Clinical Psychology Flashcards
(286 cards)
1
Q
What are the two qualities of all defense mechanisms?
A
- They operate on an unconscious level
2. They servce to deny or distort reality
2
Q
Repression
A
When the id’s drives and needs are excluded from conscious awareness by maintaining them in the unconscious.
3
Q
What is the Freudian view of psychopathology
A
It stems from an unconscious, unresolved conflict that occurred during childhood
4
Q
What is the Freudian view of phobias
A
They are the displacement of anxiety onto an object or event that is symbolic of the object or event involved in the unresolved conflict.
5
Q
What is the Frudian view of depression
A
It is due to object loss coupled with anger toward the object turned inward.
6
Q
What is the Freudian view of mania
A
It represents a defense against libidinal or aggressive urges that threaten to overwhelm the ego.
7
Q
What are the goals of Fruedian psychotherapy?
A
To reduce or eliminate pathological symptoms by brinding the unconscious into conscious awareness and by integrating previously repressed material into the personality.
8
Q
Teleological approach
A
Adler; behavior is motivated by future goals more than it is determined by past events
9
Q
Four key concepts of Adler’s individual psychology
A
Inferiority feelings, striving for superiority, style of life, social interest
10
Q
Style of life
A
The specific ways a person chooses to compensate for inferiority and achieve superiority. Unifies the various aspects of the personality.
11
Q
What distinguishes a healthy and unhealthy style of life (Adler)
A
Social interest. Healthy is marked by optimism, confidence, and concern about welfare of others. Mistake. Is marked by self-centered ness, competitiveness, and striving for personal power.
12
Q
When is style of life determined
A
By age 4-5
13
Q
Lifestyle investigation
A
Adlerian therapy technique
14
Q
Main parts of awareness (Jung)
A
Conscious, personal unconscious, collective unconscious
15
Q
Archetypes
A
Primordial images that cause people to experience and understand certain phenomena in a universal way
16
Q
Five archetypes (Jung)
A
Self, persona (public mask), shadow (dark side), anima (feminine), animus (masculine)
17
Q
Two attitudes (Jung)
A
Extroversion and introversion
18
Q
Four basic psychological functions (Jung)
A
Thinking, feeling, sensing, intuiting
19
Q
Individuation (Jung)
A
Integration of conscious and unconscious that leads to the development of a unique identity
20
Q
When did development happen (Jung)
A
Throughout life
21
Q
Jungian meaning of dreams
A
Represent an unconscious message to the individual that is revealed in symbolic form
22
Q
Jung–optimist or pessimist?
A
Optimistic view of human nature and emphasis on healthy aspects I personality.
23
Q
Jung–past or present
A
Emphasis on present. Info from past only sought when it will help the client understand the present.
24
Q
Separation-Individuation (Mahler)
A
Begins at 4-5 mos of age, ends around 3. Child develops a permanent sense of self and is able to perceive others as both separate and related. Includes differentiation, practicing, reapproachment, object constancy
25
Object relations view of maladaptive behavior.
Problems in separation-Individuation. Inadequate resolution of natural tendency for infants to split into good and bad categories.
26
Object relations therapy goals
Bring maladaptive relationship dynamics into consciousness and replace them with more adaptive ones.
27
What is the view of humanistic therapies toward assessment and diagnosis?
Humanistic therapies reject traditional assessment techniques and diagnostic labels.
28
Do humanistic therapies focus on past or present?
Present
29
What are important qualities of the therapeutic relationship in humanistic therapies?
authentic, collaborative, and egalitarian
30
What do humanists believe you must understand to understand a person?
The person's subjective experience
31
What are examples of humanistic therapies?
Person-centered therapy, Gestalt therapy, existential therapy, reality therapy
32
What are constructivist therapies?
Incorporate some humanistic principles; emphasis on the client's perceived reality, which is viewed as being individually and/or socially constructed to some extent
33
What is another name for person-centered therapy?
Rogerian therapy or client-centered therapy
34
What is thought of as a major source of motivation in Rogerian therapy?
an innate "self-actualizing tendency" that guides people toward positive, healthy growth
35
What has to happen for a person to become self-actualized (Rogers)?
The self must remain unified, organized, and whole
36
How does the self become disorganized (Rogers)?
As the result of incongruence between self and experience, such as when the individual experiences conditions of worth.
37
What is the main goal of Rogerian therapy?
To help the client achieve congruence between self and experience so that he/she can become a more fully-functioning, self-actualizing person.
38
What are the three "facilitative conditions" in Rogerian therapy?
Unconditional positive regard, genuineness, accurate empathic understanding
39
Is person-centered therapy generally more directive or non-directive?
Non-directive
40
Who founded Gestalt therapy?
Fritz Perls
41
What is the main premise of Gestalt therapy?
A person is capable of assuming personal responsibility for his/her own thoughts, feelings, and actions and living as an integrated "whole"
42
What are the five main concepts of Gestalt therapy?
1. People tend to seek closure
2. A person's "gestalts" reflect his/her current needs
3. A person's behavior represents a whole that is greater than the sum of its parts
4. Behavior can only be fully understood in context
5. A person experiences the world in accord with the principle of figure/ground
43
According to Perls, what are the two parts of the personality?
Self and self-image
44
Self (Perls)
The creative aspect of the personality that promotes the individual's inherent tendency for self-actualization, or the ability to live as a fully integrated person
45
Self-image (Perls)
The "darker side" of the personality that hinders growth and self-actualization by imposing external standards
46
What is the cause of maladaptive (neurotic) behavior, according to Perls?
"coundary distrubances" between the self and the external environment that interfere with the person's ability to satifsy his needs and maintain a state of homeostasis
47
Introjection (Perls)
Boundary disturbance in which a person psychologically swallows whole concepts without understanding/fully integrating them; association with extreme compliance
48
Projection (Perls)
Bourndary disturbance in which a person disowns aspects of self by assigning them to other people; associated with paranoia
49
Retroflection (Perls)
Boundary disturbance in which a person does to oneself what one wants to do to others; e.g., turning anger at others inward
50
Confluence (Perls)
Boundary disturbance in which there is an absence of boundary between the self and the environment; causes intolderance of any difference between self and other and often underlies feelings of guilt and resentment
51
What is the major goal of Gestalt therapy?
To help the client become a unified whole by integrating the various aspects of self
52
What are the main techniques in Gestalt therapy?
Help client recognize difference between "transference fantasy" and reality; "Awareness" (full understanding of one's thoughts, feelings, and actions in the here-and-how) is the primary curative factor
53
What do elements of a dream represent for Gestaltians
different parts of the self (including parts that have not been fully accepted and integrated)
54
What are the main commonalities of the existential therapies?
Emphasis on personal choice/responsibility for developing a meaningful life; assume that people are in a constant state of evolving and becoming
55
What causes maladaptive behavior in the view of existential therapists?
an inability to cope authentically with the ultimate concerns of existence (e.g., death, freedom, existential isolation, meaninglessness)
56
What is the primary goal of existential therapy?
To help clients live in more committed, self-aware, authentic, and meaningful ways. To help clients recognize their freedom to choose their own destinies and accept responsibility for changing their own lives.
57
What is reality therapy?
William Glasser; based on choice theory, which assumes that people are responsible for the choices they make and focuses on how people make choices that affect hr course of their lives.
58
What are the five innate needs in reality therapy?
Survival, love and belonging (most important), power, freedom, fun
59
What are the two types of identities in reality theory?
Success identity (fulfilling needs in a responsible way) and failure identity (inability to satisfy needs or satisfying needs in irresponsible ways)
60
What is the view of maladaptive behavior in reality therapy?
Mental illness is the result of the individual's choices.
61
What are the main goals of reality therapy?
Help clients identify responsible and effective ways to satisfy their needs and thereby develop a success identity.
62
How does reality therapy feel about the medical model?
It rejects it
63
Reality therapy--past or present focus?
Focuses on current behaviors and beliefs
64
Reality therapy--views on transference?
Transference is detrimental to the therapy process
65
Reality therapy--stress unconscious or conscious?
Stresses conscious processes.
66
Reality therapy and value judgements
Emphasizes value judgments, especially the client's ability to judge what is right and wrong in his/her daily life
67
Personal Construct Therapy
George Kelly; focuses on how the client experiences the world and assumes that people choose the ways that they deal with the world and that there are always alternative ways for doing so
68
What are personal constructs?
Bipolar dimensions of meaning (happy/sad, competent/incompetent, friendly/unfriendly) that begin to develop in infancy and may operate on a conscious or unconscious level. They are unique to an individual and are constantly being tested and revised.
69
Personal construct therapy, view of maladaptive behavior
Maladaptive behavior is the result of inadequate personal constructs (e.g., not having a construct for an encountered situation or relying on old constructs despite invalidating evidence)
70
Personal construct therapy and the medical model
Rejects the medical model
71
Therapy goals in personal construct therapy
Help the client identify and revise or replace maladaptive personal constructs in order to better make sense of experiences
72
Personal construct therapy therapeutic relationship
Therapist and client as mutual experts and "co-experimenters"
73
Personal construct therapy techniques
"fixed role therapy" in which client plays out alternative personal constructs; repertory grid in which client identifies similarities and differences in those with whom they have close relationships; self-characterization sketch in which client describes himself from the perspective of a person with whom he has a close relationship
74
What are the main three theoretical influences on interpersonal therapy?
1. Adolph Meyer's psychobiological approach, 2. Sullivan's interpersonal theory, 3. Bowlby's attachment theory
75
What does IPT view as the cause of maladaptive behavior?
problems in social roles and interpersonal relationships that are traceable to a lack of strong attachments early in life
76
What are the primary goals of IPT?
symptoms reduction and improved interpersonal functioning
77
How is symptom reduction approved in IPT?
Education about the disorder, instillation of hope, pharmacotherapy when necessary
78
What are the four main primary problems areas in social functioning targeted in IPT?
1. Unresolved grief, 2. Interpersonal role disputes, 3. Role transitions, 4. Interpersonal deficits
79
What are the three stages of IPT?
1. Assessment of symptoms and interpersonal context, 2. Use of strategies (e.g., affect encouragement, role playing, communication analysis) to address social problem areas, 3. Review progress and discuss termination and relapse prevention
80
What is the view of maladaptive behavior in solution-focused therapy?
Understanding the etiology of the problem is irrelevant, and therapy should focus on solutions.
81
What is the main idea of the transtheoretical model?
Change entails progress through a series of stages. Analysis of empirically-supported techniques across theoretical orientations.
82
Six stages of change in transtheoretical model
Precontemplation, contemplation, preparation, action, maintenance, termination
83
What is the primary goal of motivational interviewing?
To enhance the client's intrinsic motivation to alter his/her behavior by helping the client examine and resolve his/her ambivalence about changing.
84
What are four motivational interviewing strategies?
1. Express empathy, 2. Develop discrepancies between current behavior and personal goals/values, 3. Roll with resistance, 4. Support self-efficacy
85
What does OARS stand for in motivational interviewing?
Open-ended questions; affirmations; reflective listening; summaries
86
Ludwig von Bertalanffy
Biologist who first described general systems theory.
87
General systems theory
A system is an entity that is maintained by the mutual interactions of its components and assumes that the actions of interacting components are best understood by studying them in context.
88
Open system
Continuously receives input from and discharges output to the environment and is more adaptable to change than a closed system.
89
Homeostasis (family therapy)
The tendency for a family to act in ways that maintain the family's equilibrium or status quo. If problems of one family member improve, the disturbance in likely to reappear elsewhere in the family.
90
Cybernetics
Mathematical theory about feedback loops that has been applied to family therapy.
91
Negative Feedback Loop
Reduces deviation and helps a system maintain the status quo
92
Positive Feedback Loop
Amplified deviation or change and thereby disrupts the system. In therapy, promotes appropriate change in a dysfunctional family system.
93
Who are some early contributors to family therapy theory?
Nathan Ackerman, Gregory Bateson, Murray Bowen
94
"Grandfather of family therapy"
Nathan Ackerman
95
Double-bind communication
Communication that involves conflicting negative injunctions, with one being expressed verbally and the other being expressed verbally. Bowen hypothesized that these communications across generations led to development of schizophrenia in a family member.
96
What are the main assumptions of communication/interaction family therapy?
All behavior is communication; Communication has a report function (content/informational) and a command function (nonverbal statement about relationship); communication patterns are either symmetrical or complementary
97
Symmetrical communications
Reflect equality between communicators but may escalate into a competitive "one-upsmanship" game in which each participant tries to outdo the other
98
Complementary communications
Reflect inequality and maximize differences between communicators. Common pattern is for one participant to assume the dominant role while the other is submissive.
99
Communication/interaction family therapy--view of maladaptive behavior
Circular model of causality that regards a symptom as both a cause and effect of dysfunctional communication patterns, which include blaming and criticizing, mindreading, and overgeneralizing.
100
Therapy goals/techniques in communication/interaction family therapy
Primary goal is to alter the interactional patterns that are maintaining the presenting symptoms, by using both direct techniques and paradoxical strategies
101
Extended family systems therapy
Extends general systems theory beyond the nuclear family, and describes the functioning of the extended family and its members
102
Differentiation of self (Bowen)
Refers to a person's ability to separate his or her intellectual and emotional functioning
103
Emotional triangle (Bowen)
When a two-person system experiences instability or stress, a third person may be recruited into the system to increase stability and reduce tension.
104
Family projection process (Bowen)
Process by which parental conflicts and emotional immaturity are transmitted to children, which causes a child to have a lower level of differentiation that his or her parents.
105
Bowen--view of maladaptive behavior
Behavioral disorders are the result of a multigenerational transmission process in which progressively lower levels of differentiation are transmitted from one generation to the next.
106
Bowen (extended family systems therapy) goals
Increase differentiation of all family members.
107
Extended family systems (Bowen) techniques
Therapist serves role of an "active expert" who helps family members achieve greater differentiation. Use of genograms.
108
Salvador Minuchin
Creator of structural family therapy
109
Structural family therapy
Focuses on implicit family structures and the boundaries between family members
110
Boundaries (Minuchin)
"Barriers" or rules that determine the amount of contact that is allowed between family members. Overly rigid boundaries lead to disengaged family members; diffuse boundaries lead to enmeshed family members.
111
Three types of rigid triads
Detouring, Stable Coalition, Triangulation
112
Detouring (Minuchin)
Parents focus on the child either by overprotecting or blaming (scapegoating) the child for the family's problems
113
Stable coalition (Minuchin)
Occurs when a parent and child for a cross-generational coalition and consistently "gang up" against the other parent
114
Triangulation (Minuchin)
aka unstable coalition; occurs when each parent demands that the child side with him/her against the other parent
115
Minuchin/structural family therapy view of maladaptive behavior
Family dysfunction viewed as a result of on inflexible family structure that prohibits the family from adapting to maturational and situational stressors in a healthy way.
116
Minuchin/structural family therapy goals
Restructuring the family is the primary long-term goal. Therapy may also address symptom relief and other short-term goals using behavioral techniques.
117
Three major therapy techniques in structural (Minuchin) family therapy
Joining, evaluation the family structure, restructuring the family
118
Joining (Minuchin)
"joining" the family in a position of ledership by tracking and adopting the family's affective and communication style (mimesis)
119
Family (structural) map
Helps clarify and map family interaction patterns
120
Enactment
Structural family therapy technique in which family is asked to role-play their relationship patterns
121
Reframing (Structural family therapy)
Relabeling behaviors so that they can be viewed in more positive ways
122
Strategic family therapy--stages of session
1. Social stage (observe and encourage involvement), 2. Problem stage (gathers information), 3. Interaction stage (discuss problems) 4. Goal-setting (agree on contract that defines the goals of treatment)
123
Strategic family therapist--active or passive?
active, take-charge role
124
Directives (strategic family therapy)
assignments to be performed outside of therapy, issued by the therapist
125
Paradoxical intervention (structural family therapy)
intervention that alters the behavior of family members by helping them see a symptom in an alternative way or recognize they have control over their behaviors, or by using their resistance in a constructive way
126
Types of paradoxical interventions
ordeals, restraining, positioning, reframing, prescribing the symptom
127
Ordeals
unpleasant tasks that the client must perform every time a symptom occurs
128
Restraining
encouraging the family not to change
129
Positioning
Exaggerating the severity of a symptom
130
Reframing
Relabeling a symptom to give it a more positive meaning
131
Prescribing the symptom
instructing a family member to deliberately engage in the symptom
132
Milan Systemic Family Therapy--view of maladaptive behavior
there are circular patterns of action and reaction in a family system; maladaptive behavior results when a family's patterns become so fixed that family members are no longer able to act creatively or make new choices about their lives
133
Goal of Milan Systemic Family Therapy
"Help family members see their choices and to assist them in exercising their prerogative of choosing"
134
Techniques in Milan Systemic Family Therapy
Use of a therapeutic team, hypothesizing, neutrality, paradox, circular questions
135
Milan--hypothesizing
deriving and testing hypotheses about the family system
136
Milan-neutrality
therapist remains an ally of the entire family rather than becoming recruited into family coalitions or alliances
137
Milan-paradox
use paradoxical strategies to provide family members with information that will help them derive solutions to their own problems
138
Milan-circular questions
questions asked of each family member to help them recognize differences and similarities in their perceptions
139
Therapeutic techniques in behavioral family therapies
1. Focus on observable behaviors, 2. Ongoing assessment of behaviors, 3. Emphasis on changing behaviors based on contingent reinforcement, 4. Focus on improving communication and problem solving skills
140
Object relations family therapy view of maladaptive behavior
Result of both intrapsychic and interpersonal factors; Major source of dysfunction is projective identification
141
Projective identification
Occurs when a family member projects old introjects onto another family member and then reacts to that person as through he or she actually has the projected characteristics or provokes the person to act in ways consistent with those characteristics.
142
Object relations family therapy primary goals
to resolve each family member's attachment to family introjects; insight is considered essential to change; recognizes multiple transferences
143
Mara Selvini-Palazzoli
developed Milan systemic family therapy
144
Group therapy stages (Yalom)
1. Orientation, Hesitant Participation, Search for Meaning, Dependency, 2. Conflict, Dominance, Rebellion, 3. Development of Cohesiveness
145
Characteristics of group therapy stage 1 (Yalom)
attempts to determine structure and meaning, restricted/rational communication style, speaking directly to leader, advice seeking/giving, search for similarities among group members
146
Characteristics of group therapy stage 2 (Yalom)
group members attempt to establish preferred amount of power and a social pecking order emerges; hostility toward one another and the therapist
147
Characteristics of group therapy stage 3 (Yalom)
unity, imtimacy, and closeness become chief concerns; trust/self-disclosure increase; attendance improves and concern is shown for absent members
148
Yalom's view of cohesiveness
it is critical in group therapy, the group equivalent of the therapeutic relationship
149
Yalom--three roles of group therapist
Creation/maintenance of group; Culture building; Activation and Illumination of the Here-and-Now
150
Activation and Illumination of the Here and Now (Group Therapy)
1. Here is your behavior, 2. Here is how if makes others feel, 3. Here is how it influences what others think of you, 4. Here is how it affects your opinion of yourself
151
Yalom's view of group/individual therapy together
Unnecessary and not beneficial unless needed for a specific crisis or to protect against early termination from group
152
What percent of group members drop out during the first 12-20 sessions?
10-35%
153
What makes a good candidate for group therapy?
Problems related to interpersonal issues, motivated to change, positive view of group therapy, psychologically and verbally sophisticated, prefers to get involved in therapy slowly, finds peer support and feedback beneficial
154
What makes a bad candidate for group therapy?
incompatibility with group norms for acceptable behaviors, inability to tolerate the group setting, certain symptoms or diagnoses (e.g., severe depression and withdrawal, paranoia, acute psychosis, brain damage, sociopathy
155
Main elements of feminist family therapy
emphasis on power differentials between men and women and interpretation of events within an oppressive social context
156
What is feminist therapy's view of maladaptive behavior
1. Problems related to nature of traditional feminine roles; 2. Symptoms are "survival tactics" or ways of exercising personal power, 3. Arbitrary labels that sociality has assigned to certain behaviors in order to exert control
157
Goals of feminist therapy
Empowerment; identifying and altering the oppressive forces in society that have affected their clients' lives
158
Techniques of feminist therapy
1. Striving for an egalitarian relationship; 2. Avoiding labels, 3. Avoiding revictimization, 4. Involvement in social actions
159
Feminist therapy view of self-disclosure
Appropriate self-disclosure is necessary to have a more egalitarian relationship with the client
160
Feminist therapy and assessment/diagnosis
not used; avoid traditional labels describing feelings and behaviors
161
Difference between feminist and nonsexist therapy
Nonsexist therapy focuses more on individual factors and personal behavior; feminist therapists prioritize the role of sociopolitical factors
162
Self-in-relation theory
extends traditional object relations theory by proposing that many gender differences can be traced to differences in the mother-daughter and mother-son relationship
163
Hypnosis is effective for treating:
acute stress disorder and other anxiety disorders; obesity; insomnia; chronic pain
164
Hypnosis and repressed memories: accuracy
may produce more pseudo memories than actual memories
165
Hypnosis and repressed memories: confidence
hypnosis may exaggerate confidence in memories, especially inaccurate memories
166
Hypnosis and repressed memories: usefulness
recovered memories (even if historically inaccurate) often reflect issues and experiences relevant to treatment and can produce symptom improvement
167
Acupuncture effectiveness
evidence for effectiveness in reducing certain types of pain in for managing chemotherapy-induced nausea and vomiting
168
Acupuncture mechanism of action
release of endorphins, modification of blood flow
169
Reflexology
effectiveness has not been demonstrated
170
Yalom--how to reduce premature termination
prescreening, post-selection preparation for clarifying misconceptions/unrealistic expectations
171
Health Belief Model
Health behaviors are influenced by 1. person's readiness to take a particular action (including perceived susceptibility and severity) 2. person's evaluation of costs/benefits of action, 3. internal and external "cues to action" that triggers response
172
Gerard Caplan
Distinguished between four types of consultation: client-centered case consultation, consultee-centered case consultation, program-centered administrative consultation, consultee-centered administrative consultation
173
theme interference
when a past unresolved conflict related to a particular type of client or circumstance is evoked by and interferes with the consulter's current situation
174
parallel process
occurs when a therapist (supervisee) replicates problems and symptoms with the supervisor that are being manifested by the therapist's client
175
Eysenck (1952)
Summarized results of 24 therapy outcome studies between 1920 and 1950 and found "small or nonexistent" effects
176
Smith, Glass, and Miller (1980)
Used meta-analysis to combine results of 425 outcome studies published between 1941 and 1976--found a mean effect size of .85
177
Is one type of therapy generally more effective than others?
Meta analyses have said no
178
What types of disorders is CBT better for?
Panic, phobias, compulsions
179
Howard et al. (1996)
relationship between treatment length and outcome "levels off" at about 26 sessions
180
Howard et al.' s phase model of therapy
1. Remoralization, 2. Remediation 3. Rehabilitation
181
Howard-remoralization
client's feelings of hopelessness and desperation respond quickly to therapy; remoralization usually accomplished during the first few sessions
182
Howard-remediation
focus on the symptoms that brought the client to therapy; symptomatic relief usually requires about 16 sessions
183
Howard-rehabilitation
focus on unlearning troublesome, maladaptive, habitual behaviors and establishing new ways of dealing with various aspects of life; number of sessions depends on goals and problems
184
Sue at el (1991) effectiveness of therapy in different ethnic groups
Best outcomes in oder: 1. Hispanics, 2. Anglo, 3. Asian, 4. African American
185
African-Americans and therapy services
fewer AA than whites receive mental health services, but AA individuals receive a disproportionate share of mental health services in emergency room or psychiatric inpatient settings
186
Asian Americans and therapy services
under-represented in both outpatient and inpatient settings
187
African Americans and psych disorders
AA less likely to receive treatment for depression, but more likely to receive treatment for illicit drug use
188
premature termination and race
members of minority groups more likely to terminate therapy prematurely than whites
189
Sue and Sue (2003) therapy dropout
50% of minorities drop out after first session, compared to 30% of whites
190
Sue et al (1991) droupout rates in CMH settings
1. African Americans, 2. White Americans/Hispanics, 3. Asians
191
therapist-client matching
Sue and Sue (1991) founds ethnic matching deducted premature termination rates for Asian, Hispanic, and White americans but not African Americans; Maramba and Hall (2000) concluded that ethnic matching has a small but nonsignificant effect on number of sessions attended
192
Most common mental health problems in older adults
1. anxiety, 2. severe cognitive impairment, 3. depression
193
Older adults--more or less heterogeneous than other groups?
more heterogeneous than other groups
194
Older adults and response to therapy
generally respond as well as other populations, but more slowly
195
Gatz (1998) meta analysis of therapy in older adults--dementia
1. Behavioral and environmental interventions "well-established" for behavior problems associated with dementia, 2. Memory and cognitive retraining "probably efficacious" for dementia
196
Gatz (1998) meta analysis--depression
cognitive, behavioral, and brief psychodynamic interventions all "probably efficacious"
197
Rate of relationship victimization (physical assault)
20.4% for women, 7% for men
198
Risk factors for spouse/partner abuse in women
younger, heterosexual, American Indian/Alaskan Native, incomes < 10,000/year
199
best predictor of cessation of battering
income
200
Goals of interventions for battered women
emphasize self-determination, safety, increasing self-esteem, empowerment, control
201
Expressive abuse
abuse that is primarily the expression of emotion, is mutual or reciprocal, and is followed by remorse; joint treatment in indicated
202
Instrumental abuse
abuse that is committed without provocation to achieve a goal, is unilateral, and is not followed by remorse; joint treatment is contraindicated
203
Factors that predict staying in an abuse relationship
1. emotional attachment to the batterer, 2. desire to "save" relationship, 3. have been in relationship for extended period of time, 4. economic dependence, 5. belief that the batterer will change, 6. fear of retaliation against self or children
204
Diagnostic overshadowing
tendency for health professionals to attribute all behavioral, social, and emotional problems to intellectual disability in individuals with this diagnosis
205
Alloplastic intervention
goals is to make changes in the environments so that it better accommodates the individual
206
Autoplastic intervention
goals is to change the individual so that she/he is able to function more effectively within his/her environment
207
Leading causes of therapist distress
1. suicidal statements, 2. lab of therapeutic distress, 3. issues related to confidentiality
208
Gender and mental illness
rates of mental illness higher in females than males, but rate of hospitalization higher in males than females
209
Demographic characteristics of psychiatric inpatients-marital status-
admission rates loses among widowed, intermediate for married and divorced/separated, and highest among single
210
Demographic characteristics of psychiatric inpatients-race
whites represent largest number, but patients from other races are over-represented
211
Demographic characteristics of psychiatric inpatients-age
largest proportion of admission in 25-44 age range
212
Demographic characteristics of psychiatric inpatients-diagnosis
schizophrenia most common in 18-44 age range; organic disorder (then affective disorder) most common in 65+ age range
213
Rate of whites in mental health
represent 70% of both inpatient and outpatient admissions
214
Boyd-Franklin's multisystems model
model for therapy with African American clients; addresses multiple systems, intervenes at multiple levels, and empowers the family by utilizing its strengths
215
LaFromboise et al. (1990) network therapy
incorporates family and community members into the treatment process and sees problems within context; recommended for native american clients
216
somatic complaints more likely to be expressed by
Hispanics and Asians
217
LGBT mental health
higher risk for depression, anxiety, substance use, and suicidality; evidence indicates thesis due to prejudice/discrimination, not sexual orientation
218
sexual identity in LGB males versus females
males had earlier onset of attraction, labeling, and same-set encounter than females; similar ages of coming out
219
Sue and Sue (2003) three parts of cultural competence
Awareness, Knowledge, Skills
220
Cultural Awareness
awareness of own assumptions, values, and beliefs
221
cultural knowledge
attempts to understand the world views of culturally diverse clients
222
cultural skills
use of therapeutic interventions that are appropriate for culturally different clients
223
Credibility (Sue and Zane 1987)
the client's perception that the therapist is an expert and trustworthy
224
Giving (Sue and Zane 1987)
client's perception that he/she has received something from therapy
225
Three aspects of indigenous healing
1. rely on community/family networks, 2. integrate religious/spiritual practices, 3. conducted by traditional healer/respected community member
226
Berry et al. (1987) for categories of acculturation
1. Integration (high new culture, high old culture), 2. Assimilation (high new culture, low old culture), 3. Separation (low new culture, high old culture), 4. Marginalization (low new culture, low old culture)
227
Sue 1978-worldview
how a person perceives his/her relationship with the world; determined by locus of control and locus of responsibility
228
Cultural encapsulation (Wrenn 1985)
1. define reality according to own cultural assumptions/stereotypes, 2. disregard cultural differences, 3. ignore evidence that does not conform to beliefs, 4. disregard own cultural biases
229
Emic orientation
culture-specific theories, concepts, and research strategies; attempt to see things through the eyes of the members of that culture
230
Etic orientation
phenomena that reflect a universal (culture-general) orientation; involves viewing people from different cultures as essentially the same
231
High-context communication
grounded in the situation, depends on group understanding, relies heavily on nonverbal cues, helps unify a culture, slow to change
232
Low-context communication
relies primarily on the explicit, verbal part of a message
233
Internalized oppression
system beating, system blaming, avoidance of whites, denial of significance of race
234
Conceptual incarceration
adopting a white worldview and lifestyle
235
split-self syndrome
polarizing oneself into "good" and "bad" components, with the bad components representing one's African American identity
236
Playing it cool
concealing anger or other unacceptable feeling by acting composed and calm
237
Uncle Tom Syndrome
adopting a passive or "happy-go-lucky" demeanor
238
Cultural paranoia
a healthy reaction to racism, when a client does not disclose to a white therapist due to fear of being hurt of misunderstood
239
Functional paranoia
unwillingness to disclose to any therapist, regardless of race or ethnicity, due to general mistrust and suspicion
240
Intercultural Nonparanoiac Discloser
Low functional paranoia, Low Cultural Paranoia; willing to self-disclose to and anglo or AA therapist
241
Functional Paranoiac
High functional paranoia, Low cultural paranoia; nondisclosure to all therapists, due primarily to pathology
242
Health Cultural Paranoiac
Low functional paranoia, high cultural paranoia; self-disclose only to AA therapist, due to past experiences with racism or the white therapist's attitudes or beliefs
243
Confluent Paranoiac
High functional paranoia, high cultural paranoia; non disclosing to all therapists due to combination of pathology and the effects of racism
244
sexual stigma
the shared knowledge of society's negative regard for any nonheterosexual behavior, identity, relationship, or community
245
Heterosexism
cultural ideologies that promote and perpetuate violence against homosexuals
246
Sexual prejudice
negative attitudes based on sexual orientation
247
Atkinson, Morten, and Sue 1993-Racial/Cultural Identity Development Model
1. Conformity, 2. Dissonance, 3. Resistance and Immersion, 4. Introspection, 5. Integrative Awareness
248
Cultural Awareness
awareness of own assumptions, values, and beliefs
249
cultural knowledge
attempts to understand the world views of culturally diverse clients
250
cultural skills
use of therapeutic interventions that are appropriate for culturally different clients
251
Credibility (Sue and Zane 1987)
the client's perception that the therapist is an expert and trustworthy
252
Giving (Sue and Zane 1987)
client's perception that he/she has received something from therapy
253
Three aspects of indigenous healing
1. rely on community/family networks, 2. integrate religious/spiritual practices, 3. conducted by traditional healer/respected community member
254
Berry et al. (1987) for categories of acculturation
1. Integration (high new culture, high old culture), 2. Assimilation (high new culture, low old culture), 3. Separation (low new culture, high old culture), 4. Marginalization (low new culture, low old culture)
255
Sue 1978-worldview
how a person perceives his/her relationship with the world; determined by locus of control and locus of responsibility
256
Cultural encapsulation (Wrenn 1985)
1. define reality according to own cultural assumptions/stereotypes, 2. disregard cultural differences, 3. ignore evidence that does not conform to beliefs, 4. disregard own cultural biases
257
Emic orientation
culture-specific theories, concepts, and research strategies; attempt to see things through the eyes of the members of that culture
258
Etic orientation
phenomena that reflect a universal (culture-general) orientation; involves viewing people from different cultures as essentially the same
259
High-context communication
grounded in the situation, depends on group understanding, relies heavily on nonverbal cues, helps unify a culture, slow to change
260
Low-context communication
relies primarily on the explicit, verbal part of a message
261
Internalized oppression
system beating, system blaming, avoidance of whites, denial of significance of race
262
Conceptual incarceration
adopting a white worldview and lifestyle
263
split-self syndrome
polarizing oneself into "good" and "bad" components, with the bad components representing one's African American identity
264
Playing it cool
concealing anger or other unacceptable feeling by acting composed and calm
265
Uncle Tom Syndrome
adopting a passive or "happy-go-lucky" demeanor
266
Cultural paranoia
a healthy reaction to racism, when a client does not disclose to a white therapist due to fear of being hurt of misunderstood
267
Functional paranoia
unwillingness to disclose to any therapist, regardless of race or ethnicity, due to general mistrust and suspicion
268
Intercultural Nonparanoiac Discloser
Low functional paranoia, Low Cultural Paranoia; willing to self-disclose to and anglo or AA therapist
269
Functional Paranoiac
High functional paranoia, Low cultural paranoia; nondisclosure to all therapists, due primarily to pathology
270
Health Cultural Paranoiac
Low functional paranoia, high cultural paranoia; self-disclose only to AA therapist, due to past experiences with racism or the white therapist's attitudes or beliefs
271
Confluent Paranoiac
High functional paranoia, high cultural paranoia; non disclosing to all therapists due to combination of pathology and the effects of racism
272
sexual stigma
the shared knowledge of society's negative regard for any nonheterosexual behavior, identity, relationship, or community
273
Heterosexism
cultural ideologies that promote and perpetuate violence against homosexuals
274
Sexual prejudice
negative attitudes based on sexual orientation
275
Conformity (ID Dev.)
Preference for dominant culture, depreciating attitudes toward one's own culture
276
Dissonance (ID Dev.)
confusion and conflict over the contradictory appreciating and depreciating attitudes one has toward the self and toward others of the same and different groups
277
Resistance and Immersion (ID Dev.)
actively reject the dominant society and have appreciating attitudes toward self and members of own group
278
Introspection (ID Dev)
uncertainty about rigidity of beliefs; conflicts between loyalty/responsibility toward own group and feelings of personal autonomy
279
Integrative Awareness (ID Dev)
sense of self-fulfillment with regard to cultural identity and strong desire to eliminate all forms of oppression; multicultural perspective
280
Black Racial (Nigresence) Identity Development Model
Pre-Encounter (race/racial identity have low salience); Encounter (interest in developing a black identity); Immersion-Emersion (idealizes blacks/black culture, rejection of white culture); Internalization (high race salience, have adopted a pro-black, non-racist (Afrocentric) or biculturalist orientation)
281
White Racial Identity Development Model
Contact Status (obliviousness and denial); Disintegration status (suppression of information and ambivalence); Reintegration (selective perception and negative out-group distortion); Pseudo-independent status (selective perception and reshaping reality); Immersion-Emersion status (hyper vigilance and reshaping); Autonomy (flexibility and complexity)
282
Parallel interaction
occurs when the therapist and client have similar levels of racial/cultural identity
283
Progressive interaction
therapist racial identity if more advanced than client's
284
Regressive interaction
client's racial identity is more advanced that therapist's
285
Crossed interaction
statuses of client and therapist represent opposite attitudes toward race
286
Troiden's Homosexual Identity development model
1. Sensitization; Feeling different (middle childhood), 2. Self-Recognition/Identity Confusion (onset of puberty, recognition of homosexual attraction); 3. Identity assumption (becomes more certain of homosexual identity); 4. Commitment/Identity Integration (adopted a homosexual way of life and publicly disclosed homosexuality)
