counseling families, diagnosis, neurocounseling, advanced concepts Flashcards
DSM
initially released in 1952, 100 diagnostic categories, 3rd edition 1980 psychodynamic->medical model, multi axial system; 4th in 2004 with 297 disorders; 5th in 2013 with 20 chps with grouping matching structure of ICD,
DSM 5
non axial, doesnt separate diagnosis of substance abuse and dependence.”retardation” is no longer used, ASD now encompasses other disorders like aspergers, easier to be diagnosed with ADHD, dysthymia is new dx, PMDD is new, greivment is no longer excluded from depressive disorder, no longer use term “gender id disorder”, gender dysphoria is new diagnostic categoy. Paraphilia is not a disorder and is not treated vs paraphilic where there is distress and others are harmed; 5 has more ratings or specifiers than previous editions (some exams use dimensionality to express severity)
allen francis
md chaired DSM taskforce and wrote final edition for 3rd edition and thought 5th was risky for patients and sad for psychiatry (thought many “normal” people would be labeled as having disorder)
billing to insurance
only ICD 10 codes are used to bill (HIPAA requirement) not DSM code
dr bonnie badenoch
helped convinced field of counseling that a neuroscientific mindset in counseling would be beneficial, ideally using fMRI scans to measure blood flow to brain to engage activity in different brain sites (also done by PET scans)
neuroplasticity
concept that the brain can change and new neural connections can be made at any point in life
neurogenesis
new neurons can be formed
mirror neuron concept
indicates that a neuron or neurons fire if you perform a behavior; same neurons fire if you witness the behavior in someone else
IPNB
interpersonal neurobiology. I.e. if a bear chases us we feel fear, if we witness a bear chasing someone else we feel fear, it is involuntary
CET
cognitive enhancement therapy; evidence based neurocounseling modality used with people with schizophrenia. Used neurocog video games and coaching to improve functioning
criticisms for neurocounseling
scanning can be unsafe, too much significance to blod flow in brain, not humanistic enough
confidentiality with families
you do not disclose info about one member to another unless with permission
AAMFT
american assoc. For marriage and family therapy. See marriage and fam therapy as seperate profession in and of itelf
IAMFC
international assoc. Of marriage and fam counselors; div of ACA, believe marriage and fam counseling is specialty mastered by someone with speicalized training
linear causality
assume that a causes b; generally accepted and valid concept in ind counseling
circular causality
more accepted by marriage and fam therapistsl related to cybernetics which gregory bateson became interested in. everyone influences everyone else so prob resides in family rather than ind.
cybernetics
analysis of informational interactions. How flow of info regulates and controls a system. Concept used by fam therapists, usually assoc with work of weiner. Family has feedback loops.
norbert weiner
1940s mathemetician pioneered cybernetics
homeostasis
can be good or bad but is a maintained balanced state. A family will attempt to hold onto given pattern of functioning that could be disfunctional.
adaptability
fams ability to change or display flexibility
enmeshment
family members are over involved with each other and lose autonomy
non sumativity
suggest that any system in the family is greater than the sum of parts. Better to examine patterns rather than ind. Behavior.
morphostasis
familys ability to balance stability
morphogenesis
familys ability to change
aspirational ethics
non mandatory ethics, describe ideal or optimal practice.
mandatory ethics
standards of practice
experiential conjoint therapy
closely related to virginia satir. conjoint = two or more family members are in therapy at the same time.
virginia satir
SW saw families in 1951, family could be healed via love, improve intrafamily communication, leading figure in experiential therapy
satirs stress positions
placating, blaming, being overly reasonable, being irrelevant
placating
trying to please everyone out of fear of rejection
blamer
basically asserts that “it is your fault i am the way i am”
persno who becomes overly reasonable
likely to engage in the defense mechanism of intelectualization; functions like a computer to keep emotions in check, aka responsible analyzer
being irrelevant
distracts family from problem via constantly talking about irrelevant topics
excitation
expressing true emotion
salvador minuchin
father of structural family therapy. Family therapy is science that required therapeutic interventions beyond warmth.
carl whitaker
dean of experiential family therapy. Liked to say that experience not education changes families, so best way to access unconscious is symbolically. Approach aka experiential symbolic family therapy. Liked to “join” with family and experience their dynamics, believed a co-therapist to be helpful. Assoc with. Psychotherapy of the absurd (actual tug of war when in power struggle). Promoted craziness and creativity of family members. Described as atheoretical.
luwig von bertalanffy
biologist who popularized notion of connectedness of all living things and systems theory model
murray bowen
based family therapy on systems theory. triangulation.
david premack
work suggests that a family member must complete unpleasant task before they can engage in a pleasant task. Unpleasant task=low probability behavior (LPB); pleasant task=high probability behavior (HPB)==premacks principle.
quid pro quo
one thing for another, makes use of behvaioral contingency contract based on the notion that one member will do something if another does something comparable.
time out
when a fam member is isolated so they do not receive reinforcement for dysfunctional behavior
reciprocity in marriage
in most cases, 2 ppl will reinforce each other about the same level over time and when this doesnt happen, marriage discord will result.
behavioral family therapy
1960s, focused on children in fam with problems,
gerald patterson
popularized parent training in home, pioneer of behavioral family therapy
psychologist robert liberman and richard stuart
pioneer o behavioral family therapy
family sculpting
virginia satir, experiential/expressive technique in which one member places other members in physical position that represents their relationships.
remarriage
4/10 new marriages, about 30% of divorced persons are remarried within 1 year
nathan ackerman
pioneer of psychodynamic family counseling. Was initially child psychiatrist who in 1938 recommended studying family. Before ackerman, it was innapropriate to include fam members in treatment.
object term psychodynamic family therapy
sig other with whom which a child wishes to bond. An ind. Attempts to establish a relationship with object to satisfy needs. When this doesnt happen, anxiety is manifested.
introjects term psychodynamic family therapy
client unconsiously internalized the pos and neg characteristics of the objects within themselves. Determines how individual will relate to others.
second order change
more desirable than first-order change. Structural change to family taht alters undesirable behavioral patterns.
first order change
superficial changes i.e. behavioral changes without structural changes. Ameliorates symptoms temporarily.
greek chorus
a consultant or supervisory team that observes session from one-way mirror and sends messages to therapist or family. Strategic therapy.
james framo
Famous psychoanalytic family therapist. Believes important objects fuel love/hate feelings in kids. More pathological early life is, the more the adult will fit relationships to love-hate scenario from childhood.
robin skynner
Famous psychoanalytic family therapist. Kids with poor role models possess protective systems.
jay hayley
Impacted by Erickson. Coined term strategic therapy. Believed in designing a strategy for each specific problem. Worked with Minuchin to train ppl. Believes in giving clients directives
strategic therapy
Chloe Madanes & Jay Haley. solution/sympotm focused and very action oriented. Madanes believed symptoms served function and advocated techniques using pretend techniques that are somewhat paradoxical.
directive/perscribing
strategic term. When therapist tells a client or family what to do. When a person follows a directive, symptoms are under control.
double bind (strategic therapy)
A no-win situation characterized by contradictory messages. Constitutes a paradox. A therapeutic technique.
paradox
strategic term. direct antithesis of common sense. Helper prescribed what the client would probably do anyway and cna even tell them to exaggerate it.
relabeling
relabeling/redefining/Reframing: strategic term. occurs when you redefine a situation in a positive context making the beheavior seem acceptable or positive to the client. Looking to evoke a diff emotional response. used by Hayley and followers
person with power in strategic therapy
one who makes decisions. Hayley believes you can enhance the power of someone in family by speaking to them first in the context of therapy
incongruous hierarchy
madanes/strategic term. When a member is in control who should not be (a child daughter in control of mother).
restraining
strategic term. a therapist may warn the ind or family about negative consequences of change. Helps overcome resistance by suggesting that it may be best if the family doesn’t change
positioning
strategic term. a helper accepts the clients predicament and then exaggerates the condition
behavioral dispute
REBT term. Client tries to behave in a way that is marketly diff from his/her normal undesirable path.
cultural encapsulation
term suggested by Wrenn. Results in a counselor imposing goals from his her own culture onto folx from another culture.
african american families
fewer are getting married and less likely to be concerned about gender roles. Best approach would be bowne’s family therapy, minuchins structural therapy or hayleys strategic family therapy. Problem-focused, brief or multigenerational approaches seem to fair best.
asian american families
solution-focused/problem-focused modalities seem to be best approach.
latino families
expectations are often that therapy should mimic medical treatment. Short term behavioral or structural approaches appear to work well.
cohesion
level of emotional bonding between family members
circumplex family model:
a key factor is that the family should have balance in cohesion as well as adaptability.
