Intervention Flashcards

Question

MI Planning

Answer 1

- Targeted behaviour change - Why making change - Steps need to take place - Who can support - How to know if plan is working - What can get in the way and how to address it - What to do if plan does not work out

Answer 2

Client centred Directive method to enhance intrinsic motivation Effective for alcohol and substance use Components: Collaboration, compassion, evocation, acceptance Processes: Engaging, focusing, evoking, planning OARS: open-ended questions, affirmations, reflection, summaries DARN-CAT: desire, ability, reasons, need - commitment, activation, taking steps Key interventions: evocative questions and reflection, important and confidence rulers, decisional balance, exchanging info, exploring goals and values, looking back and forward, querying extremes Self efficacy enhancement: build confidence to make and maintain behaviour change

Answer 3

Focus on problems, origin and amelioration Look for change already occurring and seek to build on these Grounding: positive psych Explore strengths and build on Achievement of positive aims, not treating deficits Goal attainment rather than problem solving Client goal - better way to achieve it Can be just do more of what already works Building NOT teaching NOT seeking change but deeper and more consistent grounding in who the person is

Answer 4

- Inquiry into precession change to initiate conversation - Use MIRACLE QUESTION to frame goal - Search for exceptions to patterns and explore possible solutions - Use scaling questions for status and anchor progress - Positive feedback and homework

Answer 5

Changes occur when making and attending first appointment Co-construct positive goal When not identifying presession change —> narrow focus, inquire about goals for current session (what would happen to make the session useful) Patients are often actively coping and finding solutions to keep them functioning - focus on these adaptive efforts leading to discussion of strengths and solution

Answer 6

Goals to achieve solution rather than lessening or eradicating problems Shift the focus to future and all is going well, positive changes Allow patient step out of current constraints

Answer 7

Eg. Problem patterns at work may not show up on friendships Explore variations in problem patterns, pointing the way to persons strengths Helpful for those who strongly identify with their problems Patient is the patient expert in therapy

Answer 8

Gauge progress and anchor solution focus Exploring what they are doing and when they are making progress In beginning of second session and subsequent Positive movement: exploring what make the movement posible Negative movement: what to do to avoid failing to the bottom end of the scale

Answer 9

Reflecting strengths client can build to reach goals Client to perceive, internalise, extend strengths Homework: bridging time gap between sessions - NOT skills teaching as in CBT. Failure to do homework: NOT right one at the time, clear way for exploration for alternative exercises

Answer 10

NOT require diagnosis, only a clear goal Can be for children, adolescents and families Look for exceptions and strengths to build upon these

Answer 11

Time limited 12-16 sessions Thoughts, emotions, behaviours Core beliefs or schemas For depression, GAD, panic, social phobia, OCD, PTSD, schiz First line treatment for most Focus: teaching skills so client becomes their own therapist Goal setting, open to feedback, completing homework

Answer 12

Relevant data - core belief - conditional assumptions - compensatory strategies - situations - automatic thoughts - meaning of automatic thoughts - emotions - behaviour

Answer 13

Identifying and evaluating thoughts causing distress Identify - examine - evaluate - modify thoughts, assumptions, schemas Catastrophe, back and white, tunnel vision, personalising, mind reading Identify core belief: helpless, unlovable, worthlessness Thought diary, worksheets, socratic questions Start cognitive w anxiety W depression start with behaviour first

Answer 14

Chain analysis - vulnerability, activating events, thoughts, feelings, behaviours Freeze a frame - describing the timelines of a specific events - helpful for suicide prevention Understand function of behaviours

Answer 15

Experiment to test validity of belief or reinforce new belief Not always possible Goal: cognitive flexibility For those who get something but dont yet connect w emotion Reinforce collaboration

Answer 16

Education about - the illeness - mastering techniques to manage symptoms Become independent in managing their own condition Eg early symptom detection, emotional regulation, activity scheduling Improve treatment outcomes for bipolar and schiz

Answer 17

Imaginal: trauma, when vino not possible In vino: real life Interoceptive: bodily sensation, used for panic and agoraphobia Improve self efficacy and reduces anxiety 4 steps: - preparation - creation of hierarchy - initial exposure - repeated exposure SUDS: subject unit distress score 1-100 Repeated daily is ideal

Answer 18

Activity schedule For depression Start with this for depression before cognitive therapy Increase sense of pleasure and mastery Determine level of activity Things contribute to distress Identify plan for activities to increase PLEASURE AND MASTERY feel motivated once starting doing activities

Answer 19

Discussion of benefits and drawbacks Purpose: provide w rapid, reliable; easy to apply means to cope and moderate anxiety - Progressive muscle relaxation - notice tension, tense and relax different muscle groups - Breathing restraining - hyperventilate when anxious eg panic, re-breath the air they exhaled by cupping hands over mouth, or lunch bag - taught in session, practice for homework- Slow and calm breathing: diaphragmatic breathing, rhythmic breathing ^^^ the above 2 NOT CBT specific

Answer 20

- mood checking and agenda setting - review homework - discuss agenda topics and teaching skills - setting homework - summary - feedback Treatment outline: Depression: assessment, psycho ed, behavioural activation, cog restructuring, core belief work, symptom improvement, termination Anxiety: assessment, psycho ed, emotional regulation, cognitive strategies, exposure work, core belief, symptoms improvement, termination

Answer 21

Time limited and brief First line for many Cog, behaviour, education Guided discovery Collaboration Structured Homework, skills building Though log, common thinking errors, behavioural experiment, modification, underlying belief

Answer 22

1. Meta analysis OR systematic review of level 2 studies 2. Test accuracy w independent, blinded comparison, among consecutive persons w a defined clinical presentation 3.1. Pseudorandomised controlled trial (alternate allocation or other method) 3.2. Comparative w concurrent controls: non randomised, experimental, cohort, case control, interrupted time series 3.3: comparative study without concurrent controls: history control; 2 or more single arm, interrupted time series 4. Case series

Answer 23

Unconscious - subconscious Goal: improve personal connection w others Founded: freud psychoanalysis Client - therapist is key factor More time limited and outcomes focused than tradition Depression, anxiety, personality Candidate: capacity for self reflection, looking to obtain insight Brief therapy: 25 sessions

Answer 24

Both: intrapsychic prosesses, unconscious processing more than others Dynamic: shorter (frequency and number of sessions)

Answer 25

Recognising, acknowledging, understanding, expressing, overcoming negative and contradictory feelings and repressed emotions Improve interpersonal experiences and relationships Understand how repressed emotions from past affect current decision, behaviour, relationships Therapist active role but NOT directive Therapist role: look for avoidance, evasive behaviours, to help client process subconscious desired, appraisal, and fears Goal: uncover and process internal conflicts Client to express full range of emotion, allow therapist to analyse patterns and interpret underlying maladaptive thoughts and conflicts Therapist look for avoidance strategies and contradictory expressions Challenge internal conflicts thoughts: goal setting, reality testing, confrontation, empathetic validation Sound alliance is crutial not only relive symptoms but foster positive presence of psych capacities and resources

Answer 26

Dysfunctional defence mechanism (D) Anxiety and Inhibitory affects (A) Unacceptable feelings and impulses (F) Parents and past person (P) Current people (C) Transference w therapist (T)

Answer 27

Resolve presenting problems by targeting specific elements in problem formulation Defence restructuring: recognise defence and motivate to give up defence Affect restructuring: - affect experiencing: experience and accept forbidden adaptive feelings without anxiety - affect expression: seek socially acceptable ways to express forbidden feelings Self-other restructuring: develop more tolerant attitude towards self and - more accurate and compassionate view of others - modifying internalised models of self, others, relationships learned during childhood

Answer 28

Transference: client respond to T in the way they respond to P Resistance: using various D to regulate A associated w threat of uncovering F - therapist respond in supportive rather than a punitive way Therapist: psychological reaction to client resistance - source of info about how their D impacts others Countertransference: immediate, intense, reactions from T to client behaviours Can be therapist own sensitivities to particular issues

Answer 29

Termination: problems resolved, grief associated w ending therapy is addressed Triagles of conflicts Recognise and relinquish dysfunctional defences and replace w more adaptive ones Desensitise to experience if forbidden feelings and impulses to help develop healthy way to express these Help develop more positive self-image and capacity to engage in positive relationships

Answer 30

- each person has unique way of perceiving and understanding the world - take subjective than objective view (what is it like to be this person) - reject objective scientific method - endorse idea that people have free will and capable of choosing their own actions - all people have tendency to grow and fulfil their potential

Answer 31

Rogers Person conscious and own ideas People could fulfil their grow if they have positive self regard, only happen if they have unconditional positive regards to others Feel valued and respected without reservation from others Problems: they think they only be loved if they meet certain conditions - leading to incongruence between real self and ideal self Closing the gaps with unhelpful way, eg chasing achievements that dont make them feel content Maslow People have variety of needs in hierarchy Satisfied all needs - self actualised Prolong period of needs not satisfied - fixation

Answer 32

Methods to understand people subjectively Avoid methods studying people objectively, including quantitative approach Prefer: qualitative and unstructured interview Analyse materials eg diaries, letters, biographies

Answer 33

Lack of objectivity: criticism Facilitate growth by building strengths and fostering sense of agency to achieve goal and fulfil potential Client centred Therapeutic relationship is key

Answer 34

Perceptions and self concept are organised through personal stories - working with these stories in therapy Therapist: help client identify which aspects they focus/ omit - identify opportunities for growth and healing Help replace dominant, maladaptive narratives with healthier alternatives Encouraged to separate themselves from the problem Useful for indigenous aus - yarning Opening up to address sensitive issues such as addiction, DV, loss and grief 2 steps: - deconstructing dominant narrative (1) - reconstructing preferred, more freeing narrative (2) (1) re-examine from a new angle Separate person identity and background Through externalising conversations (2) notice aspects contradicting earlier narrative Unique moments or exceptions Use direct questions - what does this suggest to you Client evaluate impact of the story

Answer 35

Internalised: - i’m a worrier - he is unmotivated Externalised - what does the worry say - how does it affect his motivations

Answer 36

Improve couple relationships and psych conditions in children and teens Fundamental role of parents in children development and value of including the whole system Couple intervention Family communication exercise How to create functional family relationships What happens to one member happens to eveyone Use for: - substance use - depression - anxiety - bipolar - personality - eating disorders - coping w physical disabilities

Answer 37

- differentiation of self (sense of individual rather than relying on others in the family) - the triangle: relationships between 3 people impact others - nuclear family emotional process: emotional distance, relational patterns - family projection process: parents display feelings onto children / then children to others - multi generational transmission process: small differences in differentiation between children and parents leading to larger difference among extended family members - sibling position: birth order affect dynamic - emotional cutoff: conflict w no resolution - sever relationships - emotional processes in society: broader social and cultural forces influence family relationships

Answer 38

Neurotransmitter: chemicals communicating info throughout brain and body How the transmission if info is impacted when a psychotropic is taken What a drug does to the body? Effects of the drugs?

Answer 39

Psychotropic passing through the system - absorption: transfer to the blood stream - distribution: crossing into the central nervous system - metabolism: in liver, changing drug structure) - elimination: removal of agent to urination and respiration What does a body do to a drug - fate of drug in the body Age, physiological function, gender, disease, nutrition

Answer 40

Average time to eliminate 1/2 if the drug concentration from one system

Answer 41

Quantitative measure safety of drugs Therapeutic dose: concentration that give desired responses Toxic dose: concentration causing mild to severe side effects Therapeutic index: ratio of toxic to therapeutic dose The amount of agent causing effect to the mount of agent causing toxicity Higher therapeutic index = more desirable as risk is less Range of dose at which medications is effective without unacceptable adverse side effects

Answer 42

Potentiation: one drug enhance effect of second drug Drug can also be antagonistic and counter the other’s effects Placebo response: Shown therapeutic response as if actual drug is present

Answer 43

Aminobutyric acid GABA Acetylcholine: memory, learning, attention Epinephrine (adrenaline): regulate fight or flight response - anxiety Norepinephrine: wakefulness and alertness Dopamine: behavioural regulation, movement, learning, mood, attention - schiz Receptors are activated by amphetamines and cocaine

Answer 44

Antidepressants Physiological symptoms: sleep, appetite, fatigue, inflammation, sex drive, restlessness, concentration, forgetful. For those poor psych candidates eg low intelligence, refusing therapy 2 primary groups: - typical: fluoxetine, fluvoxamine - MAO inhibitors: phenelzine, tranylcypromine Clinical picture: anxiety, agitation, obsessional, rumination, irritability, aggression - SSRI BEST CHOICE Apathy, low energy, inability to feel pleasure, low motivation - DOPAMINE OR NORADRENERGIC preferred Start at low dose and gradually increase 4-5 weeks of treatment - increase dose if no positive response

Answer 45

Acute treatment: first dose and extends till asymptomatic Continuation treatment: avoid relapse, continue treatment for at least 6 more months Maintenance treatment: relapse prevention, continue lifelong treatment for best outcome Drugs do not act immediately Take 2-4 weeks for symptoms to be improved Manage expectations w clients

Answer 46

Increase anxiety, restlessness, insomnia during first week or two SSRI and SNRI prescribed for depression, low incidence of side effects Late onset side effects: sexual dysfunction, decreased apathy, weight gain,

Answer 47

Under dosing Poor compliance Misdiagnosis: bad for bipolar Co-morbid substance abuse: alcohol use Longterm use if benzodiazepines for depression Premature discontinuation Rapid discontinuation (getting off too quickly)

Answer 48

Clinical actions may take 2-4 weeks Not happy pills, no do erase feelings of sadness, emptiness Improve physical symptoms only: better sleep, less fatigue, emotional control They may say “i’m not better” May be side effects NOT ADDICTIVE Avoid alcohol Never discontinue cold turkey - withdrawal symptoms Include exercise and reduction of substance for sleep

Answer 49

- misdiagnosis - missing common unsuspected medical co-morbidities (obstruct sleep apnea, restless legs syndrome, sleep disturbance) - 15-20% present w atypical symptoms eg weight gain, hypersomnia, carb craving

Answer 50

MAO Inhibitors - never use w SSRI Tricylic antidepressant- may increase TCA level lithium- SSRI may increase lithium level Carbamazepine: SSRI may increase this St John wort: may be dangerous 5-HTP with SSRI: serotonin syndrome and can be dangerous

Answer 51

Reduce frequency of episodes Primary: Lithium- decrease chance of suicide, prevent relapse for mania than depression - manic episode: anti manic medications or antipsychotic medication (olanzapine) - for behaviour control Manic episode: - extreme: antipsychotic, benzo - classic: lithium, divalproex - mixed mania: divalproex - rapid cycling: lamotrigine or divalproex Depressive episode: mood stablizer eg lamotrigine, olanzapine, OFC, lithium Combination of medication: lithium -‘d quetiapine

Answer 52

Therapeutic range close to toxic range Need to gradually increase dose + close monitoring blood level One mood stablised - reduce dose for maintenance Side effects: nausea, diarrhea, vomitting, hand tremor, sedation, muscular weakness, weight gain, dry mouth Toxicity: slurred speech, severe vomiting, tremor, hypotension, seizures, shock, coma, even death

Answer 53

Not treating emotional problems Continue medication even once episode is resolved Regular blood monitoring required for lithium NOT ADDICTIVE lifestyle management: regular sleep, avoid shift work, sunlight exposure Avoid alcohol and drugs, avoid substances interfering sleep eg caffein Limit travel across timezone

Answer 54

GAD - SSRI, buspirone Stress related anxiety: tranquillizers help reduce restlessness, insomnia for situational stress, diazepam, lorazepam Antianxiety only be used for 1-4 weeks If just one in a series of chronic life crisis: NO benzodiazepines Panic: 4+ attacks in a month - medication for panic disorder, alprazolam, lorazepam, MAO inhibitors, antidepressants Social phobia: not treated w med, beta-blockers, MAO inhibitors, venlafaxine, SSRI, may be helpful Medical illness causing anxiety: treat the illness Anxiety as part of mental conditions: treat the condition

Answer 55

2 phases: - eliminate or reduce frequency and intensity of panic attacks w anti panic drugs (3 groups - see below) - once panic attacks are controlled, gradually exposure to feared situations 1. High potency benzodiazepines: - effective, quick - require large dose, sedation is common problem 2. Antidepressants: tricylics, SSRI (selective serotonin reuptake inhibitors), venlafaxine, mirtazapin - effective, not addictive - side effects, delayed onset 3. MAO inhibitors - effective, not addictive - delayed onset, restrictions involved

Answer 56

Substance abuse Cold turkey (discontinuation or rapid taper of benzodiazepines) - withdrawal, 1-3 taper advised Misdiagnosis: failure to recognise depression or psychotic illness, benzodiazepines makes depression worse Sedated from benzodiazepines Cognitive impairment for older clients using benzodiazepines Discontinuation of caffein

Answer 57

Allow 2-6 weeks Daily doses required Combine w therapy Tranquillizers for short term use only Do not discontinue No alcohol

Answer 58

Positive (high) - delusions and impaired thinking - hallucination - confusion and impaired judgement - anxiety, agitation, emotional dyscontrol Negative (depressed) - flat, blunnted affect - poverty of thoughts - emptiness - retardation, inactivity - blunting of perception Disorganisation - incoherent speech - bizarre behaviour - extreme confusion Characterological traits - social isolation, sense of alienation - low self esteem - social skills deficits

Answer 59

Referred to a psychiatrist Start w early sighs of psychosis appear Early intervention prevent more florid psychotic episodes occurring Do little to affect characterlogical traits or negative symptoms All are equally effective in reducing positive symptoms Choice is about side effects eg weight gain, metabolic effects, sedation effects, restlessness, blurry vision, dry mouth Start at low dose Decrease in arousal, emotional dyscontrol, agitation Some symptoms can take several weeks to response eg hallucinations, distorted thinking Reduce and maintain for one year Treating for 2-3 years before medication free trial

Answer 60

Side effects Non compliance - more suffering Schiz is prone to relapse, keep taking medications even when feeling fine Length of treatment: one year + Not additive Avoid high temperatures, sunlight, some medications have photosensitivity side effects Avoid amphetamines, cocaine, l-dopa

Answer 61

Antidepressant and CBT 4-8 weeks

Answer 62

Psychotropic for particular symptoms NOT the personality disorder Impulse control: SSRI, atypical antipsychotic Schiz (peculiar thinking): antipsychotic, olanzapines Sensitivity to rejection: atypical antipsychotic Emotional instability: lithium, divalproex, atypical antipsychotic

Answer 63

Prolonged medication treatment Risk of being abused by predisposed to chemical dependency Stimulants: - ritalin - metadate - adderall

Answer 64

Treatment of choice: psycho therapy Medications for symptoms only: panic, depression) Treating w benzodiazepines is NOT effective

Answer 65

Obstructive sleep apnoea: CPAP (airway pressure) Insomnia: shortterm benzodiazepines (temaze, serepax) Dependence within a few weeks of use Take in sleep phase, sedation effect Nightmare may occur

Answer 66

Acamprosate (campral) - alcohol dependence, 3 times per day, no side effects, modest efficacy Naltrexone (revia)- opioids Methadone - opioids

Answer 67

Smoke Rapid absorption to the brain Effect within 5-10 mins Peak at 30 mins Diminish at 90 mins to a few hours High dose causes: delirium w confusion, agitation, loss of coordination, hallucinations Acute anxiety or panic Long term effects: bronchitis, lung cancer Main effects: euphoria; disinhibition, increased appetite Withdrawal: insomnia, hyperactivity, decreased appetite

Answer 68

Narcotics Central nervous depressants Slow respiration, increased body temperature, slurred speech and impaired memory, Overdose: convulsions, coma, death Analgesics: Stop brain from receiving pain signals Addictive, high rate of abuse State of sedation Withdrawal: anxiety, dysphoria, muscle aches, irritability, vomiting, diarrhea, restlessness, sick and painful

Answer 69

Stimulant Frightening paranoia Fast acting stimulant w short acting effects Surge dopamine Difficulties sleeping; apathetic, irritable, agitated, depressed

Answer 70

Excess activity, appetite reduction, euphoria, alertness, increased libido Anxiety, paranoid, psychosis, violence, tremors Withdrawal: anxiety, sleep disturbance, chronic fatigue, irritability, depression and craving Overdose: Seizures, agitation Last 2-4 hours

Answer 71

Mostly used for depression Drowsy, sedated, decreased inhibition Works like a numbing agent Liver, digestive, nutrition problem Wernicke-koraakoffs syndrome: eye movement disturbance, lack of muscle control, coordination, confusion, short term memory problems - can be treated w thiamine. - if not psychosis may develop and can be permanent Overdose: coma, death, nausea, vomiting, cold clammy skin High level: agitation, irritability, anxiety, insomnia, trermors Dangerous withdrawal: psychosis, seizures, within 2-3 days not drinking

Answer 72

Inhale shoe polish, paint thinner, certain types of glue, petrol fumes Depress the central nervous system Mild intoxication to unconsciousness Last for a few minutes to few hours Lung disease and brain damage Overdose: death, coma, seizures

Answer 73

Reduce fatigue, increases alertness, decrease appetite, raise heart raise Large dose cause headaches, irritability, stomach upset Dependent of caffeine, feel sleepy, lethargic without Small quantities is safe, large dose can be dangerous Unaware, amount of caffeine they are ingesting

Answer 74

St johns wort is s herbal condition used to treat nervous conditions Popular herbal remedy for mild depression Dry mouth, dizziness, photosensitivity, gastro, fatigue, as specific common side effects Safety in pregnancy is not yet clear Encouraged to discuss, any supplements w doctor. Efficacy for treating mild depression Unclear whether it’s just simple placebo

Answer 75

ADHD: methylpheniDATE Mood stablizer, bipolar: lithium Anti-psychotic (also for aggression in ASD): risperidone Anti-psychotic: clozapine Anti-psychotic: olanzapine - dole, -done, -zole SSRI, antidepressants: - (zoloft) sertraline - (celexa) citalopram - (lowan, prozac): fluoxetine - (lexapro): escitalopram Benzodiazepines: - (xanax) acute anxiety, panic: alprazolam - (valium) acute stress related anxiety: diazepam - (klonopin) acute anxiety/ panic: clonazepam - (alprazolam) anxiety/ panic

Answer 76

Consistency of measure: - test-retest: repeat and get similar result - alternate forms: scores on both test highly correlated - internal consistency: how well items relate to one another (cronbach) - interrater consistency: observation data from multiple sources (eg 2 clinicians) - measure how much raters agree with what they are observing

Answer 77

Test accurately measures what it is supposed to Construct: validity of measure being used - does it assess what it’s supposed to Criterion-related: how accurately a test measure the outcome it was designed to measure Content: instrument contains construct-relevant material and does not contain irrelevant material, scores are not influenced by irrelevant materials

Answer 78

Gold standard Participants are randomly assigned to groups IV is manipulated differently across groups Keep variables outside IVs constant Quasi experiments: non ramdom assignment (as randomised is not legal or ethical) Between subject design: comparing effects of treatment between subjects or groups - any different effects on DV Pretest-posttest control group: popular for clinical, 2 groups, random assignment, one group receives treatment, one does not. See changes in scores before and after treatment Within subject design: comparing effect of treatment within one individual Longitudial: single groups, over time, vulnerable to many factors eg maturation, attrition, measurement effects

Answer 79

Use results from previous studies Leading method Identifying the topic Collects studies Obtain average effects Calculate weighted average effects (size of each study)

Answer 80

Efficacy: - cause and effect relationships between IV and DV - require special attention to internal validity (experimental control) - does x work Effectiveness: - how well x work in real world settings - generalisability or external validity of findings - impacts of x on community - apply to real clients, therapists

Answer 81

Most are efficacy studies External over internal validity Treatment outcomes on individuals than in comparison w control group 2 parts: - apply psych science to evaluate own practice - use science to inform how we choose to practice

Answer 82

- cultural responsiveness in providing interventions to diverse groups (understand most research done on white US) - establishing therapeutic relationships and therapeutic alliance - listening skills (show through various ways) - responding skills: supportive, empathetic, reflection, questioning, summarising - listening response: clarification, paraphrasing, reflection: reflect their feelings, summarising

Answer 83

5 stages 1. Empathetic relationships 2. Explore story and strengths 3. Setting goals mutually 4. Working and exploring alternatives and conflicts, actions involving applying changes to life 5. Generalisation of learning and termination

Answer 84

Pre-contemplation: unaware Contemplation: aware, not able to Preparation: decision maded Action: engage Maintenance: new behaviour for 6 months

Answer 85

Observation and use of measurements Termination: - safeguards wellbeing - plan at the beginning - when goals are met - not abrupt - consolidate gains and troubleshoot likely future obstacles Premature termination cause: unmet expectations

Answer 86

Skills: - congruent (genuine) - empathic - non-judgemental - unconditional positive regards - attention - collaborative relationship - respect - use counselling skills purposely

Answer 87

Rupture: misunderstanding or conflict between therapist and client Re-enactment: same type of problem is played out in therapy sessions

Intervention Flashcards

(111 cards)