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42 Cards in this Set
- Front
- Back
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Yalom's Group Therapy
-First Stage (Forming) |
-limited exploration
-attempts to determine groups structure -search for similarities among group members -reliance on therapist for direction -member oriented towards advice giving and problem solving -members look primarily to the leader for approval and acceptance as well as answers |
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Yalom's Group Therapy
-Second Stage (Transition)(Storming) |
-advice giving is replaced by criticism
-members may form cliques and exhibit hostility toward leader -high resistance, defensiveness, and anxiety -conflicts and struggles for control |
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Yalom's Group Therapy
-Third Stage (Working) (Norming) |
-high trust and cohesion
-open communication, feedback, and disclosure |
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Yalom's Group Therapy
-Therapist role |
-creation and maintenance
-technical expert and participant/model (culture building) -(illumination of the here and now) focuses the group's attention on the here and now ("here is what ur behavior is like; here is how ur behavior makes others feel") |
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Yalom's Group Therapy
Concurrent Group and Individual Therapy |
-neither necessary nor beneficial EXCEPT in certain circumstances (in crisis or to make sure client doesn't drop out prematurely)
-problem with individual therapy is it's used to "drain off the affect from the group" rather than work thru that stuff in group |
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Yalom's Group Therapy
Premature Termination |
-10 to 35 % drop out during first 12-20 sessions
-lack of proper screening is single greatest impediment to a successful group -often due to unrealistic expectations that can be reduced by prescreening and pre-therapy orientation |
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Feminist Therapy
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-personal is political; women's circumstances always reflect the position of women in society
-primary goal is empowerment, helping women become more self-defining and self-determining -strive for egalitarian relationship -avoid pathologizing -avoid blaming women for their current problems -therapist believe they must be social and political activists |
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Feminist Therapy and object relations theory
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-focus on sexual division of labor and mother-child relationship, trace it to gender differences (daughters taught to attach, while son's taught to separate)
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nonsexist therapy
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-recognizes the impact of sexism
-avoid gender-biased techniques -BUT focus more on individual (rather than social) factors and modifying personal behavior (rather than calling for need for social change) |
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Structural Family Therapy
(Minuchin) -Boundaries |
-when boundaries are overly rigid, family members are DISENGAGED (isolated) from one another
-when boundaries are too diffuse or permeable, family members are ENMESHED (overly dependent and close) |
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Structural Family Therapy (Minuchin)
-Rigid Triads |
-3 chronic boundary problems
**detouring: focus on the child either overprotecting or blaming ('scapegoating') for family's problems **stable coalition: parent and child 'gang up" on other parent **triangulation: (unstable coalition) child is constantly pulled, parent demands that the child side with him/her against other parent |
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Structural Family Therapy (Minuchin)
-Maladaptive Behavior and Goals |
-overly inflexible or diffuse boundaries that prohibit family from adapting to stressors in a healthy manner
-GOALLLL!!! restructuring the family; action PRECEDES understanding; more about changing behaviors than insight |
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Structural Family Therapy (Minuchin)
-Therapy Techniques |
-Joining: mimesis (mimicry, meet the family culture in their terms)
-Family Map -Unbalancing: deliberately stress out the family's homeostasis to facilitate transformation -Enactment: family members role-play relationship patterns to watch it in the room -Reframing -Enactment: |
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Transtheoretical Model (overview)
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-process of change is essentially the same regardless of target behavior
-optimal interventions are those that match the individual's stage of change |
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Transtheoretical Model (stages)
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-precontemplation (unaware or underaware of problem, not intention to change) (benefit most from information that increases motivation for change)
-contemplation (aware of the need for change, considering change in next 6 months but not committed)(need support for their decision to change) -Preparation (clear intent to take action within the next month)(need help with identifying effective strategies) -Action (actually takes steps to bring about change) -Maintenance (change has lasted for at least 6 months and taking steps to prevent relapse) |
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Gestalt Therapy
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-self (inherent tendency for self-actualization) and self-image ("darker side", inhibits growth by imposing external standards)
-maladaptive behavior: lack of integration, abandoning self for self-image -transference is counterproductive, just a fantasy -use awareness of feelings thoughts, etc in here and now |
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How does a feminist therapist achieve egalitarianism in tx?
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Judicious use of self-disclosure
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Milan Systematic Family Therapy (MSFT)
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family's patterns becomes so fixed, lose ability to creatively act or to make new choices about their lives
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MSFT Goals
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help family members understand their relationships and problems in alternative ways, which paves the way to seeing new solutions and making new choices
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MSFT Therapy Techniques
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**team-one or two members work with family while others observe sessions
**counterparadox (to help derive solutions to their own problems) **circular questions (who was more upset, mom or dad?) asked to all members |
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Cultural Groups and Therapy
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-all groups likely to show improvement following therapy
-Hispanic Americans had best outcomes -in order, Anglo, Asian, African Americans |
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Premature Termination and Groups
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-minority groups are more likely than Anglo clients to terminate therapy prematurely
-African Americans have higher dropout than Anglo & Hispanics -Asians have a lower dropout rate |
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Cultural Encapsulation
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tendency of counselors to interpret everyone's reality through their own cultural assumptions and stereotypes
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Emic
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understanding the culture from the perspective of members of that culture; understand culture by going in
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Etic
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culture general; assumes that universal principles can be applied to all cultures; understand culture from "outside"
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Low context Communication
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-mostly Anglos
-emphasizes verbal messages -less unifying -can change rapidly and easily |
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High context Communication
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-characteristic of African-Americans and other culturally-diverse groups
-emphasizes group identification and nonverbal msg -anglo therapis may misinterpret nonverbal communication as an unwillingness to communicate |
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Acculturation
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the degree to which members accept and adhere to values, etc, of his group and dominant group
-Integration: maintains both -Assimilation: accept majority, relinquishes own -Separation: withdraw from dominant and accepts own -Marginalization: no identification with either |
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Sue: Racial/Cultural ID Development Model
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1) Conformity
**prefer dominant group 2) Dissonance **conflicting attitude to own and dominant groups 3) Resistance and Immersion **prefer own, reject dominant 4) Introspection **inflexible attitudes toward own and dominant group 5) Synergetic Articulation/Integrative Awareness **multicultural perspective |
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Black Racial Identity (Cross)
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1) Pre-Encounter
**racial id is saliently low 2) Encounter **event-->interest in developing id 3) Immersion-Emersion **begin to develop black ID 4)Internalization **Black Nationalism, Biculture (white & black), Multicultural |
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White ID Development (Helms)
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1) Contact
**little awareness of racial ID 2) Disintegration **more contact with AA, person aware of being white, confusion 3) Reintegration **Accept white superiority and AA inferiority 4) Pseudo-Independence **recognize whites responsible for racism 5) Immersion-Emersion **what it means to be white 6) Autonomy **internalize nonracist white identity, appreciates racial differences |
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Psychotherapy guidelines for Specific Groups: African-Americans
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-multisystems approach
-extended family system therapy -gender roles are flexible -relationships btwn men and women tend to be egalitarian -extended kinship network (extended family and individuals outside) -healthy cultural paranoia (nondisclosive to white therapist; disclosive to black therapist) |
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Psychotherapy guidelines for Specific Groups: Asian
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-prefer directive, structured therapy
-somaticize psychological problems -avoid open expression of emotion -hierarchical family structure -emphasis on family and community than individual |
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Psychotherapy guidelines for Specific Groups: American Indians/Alaskan Natives
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-collateral social system (family, community, tribe)
-adopt a holistic view of illness (disharmony with nature) -incorporate traditional healing practices -build trust and credibility by demonstrating familiarity with and respect for client's culture -listen more than talk -seasonal rhythms |
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Psychotherapy guidelines for Specific Groups: Latinos
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-family welfare prioritize over individual
-gender roles may be clearly defined -highly value connectedness and sharing -share problems within not outside of fmaily -attribute control of life events to luck, supernatural forces, acts of God, -therapist needs to be active, directs, solution-focused |
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Psychotherapy Outcomes: Eysenck
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72% indiv improve not receiving therapy
66% in eclectic therapy 44% in psychoanalysis |
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Psychotherapy Outcomes: Smith, Glass, Miller
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-mean effect size of .85 (the average therapy client is better off than about 80% of those who need therapy but are untreated)
-no quality control -only using published studies |
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Efficacy vs. Effectiveness Studies
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Efficacy
**conducted under well-controlled conditions **establish whether a tx has any effect Effectiveness **conducted in clinical and other applied settings with less experimental control **best for assessing clinical utility |
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The effects of treatment length
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-tx length and outcome levels off at about 26 sessions
-dose dependent effect: (Howard): 75% show marked improvement @ 26 sessions. 85% at 52 |
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Phase model of Tx
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(Howard)
-Remoralization (first few sessions...hopelessness and desperation start to decrease) -Remediation (about 16 sessions...focus on sx relief) -Rehabilitation (unlearning bad patterns, learning new ways of dealing) |
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Weltkrieg
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world war (m)
Weltkreig (-e) |
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Psychotherapy with older adults:
common mental health problems |
in order:
anxiety severe cognitive impairment depression in order interventions **behavioral and environmental **memory and cognitive retraining **CBT and brief psychodynamic for depression |
