Counselling Therapy Theory

Question 0

What is psychic energy or libido?

Answer 0

The energy that emanates from drives (initially only ‘sexual’).

Question 1

What are (Freud’s psychoanalytical) drives?

Answer 1

Drives (or instinct) are basic motivators (unconscious). Including self-preservative drives (e.g breathing, eating, drinking, excreting) and species-preservative drives (e.g sexuality).

Question 2

What is the pleasure principle?

Answer 2

That human motivation is sexual in the broad sense that individuals are motivated to bring themselves pleasure, and avoid pain.

Question 3

What is the conscious, pre-conscious and unconscious?

Answer 3

Conscious - all the sensations and experiences that the person is aware of at any point in time.
Pre-conscious - memories of events and experiences that can easily be retrieved with little effort. Bridge to the unconscious.
Unconscious - is the container for memories that are threatening to the conscious mind and must be pushed away. E.g hostile or sexual feelings towards a parent

Question 4

In psychoanalytical (Freud) theory, how does the unconscious present itself and how do humans manage it?

Answer 4

Through dreams, Freudian slips, forgetting, behaviour and defence mechanisms.

Question 5

Describe the psychoanalytical theory of personality structure. (i.e Id, Ego, Superego)

Answer 5

Three basic systems that function together as a whole: Id, ego, superego.

ID - inherited and physiological forces/instincts (e.g hunger) non- conscious behaviour. Operates on the pleasure principle, through the primary process.

Ego - mediates between the world and the individuals ID, follows the reality principle, through the secondary process. Function is to plan, test reality, think logically, develop plans for satisfying needs.

Superego - collective social standards ( e.g what ones parents want). Non-rational seeks perfection and adherence to an ideal, inhibiting both the ego and the id.

Question 6

What is the name given to the investment of energy toward satisfying needs (by the ID)?
What is the name given to the control of the ID’s energy investment by the ego?

Answer 6

Cathect(invest energy)/ cathexis

Anticathexis

Question 7

What are some of the contributions Anna Freud made to psychoanalytical psychology? (name the two added mechanisms and added element of childhood development[ hint: ego] and describe what ‘defense against the reality’ pertains to.)

Answer 7

Two mechanisms:
Alturism - ‘helpful to avoid feeling helpless’
Identification with an aggressor - actively assuming a role one has been passively traumatised by.

Added other measures for maturation such a moving from dependence to mastery (also known as ‘developmental lines), showing how as children develop that form a more ego-centered view of the world (Reality/rational view) - showing an increased emphasis on the ego.

Defense against the reality - pertains to motivations that are not derived from internal drives alone but from the external world (the environment).

Question 9

What is ‘relational psychology’ (psychoanalytical)?

Answer 9

Focus on therapist client interactions
Therapist knowledge of psychoanalysis helps client
therapist doesn’t try to be objective. But relates to patient.

Question 10

What are the further developments of psychoanalytical theory?

Answer 10

Ego-psychology (Anna Freud, Erik Erickson)
Object-relations psychology (Donald Winnicott, Otto Kernberg)
Kohut’s self-psychology
Relational Psychoanalysis (mitchell)

Question 11

List the psychosexual stages of development (According to Freud)

Answer 11

Oral (birth - 18 months)
Anal stage (18 months - 3 years)
Phallic stage (3 - 5/6)
Latency (6-12)
Genital (13+)

Question 12

What is ‘ego psychology’ (furthered by Anna Freud [children] and Erik Erikson [adulthood])

Answer 12

psychoanalytical psychology that also focuses therapeutic efforts towards the EGO and not just the ID

Question 13

What is ‘ego psychology’ and who were it’s two major contributors?

Answer 13

A development of psychoanalytical theory focused on children, developmental processes and what is normal.

Anna Freud - ego development in children, additional defense mechanisms e.g., altruism

Erick Erickson - 8 stages of psychosocial development e.g infancy (trust v mistrust) linked to oral stage (e.g parents provide food) AND preschool (initiative v guilt): guilt because of anger towards same sex parent (e.g., desire for opposite sex)

Question 14

What is ‘object-relations’ psychology? (a further development of psychoanalytical theory)

Who were it’s two main contributors?

Answer 14

A further development of psychoanalytical theory that focuses on child-parent relationship.

Donald Winnicott
Otto kernberg

Question 15

What did Donald Winnicott contribute to Object relations psychology? (psychoanalytical theory)

Answer 15

Concept of the "good enough mother" (parent adaptive)
True self (distinction between parent and self)
False self (opposite of true self)

Question 16

What did Otto Kernberg contribute to Object relations psychology? (psychoanalytical theory)

Answer 16

Borderline disorders (i.e unstable, self-harming)
Splitting (fail to see ‘full picture’ of self and others)
central part of DBT (dialectic behaviour therapy) by linehan

Question 17

What is the purpose of traditional psychoanalysis?
(how long does it run for, how is the patient assessed, what is the focus of the treatment, techniques used and the nature of the counselling relationship)

Answer 17

4-5 sessions per week for 3-8 years
Assessment = projective tests, dreams, childhood issues
Focus= Resolving unconscious conflict (perceive reality without the use of ego defenses)
Techniques/relationship = Free association (unconscious becomes conscious), transference (e.g counsellor becomes a parent).

Question 18

What is the purpose of Psychoanalytic psychotherapy?
(how long does it run for, how is the patient assessed, what is the focus of the treatment, techniques used and the nature of the counselling relationship)

Answer 18

Once a week for several years
Aims to resolve unconscious conflict
still use free association and assessment techniques
disorders not severe (mild depression)

Question 19

What is the purpose of brief psychoanalytical therapy?
(how long does it run for, how is the patient assessed, what is the focus of the treatment, techniques used and the nature of the counselling relationship)

Answer 19

Often 12-16 sessions over a few months
still aims to resolve unconscious conflict
uses different techniques (ask questions, disagree, confront client, make suggestions)
Core Conflictual Relationship Theme (three phases)
*1st: client becomes aware of conflict (4 sessions)
*2nd: unconscious origins (5-12 sessions)
*3rd: termination of sessions (13-16 sessions)

Shares much in common with CBT.

Question 20

Briefly outline what the empirical evidence says about Psychoanalytical therapies.

Answer 20

Psychanalytical therapies are not scientific
Almost no studies, little evidence, most evidence is case studies.
Methodological issues in studying (long length, hard to define/measure concepts, non-manualised)

Question 21

What are the 3 steps to finding and dealing with the Core Conflictual Relationship Theme in Brief Psychoanalytical therapy?

Answer 21

Core Conflictual Relationship Theme (three phases)

• 1st: client becomes aware of conflict (4 sessions)
• 2nd: unconscious origins (5-12 sessions)
• 3rd: termination of sessions (13-16 sessions)

Question 22

In integrative therapies, what is theoretical integration and what is technical eclecticism?

Answer 22

Theoretical integration: theories merged e.g cylinical psychodynamics (psychoanalysis and behaviour therapy)

Technical electicism - only one theory uses (techniques from other theories reinterpreted) e.g multimodal theory, Bandura’s social learning theory
.

Question 23

In Person-centered therapy theory - describe the theory of personality (i.e positive regard)

Answer 23

• psychological development (social animals)
– need for positive regard (e.g., love, physical touch,
valued). Develops self-worth
– if not satisfied, self-worth undermined
• development and conditionality
– unconditional positive regard (one self, healthy)
– conditional positive regard (two selves, unhealthy)
• self-regard and relationships (relationships
improve if we have an unconditional positive
regard for others

Question 24

In Person-centered therapy theory - what are the characteristics of a fully-functioning person?

Answer 24

• the fully functioning person
– positive regards to self and others
– openness, creativity and responsibility
– understand the needs of self and others
– personality to flourish unfettered by the views of others
(the authentic self)

Question 25

In person-centered therapy - what are the goals (who do they come from?), what assessment and diagnosis are used? what are the necessary and sufficient conditions for client change? and what are the results?

Answer 25

Goals – come from client, not counsellor – awaken the “real you” (conditional positive regard is in most cases the cause of the problem) – stop trying to please others Assessment and diagnosis (rarely done) Necessary and sufficient conditions for client change: – psychological contact (i.e., a meaningful relationship) – incongruence in client (“real” versus “actual” self) – counsellor is open and genuine – counsellor displays unconditional positive regard – empathic counsellor Results – client perceives empathy and acceptance, feels like they have responsibility and unconditional positive regards, explores ideas, experiences the 'real self' and changes their own attitudes and behaviour.

Question 26

Summarize the empirical evidence for person-centered therapy.

Answer 26

Positive evidence, many studies focusing on the concept of 'empathy', not found to be as effective as CBT.

Question 27

In operant conditioning (behavioural therapy), what is | positive reinforcement and negative reinforcement

Answer 27

• positive reinforcement: stimulus presented after behaviour results in increased behaviour • negative reinforcement: stimulus withdrawn after behaviour results in increased behaviour • other terms: intermittent reinforcement, shape behaviour, extinction, punishment

Question 28

What is Albert Bandura's Social cognitive theory? (hint: learning by observation)

Answer 28

social cognitive theory (Albert Bandura) – role of thoughts in conditioning (e.g., observation and modelling in social life) – Jones (1924): child fearful of rabbits • watched other children play with rabbit • rabbit introduced at distance (distance decreased over time) • child eventually plays with rabbit – useful to explain the aetiology and treatment of psychopathology (e.g., modelling and specific phobias)

Question 29

What is social skills training? (behavioural therapy)

Answer 29

social skills training (e.g., LeCroy, 2007) – Theory = operant conditioning and social cognitive theory – specific social skills identified (e.g., introducing yourself, inviting someone out, engaging in social conversations) – therapist or clients model desired behaviours (feedback for positive reinforcement) – behaviours practised in real-world situations (e.g., pub) – client’s keep diaries, record behaviours and report successes and failures back to group

Question 30

What is assertiveness training? (behavioural therapy)

Answer 30

• assertiveness training (e.g., Alberti & Emmons, 2008) – theory = operant conditioning and social cognitive theory – difference between aggression and assertiveness – rights of self and others – specific behaviours identified (e.g., learning to say “no,” expressing a minority point of view) – use of feedback, role plays, diaries and real-world situations

Question 31

What is Acceptance and Commitment Therapy (ACT)? (behavioural therapy)

Answer 31

Hayes and colleagues argue a development of traditional behaviour therapy (e.g., Pavlov) – accept negative thoughts, feelings, events or situations because of conditioning (but not necessarily the “truth”) – commit to new values and behaviours – brief case study: Mark nervous about dating • accept negative thoughts and feelings (not the “truth”) • commit to behaviour of asking for a date

Question 32

What is Dialectical Behaviour Therapy (DBT)? (behavioural therapy)

Answer 32

– primarily to treat borderline personality disorder – based in part on psychoanalysis (Kernberg’s “splitting”) – Linehan argues based in part on behaviour therapy • behaviour therapy used to decrease self-destructive behaviours • goals defined in terms of specific behaviours • positive reinforcement or modelling to help client attain goals • groups often run using behaviour therapy (e.g., assertivenes

Question 33

Why does behavioural therapy seem to raise ethical issues?

Answer 33

– belief that behaviour therapy is used against people’s will – often used to treat developmental delays, autism or psychotic disorders (i.e., unable to give informed consent) • steps taken – informed consent from legal guardians or person

Question 34

Summarise the empirical evidence for behavioural therapy.

Answer 34

Generally on par with CBT, significant improvements. DBT found to be particularly good at treating borderline personality disorder.

Question 35

What is Ellis's Philosophical assumption based on Epictetus? (REBT)

Answer 35

Epictetus (a Stoic philosopher in Roman times) who argued that “people are disturbed not by things, but by their view of things” (see Sharf, 2012, p. 334)

Question 36

What is Ellis's Hedonism assumption? (REBT) and what are the two-types of hedonism?

Answer 36

hedonism (seek pleasure, avoid pain) • purely hedonistic (e.g., drug induced daze): long-term problems • “responsible hedonism”: think of long-term consequences

Question 37

What is Ellis's humanism assumption?(REBT)

Answer 37

Humanism • inalienable rights (e.g., respect, inherent self-worth) • unconditional self-acceptance • with regards to right and wrong, distinguish self from behaviour

Question 38

What is Ellis's rationality assumption?(REBT)

Answer 38

logic and science are important, but this does not imply unemotional.

Question 39

What factors does Ellis think contribute to human "disturbability" ? (REBT) are some people more resilient than others?

Answer 39

Biological factors - attempts to control social situations, genetic origins of some disorders (OCD) Social Factors - value the opinion of others highly, "musturbation" - beliefs that we 'should' and 'must' do certain things. Some people are resilient (u,e rational thoughts), some people are easily disturbed (i.e irrational thoughts)

Question 40

In Rational Emotive Behavioural Therapy (REBT), what are the goals, assessments, therapeutic relationship?

Answer 40

Goals of therapy – reduce self-defeating emotions and behaviour – self-actualised Assessment – little attention to formal diagnoses – focus on self-defeating cognitions and behaviour Therapeutic relationship – quick, direct, assertive, ready to disagree and argue – clients reported that Ellis was attentive, concerned and displayed good rapport

Question 41

What is A-B-C-D-E (in REBT) and what does it stand for?

Answer 41

the A-B-C-D-E therapeutic approach is used by counsellor to understand aetiology and to direct treatment (also taught to client) * A “Activating Event” (what caused it) * B “Belief” (beliefs about the event - irrationality) * C “Consequence” (consequences of that belief) * D “Dispute” (dispute the irrational beliefs) * E “Effective (effective new rational beliefs replace the irrational ones)

Question 42

Summarise the empirical evidence for the effectiveness of Rational Emotive Behavioural Therapy (REBT)

Answer 42

Yes, on par with CBT and good long-term prognosis. Useful with children and adolescents for example: various school-based programmes (e.g., “Thinking, Feeling and Behaving”) • integrated into school timetable • typically takes 12 to 16 weeks with weekly sessions • programmes typically include games, stories, role plays, writing, drawing and brainstorming

Question 43

What are some of methodological problems in studies of REBT?

Answer 43

* adherence to theory (i.e., irrational and rational beliefs) • purity (i.e., absence of other theories) • differentiability (i.e., clear that REBT is being used) • quality (i.e., is the REBT well done?)

Question 44

What are the central features of Aaron Beck's Cognitive Therapy?

Answer 44

That cognitions shouldbe/are the primary consideration

Question 45

in Cognitive therapy what are automatic thoughts?

Answer 45

Self-talk, conscious, brief and uncontrolled (automatic) that impact on emotions and behaviour.

Question 46

In Cognitive therapy what are schemas?

Answer 46

Are general belief (or belief-sets) often forged in childhood that generate automatic thoughts. Schemas can be adaptive or maladaptie: (good example, p. 376). Extremely successful business man “I am what I do or produce.” But now that he’s retired, he’s depressed

Question 47

In cognitive therapy give an example of cognitive distortions? (incorporate in schemas)

Answer 47

– “all or nothing thinking” (e.g., Unless I get an A on the exam, I will have failed) – “mind reading” (e.g., My friend no longer likes me because he’ll no longer go shopping with me) – “catastrophising” (e.g., I know that when I meet the regional manager, I’ll say something stupid and jeopardise my job) – “overgeneralisation” (e.g., Because I do poorly in math, I’m not a good student)

Question 48

In Cognitive therapy - what are the goals, assessment, therapeutic relationship and therapeutic process?

Answer 48

Goal: remove biased or distorted thinking Assessment – interviews (current thinking, but also person’s history) – self-monitoring (e.g., Dysfunctional Thought Record): situation, automatic thoughts, emotions, alternative response (i.e., alternative interpretations), outcome – scales and questionnaires (e.g., Beck Depression Inventory, Schema Questionnaire) The therapeutic relationship is collaborative and the therapeutic process is structured and includes homework.

Question 49

what is Mindfulness-Based Cognitive Therapy, and what is is designed to treat? and what is the structure of treatment?

Answer 49

TREATS: Relapse prevention for individuals who have experienced severe episodes of depression THEORY: Buddhist philosophy, don’t try to change thoughts or feelings focus on “decentering”: learn to accept thoughts or feelings (thoughts or feelings not reality) STRUCTURE of treatment • two-hour sessions, once a week for eight weeks (role plays, homework, thought diaries) – first four weeks: teach and practice non-evaluation – second four weeks: test how non-evaluation can reduce the impact of thoughts or feelings

Question 50

What is Schema-focused Cognitive Therapy?

Answer 50

For people diagnosed with a personality disorder (e.g., borderline) (designed by Jeffrey Young) • Focus on schema developed during childhood • Schemas often problematic for clients: abandonment, abuse, emotional deprivation, defensiveness, social isolation • counsellor actively tries to trigger schemas and emotions in a range of situations (e.g., role plays in clinic, scenarios in real-world situations)

Question 51

What are some further developments of Cognitive therapy?

Answer 51

Mindful-ness based cognitive therapy | Schema-focused cognitive therapy

Question 52

How is Cognitive therapy combined with other therapies?

Answer 52

Behaviour therapy (often called CBT) – philosophically incompatible (e.g., Skinner) – but Beck used behaviour therapy (e.g., depression) Person-centred therapy (both attempt to see the world from the client’s perspective) Rational-emotive-behaviour therapy (REBT) – cognitive therapy: work with client to change automatic thoughts and schema – REBT: counsellor challenges irrational beliefs Psychoanalysis (unconscious beliefs and behaviour)

Question 53

How might cognitive therapy be used in a group setting?

Answer 53

For example, Free (2007) suggested five modules – One: Surface Beliefs and Processes – Two: Beneath the Surface: Exploring Your Negative Belief System – Three: Testing Your Beliefs – Four: Changing Your Thinking and Feeling – Five: Changing Your Counterproductive Behaviour • use of role plays, diaries, real-world settings

Question 54

Summarise the empirical evidence for Cogntive Therapy.

Answer 54

Generally a well-tolerated treatment that is usually on par with behavioural therapy. Used in the treatment of deppression/anxiety etc. Limited evidence for mindfull-ness based cognitive therapy because it is new, but recent study is promising.

Question 55

What is the underlying philosophical foundation of constructivist approaches to therapy?

Answer 55

The only 'reality' is the one that you construct - entirely a subjective intepretation. Postmodern i.e an ambiguous overarching term for skeptical interpretations and criticism. It is often associated with deconstruction and post-structuralism. Little interest in science ( because science assumes an external/objective reality) Little to no theory regarding the aetiology of psychopathology.

Question 56

In constructivist approaches, what is solution-focused therapy? What are the general principles? what are the techniques regarding therapeutic change? What type of assessment is used? what are the Goals?

Answer 56

General principles – focus on what client says and does – not interested in what causes psychopathology you don’t want to know why the door is locked, just how to open it) – therapy brief (in one survey, average of two sessions) Assessment - not really relevant, may assess motivation. Goals - keep it simple, look at what works and promote it (compliment the client when something works), if something doesn’t work, just drop it Techniques for Therapeutic change (many) - collaborative relationship (helps to find solutions) – compliment client (promote solutions) – pre-therapy investigation (what’s worked in the past) – the miracle question (what would a future where the problem solved was solved be like?, what signs?) – scaling

Question 57

In constructivist approaches, what is Narrative therapy? What are the general principles? what are the techniques regarding therapeutic change? What type of assessment is used? what are the Goals?

Answer 57

Central principle = client develops a new story AKA personal construct therapy = counsellor explores settings, characterisations, plots and themes Assessment - client's accounts problems Goals - client sees life as a positive story (develop meaning and understanding regarding one’s personal journey) – resolve problems by creating a new story Techniques (many) - externalising the problem (problem becomes the focus not the person). For example (p. 470), “Samuel does not have a bad temper; rather, Temper is interfering with Samuel” – unique outcomes (exceptional times when an individual is highly successful and highlights their story) – alternative narratives (explore alternative stories) – positive narratives (highlight the positive) – questions about client’s future (create a new story?) – support for client’s stories (nurture, compliment)

Question 58

Summarise the empirical evidence for constructivist theories.

Answer 58

very anti-science, but some scientific study has been conducted. lots of methodological issues given no real 'theory' Small positive results for solution-focused therapy and 'large-effect' on a self-report measure (obvious problem) possibly related to hawthorne effect. Personal construct therapy - appears better than no treatment.

Question 59

What is Feminist therapy? (how is it different from other theories/therapies?)

Answer 59

Concept of “feminist therapy” – not a single theorist or theory (e.g., like cognitive therapy) – more an awareness that social forces are important – guiding principle: “women are valuable and that social change to benefit women is needed” (p. 486)

Question 60

What are the goals of feminist therapy?

Answer 60

– therapy for change, not adjustment (e.g., married women who reports severed headaches, but is also handling a demanding job and has extensive house duties) – self-esteem (e.g., rejecting external sources) – balance of personal and social demands (e.g., sacrificing one’s own educational aspirations) – body image (e.g., media) – affirming diversity (e.g., class, age, race, power) – empowerment and social action (fighting against discrimination and sexism)

Question 61

What assessments are used my feminist therapy? | What is the therapeutic relationship?

Answer 61

Assessment (critical, because of focus on person rather than society). For example, eating disorders Therapeutic relationship (safe and empowers)

Question 62

What kinds of techniques are used in feminist therapy?

Answer 62

Techniques of feminist therapy (used along with other theories of counselling) Determine situation: • need to consider social context (not person-focused) Cultural, gender and power; analysis and intervention. e.g cultural context of behaviour, gender-role expectations, increase clients awareness of power-play Power awareness and Skills: Somatic (control over body) Intrapersonal (autonomous thinking) Interpersonal (effective and communicative) Spiritual and existential (derive one’s own meaning) Empowerment (legal, social, moral) – assertiveness training (e.g., work situations) – reframing and relabeling (e.g., eating disorders) – therapy-demystifying strategies (e.g., self-disclosure)

Question 63

What therapies is feminist therapy often combined with?

Answer 63

Psychoanalytical - (though sexist elements are rejected e.g penis envy v womb/breast envy), because the unconscious is useful for describing the persistance of gender roles and the repression of personal wishes and desires. CBT - focus on gendered beliefs and schemas as 'irrational'. Develop schema to promote independence. Narrative therapy - views about gender/culture are socially constructed, encourage client to develop stories free of socially constructed views and limitations.

Question 64

How is group counselling utilized in feminist therapy?

Answer 64

Historical dimension – feminism to some extent developed from groups – groups involved in social activism and development of women’s shelters, legal aid (etc.) Structure of groups differ (but all female) – some: leaderless, noncompetitive, emotional support – others: involve counsellors and focus more on specific Issues (e.g., body image, self identity) • often used for adolescents (e.g., identity development, relationships with peers)

Question 65

Summarise the empirical evidence for feminist theories.

Answer 65

Not much scientific research – more emphasis on political and social action – feminist therapy often mixed with other therapies Some supporting evidence.

Question 66

What are the two approaches to family therapy?

Answer 66

– Bowen’s intergenerational approach (then case study) – structural family therapy (then case study)

Question 67

What aspects of computers/biology (in the 1940s - 50s) triggered family therapy and why?

Answer 67

Implications for counselling – multiple causes for abnormal behaviour – different ways to get a particular outcome – system can be stable and resistant to change even when operating in a dysfunctional state' LINEARITY AND CIRCULARITY IN A SYSTEM. VERSUS linear causality.

Question 68

In family therapy Bowen's Intergenerational approach, what is differentiation?

Answer 68

self with regards to family: • a highly differentiated person is well aware of personal opinions, has a good sense of self, able to stand their ground, argue their case and works well in a family system • a poorly differentiated (or “fused”) person indicates dysfunction

Question 69

In family therapy, Bowen's Intergenerational approach, what is Triangulation?

Answer 69

Triangulations are 'natural' because dyads are unstable (but family members may allie themselves with someone in family to battle against another family member) • third person can be from outside immediate family

Question 70

In family therapy, Bowen's Intergenerational approach, what is 'emotional systems'? (regarding differentiation and it's impact on conflict)

Answer 70

* low levels of differentiation = emotional conflict | * emotional problems are compounded because Bowen believes we select partners who have similar levels of differentiation

Question 71

In family therapy, Bowen's Intergenerational approach, what is family projection process?

Answer 71

• low levels of differentiation, problems often projected onto other members of family (typically, a child) • for example, child stays home from school (“fused” with parents)

Question 72

In family therapy, Bowen's Intergenerational approach, what is emotional cuttoff?

Answer 72

e.g a child tries to seperate.

Question 73

In family therapy, Bowen's Intergenerational approach, what is Multigenerational transmission process?

Answer 73

the idea that low levels of differentiation ricochets though the generations (causing conflicts)

Question 74

What are the goals and techniques of Bowen's integenerational approach?

Answer 74

Therapy goals – increase differentiation to increase family health – promote balance between individual and family needs Techniques – evaluation interview (if possible, all relevant people) family history (investigate/identify differentiation and triangulation) - maintain neutrality

Question 75

In Bowen's intergeneration approach, what are genograms and how are they used?

Answer 75

Genograms (p. 543) are diagrams where: • squares are males, circles are females • person with two squares or circles is “client interpretation (use genograms to educate family about multigenerational transmission process)

Question 76

In Bowen's intergeneration approach, what is detriangulation of family members and how is it done?

Answer 76

* amend destructive triangulations * work with healthiest person * maintain calm and neutral approach

Question 77

What are the two main elements of a family investigated and identified in Bowen's integration approach?

Answer 77

differentiation and triangulation

Question 78

What is Minuchin's theory (i.e conceptual building blocks) (for structural family therapy)

Answer 78

The disengaged or enmeshed family as boundaries to families functioning as a system with a sound rule-set and hierarchical structure (parents at top) Minuchin’s theory (i.e., conceptual building blocks) – family structure (the rules of family interaction). Ideally, should be hierarchical (parents at apex) – family subsystems (of varying sizes) – boundary permeability (e.g - - - clear, -----rigid, . . . diffuse, =====affiliation (threelines) overinvolvement) • disengaged (no one cares) • enmeshed (everyone overly involved) – alignments and coalitions during crises – families become dysfunctional when rules are inoperative and boundaries are too rigid or too permeable. In essence, family can’t function as a system

Question 79

What are the goals of Structural family therapy? | What are the techniques?

Answer 79

Goals: repair rules, boundaries and hierarchies Techniques: – draw genograms (as did Bowen) – family mapping to express boundaries in family – accommodating and joining (bring change by working within family system) – enactment (e.g., act out a family argument) – intensity (review “intensity” of family communications) – changing boundaries (e.g., give parents more power) – reframing (different interpretation of family events)

Question 80

Summarise the empirical evidence for Bowen's intergenerational approach and Structural Family Therapy.

Answer 80

There is a perception that there is no scientific evidence because it would be difficult to conduct research. Social constructivist views often cited. Some positive evidence. Differentiation was a supported concept (linked to anxiety, marital satisfaction and psyc distress) Triangulation was not suported, nor was couples marrying other individuals with similar levels of differentiation.

Question 81

In integrative therapies, what is theoretical integration and what is technical eclecticism?

Answer 81

Theoretical integration • theories merged • for example, cyclical psychodynamics (psychoanalysis and behaviour therapy integrated at a theoretical level) Technical eclecticism • only one theory used (techniques reinterpreted) • for example, multimodal theory (Bandura’s social learning theory)

Question 82

What is Wachtel's Cyclical Psychodynamics? (integrative therapy)

Answer 82

Psychoanalysis (within self) + behaviourism (behaviour and environment) A CYCLE: – problems within oneself create behavioural problems – behavioural problems create problems within oneself e. g., not interested in sales, don’t work hard at job - ---> loose job as salesperson, anxious about finances – use both theories to understand aetiology and treatment – liked optimism of the behavioural perspective – didn’t like cognitive therapy (preferred psychodynamics)

Question 83

How might Wachtel's Cyclical Psychodynamics therapy happen? (integrative therapy) (i.e case study)

Answer 83

• psychoanalytic aspects - Gains insight into origins of behaviour (unconscious, parental/childhood) Behavioural aspects – e.g systematic desensitisation to fears

Question 84

What is the central idea of Prochaska's Transtheoretical Approach?

Answer 84

essence: move client through the various stages of change using whatever theory, therapy or techniques you can

Question 85

What are the 5 stages of change in Prochaska's transtheoretical approach?

Answer 85

stages of change (e.g., smoking cessation) PC - PAM – precontemplation (think about change) – contemplation (seriously considers change) – preparation (intends to and initiates some changes) – action (demonstrates consistent change) – maintenance (works to prevent relapse)

Question 86

What are some level of problems and relevent therapies that might be enacted in Prochaska's transtheoretical approach?

Answer 86

– symptoms (e.g., behaviour therapy) – maladaptive thoughts (e.g., cognitive) – interpersonal (e.g., social skills training) – family (e.g., family therapy) – intrapersonal conflicts (e.g., psychoanalytic)

Question 87

What are the sever modalities of Lazarus' multimodal approach? what is the goal of therapy? what assessment is used?

Answer 87

BASIC ID (e.g smoker, considered in brackets) – B: Behaviour (e.g., smoking behaviour) – A: Affect (e.g., agitation when haven’t smoked) – S: Sensation (e.g., nausea when haven’t smoked) – I: Imagery (e.g., visions of cancerous tumor) – C: Cognition (e.g., concerns about death) – I: Interpersonal Relationships (e.g., impact on family) – D: Drugs (e.g., nicotine patches) ``` GOAL = change all levels Assessment = full assessment of all modalities. ```

Question 88

Summarise the empirical evidence for integrative therapies.

Answer 88

Science tends to focus on "what therapy works best?" Difficult to specify accurately the nature of the therapy. Limited evidence of effectiveness. little support for 'stages', stages are hard to define or evaluate