Clinical Psychology Flashcards
(119 cards)
1
Q
Freudian topography
A
Conscious level: thoughts, feelings, perceptions in awareness
Preconsciousness: just below the conscious level, contains material not currently in awareness but readily accessible to consciousness
Unconscious: largest component of psyche, contains threatening emotions, memories, and other material not available to awareness
2
Q
Structural theory
A
- psychic structure consists of id, ego, and superego
3
Q
Id
A
present at birth, consists of all of the basic biological instincts that drive or direct behavior
- the most important are sexual (life) and aggression (death) instincts
- functions according to pleasure principle, seeks immediate gratification, relies on primary process thinking (unconscious, impulsive, irrational)
- they must be deduced from dreams, slips of the tongue, and free associations
4
Q
Ego
A
- part of the id modified by interaction with the external world
- reality principle
- seeks gratification of the id’s instincts but attempts to do so in ways compatible with reality
- operates at all 3 levels of consciousness
- relies on secondary process thinking, logical and rational
5
Q
Superego
A
- last component to develop
- serves as the conscience, operates at all 3 levels of consciousness
- evolves from internalization of parental prohibitions, standards, and values
- attempts to permanently block the id’s socially unacceptable instincts
6
Q
Freudian conflict
A
- anxiety emerges from conflicting demands of id, ego, and superego
- when ego is unable to resolve anxiety using realistic, rational means, it employs defense mechanisms, which operate at an unconscious level and deny or distort reality
- repression, denial, reaction formation, rationalization, projection, displacement, regression, sublimation (repression is the most basic and underlies all)
7
Q
Freudian goals and techniques
A
- Goals: to bring unconscious unresolved conflicts into consciousness and strengthen the ego so that behavior is based less or instincts and more on reality
- Targets of analysis: client’s free associations, resistance, dreams, and transference
- Procedures of analysis: confrontation, clarification, interpretation, working through
- countertransference
8
Q
Jung’s Analytical Psychology
A
- rejected Freudian principles, holding a more positive view of human nature, believed development continues into adulthood, behavior affected by past events and future goals
9
Q
Jung’s structure of the psyche
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1 - Conscious: ego with all thoughts, feelings, present awareness
2 - Personal unconscious: forgotten and repressed memories, complexes (collections of thoughts, feelings, and attitudes ie power, inferiority)
3 - Collective unconscious: wisdom shared by all people, developed and passed from generation to generation; archetypes, universal mental structures, including the persona, shadow, anima/animus
10
Q
Jung’s personalities
A
Introversion: direct their energy inward, prefer alone time
Extroversion: direct their energy outward, seek social contact
11
Q
Jung’s personality functions
A
sensing, thinking, feeling, and intuiting
- personality is combo of dominant attitude and function, ie introverted-sensing, extraverted-thinking
12
Q
Jung’s goals and techniques
A
- Goal: to bring unconscious material into consciousness to facilitate the process of individuation, an integration of all conscious and unconscious aspects of the self into a unified whole
- Techniques: dream interpretation, active imagination, analysis of transference
13
Q
Adler’s Individual Psychology
A
- rejected Freud’s theories and replaced his sexual instincts with an innate social interest, more interested in conscious processes, and adopted an approach focused on the effects of future goals on current behaviors
14
Q
Adler’s inferiority v superiority
A
- feelings of inferiority: develop during childhood (first 4-5 years) in response to real or imagined disabilities and inadequacies, and people are motivated to overcome their sense of inferiority using some compensation
- striving for superiority: innate drive toward competence and effectiveness
15
Q
Adler’s Style of Life
A
- describes the ways in which a person strives for superiority
- healthy style of life: goals that reflect not only concern for personal accomplishment but also the welfare of others
- mistaken/unhealthy style of life: overcompensation for feelings of inferiority, self-centeredness, lack of concern about well-being of others
16
Q
Adler’s goals and techniques
A
- Goal: to replace a mistaken style of life with a healthier, more adaptive one
3 phases:
1 - therapeutic relationship
2 - development of the client’s mistaken style of life
3 - developing social interests - Techniques: early recollections, dream interpretation, encouragement, modeling, prescribing the symptom, modeling, encouragement, and “acting as if”
17
Q
Neo-Freudians
A
- generally downplayed instinctual drives and focused on social and cultural influences on personality
- more positive view of human nature
- include Karen Horney, Harry Stack Sullivan, Erich Fromm
18
Q
Karen Horney
A
focused on the impact of early relationships; certain parenting behaviors cause a child to experience basic anxiety, or a feeling of helplessness and isolation in a hostile world; child adopts certain interpersonal coping strategies - moving towards others, moving against others, or moving away from others - healthy person uses all, neurotic uses only one
19
Q
Harry Stack Sullivan
A
- prototaxic mode: before symbols are used, discrete unconnected momentary states and an inability to differentiate between self and external world
- parataxic mode: autistic symptoms, differentiate certain aspects of experiences, seeing casual connections that are unrelated
- syntaxic mode: meaningful symbols, logical thought, and interpersonal communication
Neurosis: arrest at parataxic mode leads to parataxic distortions, due to unsatisfactory early relationships
20
Q
Erich Fromm
A
society prevents individuals from realizing essential nature to be creative, loving, and productive; 5 character styles - receptive, exploitative, hoarding, marketing, and productive - only productive permits a person to find nature
21
Q
Ego-Analysts
A
- Anna Freud, Erik Erikson, David Rappaport, Heinz Hartmann
- greater emphasis on ego role in development
1 - ego-defensive: resolution of internal conflicts
2 - ego-autonomous functions: adaptive, non-conflictual, learning, memory, comprehension, and perception - healthy behavior: under conscious control, pathology: ego loses autonomy from id
22
Q
Object Relations Theory
A
- Melanie Klein, Ronald Fairbairn, Donald Winnicott, Otto Kernberg, Margaret Mahler
- behavior is motivated by a desire for human connection rather than sexual or aggressive drives
- focuses on the impact of early relationships between a child and significant other (“objects”) in the child’s life
23
Q
Object Relations Theory: object constancy
A
the ability to maintain a predominantly positive emotional connection to a significant other independent to one’s need state or the ability to gratify one’s needs
- when a child is not provided adequate care, lead to splitting, abnormalities in object relations
24
Q
Mahler’s object constancy model
A
1 - normal autistic stage: first few weeks of life, infant aware only of self
2 - normal symbiotic stage: infant becomes aware of the external world but is unable to differentiate between self and others
3 - separation-individuation stage: 5-36 mos - differentiation, practicing, rapprochement, and beginning of object constancy - finality is integration, stable mental representations of self and others
25
Object Relations goals and techniques
- Goal: to replace maladaptive internalized representations of interpersonal relationships with healthier, more adaptive ones in order to improve relationships
- Foundations: client-therapist relationship is essential, therapy as "reparenting," providing empathy, support, and acceptance
- Techniques: analyzing resistance and transference, interpreting dream, and other psychoanalytic techniques
26
Person-Centered Therapy
- Rogers held the belief that people have an innate self-actualizing tendency that motivates and guides their behavior
- Incongruence: discrepancy between self and experience that can impeded self-actualization and lead to psychological maladjustment
- conditions of worth: mother provides affection, child behaves in certain ways
27
Person-Centered goals and techniques
- Goal: help the client maintain a state of congruence by developing a more flexible self-concept that enables one to respond to new experiences in open, non-defensive ways
- Techniques: empathy, congruence, unconditional positive regard
28
Gestalt Therapy
- Perls integrated psychoanalysis, behaviorism, and humanism, and focused on visual and auditory perception
- Assumption: all behavior is motivated by a striving for homeostasis/balance; when people are in a state of imbalance, they are motivated to obtain something from the environment to restore homeostasis, then retreat.
29
Gestalt boundary disturbances
- Boundary disturbances: chronic problems that interfere with growth, disturb the boundary between the person and the environment, person cannot satisfy needs
- Types: introjection (internalize other's beliefs), projection (attribute aspects of self to another), retroflection (doing to oneself what one would like to do to another), deflection (avoid contact with others), confluence (blurring of separation between self and other, loss of identify)
30
Gestalt goals and techniques
- Goal: to help the client achieve self-awareness and assume responsibility for thoughts, feelings, and actions
- Foundation: active, directive role, focus on current reality, distinguish between fantasy (transference) and reality
- Techniques: "I" statements, dream work, empty chair techniques
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Existential Therapy
- person's struggle with the ultimate concerns of existence - death, isolation, meaninglessness, freedom, responsibility
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Existential anxiety
- Existential (normal) anxiety: unavoidable consequence of life's conditions, serves as a catalyst for personal change and growth
- Neurotic anxiety: out of proportion to cause, outside awareness, loss of subjective sense of free will and inability to take responsibility in one's own life
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Existential goals and techniques
- Goals: to help clients minimize neurotic anxiety, learn to tolerate the unavoidable existential anxiety of living, and live more fulfilling, authentic life
- Techniques: no particular techniques, use integrate those from other approaches
34
Reality Therapy
- incorporates humanistic-existential, cognitive, and behavioral approaches
- based on choice theory: the choices people make determine the quality of their lives
- 5 basic needs: love and belonging, power, fun, freedom, survival
- Success identity: person chooses to fulfill needs responsibly
- Failure identity: person choose to meet needs irresponsibly
35
Reality therapy goals and techniques
- Goal: to replace the client's failure identity with a success identity by helping client assume responsibility for action and adopt more appropriate ways to meet needs
- Techniques: instruction, modeling, role-play, contracts, confrontation, humor
- WDEP: W - clients identify wants, needs, perceptions; D - clients identify what they are doing and their future direction; E - clients engage in critical self-evaluation; P - clients develop positive plans
36
Beck's Cognitive Behavior Therapy
- how we act and feel is largely determined by how we think and that maladaptive behavior is due to a combo of biological and environmental factors that predispose a person to faulty cognitive patterns
- Schemas: core beliefs, enduring ideas, experiences, adaptive or maladaptive
- Automatic thoughts: spontaneous thoughts that arise response to events and that the person may not be fully aware of.
- Negative cognitive triad: negative thoughts about oneself, the world, and the future
37
Cognitive distortions
- systematic errors in reasoning
- Arbitrary inference: drawing erroneous conclusion
- Selective abstraction: focus on certain (negative) details and disregard other info
- Overgeneralization
- Personalization
- Dichotomous/all or none thinking
38
CBT goals and techniques
- Goal: to help the client identify and replace maladaptive cognitive patterns; also identify specific goals with client
- Foundations: collaborative empiricism
- Cognitive techniques: reattribution, redefining, thought recording, Socratic questioning
- Behavioral techniques: activity scheduling, behavioral rehearsal, exposure
39
Rational Emotive Behavior Therapy (Ellis)
- ABC model of emotional disturbance and dysfunctional behavior
40
REBT Irrational Beliefs
- beliefs that elicit emotions and behaviors that interfere with a person's goals
- "Awfulizing"
- "I-can't-stand-its"
- Damnation of oneself, others, or the world
41
REBT goals and techniques
- Goals: to help client identify irrational beliefs, understand why those beliefs are irrational, and replace them with alternative, rational ones
- add D and E to ABC - D: disputation of beliefs, E: replace with effective ones
- Techniques: disputation, reframing, humor, imagery, role-playing, etc
42
Stress Innoculation Training
- combines skills training with modification of maladaptive cognitions that interfere with behaviors
1 - Conceptualization: educate client about nature of stress, person's perceptions and reactions to stress
2 - Skills acquisition: skills for coping with stress
3 - Application and follow-through: client applies new skills in stressful situations that gradually increase in intensity (imagination to in vivo)
43
Self-instructional training
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- help impulsive children develop self-control, based on the premise that people can modify behaviors through self-talk
1 - Cognitive modeling
2 - Overt external guidance
3 - Overt self-guidance
4 - Faded overt-guidance
5 - Covert self-instruction
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44
Problem-Solving Therapy
- assumption that psychological problems are based in deficits in social problem-solving skills
45
Biofeedback
- process in which a person learns to reliably influence physiological responses; monitoring the response and then provide feedback about the status of the response
- EMG biofeedback: muscle tension
- EEG biofeedback aka neurofeedback: brain wave activity
- Thermal biofeedback: skin temperature
46
Systems theory
-focuses on the interrelatedness of elements in a system and incorporates principles of general systems theory (structural aspects of living systems, composed of subsystems that are interdependent and autonomous), and cybernetics (how feedback mechanisms control the functioning of systems)
47
Family systems assumptions
- wholeness: elements of a system produce an entity that is greater than the sum of the individual elements
- open vs closed systems: family is never fully open or closed but varies depending on circumstances
- homeostasis: family members maintain stability and resist change by relying on consistent patterns of interaction
- negative vs positive feedback
- equifinality (different processes have the same outcome) vs equipotentiality (same processes have different outcomes)
48
Communication Theory
- the communication patterns within a family system shape the function of the system
- Level of communication: report level is verbal and conveys the literal meaning of the message; command (metacommunication) is usually nonverbal and expresses the relationship between communicators
- Double-bind communication: contradictions between the report and command levels
- Symmetrical (based on equality) vs complementary (based on inequality) interactions
49
Postmodernism family therapy
- narrative family therapy, solution-focused family therapy
- based on the assumption that reality is created through social interaction and therapy is a creative process, therapist collaborates with family to deconstruct old views and co-construct new realities
50
Bowen's extended family systems therapy
- multigenerational family therapy, emotional processes are transmitted from one generation to the next
- differentiation of the self: member's ability to separate intellectual and emotional functioning
- Triangles: three-person emotional systems
- nuclear family emotional system: methods used to deal with anxiety and stress
- family projection process: projection of parental problems onto a child
- multigenerational transmission process: patterns of differentiation are transferred from one generation to the next
- emotional cutoff: member tries to distance to deal with conflict - low level differentiation
- sibling position: birth order contributes to child's role
- societal regression: impact of societal stress on family
51
Bowenian therapy
- genograms, process questions, relationship experiements
52
Structural family therapy (Minuchin)
- family structure: family structure is determined by repetitive patterns within subsystems: spousal, parental, and sibling
- boundaries: clear, rigid, diffuse
- Rigid family triads: triangulation, detouring (reinforce deviant bx to shift focus), stable coalition (ganging up)
53
Structural family therapy goals
- to restructure the family so that it's better able to respond adaptively to stress
- Joining: building rapport, tracking
- Formulation: identifying patterns
- Restructuring: enactment, reframing, boundary marking, unbalancing
54
Strategic family therapy
- communication and power are key constructs, power is a person's ability to influence or control relationships
- Goals: alter interactions that maintain problem bx
- Direct directives: instructions that family members follow
- Indirect directives: reframing, paradoxical interventions (ask member to do something they are likely to resist, changes interaction)
55
Strategic family therapy
1 - social stage: speaks to members, observes
2 - problem stage: ask about presenting problem
3 - interaction stage: members discuss problems
4 - goal-setting stage
5 - task-setting stage: directive to complete at home
56
Milan systemic family therapy
- problematic bx involve repetitive behavioral interactions (games) that maintain homeostasis
- team of 4 therapists with 2 behind one-way mirror, structured sessions 1x month for 10 sessions
- strategies: hypothesizing, neutrality, circular questioning (ask members questions in specific order), positive connotation, paradoxical prescriptions (ask members to engage in problematic behavior)
- family rituals
57
Behavioral family therapy
- behavior is learned and maintained by antecedents and consequences
- contingency contracts, shaping, communication and problem-solving skills, modeling, rehearsal
- operant interpersonal therapy: increase positive reinforcement exchanged by couples
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Solution-focused therapy
- techniques: miracle question, exception questions, scaling questions, formula first session task (self-monitoring)
59
Multimodal therapy
BASIC ID: behavior, affect, sensation, imagery, cognition, interpersonal relationships, and drugs/diet/exerise
- tracking, bridging (preferred topic first)
60
Transtheoretical model
Stages of change: pre, contemplation, preparation, action, maintenance, termination
- decisional balance, self-efficacy, temptation
61
Motivational interviewing
- resolving ambivalence, client-centered
| - OARS: open-ended qs, affirmations, reflective listening, summaries
62
Interpersonal psychotherapy (IPT)
- interpersonal problem areas: role transitions, role disputes, interpersonal deficits, complicated grief
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Group therapy
- homogeneous (cohesion, trust) v heterogeneous (diversity, growth, range of beliefs) groups
- closed v open groups
- group size: 7-10 most effective
- inclusion v exclusion criteria
- premature termination: 30-40% groups
- concurrent individual and group therapy
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Formative stages of groups
- Orientation, hesitant participation, search for meaning, and dependency
- Conflict, dominance, rebellion
- development of cohesiveness
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Feminist therapy
- personal is political, commitment to social change, need to honor perspective of women, therapeutic relationship as egalitarian, reformulation of traditional views of psychological distress, recognition of oppression
- goals: empowerment, transformation
- techniques: gender-role analysis and intervention, power analysis and intervention, consciousness raising, assertiveness, therapist self-disclosure, social action
- self-in-relation theory: object relations based, identity comes from mother-daughter, mother-son relationships, need to define self as different from mother
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Etic vs emic perspective
Etic (universal): people from different cultures are essential the same, mainstream theories can be applied to everyone
Emic (culture-specific): people from different backgrounds differ in important ways
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Cultural encapsulation
therapists inability to understand and work effectively with clients from different background
- defines reality according to own set of cultural assumptions
- insensitive to cultural variations
- disregards evidence disproving assumptions
- relies on simple, technique oriented solutions
- evaluates others based on own perspective
68
Worldview
- manner in which people perceive, evaluate, and react to situations they encounter
- locus of control, locus of responsibility
- internal loci: masters of fate/successes (mainstream American culture)
- external loci: minority cultures
69
Acculturation
Integration orientation: retain own culture, adopt dominant culture
Assimilation: reject own culture, adopt dominant culture
Separation: retain own, reject dominant
Marginalization: reject both own and dominant cultures
70
Healthy cultural paranoia
Functional paranoia: pathological condition characterized by pervasive distrust and suspiciousness
Healthy cultural paranoia: distrust and suspiciousness but refers to the normal response of African American individuals to oppression and racism
71
Microinsults
nonverbal messages or insensitive remarks that demean the person's racial or ethnic background
ie. you got this job from affirmative action
72
Microinvalidations
communications that exclude, negative, or nullify the pathological thoughts, feelings, or experiential reality of a POC
ie. white therapist saying race doesn't matter to a POC
73
Microassaults
explicit verbal or nonverbal racial derogations meant to hurt or harm the intended victim and involve name-calling, avoidant behavior, or intentional discrimination
ie. serving all Muslim customers last
74
Communication styles
cultural differences in communication
High-context communication: relies heavily on culturally-defined meanings, nonverbal messages, and the context in which it occurs and is characteristic of several ethnic/cultural minority groups
Low-context communication: relies on the verbal message, independent from the context, characteristic of European Americans
75
Diagnostic overshadowing
attributing all problems to one feature/diagnosis, ie routinely attributing presenting problems of minorities to conflicts related to race, sexual orientation, etc without considering other contributors
76
Racial/Cultural Identity Development Model (R/CID) - Sue et al
1 - Conformity
2 - Dissonance
3 - Resistance & Immersion
4 - Introspection: conflict between autonomy and constraints, question loyalty to culture and rejection of dominant culture
5 - Integrative Awareness: resolved conflicts, appreciate own and dominant cultures
77
Cross' Black Racial Identity Development Model (Nigrescence Model)
1 - Pre-encounter: prefer White culture, internalized negative stereotypes about Blacks
2 - Encounter: important events challenges worldview
3 - Immersion-Emersion: denigrate White culture, glorify Black culture
4 - Internalization: develop a sense of security about Black identity
5 - Internalization - Commitment: internalize Black identity, work for equality
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Helms' White Racial Identity Development
Contact: lack of racial differences - "colorblind"
Disintegration: interactions with minorities leads to greater awareness of inequality
Reintegration: resolve conflicts by adopting White superiority and minority inferiority
Pseudo-Independence: dissatisfied by racism, unintentionally perpetuate it though with White views
Immersion-Emersion: explore Whiteness, proud of own race without being racist
Autonomy: internalize a nonracist White identity, recognize strengths/weaknesses and similarities/differences of all cultures
79
Troiden's Model of Homosexual Identity Development
Sensitization: feeling different than others, puberty
Identity Confusion: middle-late adolescence when same-sex attraction emerges; responses include denial, avoidance, repair, redefinition, or acceptance
Identity Assumption: during or after late adolescence, more interaction with queer people, more tolerance
Identity Commitment: internalize and accept homosexuality
80
Counseling: African Americans
- what are their experiences with discrimination
- family is nuclear, extended family, friends, community members
- male-female relationships are egalitarian
- religious and spiritual beliefs?
- emphasize empowerment through egalitarian relationship
- multi-systems approach, time-limited, problem-solving
81
Counseling: Hispanic Americans
- - what ethnic/cultural designation preferred
- psychological symptoms as somatic complaints
- short-term therapy + medication, offer a tentative solution to presenting problem early on
- religious and spiritual beliefs?
- family welfare over individual welfare
- traditional family and gender roles, machismo, marianismo
- formal style (formalismo) in initial session, personalismo in subsequent sessions
- active, goal-oriented, time-limited, CBT approach
- cuento therapy and family therapy
82
Counseling: American Indians
- tribal affiliation
- sharing and cooperation important, family and tribe take priority
- the spirit, mind, and body are interconnected
- communication styles: nonverbal communication, ie direct eye contact, firm handshake can be disrespectful
- network therapy: empowers clients to cope by utilizes social support system
83
Counseling: Asian Americans
- psychological problems as somatic symptoms due to holistic view of mind and body
- hierarchical, traditional gender roles, family needs over individual needs
- children may have positive dependent relationships with parents
- fear of losing face and shame, difficulty disclosing personal problems with those outside the family
- formal style, communication differences, ie silence and avoidance of eye contact are respectful and polite
- establish credibility by disclosing experience
- brief structure and solution focused, therapist as authority, suggest specific courses of action, behavioral approaches
84
Counseling Lesbian, Gay, and Bisexual
- no single model of psychotherapy
- consider own views and biases, stigmas
- recognize intersectionality - all cultures of client
85
Counseling: Older Adults
- consider heterogeneity of older adults
| - assess cognitive abilities and adapt
86
Risk Factors for Suicide
History of suicide, warning signs, age (age 50-59), males (4x more than females), race/ethnicity (Whites overall, but recently American Indians ages 15-34 had highest rates), marital status (recent divorce), psychiatric diagnosis (MDD, SUD, schizophrenia for adults, MDD, CD, SUD, ADHD for teens), hopelessness, physical health
87
Interventions for suicidality
hospitalization, outpatient management: increase frequency of contacts, emergency phone numbers, involve family and friends, ensure no firearms
88
Child Maltreatment: Victim Characteristics
- neglect most common, followed by physical, emotional, and sexual abuse
- age: peak at 14
- higher in girls than boys due to sexual abuse
- risk of PA: low birth weight, prematurity, difficult temperament, chronic physical illness and disabilities
89
Child Maltreatment: Perpetrator Characteristics
- biological parents, followed by nonbio parents, parents' partners, other relative, and other unrelated adults
- more likely women than men, except for with sexual abuse, more likely male and someone other than bio parent
- other factors: depression, substance abuse, other emotional problems, parenting deficits, martial and family problems, situational problems and stress
90
Intimate Partner Violence
- ~30% of women and men, higher for women
- victim risk factors: younger age, history of maltreatment, poor access to resources
- perpetrator risk factors: antisocial, low self-esteem, hx of violence, drug use, jealousy/possessiveness, unemployment, childhood hx of maltreatment
- relationship factors: cohabitation (rather than marriage), marital instability, stepchildren
- community factors: weak community sanctions against IPC, poverty, traditional gender norms
91
Cycle of Violence
Phase 1: tension building - escalation of verbal abuse and minor physical abuse that may last days, weeks, months, woman walks on eggshells to appease partner
Phase 2: acute battering incident - intense violent incident, women most often seek help during this phase
Phase 3: loving contrition - perpetrator is remorseful, apologetic, and promises it will never happen again
92
IPV treatment
- no approach has been empirically been found to be effective for different forms of IPC or populations
- there is evidence that a combo of arrest of offender, mandated treatment, and support for victim is more effective than arrest alone
93
Psychotherapy outcomes: Eysenck
- Eysenck (1952): 44% and 66% of patients with neurotic disorders who received psychodynamic or eclectic therapy showed improvement, 72% of patients with similar symptoms who did not receive therapy improved
- Conclusion: those who do not receive therapy have better outcomes
94
Psychotherapy outcomes: Smith, Glass, & Miller
- first to use meta-analysis
- average treatment effect size of .85
- conclusion: average therapy client was better than 80% of patients in no-treatment
95
Medical cost offset
patients with diabetes, hypertension, or other chronic medical illness experienced 18-31% reduction in medical costs after receiving mental health services
96
Dose-effect model
- 50% of psychotherapy clients show improvement by 6-8th session
- 75% by 26th session
- 85% by a year
97
Phase model
the nature of a client's improvement over time can be described in three phases:
1- Remoralization and decrease in hopelessness in the first few sessions
2- Remediation is symptom relief, up to 16 additional sessions
3- Rehabilitation is gradual improvement in patterns
98
Common factors to forms of psychotherapy
- Extratherapeutic/client characteristics: severity of symptoms, motivation, psychological mindedness, resilience, sources of support (40% variability)
- Relationship/therapeutic alliance factors: therapist's empathy, warmth, and acceptance (30%)
- Expectancy: placebo effect/client's positive expectations (15%)
- Techniques: strategies (15%)
99
Efficacy vs Effectiveness
Efficacy: experimental research with random assignment, maximizes internal validity, but limits external validity
Effectiveness: real world research, with max external validity
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Utilization of services
- Outpatient mental health: highest for Whites, followed by American Indian/Alaskan Native, African American, Hispanic, and Asians
- Inpatient: American Indian/Alaskan Native, African American, Hispanic, White, and Asians
101
Client-therapist matching
- racial/ethnic matching had greater impact on client's perceptions of therapist than on outcome
- larger for African Americans, than Asians, Hispanic, Whites
- matching may reduce the risk of premature termination
- minorities prefer matching race/ethnicity
- cultural competence, compassion, and similar worldview have greater impact than matching on outcomes
102
MMPI/MMPI-2
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10 scales (Hs, D, Hy, PD, Mf, Pa, Pt, Sc, Ma, Si), 9 validity scales, empirical criterion keying, conversion V (1, 2, 3), psychotic V (6, 7, 8)
MMPI-A: age 14 to 18
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103
NEO Personality Inventory-3
measures Big 5: extraversion, agreeableness, neuroticism, openness, conscientiousness
104
Myers-Briggs Type Indicator
based on Jung's personality typology, 4 bipolar dimensions
- introversion-extroversion
- sensing-intuitive
- thinking-feeling
- judging-perceiving
105
Rorschach
10 cards; 5 black and gray, 2 with some red, 3 pastel; free association and inquiry phases; Scoring: location, determinants, content, popularity, form quality
106
TAT
30 cards; scoring involves identifying the hero and needs, press, thema, and outcomes expressed
107
Strong- Campbell Interest Inventory
general occupational themes, basic interest scales, occupational scales, personal styles scales, administrative indices
108
Kuder Occupational Interest Survey
choose most and least preferred activities from three activities; scores on occupational scales, college major scales, vocational interest estimates, dependability indices
109
Halsted-Reitan Neuropsychological Battery
- separate tests of lateral dominance, psychomotor functions, sensory-perceptual functions, speech and language, visual-spatial skills, abstract reasoning, mental flexibility, and attention and concentration
- performance on individual tests and overall, to calculate Halstead Impairment Index
110
Luria-Nebraska Neuropsychological Battery
11 scales that measure specific functions; each item's raw score converted to a scaled score that ranges from 0 (normal) to 2 (brain injury), then summed and converted to T-scores
- takes less time to administer, more thorough assessment of damage than H-R
111
Bender Visual-Motor Gestalt test
- measure of visual-motor integration skills (design copy and recall)
- assesses school readiness, performance, learning disabilities, and in conjunction with others, for brain damage
112
Benton Visual Retention Test
identify brain damage by reproducing figures on 10 cards from memory
113
Beery-Buktenica Developmental Test of Visual-Motor Integration
screen visual-motor impairment by copying increasingly complex geometric figures
114
Wisconsin Card Sorting Test
- examinee's ability to form abstract concepts and shift cognitive strategies in response to feedback
- 64 response cards, with four symbols, sort and adapt to feedback
- sensitive to frontal lobe damage
115
Stroop Color-Word Interference Test
- examinee's ability to inhibit a prepotent verbal response and provides info on cognitive flexibility, selective attention, and processing speed
116
Tower of London
- measure of higher-order executive functioning and working memory
- move colored discs one at a time across pegs to match configuration on a card
117
Mini Mental State Exam
screen tool for cognitive functioning, including orientation, registration, attention and calculation, recall, language, and visual construction
118
Glasgow Coma Scale
- assess level of consciousness following acute brain injury
- rating an individual in three categories: eye opening, motor response, and verbal response
- score range is 3 to 15, 3 indicating deep coma, 15 fully alert person
119
Rancho Los Amigos Scale of Cognitive Functioning
tracking improvements in cognitive functioning following head injury, scoring patient on 1-10
