Flashcards in Final Deck (48):
1
Characteristics of psychotherapy
-interactions between a licensed professional that helps client with problems that may be related to disorders of thinking, emotional suffering, or problems of behavior.
-modes of treatment: individual, couples, group, family
-doesn't include help lines, self help groups
2
Trans-theoretical model of change (know the stages of change)
-precontemplation: no intent to change
-contemplation: intent to change in the foreseeable future
-preparation: intent to change in the immediate future(i.e. next month)
-action: made specific changes in their lifestyles within the past six months
-maintenance: working to prevent relapse.
3
Motivational Interviewing
-Strategies to help at different stages of change
-used to reduce resistance and promote change behaviors
*Asking Permission – “Do you mind if we talk about your smoking?
*Eliciting Change Talk – “What would you like to see different about your current situation?”
*Explore Importance - “Why did you say taking your medication is an 8 out of 10 and not a 5?”
*Affirmations – “You showed a lot of strength to stick with your plan.”
4
Common factors among psychotherapies
-all psychotherapy techniques are rooted in a theory of motivation and change
-licensed professional
-therapeutic relationship
-ritual space
5
What is a theoretical orientation, and why is it important to have one?
-a conceptual framework used by a counselor to understand client therapeutic needs
-helps a client because each one is different and a framework may work better for one individual compared to another
6
Dodo bird hypothesis
-common factors support the general effectiveness of most "bona fide" treatments(basically that all approaches produce similar affects)
-however very controversial because research has showed that some treatments are more effective in treating specific disorders
-also some treatments are harmful
7
Transference
-when client transfers information about their relationships to clinician and they start talking about it.
-reliving old relationships and transferring that onto the therapist.
8
classical conditioning
Classical: Pavlov-pairing stimuli and making associations
○ Ex paired bell with food.food causes salivation Once paired these two, the bell will also cause salivation.
○ Relates to anxiety because people will pair something with fear which causes anxiety
- ex little albert
-Emotional reactions can be trained through classical conditioning
-This relates to Anxiety and avoidance towards fear
-Video of baby and furry animals
-Would bang a loud noise above child head so now paired every time they see a fury animal
-Only rang bell for the rabbit
-But there was still a fear of response on the other animals
Dog, bunny, monkey
9
Operant Conditioning
-B.F. Skinner
-We learn based on the consequences of our behavior (behavior is controlled by consequences)
-Reinforcement: Consequences that lead to an increase in behavior
-Punishment: Consequences that lead to a decrease in behavior
behavior is controlled by consequences followed by reinforce frequency will increase punisher will decrease
10
What makes reinforcers effective?
-Immediate
-Contingent
-Tailored to the individual
-Powerful enough to motivate
-Shaping:
Reward successive approximations to desired behavior
Can be used to teach complex behavior
11
Potential negative effects of using punishment
-Can lead to negative emotional responses and aggression
-Use of punishment may reinforce the person providing the punishment
-Teaches what not to do rather than what the individual should do
-Models undesirable behavior
12
Behavioral techniques (Exposure therapy, shaping, behavior activation)
*Exposure Therapy:
-Based on classical conditioning
*Systematic desensitization:
-Using progressive steps
-Exposing from less to more instances and have to sit through it in a step like manner
This helps unpair the anxiety stimulus
*Exposure:
-Feared stimulus is not associated with the worst case scenario
-Anxiety will reduce (or can be tolerated)
-Gain a sense of mastery
*Flooding:
-is throwing the person in the situation they are scared of.
-May be rather traumatic
-ex throwing someone who is scared of dogs into a dog park
-Flooding has high rates of dropout
*shaping:
-reward successive approximations to desired behavior
-can be used to teach complex behaviors
*Behavior Activation
-Depression related to:
Lack of environmental reinforcement
-Increase previously enjoyable activities
13
Pivotal Response Treatment (Identify components of PRT)
1.Utilizing client choice:
-use client-preferred materials, topics, and toys
-loosely structured sessions
-follow client's lead during interactions
2. Presenting a balance of easy and difficult tasks:
-intersperse numerous, previously learned tasks with occasional new skills the client has not already learned
-allows opportunities for client to experience success
-decreases exposure to failure
3.using immediate and natural reinforcers:
-use rewards that are directly and functionally related to the task,
4. Reinforce attempts:
-if trying is reinforced, we will get more trying in the future
-decreases frustration on the part of the client
-helps client to understand that their behavior control their environment
14
ABC model in cognitive therapy
-Antecedent: something that happens in our environment. Ex. Imagine coming home and front door is open.
-Belief: background, what are my schemas about the world? Also includes what emotions may be there Ex. If I have the belief that the world is a scary place, or I live in an unsafe place, reaction would be to run out of my house. Emotions could be fear, feeling cautious about going in. another belief could be that I forgot to lock the door, or maybe a family member left the door open.
-consequences: reaction to door being open, ex run away
15
Cognitive distortions, core beliefs, and automatic thoughts
*All or nothing thinking:
-Sometimes called black and white thinking
-If I'm not perfect I have failed
-Either I do it right or not at all
*Mental Filter:
-Only paying attention to certain types of evidence
-Noticing our failures but not seeing our successes
-Negativity environment imposed to the positive seeing our failures not the accomplishments
*Jumping to conclusions
There are two key types of jumping to conclusions:
-Mind reading:
Imagining we know what others are thinking
-Fortune telling:
Predicting the future
*Magnification (catastrophizing) and minimizing:
-Blowing things out of proportion catastrophizing or inappropriately shrinking something to make it seem less important
16
Automatic thought record
*Situation: recall the problematic situation ex I waved at my friend on the street but he did not wave back when he saw me wave
*Automatic Negative thought: the first negative reaction to the situation ex why did he ignore me? He must be mad at me
*emotion: how were you feeling? How intense was each emotion ? scale 1-10 ex angry -9 sad-9 confused-10
*challenge automatic negative thought: what do you know about yourself and the situation that could challenge the automatic negative thought? Ex this is a busy street he may have not realized it was me
*new balanced thought: the more balanced thought after the challenging automatic negative thought ex he and I have been friends for some time now its not like him to ignore me, there must be a reasonable explaination
*emotion: how instense are the previously stated emotion? What new emotions are you feeling? Ex angry-5 sad-3 confused-7
17
SMART goals
S-specific
M-Measurable
A-achievable
R-realistic
T-time sensitive
18
Genograms
family tree, used to understand different relationships in the family
19
The identified patient
-Individual’s functioning is a manifestation of the way the family functions
20
advantages of group therapy
*advantages:
-provide social atmosphere that mirrors the real world
-cost effective
-normalizing
-accountability
-members provide and receive support and challenges that help to facilitate growth
-diversity of perspectives
21
disadvantages of group therapy
-confidentiality
-less control for the therapist
-excludes certain individuals ex social phobia
-personality clashing
-less individual attention
-harder to build trust and safety
22
types of group therapy
-support/process
-psychoeducational/skills training. ex:anger management, mindfulness, social skills, dialectical behavior therapy skills
-expressive: art/dance/music therapy
23
Yalom's group therapeutic factors
-Universality: Normalizing other people facing experience that are universal human concern.Being achieved in the group project
-Altruism: The members can help each other. Lift self-esteem.Problem solving
-Instillation of hope:Having others achieve and actually make changes in their life provides hope to other members that they can also change.
-Imparting information: Help provide services.Provide pragmatic information
-Corrective emotional experience: Group can take the same role as family and correct experience process on transcript corrective feedback individual can identify their own pattern by working with the group.
-Cohesiveness: Togetherness/closeness
Need to belong for individuals
-Development of socializing techniques: Developing new ways to interact with the world
-Imitative:Group members can model these behaviors
Also serve as a negative model
Ppl engaging maladaptive coping responses
Ex drugs cutting
-Existential factors:Taking responsibility in one's own action
Provide support and expectation in the group context
-Catharsis:Being to share story emotion,
Leading to relief
-Interpersonal learning:
Learning from modeling
-Self-understanding:
being able to understand through the group connect from mirroring group content
24
Couples therapy principles
-Alter the view of the relationship:
Objective and shared view rather than one-sided and blaming
-Modify dysfunctional interactional behavior:
Help to develop new, positive methods of interaction
-Eliciting avoided private behaviors: Having clients express emotion during session
-Improving communication:Developing communication that is not abusive or ridiculing
-Promote strengths:
Build resilience and increase enjoyment
25
PRIDE skills
-Praise:say what you like, especially about positive behaviors
-Reflect: repeat, summarize or expand on what the child says
-Imitate:do what they do
-Describe:describe what the child is doing
-Enjoy: say it with positive energy
26
effective time out procedure
effective command if they comply praise. if not timeout warning. if after warning they comply praise. if not give timeout which should lead to compliance
27
CDI vs. PDI
sessions
*Child Directed Interaction Focuses on:
-Improving the parent-child relationship
-Reinforcing positive behaviors
-Ignoring minor misbehaviors
-Promoting social and verbal development
-Reduce parent’s leading behaviors
*CDI phase:
-A teach session
-Coaching sessions
-Daily practice
-5 minutes of “special time”
-Weekly assessment of parenting skills and child behaviors
*Parent Directed Interactions
-Effective commands
-Consistent follow-through
-Use of timeout
-Teach session
-Effective commands
-Timeout procedures
-Coaching Sessions
-Teach child timeout procedure
-Practice compliance
-Stop aggression
-Public behaviors
28
Feminist therapy (Core tenets)
-developed by Laura Brown
-grew from influence of the women's movementin 1960s
-focus of therapy is helping clients to address social and gender role restraints
Core tenets:
-The person is political
-The counseling relationship is egalitarian
-Pain and resistance are viewed as a positive confirmation of the desire to live and overcome distress
-Women’s experiences are honored
-Use of integrated analysis of oppression
29
Multicultural counseling (What makes up cultural competence)
*Cultural competence: knowledge, attitudes, and skills related to
-Therapist awareness of own cultural values and biases
-Therapist awareness of client’s worldview
-Use of culturally appropriate intervention strategies
-Understanding to work with broader individuals of any culture this is an active process is an exposure to a diverse group of people
-Therapist awareness: view of their own biases and understand their own stereotype with diff cultures
Ex need to apply different cultures such as go to work with diff cultures then go home to dominant white neighborhood
-Culturally Appropriate intervention: respect their client's belief system values taboos indigenous healing practices, understand family structure hierarchies
30
Multicultural counseling research
*training improves client ratings of therapist cultural competence
-This can be taught and worked on "a muscle that can be built"
*Counselors are not very good at rating their own cultural competence
-Lack of empathy
*When counselors avoid discussing race, clients have difficulty talking about race
-Clients have difficulty talking about race
*Clients tend to rate ethnic minority therapists higher on multicultural competence than White therapists
-White therapist don’t think about oppression or privileged
-Even though they rate better
*Cultural competence predicts therapy outcomes, not ethnic match
31
Integrative and eclectic approaches to psychotherapy
*Paths towards integration:
-Technical eclecticism:
what is the evidence say and approach technique to work on this problem and this problem
-Taking techniques of any movement with a certain client certain problem not theory grounded
-Theoretical integration
aspect of therapy the are applying two therapy "theory smooshing"
-Common factors
what they have in common than focus on the technique of helping client later
-Assimilative integration
A firm browning of one approach the clinician has the ability to apply a different aspect of approach
* Integration:
The process of drawing from multiple psychotherapeutic approaches in order to treat a client.
-Research shows that most “master therapists” from different orientations are more similar in technique than different
-It helps for beginning counselors to draw on a specific theory
-General movement in the field towards greater acceptance of integration
32
Termination
*Reasons treatment ends
-Client or therapist life transitions
-Premature termination (dropout)
-Progress is not being made
-Goals have been accomplished
-It is important to prepare for termination
33
Psychodynamic
-derived from the work of Freud
*Fundamental theory: we have a motivating unconscious.
-desire to love, connect, and be loved by others
-we are motivated to seek pleasure and avoid pain
-emotion precedes thought
34
pyshcodynamic causes of psychological difficulties
*causes of psychological difficulties:
-result of unconscious interpersonal wishes and fears that are either unmet or inappropriate(often connected with early relationships to primary caregivers)
-intrapsychic conflicts between parts of the self lead to symptoms or problematic behaviors
35
psychodynamic change occur
*change occur:
-client develops openness to self-discovery
-understanding patterns of relating to others
-finding ways to disentangle influences of the past from current behavior
-finding new ways to cope
36
Goals of treatment psychodynamic
*goals of treatment:
-allow the client to express interpersonal wishes/fears
-work toward understanding where there interpersonal wishes/fears came from
-help the client explore new interpersonal patterns and expectations
37
elements of psychodynamic
*elements: affect and emotion
-exploration of experiential avoidance
-identifying themes and patterns(past experiences, interpersonal relations, wishes dreams)
38
Psychodynamic therapetuic approaches
*therapeutic techniques:
-addressing transference and counter transference
-interpretation
-free association
-dream analysis
-projective tests
-application when working with children:play therapy
39
Behavioral
Bandura posits that people learn from one another, via observation, imitation, and modeling. The theory has often been called a bridge between behaviorist and cognitive learning theories because it encompasses attention, memory, and motivation. booboo doll.
40
Cognitive therapy
-founders: Albert Ellis (rational-emotive therapy)
-Aaron Beck (cognitive therapy)
-ABC model
*thoughts are irrational if they:
-distort reality
-are illogical
-prevent you from reaching your goals
-lead to unhealthy emotions
-lead to self-defeating behavior
41
What are the types of irrational ideas?
*types of irrational ideas:
1.one should be loved or approved by everyone
2.in order to be worthwhile, one must be competent and achieving in every aspect of life
3.it is awful and catastrophic when things are not the way one would very much like them to be
4. if something is bothersome, one should dwell on the possibility of its occurring
42
Goals of cognitive therapy
1. identify automatic thoughts
2. combat problematic thought patterns by challenging and replacing them
3. uncover client's core beliefs that are overly rigid, concrete, or inappropriate
4. thus, reduce client symptoms of dysfunction
43
cognitive therapeutic process
-Use socratic questioning to help clients identify automatic thoughts, assumptions, and core beliefs( what evidence is there?what other explanations are there? if true, what are the implications?)
-challenging distorted beliefs
-homework
44
Characteristics of treatment cognitive therapy
-relatively short term:8-16 sessions
-problem-focused and therapist directed: therapist might assign homework and sets agenda for each session. Homework might involve behavioral practice or writing assignments
45
family systems theory
*problematic behaviors may:
-serve a purpose
-be patterns handed down across generations
*a change in one member effects all members
-Murray Bowen, Virginia starr, Salvador Minuchin
46
What therapies are used in family systems?
*systems therapy:
-the family unit is the client: informed consent issues. "no secrets" policies
-family unit difficulties require a shift in the dynamics of the family.
47
what is the clincial strategies in systems therapy?
*joining:
-form a therapeutic alliance with all family members
*diagnosis:
-identify interactional patterns that give rise to enable problematic behaviors
*enactments:
acting out family conflicts during therapy in order to assess and alter existing interactional styles
*restructuring:
-change interactions that directly relate to problems
48