FINALS STUDY GUIDE Flashcards

Question

Reasons and solutions for client non-compliance (homework, opening up to therapist, talking too much, angry clients, overly compliant)

Answer 1

HOMEWORK Reason: -lack of time, -worried about doing it incorrectly and being judged, -too hard or time consuming Solution: -integrate or re-explain why so important to outcome - there to teach new skills not to judge, -engage clients in redesigning OPENING UP TO THERAPIST Reason: -worried about confidentiality -negative experience with clinician or violated by people in their lives -fear of negatively judged -fear of critical feedback of symptoms Solution: -be direct—but in an empathic way - First, make an observation to the client (e.g., "You seem reluctant to talk to me about these difficulties") and then pose an open-ended question -talking sign of courage TALKING TOO MUCH Reason -clients simply do not know what is expected of them in the therapeutic setting -anxiety (could be diversion tactic) -talkativeness can be related to specific psychological problems. (OCD) Solution -acknowledge this and reassure clients that there is a framework to their questioning -leave time in end for chatting -bringing up this problem in therapy and helping clients to acquire better social skills. ANGRY CLIENTS Reason -have tried to improve their lives on their own with limited success. -might keep these concerns bottled up. When they feel frustrated, their frustration emerges as anger -might have grown up in homes in which anger was frequently exhibited. Solution -not get "sucked into" the anger. Instead, view it as another window into the client's life for case conceptualization -"You seem very frustrated today. Can you help me to understand why?" -ground rules (no yelling in session) -working on anger management in therapy OVERLY COMPLIANT Reason -the motivation for doing the work of therapy was coming from her desire to please, instead of from intrinsic motivation to get over her condition Solution -taking a more active role in designing the homework the client felt that she had herself to answer to—not just the clinician.

Answer 2

- is achieved through HIPPA (regulates the way that protected health information is communicated ) and consent forms - should discuss confidentiality in first meeting - FIRST, tell client how important confidentiality is to you and clinic and bound by law - will not speak about them with anyone except your supervisor, other clinicians who attend group meetings with your supervisor, or other people at the clinic who are directly involved in their care - discuss the specific circumstances under which confidentiality must be broken (state laws mandate) - can be broken when you are doing employee assessments for an employer, student assessments for a school district, or assessments that are ordered by the court because you are working for that third party not the client

Answer 3

Client should be made aware (1) they threaten to harm themselves; (2) they threaten to harm specific other persons; (3) they tell you about the abuse of a child; or (4) their records are subpoenaed by a court of law. Some states and provinces also have other mandatory reporting laws (e.g., mandatory reporting of abuse of adults who cannot protect themselves).

Answer 4

IMPORTANT POINTS Consent must be obtained for assessment and therapy. Written consent is superior to oral consent. Let clients read through consent forms at their own pace, check that they have understood what they read, and invite questions. Clients should also be presented with a statement of the clinic's privacy practices (HIPAA document). ESSENTIALS Clients must understand the purpose and nature of the activity. Clients must be informed about likely benefits and risks of the activity. Clients must be told of alternatives to the activity (e.g., other treatments) and likely consequences of nonaction. Consent forms must also make clear that clients can refuse to participate in the given activity or withdraw at any time without prejudice. Consent forms must also include a discussion of confidentiality protections and limitations.

Answer 5

TRAIN BEGINNING CLIENTS - in assessment - case concept - how to be a therapist - ethics - constantly evaluate - skills ENSURE THAT CLIENTS RECEIVE COMPETENT CARE - supervisors are legally and ethically liable for any harm done by a trainee under their supervision - must always be aware of the status, treatment course, and current level of functioning of each client SERVE AS MENTOR - help chart trainees career path - helping trainees develop their own supervision skills

Answer 6

KEEPING THE END POINT IN MIND (cornerstone of cbt time limited) -provides clients with some external pressures to make changes by a specific time (motivation) TEACH CLIENTS TO BE OWN THERAPIST -framed as positive step from the beginning so they can use their newly acquired skills to deal with their difficulties on their own LAST COUPLE OF SESSIONS - needs to have a clear sense of what he or she has accomplished - needs to set some goals for the future - must ensure realistic expectations for the future - must know what to do if symptoms reemerge.

FINALS STUDY GUIDE Flashcards

(30 cards)