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NURS 661 > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

Examples of Expressive Therapy

A

Rituals, Language arts, Visual arts, Drama, dance

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2
Q

What is expressive therapy?

A

Offers support and introspection by looking at negative thoughts and sad mood

Uses arts to look a difficult emotions

Counter conditioning is where the patient perceives safety, nurturing, and acceptance in the session –> fear diminishes

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3
Q

What is supportive therapy

A

Based on the patient’s psychodynamics, strengthen the defenses

More like talk therapy –> not as structured as expressive psychotherapy

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4
Q

Goals of treatment for supportive therapy

A

Strengthen the defense mechanisms that the patient already has

Promote problem-solving

restore adaptive functioning

Provide symptom relief

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5
Q

What is the diathesis-stress model

A

Genetic vulnerability + Nurture as our BDNF forms = how we’ll react to stress

Explains why some people can handle more amounts of stress and others cannot

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6
Q

HPA axis and stress

A

Stress occurs –> hypothalamus goes into overdrive –> produces cortisol

endocrine/nervous/immune systems = stress response

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7
Q

EMDR
- what does it stand for
- what model does it follow

A

Eye Movement Desensitization and Reprocessing

Adaptive information processing model

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8
Q

Psychodynamic therapy change agent

A

classical - insight

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9
Q

psychoanalytic therapy

A

aims to restructure defenses

based on freud

how the unconscious mind influences

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10
Q

Who would use group therapy

A

difficult with anger

lonely, loss, really shy, depression, social anxiety, addictions

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11
Q

Supportive therapy goals

A

therapeutic alliance to help patient

aims to strengthen defenses, promote problem solving

improve self-esteem to cope with life stressors

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12
Q

Who would use supportive therapy

A

learning how to live alone (widow),

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13
Q

Who would use Trauma Focused Cognitive Behavioral Therapy

A

people dealing with the negative effects of trauma

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14
Q

Who would use psychoanalytic therapy

A

abusive relationship - can’t remember that time period

someone who is experiencing repression - ie can’t remember parts of their childhood

repressed memories
nightmares

because it looks at how the unconscious mind can influence us

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15
Q

What are the contraindications of EMDR

A

strabismus and other eye disorders

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16
Q

Which defense mechanism improves empathy, insight, immune function, attention, and emotional regulation?

A

mindfulness

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17
Q

What is reframing

A

Developing a new conceptual or emotional outlook relation to situations experienced, and putting it into another frame which follows the facts or evidence equally well, changing its whole definition. Restarting

Looking at something from a different angle

ie. Looking at a problem as a challenge rather than a defeat

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18
Q

What is the Adaptive Information processing model (AIP)

A

Humans have an inherent information processing system that usually processes experiences to a physiological adaptive state in which information can be taken in and learning can occur. Memory is stored in a way that allows for connection with other adaptive memory networks

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19
Q

What disorders use EMDR?

A

Schizophrenia and bipolar disorder

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20
Q

Function of acetylcholine

and where the tracts are

A

Decrease levels is associated with memory and cognitive impairments. An increase is associated with Alzheimer’s disease

present in cholinergic track - extending from the limbic structure to the cortex

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21
Q

Function of cortisol

-and r/t PTSD

A

Stress hormone, inhibits inflammatory

PTSD - chronically lower cortisol

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22
Q

Function of dopamine

A

responsible for motor action and the reward system. Too much may change mood, increase motor behavior, and disturb frontal lobe functioning, resulting in depression, memory impairment, and apathy. Too little-parkinson’s/EPS symptoms; Too much-hallucinations

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23
Q

Function of Gaba

A

Calming neurotransmitter;
- too much-sedation
- too little: anxiety

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24
Q

Glutamate

A

Excitatory neurotransmitter involved in memory. Can cause problems with ACH if dysfunctional. Too much agitate neurons and can be toxic

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25
What is the defense mechanism? Ex: Anger and hostility are transformed into pain and somatic complaints
Hypochondria
26
What is the defense mechanism? Ex: Identification with the aggressor through which the person becomes aggressive to gain control Unconscious adoption of other people's thoughts and or traits
introjection
27
What is the defense mechanism? Avoiding, no social engagement
isolation
28
What is the defense mechanism? Ex: a child begins wetting the bed after a sibling is born
Regression
29
What is the defense mechanism? Ex: Instead of feeling sad, a person gets drunk
Acting out
30
What is the defense mechanism? Ex: The child cannot remember her anger or hitting her mother
Repression
31
What is the bilateral and unilateral approach of EMDR
Bilateral --> activation of both sides of brain --> use bilateral stimulation of sight and touch (tappers)
32
Neuroplasticity
brains ability to adapt chronic stress decreases neuroplasticity having good self coping skills helps the brain process change and adapt
33
Serotonin
helps calm you down and makes you happy main NT in depression --> Rx SSRI
34
What type of assessment question is this? How many drinks did you have? Do you smoke? Are you anxious or depressed?
Closed-ended questions
35
What type of assessment question is this? You must have been so hurt by that. That is very frustrating. It is hard to lose someone you love.
Empathetic statement
36
What type of assessment question is this? Tell me about your family situation. Try to describe how you felt when.... Share with me what you think a good outcome would be
Gentle command
37
What type of assessment question is this? How have you been sleeping? How is school going?
Qualitative questions
38
What type of assessment question is this? Can you describe the depressive symptoms? Can you tell me anything more about that?
Swing questions
39
The following is an example of which type of interpersonal style: "I try to change other people too much"
Domineering
40
The following is an example of which type of interpersonal style: "It's hard for me to stay out of other people's business"
Intrusive
41
The following is an example of which type of interpersonal style: "I put other people's needs before my own"
Overly nuturing
42
The following is an example of which type of interpersonal style: "I fight with other people too much"
Vindictive
43
What is the change agent of classical psychodynmic therapy?
Insight
44
What is relational psychodynamic therapy
better understand how your mind, body, and interpersonal life Therapeutic alliance relieve your emotional pain a discover how your unconscious mind creates problems for you
45
What is the change agent for relational psychodynamic therapy
mindfulness
46
Which type of therapy would be recommended for people who suffer from grief, substance abuse, and addiction?
group
47
Which therapy for patients with mature defenses
psychoanalytic therapy
48
Which therapy for someone with trust issues or primitive defenses
supportive therapy
49
Which therapy for PTSD
trauma focused CBT
50
Which defense mechanism involves behaving in such a way, that subtle interpersonal pressure is placed on the therapist to take on dimensions of an experience or unconsciously identify with aspects of the patient? A person projects qualities of themselves that are not acceptable onto another individual and that person internalizes those qualities ie. Sam is feeling self-conscious because he gained weight but can't accept it so he convinces himself that Mike has actually gained weight.
projective identification
51
Which defense mechanism is the following example: A young aggressive and impulsive man pursues a career as a boxing coach? Socially unacceptable qualities are transformed into something socially acceptable.
Sublimation
52
Which defense mechanism refers to the patient's thoughts, feelings, and behaviors that are associated with early important relationships with caretakers and significant others that are felt toward the therapist?
transference
53
What are atypical patient responses to EMDR?
increased anxiety, dizziness, lightheadedness, fatigue, numbing, and nightmares
54
What part of the brain is affected by EMDR?
Hippocampus gets bigger and increased inhibition of the amygdala
55
Affirming statement
This must be difficult for you
56
EMDR procedures
8 steps: 1. Hx taking ---- s/s, life constraints, screening 2. client preparation ---- establish therapeutic alliance, educate about EMDR, practice safe space 3. assessing the memory target ---- patient identifies, assigns value 4. processing the memory target ---- Desensitization - bilat stimuli 5. Installation ---- Install PC 6. Body Scan ---- note tension and sensation in body 7. Closure ---- keep log, educate about distrubances 8. Evaluating treatment results
57
What is OARS associate with? What does OARS stand for?
- motivational interviewing O: Open-ended questions A: Affirmation R: Reflection S: Summarizing
58
OARS: Engagement
getting to know patient, estabilsihing trust
59
OARS: Evoking
Eliciting motivation for a specific change
60
OARS: Focusing
Guiding interaction to identify a direction of change
61
OARS: Planning
Planning a specific change strategy
62
What is cognitive restructuring?
- Strategy used to help retrain the thinking - May be helpful to use a thought diary - Start the “stinking thinking” - Change those negative into positive thoughts
63
Social Skills Training
- Helpful to introduce self and help people make eye contact and feel comfortable - Identify socially acceptable boundaries
64
What diagnosis is social skills training beneficial
- Beneficial for patients with Autism, schizophrenia ----- Have so much going on in their minds that they aren’t paying attention to social cues or social skills
65
Shame attacking exercises
When people are afraid of doing something in public --> give them exercise to do in public and hopefully help them to realize its not as bad as they think
66
Eating disorders - key risk factors
OCD traits low self esteem distorted body image adolescents females
67
OCD - describe
- Feel like they have to depend on themselves to see that things get done - Run a very tight, strict, regimen in the home - Overboard on rules, systems, and orders
68
Defense mechanism: no it’s not true, I don’t’ hate you, I just love you so so much A young boy bullies a girl because he likes her
Reaction formation
69
Defense mechanism: I am not selfish. You are the one that always betrays me, run into someone you don't like -- but are nice to them
Projection
70
reflects feelings that the therapist has toward the patient and is similar in some respects to transference
countertransference
71
What style: Its hard for me to be assertive with another person
Non-assertive
72
Interpersonal therapy - adolescents
Reduced sessions for adolescents (12 sessions) -- helps them recognize feelings, improve communication, enhance socialization  Also minimal use of the “sick role”  Addition of parents to treatment  Highly effective for depression
73
Interpersonal therapy - goals - example
 Assess the problem – identify problem and the area of interpersonal relationships that it is effecting  Active treatment – delineation of specific goals for the identified problem area, create new relational patterns, discuss events between session as they relate to the identified problem area  Termination – finishing treatment, grieve loss of therapist and discuss relapse prevention Example = patients that struggle with addiction is to stop the addiction/stop using drugs
74
Psychodynamic Therapy: general
- self-awareness and the influence of the past on present behavior - emotions not just behavior - communication and relationship with others
75
Psychodynamic therapy motivation: classic and relational
classic - drives; sex and agression relational - emotional communication and affect regulation
76
CAGE
USE: identify alcohol abuse/dependence QUESTIONS: * Have you ever tried to Cut down on your drinking? * Have people ever Annoyed you by criticizing your drinking? * Have you ever felt bad or Guilty about your drinking? * Have you ever had a drink first thing in the morning as an Eye-opener, to steady your nerves or get rid of a hangover?
77
What is Socratic dialogue?
Mutual discovery in which the therapist asks a series of questions to help the patient discover the issue themselves
78
What are the steps of cognitive restructuring?
1. Tune in - self-monitoring 2. Question Assumptions 3. Gather evidence: keep the thought diary 4. Perform Cost-benefit analysis 5. Generate alternatives - stop them and change them to positive words
79
Attunement
recognizes other's emotions and is able to read social cues
80
Egocentrism
inability to differentiate b/w self and others. "All about me" (especially in teens and kids)
81
Minimizing
Downplaying the significance of an event or emotion; common strategy in dealing with feelings of guilt
82
Erikson's: Infant
Infant (-18 mo) -- Trust vs Mistrust -- Psychosis, addictions, depression
83
Erickson's: Early Childhood (18mo - 3 yo)
-- Autonomy vs Self dought -- Paranoia, obsessions, compulsions, impulsivity
84
Late childhood (3-6)
-- Initiative vs. guilt -- Conversion disorder, phobias, psychosomatic disorder
85
Erickson's: School age (6-12)
-- Industry vs inferiority -- Inertia, creative inhibition
86
Adolescent (12-20)
-- Identity vs role confusion -- Delinquency, gender-related identity disorders, borderline psychotic episodes
87
Young adult (20-30)
-- Intimacy vs isolation -- Schizoid personality
88
Adulthood (30-65)
-- Generativity vs stagnation -- Midlife crisis, premature invalidism
89
Older adult (65 - death)
-- Ego integrity vs despair -- Extreme alienation, despair
90
Gestalt Therapy - Goal
-- Goal: assist the patient in returning to natural state of organismic self-regulation
91
Gestalt Therapy - Cycle of retroflection
Turning back onto self what is meant for someone else. Instead of engaging with the environment and directing energy outward, energy is redirected inward. Examples: biting one’s lip, self-harm, symptoms of depression and psychophysiological disorder
92
Contraindications of EMDR
Strabismus, seizures... And possibly nightmares??
93
Signs that EMDR is working
Better emotional regulation, positive self-belief, increased self-esteem, and getting better sleep
94
Steps of cognitive restructuring
Situation, feeling, and evaluate thought And decision
95
What therapy for borderline personality
DBT or psychoanalytic/psychodynamic
96
What is interpersonal therapy focused on
Relationships Bad breakup and end up with depression
97
What therapy for panic disorder
Psychodynamic
98
What therapy for MDD
CBT
99
Freud's stages: Birth - 1 yr
Oral stage main interaction through mouth - rooting reflex, sucking reflex, tasting,eating - establish trust
100
Freud's stages: 1 - 3 yr
Anal stage controlling bladder and bowel movements - potty training - learn independance
101
Freud's stages: 3 - 6 yr
Phallic stage primary focus is genitals - discover differences between males and females - boys begin to view their fathers as rivals for mom's affection - Oedipus complex
102
Oedipus complex
unconscious sexual desire for the parent of the opposite sex and wish to exclude the parent of the same sex
103
Freud's stages: 6 - puberty
Latent stage sexual feelings are inactive - super ego continues to develop while Id is suppressed - develop social skills, values, and relationships with peers and adults outside of family
104
Freud's stages: puberty - death
Genital stage - maturing sexual interest - interest in the welfare of others
105
Amygdala
mediates: fear, anger, and rage hypersensitive = irritability, anger, hypervigilance, exaggerated startle response in PTSD
106
Cohesion
sense of belonging, solidarity, and attractiveness
107
Egocentrism
tendency of young children to think that everyone sees things in the same way as the child
108
Hippocampus
midbrain - memory - inhibition of amygdala - allows coherent narrative about personal history (what happened when and where so explicit memory can weave an autobiography.)
109
Hypothalamus
-regulates BP, body temp, sleep, appetite, glucose lvls and ANS
110
Cognitive distortion: emotional reasoning
Because I feel inadequate I am inadequtate
111
Cognitive distortion: personalization
That comment must have been directed towards me
112
Cognitive distortion: Global labeling
everything I do turns out wrong
113
Cognitive distortion: Catastrophizing
If I go to the party it will be a disaster
114
Cognitive distortion: Overgeneralization
Everything always goes wrong for me.
115
Cognitive distortion: Control Fallacies
If I'm not in complete control all the time, I will go out of control
116
Cognitive distortion: Objectifying the subjective
I have to be funny to be liked. It is a fact.
117
Cognitive distortion: Selective abstraction
All of the good men are taken or are gay.
118
Cognitive distortion: Fallacy of worrying
If I worry about it enough, it will be resolved.
119
Cognitive distortion: Ostritch technique
If I ignore it, maybe it will go away.
120
Overdeterminism
Refers to the idea that a problem most often has many different causes. The patient may not be able to provide a full description of these contributions and most likely is unaware of the multiple reasons for the current symptom
121
Resilience
ability to cope
122
Thalamus
above brainstem - relay station for top-down bottom-up neural networks that connect the cortex to the limbic system - PTSD: decreased thalamic activity - Dysregulation can result in significant memory issues ---- may lead to flashbacks, nightmares, avoidance, dissociation
123
Retroflection
doing to oneself what one wanted to have done to oneself by others
124
Why use motivational interviewing?
Help individuals resolve ambivalence and plan for change It can be used alone to increase motivation for engaging in psychotherapy or in combination with other forms of therapy when resistance is encountered.
125
Narcissistic Personality Disorder - what is it - what therapy
- Consider themselves special & expect special treatment; sense of entitlement is striking; handle criticism poorly; want own way; frequently ambitious to achieve fortune & fame; relationships are tenuous psychoanalytic DBT lithium antidepressants
126
OCD - what is it - what therapy
Preoccupied with rules, regulations, orderliness, neatness, details & achievement of perfection CBT, Group Clonazepam; Clomipramine; fluoxetine 60-80mg; Nefazodone
127

NURS 661 (5 decks)

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