listening, and responding to client resistance in non confrontational way
focus is to develop discrepancies
38
double-bind commuication
- developed by Ackerman
- contradictory injunctions
- recipient of injunctions is not allowed to comment
- repetition of certain types of family interactions influence development of schizo
39
Communication/Interaction Therapy
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-focuses on impact of communication in the family
symmetrical communication (equality)
-complementary (one is more dominant)
-Therapy uses direct and paradoxical strategies
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40
Extended Family System Therapy
Bowen
- focus on differentiation-person's ability to separate intellectual and emotional functioning
- emotional triangle
- family projection process
41
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Bowenian Therapy (Extended Family System Therapy)
Therapy techniques
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- includes 2 family members and the therapist completes the triangle
- use a genogram to depict relationships between family
- partners are encouraged to talk to the therapist instead of each other
42
Structural Family Therapy
Minuchin
family hierarchies
family subsystems
boundaries
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Structural Family Therapy techniques
- Therapist will join the family in a position of leadership and try to blend
- evaluate family structure
- restructure the therapy
44
Strategic Family Therapy
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Haley & Erickson
role of communication is emphasized
Social Stage-therapist observes
Problem stage
Interaction stage
Goal setting
Therapists are active and use a variety of techniques-paradoxical interventions
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45
Milan Systemic Family Therapy
Effective for children with anorexia
based on the fact in a family system there are circular patterns of action and reaction
Goal-help members see their choices
Use of therapeutic team
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Behavioral Family Therapy
based on operant conditioning, social learning, social exchange theory
-goal is to alter environmental factors (consequences and antecedents)
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Object Relations Family Therapy
projective identification
| recognize and address multiple transferences
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First stage of group therapy
Orientation, Hesitant Participation, Search for Meaning, Dependency
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Second Stage of Group therapy
Conflict, dominance, rebellion
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Third stage of group therapy
development of cohesiveness
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Acupuncture (useful for)
reducing low back pain, migranes, and dental pain
| managing chemotherapy-induced nausea and vomiting
52
Primary Prevention
- getting before it starts
| - focused on reducing incidence of new cases by developing a program (prenatal nutrition programs, meals on wheels)
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Secondary Prevention
- tries to detect early and intervene
- attempts to reduce prevalence by reducing duration through early detection and intervention
- screening tests
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Tertiary prevention
- aim to reduce duration and consequence of mental and physical disorders
- rehabilitation programs
- halfway houses
55
Health Belief Model (health is promoted by what factors)
1. person's readiness to take action
2. eval of costs and benefits
3. internal and external cues to action
56
client centered consultation
work with consultee (teacher) to develop a plan for them to work better with the client (student)
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consultee centered consultation
enhance skills of consultee performance in delivering services
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Program centered administrative consultation
work with administrators to resolve an issue
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Conslutee centered administrative consultation
help consultee's improve functioning to better fulfill job responsibilities
60
Eysenck's conclusions about psychotherapy
effects are "small or nonexistant"
| methodology was disputed
61
Smith, Glass, & Miller (1980) meta analysis results
the average therapy client is better off than 80% of those who needed therapy but were untreated
62
Howard and colleagues (1996) results on treatment length and outcome
75% show measurable improvement at 26 sessions
85% at 52 sessions
called dose-dependent effect
63
utilization of mental health and ethnic minorities
- whites receive more services
- Af Am receive more services via emergency room & inpatient setting
- Asian Am are underrepresented in both inpatient and outpatient
64
drop out rates and ethnicity
50% of those from minority groups drop out after first session compared to 30% of whites
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therapist and client matching and effect on drop out
good for Asian, Hispanic (improved outcomes for hispanic only), & White
66
diagnostic overshadowing
when a clinician attributes beh, emo, and social problem to an individuals mental retardation
67
alloplastic vs. autoplastic interventions
alloplastic-change a person's environment
| autoplastic-focus on individual changes
68
sources of work related probs for therpsits
1. suicidal statements
2. lack of success
3. issues related to confidentiality
69
gender and hospitalization rates
-prevalence of mental illness is higher for women
being admitted to to hospitals is higher for men
-explanation-men are more likely to exhibit acting out beh
70
demographic characteristics of psychiatric inpatients
- more likely for never married
- minority status (when pop proportions are taken into account)
- age 25-44
- schizophrenia
71
When working with African Am clients it is impt to consider the following
1. worldview emphasizes interconnectedness
2. family and extended kinship (biological and extended)
3. roles in the family are flexible and egalitarian
4. health cultural parania
*directive and goal oriented approach while promoting egalitarianism
72
Working with Native American and Aliskan Natives it is impt to consider the following
1. spiritual and holistic orientation to life
2. emphasis on extended family and tribe
3. time is perceived in personal and seasonal rhythms
4. sense of cooperation and generosity
5. listening more impt than talking
* avoid direct confrontation
* network therapy-incorporates all elements of community
73
When working with Asian Americans it is impt to consider the following
1. be aware of acculturation status & attitudes toward mental illness
2. emphasis on family
3. hierarchial family structure & traditional gender roles
4. interdependence and mutual loyalty
5. restraint of strong emotions
*goal oriented and directive (CBT)
74
When working with Hispanic/Latino it is impt to consider the following
1. family welfare
2. interdependence is healthy
3. discussing intimate personal details can be challenging
4. use of concrete, tangible approach
5. they may attribute control of life events to luck
* parent child bond is stronger than other bonds
75
gender differences in coming out process
- adol males have an earlier onset of same-sex attraction, self-labeling, first same sex contact
- age of first disclosure is not different for males and females
76
Acculturation
-degree to which a member of a diverse group accepts and adheres to the majority culture
77
4 categories of Acculturation
Marginalization-does not identify with either
Separation-withdraws from dominant accepts own
Assimilation-accepts majority withdraws from own
Integration-integrates both
78
worldview is impacted by which 2 factors
person's locus of control and locus of responsibility
79
cultural encapsulation definition
define other's reality based on their own
disregard cultural differences
ignore evidence that challenges beliefs
80
Emic vs Etic
Emic-good-cultural specific theories
| Etic-view others from diff cultures the same
81
high context communication vs. low context communication
high context: relies more on nonverbal cues; helps unify culture; slow to change
low context: relies on the verbal message; less unifying; more likely to change
*High context is characteristic of many cultures
82
cultural vs. functional paranoia
cultural: healthy reaction to racism
functional: unhealthy and can result in illness-unwillingness to disclose due to mistrust
83
sexual stigma
shared knowledge of society's negative regard for nonheterosexual practices
84
Heterosexism
systems that promote antipathy, hostility, and violence agaisnt LGB individuals
85
sexual prejudice
negative attitudes due to sexual orientation
86
Racial/Cultural Id Deve Model
| (Atkinson, et al)-5 stages
1. Conformity- positive attitude toward domin culture
2. Dissonance-confusion & conflict over people in same and different groups
3. Resistance & Immersion-reject domin society
4. Introspection-uncertainty about beliefs from prev stage
5. Integrative Awareness-fulfillment with cultural id and desire to eliminate oppression
87
Black Racial ID Model
| Cross
1. Pre-encounter-adopt mainstream society
2. Encounter-greater awareness and interest in developing a Black identity
3. Immersion-Emersion-idealizes black culture and rage against whites; intense emotions subside but reject all aspects of white
4. Internalization-adopt an identity
88
Withe Racial Id Development Model
1. Contact-individual has little awareness of racism
2. Disintegration status-increasing awareness of race and racism leads to confusion & emotional conflict (over identify with minority grps)
3. Reintegration-idealizing white society
4. Pseudo Independence-questioning views and acknowledging role Whites have in racism
5. Immersion-Emersion-explores Whiteness; confronts biases, understands White privileged
6. Autonomy-nonracist white identity and actively seeking out interactions with other groups `
89
Gay/Lesbian ID development Model
1. Sensitization-feeling different
2. Self-recognition-identity confusion
3. Identity Assumption-becomes more certain of homosexuality
4. Commitment-identity integration
90
two factors in the trantheoretical model that are the primary predictors of transition from one stage to the next
perceived self-efficacy
decisional balance
91
when parents avoid the tension between them by blaming or overprotecting the child
Minuchin (family theray)
Detouring
92
A nonsexist practitioner
uses non-biased techniques designed to promote personal growth
93
Meta-analysis revealed that ____ had the largest effect size for therapy outcomes of children and adolescents
female adolescents
94
Sullivan's interpersonal approach identified ____ as the primary cause of psychopathology
excessive anxiety
95
Sullivan believed human behavior is motivated by
Need for satisfaction
| Need for security
96
From a psychoanalytic perspective, a phobia is
an externalization of a forbidden impulse
97
An initial first step to multicultural therapy
is to assess for the following:
- stage of racial/ethnic development
- degree of acculturation
- world view
98
An American Indian group may place greater emphasis on the family and tribe (associated term)
consensual collateral
99
When working with an African American with healthy cultural paranoia an Anglo therapist would
help the client increase awareness of feelings of suspiciousness, frustration, and antipathy
100
According to Sue & Zane, the most impt factor in culturally sensitive therapy is
using techniques that establish credibility
101
existential therapist is most likely to described existential anxiety as
a potential stimulus for growth
102
instructing a client to maintain and/or exaggerate a target symptom
prescribing
103
They believed in 3 major life tasks - friendship, occupation, and love
Adler
104
In Extended family systems therapy (Bowenian), if a family member exhibits a high degree of fusion, but one member is more differentiated, the likely approach would be
work with the most differentiated family member
he assumed that working with the most differentiated member would have positive effects on other family members
105
Minuchin's structural family therapy approach is best described as
manipulative, unyielding, and crisis provoking
focuses on marking boundaries, escalating stress, utilizing symptoms, and manipulating mood
for example, he may imitte a dysfunctional beahvior in an exaggerated way
106
Primary advantage of manualized therapy
it standardizes treatment delivery so that, in research, txt effects can be more clearly ascertained
107
As defined by Carl Jung, individuation refers to
integrating parts of the self to create a unique identity
108
According to Mahler's object relations, separation-individuation begins when
4-5 months
109
according to traditional psychoanalysis, transference is
a form of resistance
110
when conducting marital therapy what is the difference in approach if there is instrumental vs. expressive violence present
expressive-not as severe or abusive-can conduct conjoint therapy
instrumental-see separately
111
CBT is more effective with older adults when...
it is conducted in a slower manner/pace at higher levels of abstraction (focus on schemas and relationship scripts)
112
In a study by Sue et al. (1991) and outcomes of an outpatient program, they found what differences regarding ethnicity
Hispanic Am had best outcomes followed by Anglos, Asian Am, and Af Am
