Comp Exam New COPY Flashcards
Narrative (Family) (12)
- No objective reality, we attempt to label people to control things, this is a fiction
- We live in a story of our own making; we can shift understanding, change the story
- Power of language-control our speech, control the future
- present/future focus
- Focus on ways society oppresses people- look for lessons we are taught, make them conscious
- Most stories start thin “I am bad at math”- thicken it with context
- Externalize the problem to de-fuse with it: examples given in class- instead of “he’s sneaky”, we say “when does this sneakiness happen?” “it’s us against the sneakiness”
- Look for sparkling events: times the family has been able to avoid/overcome the problem- we want to shine these times up and make them seem more important in order to change the narrative
- Engage each member in the story
- Bring in external influences- not all our fault we turned out this way- understand the big picture of how dysfunctional patterns are created
- Ask how each family member spends their time- focus on talents and strengths.
- Write a letter after therapy to each family member detailing their strengths, what you believe is possible for them
9 Steps of EFT
ACE
RIA
ESC
- Alliance
- Cycle
- Emotions.
- Reframe the problem in terms of the cycle and attachment related emotions.
- Promote identification with disowned needs and aspects of self; integrate these into relationship interactions.
- Promote acceptance of the partner’s experience and creating new interaction patterns.
- Facilitate the direct expression of needs and wants to create emotional engagement.
- Facilitate the emergence of new solutions to old relationship problems.
- Consolidate new positions/cycles of attachment behaviors.
EFT Interventions (5)
1) Empathic reflection.
2) Validation of client realities & emotional responses.
3) Evocative questions and prompts that call up emotion through open ended questions about stimuli, bodily responses, desires, meanings, or action tendencies.
4) Heightening: Expand and intensifies emotional experience through repeating, re-enacting, focusing, refocusing, and using imagery.
5) Empathic conjecture, interpretation and inferences.
EFT assesses relationship factors: (7)
a) Strengths
b) Cycle –
c) Behaviors
d) Perceptions
e) Secondary Emotions
f) Primary Emotions
g) Attachment Needs
EFT Therapy Goals (5) CEDSA
Cycle/emotions/de-escalate/safety/attach
- ID cycle
- ID attachment emotions
- Use in session enactments to de-escalate
- Establish new ways of relating (safer)
- Form healthy attachments
Contraindications for EFT:
ongoing violence,
substance abuse,
ongoing affairs- no trust
Methods of Assessment (EFT):
Dyadic adjustment scale,
attachment hx (parents),
family environment scale
DV main points- 1. what must we know (2. and how?) and 3. when is couples counseling okay?
- Assess individually for violence/risk/suicide/affairs-
- Use written assessment: Partner Violence Scale (has gender bias)
- Couples counseling okay iff: violence has stopped, violence is only mild, perpetrator takes responsibility for abuse and agrees to nonviolent tx
Safety Planning Steps:
- Identification that the risk is increasing
- Identification of specific steps survivor can take once they’ve realized risk is increasing
- Methods for maintaining safety once survivor leaves
Psychoanalytic Terms (3)
- behavior determined by unconscious factors/patterns early in life/developmental drives
- Id- pleasure principle
ego- reality principle
superego- perfection principle/concience & standards - anxiety- reality (danger), neurotic (instincts will get you in trouble), moral (fear of one’s own conscience getting you in trouble)
defense mechanisms (11)
RRRFR
CIPIDDS
rrrfr cipidds
- repression,
- regression
- reaction formation (express opposite of true impulse),
- rationalization
- compensation (focus on accomplishments to avoid shortcomings)
- Introjection (swallowing others’ values),
- projection
- identification
- displacement
- denial
- sublimation
Stages of development (Freud)
Erikson (see below) vs freud psychosocial (Oral (trust), anal (independence), phallic (sexuality, approval), latency (socialization), genital (sex energy channeled into achievement))
Goal of psychoanalytic:
make unconscious conscious and strengthen the ego so behavior is based on reality not instinctual cravings/irrational guilt
Therapist Role (psychoanalytic)/Client experience/What I’m looking for:
Blank screen, transference relationship, notice areas of resistance/interpret for client
Client experience- free association, dream interpretation, explore past and present
My interests: early childhood lessons, messages received; transference relationship (who am I to him, what can I learn from it); countertransference from me; developmental tasks mastered/not and attachment style/wounds
Individual Assessments: Depression Anxiety Trauma Substance Use Suicide Career Couples DV
Intake: Intake Assessment, cultural formation interview, adult plan of care, NEO FFI
Depression: BDI
Anxiety: BAI
Trauma: TSI
Substance Use: CAGE-AID
Suicide- SAFE-T; assess risk/protective factors, intent, plan
Career- Strong Inventory (Interest- highly researched), ONET (Values)
Couples: Dyadic Adjustment Scale, Attachment hx, Experience in Close Relationships Scale,
DV: Partner Violence Scale
Terminology to Describe Assessments
Reliability (consistency), Validity (accuracy), Bias (culture, error, instructor), Compare with Z/T scores
Depressive Sx (9)
Depressed mood (sad, tearful)
Loss of interest/pleasure
Feelings of worthlessness
Suicidal thoughts/ideation/plan/attempt
Increased/Decreased appetite/weight
Insomnia or hypersomnia
Fatigue or loss of energy
Diminished ability to think or indecisiveness
Psychomotor agitation or retardation
MDD
PDD
R/O
MDD- 5+ sx for at least 2 weeks
PDD- 2+ sx for 2 years
R/O: PMDD (monthly), Substance/Medically induced (Triggers), Bipolar (Manic Ep), DMDD (Temper, Kids, 1yr)
Anxiety Sx (6)
Restlessness or feeling keyed up or on edge.
Being easily fatigued.
Difficulty concentrating or mind going blank.
Irritability.
Muscle tension.
Sleep disturbance (difficulty falling or staying asleep, or restless, unsatisfying sleep).
Separation D/O Mutism Specific Phobia Social anxiety D/O Panic D/O Agoraphobia, GAD
Separation D/O (4 weeks in kids, 6mos in adults),
Mutism (1mo),
Specific Phobia (6mos),
Social anxiety D/O (6mos),
Panic D/O (4 panic sx + 1mo avoidance/fear), Agoraphobia,
GAD (3+ sx, 6mo)
R/O for Anxiety
OCD (1hr/day, 6mos),
Body Dysmorphic D/O,
Hoarding,
Substance/Medical
PTSD
An event
1 or more intrusion symptom
1 or more avoidance symptom
2 or more cognitive and mood symptoms
2 or more arousal and reactivity symptoms
Duration of symptoms for longer than a month.
Specifiers: Dissociative symptoms, Delayed expression
Acute Stress D/O
(1-30 days) Intrusion Negative mood Dissociative sx Avoidant sx Arousal sx
Pediatric D/O Oppositional Defiant Intermittent Explosive CD Autism ADHD
Oppositional Defiant (4sx, 6mo, Angry/Argumentative/Vindictive)
Intermittent Explosive (2 outbursts/week, 3mos)
CD (3 criteria in past year)
Aggression to people/animals
Destruction of property
Deceitfulness/Theft
Serious rule violation
Autism- social defecits, rigidity of interests/behaviors
ADHD- 6 sx each of inattention & hyperactivity for at least 6 mos
