Exam 3

Question 1

What are the two defense mechanisms in short-term psychodynamic therapy?

Answer 1

Denial and repression

Question 2

What are the three major tenets of psychodynamic therapy?

Answer 2

The unconscious, defense mechanisms, and transference

Question 3

How do denial and repression work?

Answer 3

Denial- refusing to admit or recognize a problem

Repression- unconscious exclusion of painful memories, impulses, fears from conscious awareness

Question 4

What is transference? What is an example?

Answer 4

Patient reacts to therapist as if therapist was an important figure in the patient’s past. Guy has bad relationship with his mother, he treats his female therapist poorly or obsesses about her

Question 5

What are the techniques used in psychodynamic therapy?

Answer 5

Transference, tackling resistance, and interpretation, clarification, and confrontation

Question 6

What does a psychodynamic therapist do to tackle resistance?

Answer 6

Seeks to identify and understand defense mechanisms displayed

Question 7

How does therapist do interpretation, clarification, and confrontation?

Answer 7

Comments on the defense mechanisms, transference, and the unconscious conflicts going on

Question 8

What is short term psychodynamic therapy?

Answer 8

A form of therapy with the desire to make unconscious conflicts known and dealt with

Question 9

What is “insight-oriented therapy?”

Answer 9

Unconscious issues that took root at an early age being brought to the surface. Helping person understand why they’re thinking and behaving in the way that they are; help person to understand him/herself

Question 10

Is psychodynamic therapy effective?

Answer 10

Works as well as other major methods in treating depression, but doesn’t have a lot of supporting evidence outside of that

Question 11

What is interpersonal therapy?

Answer 11

Clinical problems caused and maintained by interpersonal difficulties

Question 12

What are the four conceptual areas of IPT?

Answer 12

Grief, Role disputes, Role transitions, and interpersonal deficits

Question 13

Which conceptual area of IPT is described as “diverging perceptions of conflict with significant other producing significant distress?”

Answer 13

Role disputes

Question 14

Which conceptual area of IPT is described as “Few high-quality relationships?”

Answer 14

Interpersonal deficits

Question 15

Which conceptual area of IPT is described as “bereavement process complicated by delay or excess?”

Answer 15

Grief

Question 16

Which conceptual area of IPT is described as “difficulty adapting to change in life circumstances?”

Answer 16

Role transitions

Question 17

What are the goals of dealing with role disputes?

Answer 17

ID sources of misunderstanding, intervene by communication training, problem solving or other techniques that facilitate change

Question 18

Example of a role dispute?

Answer 18

Thinking your boss is out to get you because of work related issues

Question 19

Goals of Interpersonal deficits?

Answer 19

ID problematic processes like excess dependency and hostility and aim to modify these

Question 20

Example of someone with interpersonal deficits

Answer 20

Batman. He has people that he cares about, but is typically very reluctant to expand social circle so he drives people away by refusing to communicate and being a hardass

Question 21

How to handle role transitions?

Answer 21

Re-appraise old and new roles, and ID sources of difficulty in new role and make solutions

Question 22

Example of role transition difficulty?

Answer 22

Moving out of home, breaking up with a significant other, getting fired…

Question 23

How to handle grief

Answer 23

Establish new relationships, reconstruct relationship with the deceased, encourage affect and facilitate mourning process

Question 24

What are the overall goals of IPT?

Answer 24

Resolve interpersonal problems, and focus on the here-and-now problems rather than childhood or developmental issues

Question 25

How many treatment phases are there for IPT

Answer 25

three

Question 26

What does the first phase of IPT treatment consist of?

Answer 26

Diagnostic interview, INTERPERSONAL INVENTORY, patient education, clinical formulation of patient difficulties

Question 27

What is an Interpersonal Inventory?

Answer 27

Review of patient's pattern in relationships, capacity for intimacy, and evaluation of current relationships

Question 28

Something a clinician going over an interpersonal inventory might say

Answer 28

"You tend to rush out of relationships as soon as they become close, you struggle to develop intimacy with anyone, and your current relationships are easy going because most of your relationships are passing associates"

Question 29

Second IPT treatment phase?

Answer 29

Specific strategies and goals developed for respective themes

Question 30

Third IPT treatment phase?

Answer 30

Methods of dealing with recurrent clinical symptoms, reinforcement and strengthening of progress and experiences

Question 31

What are some examples of techniques used for IPT?

Answer 31

Role playing, communication analysis, encouragement of affect, exploration of options and decision analysis, clarification, and supportive listening

Question 32

What is the most evidence-based intervention approach?

Answer 32

Cognitive-behavioral therapy

Question 33

What is behavioral therapy?

Answer 33

Problem behaviors can be learned and modified through application of learning principles

Question 34

Example of behavioral therapy dealing with fear?

Answer 34

You were swarmed by bats when you were younger, and because of that, you're afraid of bats and places associated with them. We break your link between your experience and conditioned response by slowly exposing you to bats

Question 35

Goal of behavioral therapy?

Answer 35

Do anything to break link between experience and overt conditioned response

Question 36

Methods of behavioral therapy?

Answer 36

Conditioning, modeling, observation, instruction, contingency management, problem solving, etc.

Question 37

What does CT focus on?

Answer 37

Cognitions mediate between environmental events and behavior/emotion Link between things that happen and how we deal with them behaviorally and emotionally

Question 38

What does CBT hope to accomplish?

Answer 38

Modify maladaptive behavioral and cognitive patterns. MAINTAINING FACTORS MORE IMPORTANT

Question 39

Where in a person's life does CBT treat?

Answer 39

Present functioning rather than childhood history

Question 40

What are the six behavioral techniques of BT?

Answer 40

``` Behavioral activation Relaxation training Exposure therapy Problem Solving Social Skills training Contingency management ```

Question 41

How does a clinician start behavioral activation in a patient?

Answer 41

Start with small activities to counteract the inactivity and build more and more off of that. Activities that bring more joy and meaning into people's lives

Question 42

What does relaxation training consist of?

Answer 42

Breathing retraining, progressive muscle relaxation, mindfulness techniques

Question 43

How does exposure therapy work? | What does it treat best?

Answer 43

Gradually expose to feared or avoided stimuli/situations/experiences Anxiety

Question 44

What are the steps of problem solving?

Answer 44

Define problem, generate solutions, select the best solution, implement/evaluate solution

Question 45

What does social skills training treat and how?

Answer 45

Social anxiety disorder. Rehearsal of increasingly complex behavior skills, assertiveness training, etc. Role playing is a big player in this technique

Question 46

How does contingency management work? Who does this treatment the most?

Answer 46

Finding what the ABC's of a behavior are, and implement a series of punishments and reinforcements to decrease undesirable behavior and increase desirable behavior Children, but isn't uncommon in parents, adults, etc.

Question 47

What are the two techniques used in CT?

Answer 47

ID distorted cognitions and then challenge and replace them

Question 48

How does identifying distorted cognitions work?

Answer 48

Start with recognizing negative automatic thoughts, then translate that into immediate beliefs, and show how it's apart of the client's core belief system

Question 49

Once found, how are irrational cognitions challenged and replaced?

Answer 49

1. Estimate the possibility of a person's worst case scenario happening 2. If it does happen, walk them through how they would handle their worst problem if it did happen (decatastrophizing) 3. Replace those thinking patterns with ways that the situation can be handled or worked through

Question 50

What is the idea behind recording panic attacks and anxiety?

Answer 50

There's generally a sequence of events that occur before a panic attack; we want to teach people with panic disorder that attacks are predictable and manageable

Question 51

How do we explain panic attack to clients?

Answer 51

Panic attacks are fight or flight fear responses and THEY AREN'T HARMFUL. Just a misfiring of the fear response

Question 52

What is the breathing link to anxiety?

Answer 52

Chronic hyperventilation; feeling short of breath, chest pressure, feeling of suffocation, QUICK AND SHALLOW BREATHING

Question 53

What physiological effects occur from hyperventilation during a panic attack?

Answer 53

Increased oxygen in the blood, decreased carbon dioxide, upshot: less oxygen to brain and body, and balance out of whack

Question 54

What do we emphasize about breathing skills to someone that has panic attacks?

Answer 54

Emphasize smoothly breathing from the diaphragm with normal amounts of air

Question 55

What is the meditative component to the breathing skills?

Answer 55

Count as breathe in, "relax" as breathe out, focus only on breath

Question 56

How often should breathing skills be practiced and where?

Answer 56

Twice a day, ten minutes per session. Practice in relaxing situations and quiet places

Question 57

How is diaphragm breathing taught?

Answer 57

Client lays down, a book is placed on their stomach, and the clinician tells them to focus on moving the book up and down while they're breathing. Can also be taught by having the person having a panic attack feel the diaphragm while breathing instead of the chest rising and falling

Question 58

How are thoughts explained for panic disorder?

Answer 58

Thoughts reinforce emotions and vice versa. (My chest is tight, I think I'm having a heart attack, now I'm scared I'm having a heart attack, and now I'm panicking that I'm having one)

Question 59

What's the first step of thinking skills for panic disorder?

Answer 59

Identifying thoughts: | What am I afraid of? if that were to happen, then what and what would that mean?

Question 60

What's the second step of thinking skills for PD?

Answer 60

Evaluate the odds of a negative outcome; makes you aware of the overestimation of the likelihood of the negative outcomes

Question 61

Third step of PD?

Answer 61

Challenge your perspective: | Challenges catastrophic thinking about inability to manage negative outcomes

Question 62

How does exposure to PD work?

Answer 62

Face the physical symptoms

Question 63

What's the rationale behind exposure to panic disorder?

Answer 63

If you face the symptoms directly, you learn that they aren't harmful and are tolerable

Question 64

How does symptom assessment of Panic Disorder work?

Answer 64

Identify which exercises produce symptoms similar to those in a panic attack

Question 65

What's the hierarchy for exposure?

Answer 65

Rank exercises on which make you most anxious, and then practice by working way up the hierarchy

Question 66

Goal of exposure?

Answer 66

As exposure experiences go on, notice the reduction of anxiety in response to symptoms, activities, and situations

Question 67

How do we plan for the future for PD?

Answer 67

Get the client on medication to help the process while the client isn't seeing you

Question 68

What are the most important things to keep track of for Panic Disorder after treatment has ended?

Answer 68

Accomplishments that have happened, continued maintenance (doing the exercises to keep anxiety and occurrence low), and relapse prevention (scheduling more visits when necessary and scheduling follow-ups)