Theoretical Orientations & Modalities Flashcards
(107 cards)
1
Q
What is transference from the perspective of traditional psychoanalysis?
A
1) Transference is resistance, or an unwillingness to relinquish one’s fantasy that one’s infantile wishes will be gratified
2) Transference is considered a key component of psychoanalysis because its interpretation leads to insight
2
Q
Why did Gerald Caplan develop mental health consultation?
A
Because he thought indirect services could benefit more individuals’ mental health
3
Q
What are the primary strategies used in motivational interviewing?
A
OARS - Open-ended questions, affirmations, reflective listening, and summaries
4
Q
What is the primary tenant of communication/interaction family therapy?
A
A circular model of causality where symptoms are both the cause and effect of dysfunctional communication (e.g., blaming, criticizing, mindreading, and overgeneralizing)
5
Q
What are the 2 types of communication patterns in Communication/Interaction family therapy?
A
1) Symmetrical communications reflect equality between communicators but may escalate
2) Complementary communications reflect inequality and maximize differences between communicators
6
Q
What are the 4 shared assumptions with psychodynamic theories?
A
1) Universal principles explain personality and behavior
2) Behavior is motivated by the unconscious
3) Early development is important
4) Insight into the unconscious is the key to therapy
7
Q
What are the 4 underlying characteristics of Freudian psychoanalysis?
A
Pessimism, determinism, mechanistic, and reductionistic
8
Q
What age does Freud’s ego develop?
A
6 months
9
Q
What age does Freud’s superego develop and why?
A
4 - 5 years and due to internalization of society’s values and standards as taught by parents through rewards/punishments
10
Q
What are Freud’s 5 psychosexual stages of development?
A
1) Oral (birth - 1)
2) Anal (2-3)
3) Phallic (4-5)
4) Latency (6-12)
5) Genital (12+)
11
Q
What is Freudian anxiety and how does the ego deal with it if it can’t use realistic means?
A
1) Unpleasant feelings from the autonomic nervous system that alert the ego to threats
2) Defense mechanisms that deny or distort reality
12
Q
What are the 4 basic Freudian defense mechanisms?
A
1) Repression
2) Reaction formation
3) Projection
4) Sublimation
13
Q
According to Freud, what causes psychopathology?
A
Unconscious, unresolved conflicts from childhood
14
Q
What are the 5 key components of Freudian psychotherapy?
A
1) Psychoanalysis - free associations, dreams, resistances, and transferences
2) Confrontation - seeing bx in a new way
2) Clarification - clarifying client’s feelings
3) Interpretation - connecting behavior to unconscious processes (may involve catharsis and insight)
4) Working through - assimilation of insights into personality
15
Q
What is Freudian confrontation?
A
Trying to get the client to see their behavior in a new way
16
Q
What is Freudian interpretation?
A
Connecting behavior to unconscious processes (may involve catharsis and insight)
17
Q
What are the 2 modern modifications to Freudian psychotherapy?
A
1) Collaborative, egalitarian view of therapeutic relationship
2) Reconceptualization of transference and countertransference (e.g. not a fantasy but a source of real information)
18
Q
What are the 5 key characteristics of brief psychodynamic therapy?
A
1) Time limited
2) Target interpersonal problem in first session
3) Interpretation (stage 3) happens early
4) Emphasis on strong working alliance
5) Positive transference is good because it promotes positive alliance, maximizes client’s motivation, and reduces likelihood that transference neurosis will occur
19
Q
What are the 5 similarities shared by humanistic psychotherapies?
A
1) Phenomenological approach (subjective exp is important)
2) Focus on current behavior
3) Belief in self-determination and self-actualization
4) Focus on authentic, collaborative, and egalitarian alliance
5) Rejection of assessments and diagnostic labels
20
Q
According to Rogers, what is anxiety?
A
Incongruence that signals that the unified self is being threatened
21
Q
What is the primary technique in Rogerian psychotherapy and the 3 strategies?
A
Cultivation of the right environment by using 3 facilitative conditions:
1) Unconditional positive regard
2) Genuiness/congruence
3) Accurate empathetic understanding
22
Q
How did Adler differ from Freud in 2 major ways?
A
1) Focused on social rather than instinctual factors on development
2) Took a teleological approach (bx is motivated by future goals rather than the past)
23
Q
What are the 4 key concepts in Adler’s individual psychology?
A
Inferiority feelings, striving for superiority, style of life, and social interest
24
Q
What is Adler’s style of life?
A
Adler’s style of life refers to the way a person compensates for inferiority, which unifies the various aspects of the personality.
25
What does Adler's healthy style of life and mistaken style of life mean?
Adler's healthy style of life is marked by optimism, confidence, and concern about the welfare of others.
His mistaken style of life is characterized by self-centeredness, competitiveness, and striving for personal power.
26
What did Adler think of parenting styles?
Pampered children do not develop social feelings, while neglected children are dominated by a need for revenge.
27
What did Adler's individual psychotherapy involve?
1) A collaborative therapeutic alliance
2) Identification of style of life and its consequences using a "lifestyle investigation”
3) Change in client’s beliefs/goals to foster an adaptive lifestyle
28
What is Adler's lifestyle investigation?
Examination of:
1) Client’s family constellation
2) Fictional (hidden) goals
3) Basic mistakes (distorted beliefs and attitudes)
29
What is Systematic Training for Effective Teaching based on and what are the basic tenants?
1) Adler's individual psychology approach
2) Children's misbehaviors always have 1 of 4 goals - attention, power, revenge, display deficiency
3) Children want to belong but sometimes have faulty beliefs about how to do that
30
What are the 3 major ways Jung differed from Freud?
1) Defined libido as general psychic energy
2) Focused on future goals rather than past events (like Adler's teleological approach)
3) Saw development as a lifelong process and was interested in growth after 30s
31
What are Jung's archetypes generally?
“Primordial images” that cause people to experience and understand certain phenomena in a universal way
32
What are Jung's parts of personality?
1) The persona, or public mask
2) The shadow, which is the “dark side” of the personality
3) The anima (feminine) and animus (masculine)
4) Myers-Briggs like dimensions - introversion/extroversion and thinking, feeling, sensing, intuiting
33
What does Jungian psychotherapy focus on?
Bridging the gap between the personal and collective unconscious via interpretation
34
In object relations theory, what are introjects?
Internalized representations of relationships that become part of the self and influence future social interactions/relationships
35
What is splitting and which 2 theorists is it related to?
1) Division of individuals or self into good and bad
2) Kernberg stated maladaptive splitting is related to Borderline PD overidealization and devaluing
3) Malher's stated that if splitting isn't adequately resolved during the separation-individuation process, it can cause problems
36
What is the premise of Fritz Perls' Gestalt therapy and personality theory?
Each person is capable of personal responsibility for their thoughts, feelings, and actions and living as an integrated “whole".
Personality consists of the self (self-actualizing aspect) and the self-image (the darker side that hinders growth and self-actualization by imposing external standards).
37
What are the 5 principles of Gestalt therapy?
1) People seek closure
2) A person’s “gestalts” (perceptions of parts as wholes) reflect current needs
3) Behavior represents a whole that is greater than the sum of its parts
4 ) Behavior can be fully understood only in its context
5) Experiences fit the principle of figure/ground
38
How do Gestaltian's view maladaptive behavior?
Maladaptive behavior is a growth disorder, an abandonment of the self for the self-image, and non-integration.
Maladaptive behavior stems from boundary disturbances between the self and external pressures that interfere with self-actualization and homeostasis.
39
What are the 4 Gestalt/Perl boundary disturbances?
1) Introjection - when a person fully accepts a concept without processing/understanding (e.g., overcompliance)
2) Projection - when a person disowns aspects of the self by assigning them to others (e.g., paranoia)
3) Retroflection - when a person does to themselves what they want to do to others (e.g., self-harms)
4) Confluence - absence of boundary that causes intolerance of differences between self and others (e.g., causes guilt, resentment)
40
What are key therapy techniques in Gestalt therapy?
1) Present focus because awareness is the primary curative factor
2) View of transference as counterproductive so it is confronted
3) Common interventions include games of dialogue, guided fantasies for present experiences, and dreamwork
41
What is the premises of existential therapy and how do maladaptive behaviors develop?
Existential therapies emphasize personal choice and responsibility for developing a meaningful life and state that maladaptive behavior develops because of the inability to cope with ultimate concerns of existence (death, freedom, isolation, meaninglessness)
42
What does existentialism say about anxiety?
It says existential anxiety is normal and promotes growth and motivation, but that neurotic anxiety is due to avoiding existential anxiety and can be maladaptive.
43
What are the premises underlying Glasser's reality therapy?
Glasser's reality therapy is based on choice/control theory which assumes that people are responsible for the choices they make and works to analyze how their choices affect their lives.
44
What is Glasser's view of personality?
Glasser's reality therapy assumes 5 innate needs motivate people: survival, love/belonging, power, freedom, and fun.
Responsible fulfillment of these needs leads to a "success" identity and unsatisfied/irresponsible ways results in a "failure" identity.
45
What are the basic tenants of Glasser's reality therapy?
1) Rejection of medical model
2) Focus on current behaviors and beliefs
3) View that transference is detrimental
4) Views conscious process as key
5) Emphasizes value judgments about someone's life (sounds very anti-Rogerian)
46
What are the premises underlying Kelly's personal construct therapy?
A person’s psychological processes are determined by the way they “construes” events (perceive, interpret, predict) and use personal constructs (bipolar dimensions of meaning like good/bad, competent/incompetent). Thus, maladaptive behavior is due to inadequate personal constructs (e.g., anxiety is due to an event that occurs outside of one's constructed system).
47
What are the 2 primary purposes of interpersonal therapy?
1) Symptom reduction - psychoedu, instillation of hope, and medication
2) Improve interpersonal functioning - unresolved grief, interpersonal role disputes, role transitions, and interpersonal deficits
48
What are the 2 basic tenants and 3 therapeutic techniques associated with Kelly's personal construct therapy?
1) Therapist and client both have expertise
2) Therapist and client act as co-experimenters to help the client revise maladaptive personal constructs
3) Techniques include - repertory grid, self-characterization sketch, fixed-role therapy
49
How are the 2 primary purposes of interpersonal therapy achieved?
Symptom reduction and improved interpersonal functioning are achieved by:
1) First assessing to diagnose, understand context, and identify the focus of therapy
4) Then develop strategies to improve interpersonal skills and functioning
5) Lastly, progress is reviewed and termination/relapse prevention is discussed
50
What are the basic tenants and techniques of solution-focused therapy?
1) Client is viewed as an expert
2) Therapist is viewed as a consultant
3) Questions are used to identify strengths and resources to achieve therapeutic goals
51
What are the 3 types of questions used in solution-focused therapy?
1) Miracle question
2) Exception question
3) Scaling question
52
What is the basic format of a solution-focused therapy session?
1) Identification of goals
2) Miracle question
3) Identification of exceptions and successes
4) Rate current status regarding problem
5) Reinforcement about client's successes and assignment of homework
6) Next session: What's better since the last time we met?
53
What are the 6 stages of change in the transtheoretical model?
PCP-AMT
1) Precontemplation - little insight, denial, uninformed, unsuccessful at changing, and no intentions
2) Contemplation - aware of need to change, intentions to change within 6 months, ambivalent, no commitment
3) Preparation - realistic plan to change within a month
4) Action - has taken concrete steps to change (e.g., made public statement)
5) Maintenance - has maintained changes 6+ months and is trying to prevent relapse
6) Termination - confidence to resist temptation and not relapse
54
What are the basic premises underlying Bowen's extended family systems therapy?
People produce offspring with lower levels of differentiation. Thus, a multigenerational transmission process occurs and maladaptive behavior emerges.
1) Differentiation refers to the ability to separate intellectual and emotional functioning (highly fused family = undifferentiated family ego mass)
2) Emotional triangles occur by dyads to increase stability and reduce tension
3) Family projection
55
Who coined family projection and what does it refer to?
1) Bowen
2) Family projection process refers to when parental conflict and emotional immaturity are transmitted to children
56
What are the 4 founders of different family therapies and the 3 types of families that do not have distinct founders?
1) Bowen - Extended Family Systems Therapy (Differentiation therapy)
2) Minuchin - Structural Family Therapy (Rigid triad and unbalancing therapy)
3) Haley - Strategic Family Therapy (Paradoxical therapy)
4) Selvini-Palozzi - Milan Systemic Family Therapy (Circular, team therapy)
No primary founders: Communication/Interaction FT, Behavioral FT, or Object Relations FT
57
What 3 unique therapeutic techniques are used in Bowen's extended family systems therapy?
Bowen = Differentiation therapy
1) Therapeutic triangles
2) Genograms
3) Family-of-origin visits are encouraged to help clients de-triangulate and differentiate
58
What are 4 characteristics of Bowenian therapists/sessions?
1) Therapist acts as expert coach
2) Therapist uses questions to defuse emotions and promote clear thinking
3) Sessions are educative, cognitive and controlled
4) Dyads must talk factually and calmly
59
What are the 4 premises underlying Minuchin's structural family therapy?
Minuchin = Rigid triads
1) Family structures determines how family members relate
2) Boundaries are rules about amount of contact
3) Power hierarchies determine how members combine forces during conflicts
4) Subsystems (e.g., husband-wife, child-parent dyads)
60
What type of family therapy are rigid triads associated with?
Minuchin's structural family therapy
61
What are Minuchin's 3 rigid triads?
1) Detouring - overprotecting or scapegoating the child
2) Stable coalition - child-parent dyad consistently “gang ups” against the other parent
3) Triangulation (unstable coalition) - parents demand that a child takes their side
62
What are Minuchin's 3 main therapeutic techniques (kind of like steps of therapy)?
Minuchin = Rigid triads
1) Joining - blending via tracking and mimesis
2) Evaluating - determines transactional patterns, power hierarchies, boundaries, and structural diagnoses
3) Restructuring - purposefully stressing the family's homeostasis
63
Who/what is "joining" associated with and how is it done?
1) Minuchin and structural family therapy
2) Blending, tracking, mimesis
64
In structural family therapy, what does Minuchin do during the evaluation step?
The evaluation step allows a structural family therapist determine:
1) Transactional patterns
2) Power hierarchies
3) Boundaries
4) Structural diagnoses
65
How does Minuchin promote change?
Purposefully unbalances (or stresses) the family's homeostasis in order to facilitate transformation (unbalancing techniques include enactment and reframing)
66
Who are genograms associated with?
Bowen
67
Who are family structural maps associated with?
Minuchin (duh, because its related to structural family therapy)
68
What are the 3 premises underlying Haley's strategic family therapy?
Haley = Paradoxical therapy
1) Emphasize communication and how it is used to exert control in relationships
2) Assumes bx change precedes changes in perceptions and emotions
3) Assumes altering the family's transactions and organization are the key to alleviating symptoms
69
Who makes a bad candidate for group therapy (3)?
1) Incompatibility with group norms
2) Inability to tolerate the group setting
3) Certain sxs/dx - severe depression, withdrawal, paranoia, acute psychosis, brain damage, and sociopathy
70
What symptoms or diagnoses make for a bad candidate for group therapy (6)?
1) Severe depression
2) Withdrawal
3) Paranoia
4) Acute psychosis
5) Brain damage
6) Sociopathy
71
How did Haley promote change in family therapy?
Haley believed altering the family's transactions and organization are the key to alleviating symptoms
72
What was Haley's thoughts on communication in relationships?
Haley proposed that communication was important because it is used to exert control in relationships and if this purpose is denied, pathology can develop
73
What was Haley's perspective on behavioral change?
Haley believed behavior change precedes changes in perceptions and emotions
74
What are the 4 stages of Haley's strategic family therapy?
1) Social stage - therapist encourages social interactions
2) Problem stage - therapists seeks to understand why the family came to therapy
3) Interaction stage - family discusses their problems and therapist observes their interactions
4) Goal-setting stage - therapists and family agrees about the treatment goals
75
What are 3 characteristics of strategic family therapy?
1) Active, directive therapists
2) Assignment of directives as homework
2) Paradoxical interventions
76
What are the 5 types of paradoxical interventions used in strategic family therapy?
1) Ordeals - unpleasant tasks following a symptom
2) Restraining - encouraging the family not to change
3) Positioning - exaggerating the severity of the symptom
4) Reframing - relabeling the symptom to give it a positive meaning
5) Prescribing the symptom - instructing the family member to do the symptom
77
Which 2 founders and types of family therapy are associated with paradoxical interventions?
1) Haley and strategic family therapy - for resistance
2) Milan and systematic family therapy - for enlightenment
78
According to Haley's strategic family therapy, how do paradoxical interventions work?
Paradoxical interventions help families:
1) See their sxs in alternative ways
2) Recognize the control they have of their bx
3) Use their resistance in constructive ways
79
What is the premises underlying Milan's systematic family therapy?
Milan = Circular, team therapy
Milan believed that there are circular patterns of action and reaction in families
80
From the perspective of Milan's systematic family therapy, what causes problems in families?
Problems arise when families can't act creatively or make new choices
81
From the perspective of Milan's systematic family therapy, how does therapy help families?
Therapy helps families see new solutions and make new choices
82
What 5 unique therapeutic techniques are used in Milan's systematic family therapy?
1) Teams - an inside therapist and an observer that makes suggestions
2) Hypothesizing - ideas about the functioning of the family system
3) Neutrality - therapist remains an ally of the entire family
4) Paradox - therapist uses paradoxical strategies for enlightenment
5) Circular questions - questions to help family members recognize differences in perceptions
83
What is the difference between paradoxical interventions for Milan and Haley?
Milan (systematic) therapist uses paradoxical strategies not to elicit constructive resistance (like in Haley's strategic family therapy) but rather for enlightenment about circular family interactions
84
What are the premises underlying object relations family therapy?
1) Family dysfunction is the result of unresolved intrapsychic conflicts in the family-of-origin that are replicated in current relationships
2) A primary source of dysfunction is projective identification (projections of old introjects onto another family member)
85
What are the basic techniques used in object relations family therapy?
1) Resolution of family members old introjects
2) Work with transference and resistance to encourage insight
3) Values multiple transferences in therapy
86
What are Yalom's 3 formative stages of group therapy?
1) Stage 1 - Orientation hesitant participation, search for meaning, dependency
2) Stage 2 - Conflict, dominance, rebellion
3) Stage 3 - Development of cohesiveness - unity, intimacy, closeness, concern, trust, self-disclosure, and improved attendance
87
Who makes a good candidate for group therapy (5)?
1) Primary problems are interpersonal
2) Motivated to change
3) Has a positive view of group therapy because they like peer support and feedback
4) Is psychologically and verbally sophisticated
5) Prefers to get involved in therapy slowly
88
What are Yalom's 11 curative factors?
1) Instillation of hope
2) Universality
3) Altruism
4) Interpersonal learning
5) Self-understanding and insight
6) Existential learning
7) Catharsis
8) Group cohesiveness
9) Family re-enactment
10) Guidance
11) Identification
89
What has research shown to be the least curative group therapy factors?
1) Family re-enactment
2) Guidance
3) Identification
90
What has research shown to be the most curative group therapy factors?
1) Interpersonal input
2) Catharsis
3) Self-understanding
4) Cohesiveness
91
What did the original Eysenck article find about psychotherapy?
Within 2 years of onset of symptoms, Eysenck found:
1) 72% of the control group improved
2) 66% of patients receiving eclectic psychotherapy improved
3) 44% receiving psychoanalytic psychotherapy improved
92
How do you calculate an effect size?
Subtract the mean outcome score of the control (or other comparison) group from the mean outcome score of the treatment group and divide the difference by the standard deviation of the control group. The resulting number indicates the difference between patients in the treatment and control groups in terms of standard deviation units.
10 depression (control) / 5 depression (treatment) / 1 SD of control group = effect size of 1
93
What does an effect size represent?
The difference between average patients in the treatment and control groups in terms of standard deviation units
94
What would a person-centered therapist do with transference?
Probably nothing as transference is not a major focus of person-centered therapies. Instead, person-centered therapies focus on the here-and-now.
95
According to D. W. Sue (1978), what type of client would a White therapist with an IC-IR worldview struggle with the most?
A client with an IC-ER worldview
96
What are the underlying premises of Ellis's rational-emotive behavior therapy?
REBT conceptualizes emotions and behaviors in terms of ABC chain events (A = activating event, B = belief about the event, C = Consequence of event, behavioral or emotional). In other words, REBT assumes that responses due to external events are due to beliefs about the event rather than the event itself. Thus, neurosis is caused by continual repetition of irrational beliefs.
97
What are Ellis's characteristics of irrational beliefs?
Irrational beliefs are characterized by:
1) Dogmatic demands (must’s and should’s)
2) Awfulizing (“It’s awful if ...”)
3) Low frustration tolerance
4) Negative evaluations of oneself and others.
98
What would a practioner of REBT do to help a client?
In REBT, two more events — D (dispution and alteration of irrational beliefs) and E (altered thoughts and beliefs) — are added to the ABC chain.
To help clients replace irrational beliefs, therapists adopt an educational, confrontative, and persuasive approach and use techniques like modeling, behavior rehearsal, problem-solving, in vivo desensitization, rational-emotive imagery, and cognitive homework.
99
According to Beck, what are cognitive schemas?
Schemas are underlying cognitive structures (i.e., core beliefs) that determine how individuals interpret experiences.
100
According to Beck, what are automatic thoughts?
Automatic thoughts are “surface level cognitions” that automatically activate after an event.
101
According to Beck, what are cognitive distortions?
Cognitive distortions are systematic errors or biases in information processing. Distortions are the link between maladaptive schemas and automatic thoughts.
102
According to Beck, what are common cognitive distortions?
1) Arbitrary inference
2) Overgeneralization
3) Selective abstraction (attending to detail while ignoring the context)
4) Personalization
5) Dichotomous thinking
6) Emotional reasoning
103
What 7 factors distinguish Beck's cognitive therapy from other CBTs?
1) Collaborative empiricism
2) Time-limited (~15 sessions)
3) Structured, goal-oriented, and present-focused sessions
4) Historical information may be tapped to clarify core beliefs
5) Assumes affective arousal is necessary to access and modify maladaptive cognitions
6) Socratic dialogue
7) Relapse prevention is focused on throughout treatment (e.g., self-therapy plan)
104
What are the 5 stages of Bandura's self-instructional training?
1) Cognitive Modeling: The client observes a model perform the task while self-instructing.
2) Cognitive Participant Modeling: The client performs the task as the model verbalizes the instructions.
3) Overt Self-Instruction: The client performs the task while instructing him-or herself aloud.
4) Fading Overt Self-Instruction: The client whispers the instructions while carrying out the task.
5) Covert Self-Instruction: The client performs the task while saying the instructions covertly.
105
What are the 3 stages of Rehm's self-control theory?
1) Self-Monitoring: The client is taught to monitor negative self-statements and positive outcomes
2) Self-Evaluation: The client is taught to set realistic goals and to make appropriate attributions for their behavior
3) Self-Reinforcement: The client learns to reinforce themselves with positive self-statements and activities
106
What does Comprehensive Behavioral Treatment for Tics entail?
Habit reversal training, relaxation training, and psychoeducation
107
What is stress inoculation training?
Meichenbaum’s stress inoculation model involves providing accurate information about a procedure, plus coping strategies (e.g., filmed modeling, reinforcement, breathing exercises, emotive imagery/distraction, and behavioral rehearsal)
