week seven Flashcards
First person account (willow weep for me)
women who fell into depression due to susceptibility from childhood development and conflict with parental relationships. tried to ground her depression in another person(a romantic relationship) but depression is a very inward disease and others view it as selfish and annoying. Therapy has helped her see the anger that she had toward her parents.
social work has evolved to meet changing society through three processes. Which are? (Rohen)
a shift in the profession’s view of clients from passive recipients to active partners
new demand to focus on diversity that necessitates modifications in intervention strategies
mandate to apply evidence-based practice
describe the existing gap between psychotherapy researchers and field clinicians
clinicians committed to creating particular sort of intimate relationship with their clients, while researchers committed to asking difficult provocative questions about those relationships.
way to mend this gap is to employ researchers as members of regular staff at local providers to integrate research evaluation into basic intervention processes
Six thinking rules developed by Kanfer and Schefft (Rohen)
- Think behavior: Action should comprise the main dimension on which to focus interchanges in therapy
- Think solution: direct attention toward determining which problematic situation needs resolving, what is the desirable future and how to achieve it.
- Think Positive: focus not on difficulties, reinforce positive outcomes
- Think Small Steps: target small gradual changes to reduce fears and motivate clients
- Think Flexible: adapt treatment to client’s needs
- Think Future: predict how client will cope and how they themselves would like to be different in the future
Seven basic, key features of CBT (Ronen)
- Meaning making Processes: develop a new way of understanding and accepting their behavior
- Systematic and goal-directed processes
- Practicing and experiencing: not a talking therapy but a doing therapy that encompasses practicing and experiencing as central components.
- Collaborative effort
- Client-focused intervention: treat the person not the problem, concentrates on client’s feelings, thoughts, and way of living not only the client’s problem .
- Facilitating Change Process
- Empowerment and resourcefulness: teaching self-control skills for self-help and independent functioning
concepts that demonstrate similarities between clinical social work and CBT (Ronen)
Individualism
Rational Thinking
Clearly Defined Objects for Change
Assessment, Evaluation, and Intervention Planning
Prediction
Developing Skills for Behavior Change
Empowerment
12 Structural phases that enable clinical social workers to check and recheck the intervention process, identify current stage, and clarify what is missing in order to bridge the gap between clinical social work and CBT (Ronen)
- Inventory of problem areas
- Problem selection and contract
- Commitment to cooperate
- Specification of target behaviors
- Baseline assessment of target behavior (frequency and duration of the problem)
- Identification of problem-controlling conditions( identifies the conditions preceding and following the problem’s occurrence)
- Assessment of environmental resources
- Specification of behavioral objectives
- Formulation of a modification plan
- Implementation of modification plan
- Monitoring of outcomes
- Maintenance of change
ECT video
Electroconvulsive Therapy
passing current through the brain while under anesthesia, 12 course session (3 to 4 weeks)
routine blood taking and ecg beforehand then get consent.
Fast the night before, then anesthetic,
Thirty second seizure experienced.
measures brainwaves during ECT
side affects: side affects from anesthesia, muscle pain, short term memory side affects. Patient does not have memory of two to for weeks during treatment. Sometimes have trouble learning new things after a few weeks of treatment. Long tern - patchy lost of past memories of things that happened before ECT, trouble recalling isolated memories.
What is Behavior Therapy based on? (MacLaren)
Both Pavlovian (operant) and Skinnerian (conditioning) models
factors driven increased interest and necessity in short-term models of therapy (MacLaren)
- Consumer.clinet have been empowered to ask for what they want and desire quick services
- institutional or administrative constraints (inpatient and outpatient have shortened lengths of available treatment/services - provide for broader number of people…resources limited )
- Changes in health care reimbursement procedures
Defining elements of CBT (MacLauren)
Active motivational Directive Structured Collaborative psychoeducational Problem-oriented Solution-focused Dynamic Time-Limited
Common Cognitive Distortions (MacLauren)
All-or-Nothing thinking Catastrophizing Emotional Reasoning Should, Must, Have to and Ought to Statements Personalization Mind Reading Overgeneralization Labeling Disqualifying the Positive Selective Abstraction Minimization
Shifts that occur for CBT (MacLauren)
- symptoms are targets to change
- shift away from therapists being seen as priest, healer, artist to being a consultant and catalyst for change
- CBT is not a mastery model but a coping model
- shift to parisomony treatment (preferred, not aggressive, least expensive, least intrusive,with greatest demonstrated effectiveness)
- CBT is less reactive and more planed with expected outcome
- shift toward more empirical validation of success
- instead of asking why, CBT asks what can be done and how
- need for established theoretical orientation - (eclecticism or integration denoting Mastery of many theories)
- goal of CBT shifted to help client achieve higher levels of functioning
Cognitive interventions in CBT (MacLauren)
Thought or self-help forms Disputing/challenging beliefs Rational Coping Statements Refernting Stop and Monitor Role Reversal Recording therapy sessions proselytizing Reframing Bibliotherapy/assignments
Behavioral interventions used in CBT (MacLauren)
Role Playing Skills Training Modeling In Vivo Desensitization Graded Task Assignments Activity Scheduling Reinforcements and Penalties Shame Attack.Behavioral Experiment Acting on Rational Beliefs
Emotional/Affective Interventions in CBT (MacLauren)
Forceful Coping Statements (client practices them forcefully)
Humor
Unconditional Acceptance by Therapist
Encouragement
Types of Depressive disorders
disruptive mood Dysregulation disorder
major depressive disorder
persistent depressive disorder (dysthymia)
premenstrual dysphoric disorder
substance/medication- induced depressive disorder
depressive disorder due to another medical condition
other specified depressive disorder
unspecified depressive disorder
Criteria for Disruptive Mood Dysregulation Disorder
A. Severe recurrent temper outbursts manifested verbally and or behaviorally that are grossly out of proportion in intensity or duration to the situation of provocation
B. Temper outbursts are inconsistent with developmental level
C. Temper outbursts occur, three or more times per week
D. The mood between temper outbursts is persistently irritable/angry most of the day, daily, and observable by others.
E. Criteria A-D have been present for 12 months. Has not had a period lasting 3 or more consecutive months without all of the symptoms in A-D during that time.
F. Criteria A and D are present in at least two of three settings and are severe in at least one
G. The diagnosis should not be made for the first time before age 6 or after 18
H. history or observation, age of onset before 10
I. Never been a distinct period lasting more than 1 day during which the full symptom criteria except duration for a manic or hypomanic episode have been met
J. Behaviors do not occur exclusively during an episode of major depressive disorder and are not better explained by anything else
K. Not attributable to the physiological effects of a substance or to other medical/neurological condition
What cannot coexist with DMDD
ODD, IED, bipolar disorder
What can coexist with DMDD
Major depressive disorder
ADHD
CD
substance use
If individual has ever experienced a manic or hypomanic episode should Disruptive Mood Dysregulation Disorder ever be assigned?
No
If client meets criteria for ODD and Disruptive Mood Dysregulation Disorder, what should the diagnosis be?
Disruptive Mood Dysregulation Disorder
Prevalence of Disruptive Mood Dysregulation Disorder
2-5%, but very common among children presenting to pediatric mental health clinics. More so in males and school-age kiddos
Risk factors of Disruptive Mood Dysregulation Disorder
Temperamental: children with chronic irritability typically exhibit complicated psychiatric histories
Genetic and Physiological: information-processing deficits, perturbed decision making and cognitive control
Functional consequences of Disruptive Mood Dysregulation Disorder
marked disruption in family and peer relationships disruption in school performance unable to participate in activities trouble initiating and sustaining relationships dangerous behavior suicidal ideation/attempts severe aggression psychiatric hospitalizations
Differential Diagnosis of Disruptive Mood Dysregulation Disorder
Bipolar disorders: difference involves longitudinal course of the core symptoms. BD manifests as episodic and there is distinction from child’s typical presentation. Manic periods are distinct. Irritability in Disruptive Mood Dysregulation Disorder is persistent and present over many months (not episodic)
ODD: mood symptoms of Disruptive Mood Dysregulation Disorder are rare in children with ODD. what warrants diagnosis of Disruptive Mood Dysregulation Disorder instead of ODD is presence of severe and frequently recurrent outbursts and persistent disruption in mood between outbursts.
ADHD, MDD, anxiety, autism: children with these diagnosis are usually only displaying symptoms of Disruptive Mood Dysregulation Disorder during a context of depression, anxiety, etc.
IED: IED does not require persistent disruption in mood between outbursts
