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117 Cards in this Set
- Front
- Back
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• therapeutic listening/responding
• dream interpretation • free association • analysis of resistance • insight/assimilation of new material • therapeutic alliance |
Clinical Applications of Psychoanalytic/Psychodynamic Theory
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Theory Emphasizing:
• Social Interest • Unity of personality • Finding meaningful goals • Struggle between superiority/inferiority • Understanding the family constellation • Importance of birth order |
Adlerian Psychotherapy
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• Provide encouragement
• Acknowledge the client’s experience • Client change cognitive perspective, Bx • Gather life-history data • Questionnaires/Homework • Acting as if • The Question: "What would be different if you were well?” |
Adlerian Psychotherapy
--Clinical Application-- |
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Interventions for this theory include:
• Examining Archetypal dream material • Active Imagination • Creative Techniques • Projective Techniques • Measures of Personality (Myers-Briggs) |
Jungian Therapy
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Erik Erikson: 8 Psychosocial Developmental Stages
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Infancy: Trust/Mistrust
Early Childhood: Autonomy/Doubt Preschool Age: Initiative/Guilt School Age: Industry/Inferiority Adolescence: Identity/Role Confusion Young Adulthood: Intimacy/Isolation Middle Age: Generativity/Stagnation Later Life: Integrity/Despair |
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Types of Superego Anxiety (Freud)
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• realistic: fear of real external consequences
• neurotic: fear of reprimand, loss of control • moral: fear of superego failure, rule violation, badness |
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Psychosexual Stages of Development (Freud)
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• Oral: 0-18 months
• Anal: 18 mo. – 3 years • Phallic: 3 yr. – 6 yr. • Latency: 6 yr. – 12 yr. • Genital: 12 yr. – ∞ |
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Therapy Emphasizing:
• development of true self, extinguishing false self • helping client understand “false self” • helping client to feel at center of attention in therapy • controlled regression in Tx |
Object Relations Therapy (Winnicott)
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Controlled Regression
(Object Relations) |
• process in which patient returns to stage of early dependence. Therapist must sense what "being the client" is like and be the subjective object of client's love or hate.
• Therapist must deal with irrationality and strong feelings of patient without getting angry or upset at patient. |
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• core/center of individual
• initiative, motivation • provides central purpose to personality • responsible for patterns of skills/goals • comprised of: object, subject, self-object |
Self
(Kohut) |
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in Self-Psychology: internalized image of idealized parent
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Object
(Kohut) |
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in Self-Psychology:
• patterns of unconsc. thoughts, images, ideas of other • internalized representation of oneself |
Self-object
(Kohut) |
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Subject
(Kohut) |
in Self-Psychology: internalized Grandiose Self of the child
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Bipolar Self
(Kohut) |
in Self-Psychology:
• choice between parent expectations (idealized object) and internal desire (grandiose self) • negotiation of this facilitates strengthening Sense of Self |
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Narcissistic Outbursts
(Kohut) |
in Self-Psychology:
• due to removal of mirroring selfobject, Grandiose self incorporates idealized object (Parent) to perform function of mirroring (in service of narcissism) |
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Types of Dream Content (Freud)
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• Manifest Content: experienced by dreamer
• Latent Content: symbolic/unconscious motives in dream |
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Stages of "Social Interest" development (Adler)
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• Aptitude: for cooperation/social living
• Ability:for expressing aptitude • Secondary Dynamic Characteristics: attitudes & interests as means for expressing Social Interest |
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Reorientation Techniques (Adler)
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• Immediacy
• Encouragement • Acting As If • Catching Oneself • "The Question" • Spitting in the Client's Soup • Avoiding the Tarbaby • Push-Button Technique • Paradoxical Intention • Task Setting & Commitment • Homework |
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Stages of Change
Brief Therapy |
• BEHAVIORAL description of prob
• UNDERLYING rules of interaction • REORIENTATION to possibility that rules can change • PRESCRIBING new behavioral rituals |
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Levels of "Dasein"
(Heidegger) |
• Umwelt: bio, environ., external
• Mitwelt: interpersonal rel. • Eigenwelt: intrapsychic rel. • Überwelt: spiritual rel., ideal world |
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Types of Anxiety
(Existential Therapy) |
• Normal: situation appropriate, not repressed
• Existential: regret, guilt for self-betrayal • Neurotic: out of proportion, destructive, evasive |
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Types of Isolation
(Existentialist) |
• Interpersonal: geographical, psychological, social
• Intrapersonal: separated parts of self using defense mechanisms • Existential: idea that we are all uniquely separate in our experience of the world |
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Stages in Development
of Existential Awareness (May) |
• Innocence/Openness of Infant
• 2-3 yrs: Reaction to external world • Consciousness of self as indiv. • Transcendant Consciousness: more objective view of self & experience |
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Existential Therapy
--Clinical Application-- |
• listen for themes of isolation, meaninglessness, responsibility, morality
• assess for ability to face life honestly • projective/objective instruments • help client to clarify values |
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Necessary & Sufficient Conditions for Change (Rogers)
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• Psychological Contact: engaging, connecting, impacting
• Incongruence: b/t self-perception & experience, brought into awareness • Congruence/Genuineness: w/o facade from therapist • Unconditional Positive Regard (UPR) • Empathy • Perception (by patient) of UPR |
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Aspects of Client Experience
(Rogers) |
• Experiencing Responsibility
• Experiencing the Therapist • Experiencing Process of Exploration • Experiencing the Self • Experiencing Change |
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Types of Perceived Empathy
(Rogers) |
• Cognitive: experience/motivation understood
• Affective: therapist involved in client's feeling-state • Sharing: therapist shares relevant opinions • Nurturing: therapist attentive, providing security & support |
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Gestalt Therapy (Perls)
--Key Concepts-- |
• Energy, blocks to energy
• Figure and ground • Contact • Disturbances of Contact • Unfinished business • Awareness |
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Gestalt Therapy (Perls)
--Techniques-- |
• fully functioning I-thou relationship
• creative experiments/exercises (i.e., empty chair, enactments) |
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Types of Processes facilitating Observational
Learning and Personality Formation (Bandura) |
• Attentional Processes
• Retention Processes • Motor Reproduction Processes • Motivational Processes |
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Cognitive Distortions
(CBT) |
• All or Nothing thinking
• Selective Abstraction • Mind Reading • Negative Prediction • Catastrophizing • Overgeneralization • Labeling/Mislabeling • Magnification/Minimization • Personalization |
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Types of Schemas in CBT
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• Cognitive-conceptual
• Affective • Physiological • Behavioral • Motivational |
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Qualities of Schemas in CBT
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• Adaptive vs. Maladaptive
• Active vs. Inactive/Periodic • Compelling/Learned vs. Noncompelling • Easily changeable vs. unchangeable |
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DBT -- Goals
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• decrease life-threatening Bx
• decrease therapy interfering Bx • Decrease quality-of-life interfering Bx • Increase mindfulness Bx skills |
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Four Modules of DBT
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• Mindfulness
• Distress Tolerance • Emotional Regulation • Interpersonal Effectiveness |
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Types of Goals
(Recovery Model) |
Living Goals
Treatment Goals Quality of Life Goals |
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Factors that improve
diagnostic reliability |
• consultation
• common screening measures • intake forms |
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Suicide Assessment
**Levels of De-escalation** |
• Anecdotal evidence re: safety
• Contracting/Planning (schedule follow-up visit, contact supports) • Voluntary Hospitalization • Call law enforcement re: 5150 |
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Components of
Mental Status Exam |
• Appearance
• Manner/Approach • Psychomotor Activity/Bx • Mood/Affect • Level of Orientation • Speech • Thought Process • Thought Content • Perceptions (AH, VH, SH?) • Cognition (memory, intelligence) • Level of Insight • Judgment |
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4 Forces in Psychotherapy
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• Biological
• Psychological • Social • Spiritual |
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Group Norms
(definition) |
• Explicitly stated descriptions of what actually happens in a given group
OR • Implicit notions of what other members think/feel about group expectations |
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Three Levels of Process Commentary
in Group Culture Building |
• Intrapsychic: Individual
• Interpersonal: Between Members • Systemic: Group-as-a-Whole |
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Types of Group Climate
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• Engagement: positive work atmosphere
• Conflict: tension and anger in group • Avoidance: behavior indicating avoidance of personal responsibility |
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Levels of Group Dynamics
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• Individual (intrapsychic)
• Interpersonal (dyadic) • Sub-group • Group-as-a-Whole • Administrative • Institutional • Socio-cultural • Socio-political |
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Types of Boundaries
in Groups |
• External Group Boundary
• Leadership Boundary • Therapist Boundary • Personal Boundary of Indiv. Member • Interpersonal Boundary • Internal Boundaries • Subgroup Boundary |
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• System
• Boundary • Open Systems • Closed Systems • Permeable/Dynamic Systems • Autonomy • Hierarchy • Isomorphy • Homeostasis • Specialization |
Family Therapy Concepts
from Systems Theory |
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Identify the 3 Basic Assumptions
(Bion) |
• Dependency
• Fight or Flight • Pairing |
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Stages of Group Development
**Common 5 Stage Model** |
• Forming: dependency, anxiety
• Storming: power, conflict • Norming: trust, safety, intimacy • Performing: differentiation • Adjourning: appreciation, loss |
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Group Roles -- Leaders
(Ariadne P. Beck) |
• Task Leader
• Emotional Leader • Scapegoat Leader • Defiant Leader |
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Therapeutic Factors
(Yalom) |
• Instillation of Hope
• Universality • Imparting of Information • Altruism • Corrective Recapitulation of Primary Family Group • Development of Socializing Techniques • Imitative Behavior • Interpersonal Learning • Group as Social Microcosm • Group Cohesiveness • Catharsis • Existential Factors |
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Parataxic/Interpersonal
Distortions (Yalom) |
• individuals' proclivity to distort their perceptions of others, on the basis of a personification existing mainly in fantasy
• different origins than concept of transference, but operationally very similar |
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Consensual Validation (Yalom)
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• comparison of one's interpersonal evaluations with those of others
• primary means of altering parataxic distortions |
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Common Types
of Critical Incidents (Yalom) |
• Conflict
• Strong Positive Affect • Self-Disclosure |
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• sign of a Here & Now Corrective Emo. Experience
• most therapeutic event for group member • usually involves another group member, not the therapist |
Critical Incident (Yalom)
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Components of a Corrective
Emotional Experience (Yalom) |
• risk strong expression of emotion
• sufficient safety in group • open to Consensual Validation • Recognizing maladaptive Bx • Ultimate facilitation of ability to communicate deeply, honestly |
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Stages of Change
(Prochaska & DiClemente) |
Precontemplation
Contemplation Preparation Action Maintenance Termination (Relapse) |
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Types of Reflective Responses
Motivational Interviewing |
Simple Reflection
Amplified Reflection Double-sided Reflection |
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Three Predictors of
Behavioral Change |
• Internal Perception of Need
• Sense of Self-Efficacy • Stated Intention to Change |
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• slurred speech
• lack of coordination • unsteady gait • nystagmus (involuntary eye mov't) • impairment of attention or memory • stupor or coma |
Signs of
Alcohol Intoxication |
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• tachycardia dilation
• papillary dilation • +/- blood pressure • perspiration or chills • nausea or vomiting • evidence of weight loss • psychomotor agitation or retardation • muscular weakness, • respiratory depression, chest pain • cardiac arrhythmias • confusion, seizures, dyskinesias • dystonias or coma |
Signs of
Amphetamine Intoxication |
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• restlessness
• nervousness • excitement • insomnia • flushed face • diuresis (+urination) • gastrointestinal disturbance • muscle twitching • rambling flow of thought and speech • tachycardia or cardiac arrhythmia • periods of inexhaustibility • psychomotor agitation |
Signs of
Caffeine Intoxication |
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• conjunctival injection (red eye)
• increased appetite • dry mouth • tachycardia (+heart rate) |
Signs of
Cannabis Intoxication |
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• tachycardia or bradycardia
• papillary dilatation • +/- blood pressure • perspiration or chills • nausea or vomiting • evidence of weight loss • psychomotor agitation/retardation • muscular weakness • respiratory depression, chest pain • cardiac arrhythmias • confusion, seizures, • dyskinesias, or coma |
Signs of
Cocaine Intoxication |
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• automatic hyperactivity
• increased hand tremor • insomnia • nausea or vomiting • transient AH/VH/TH or illusions • psychomotor agitation • anxiety • grand mal seizures |
Signs of
Alcohol Withdrawal |
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• dysphoric mood
• fatigue • vivid, unpleasant dreams • insomnia or hypersomia • increased appetite • psychomotor retardation/agitation |
Signs of Amphetamine
AND/OR Cocaine Withdrawal |
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Definition of "Recovery"
as Used in Research |
• No enduring symptoms
• No odd behaviors • No further medication • Living in the community • Working and relating well to others |
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Goals of Psychosocial Rehabilitation
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• Recovery/resilience
• Community integration • Quality of life |
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SMART Objectives in
Psychosocial Rehabilitation |
• Simple
• Measurable • Attainable • Realistic • Time-framed |
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Three types of Factors
in Psychosocial Rehabilitation |
• Perpetuating
• Precipitating • Predisposing |
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Central Dialectic of DBT
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Balancing Acceptance
with Change |
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Core Assumptions of DBT
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i. Escape/avoidance of affect is central to distress
ii.Acceptance of painful emotions actually decreases pain iii. Therapy is both supportive & didactic |
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Stages of Treatment
in DBT |
• Stabilize Client, Achieve Bx Control
• Achieve Non-Traumatic Emo. Exper. • Achieve Ordinary Happiness • Overcome Emptiness, Achieving Joy |
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In DBT, a Therapist Stance incorporating the use of humor to connect in the face of suicidality.
Analogous to wise, imperfect Zen Master, Bodhisattva. |
Irreverence
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Three Criteria to establish
Medical Necessity |
• Qualifying Diagnosis
• Related Functional Impairments • Mental Health Services needed to reduce/eliminate impairments |
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Types of Elder Abuse
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• Physical
• sexual • financial (undue influence) • abandonment • isolation • neglect • self-neglect |
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Psychological Affects of Stroke
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• Depression
• Apathy • Memory Loss • Dysphasia/Aphasia • Frustration • Apraxia • Dependency Issues |
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Common Causes of Delirium
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• ETOH withdrawal
• Infections, including UTI • Pulmonary Diseases • Cardiovascular Diseases • Neuro. Diseases • Medications • Environmental: lead/insecticide |
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Types of Dementia
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• Vascular dementia
• Alzheimer's • Parkinson's • Creutzfeldt-Jacob • Pick's disease • Brain Infection (AIDS, meningitis, syphilis) • Lewy-Body • Fronto-temporal • Substance-Induced |
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Six Domains of Potentially Limited Civil Capacity
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• Medical Consent
• Sexual Consent • Financial • Testamentary • Driving • Independent Living |
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term used to describe the strategic use of manipulation through fraud, misrepresentation, or physical intimidation for the purpose of taking advantage of an elderly person's vulnerability
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Undue Influence
REPORT MANDATED! |
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specific and highly predictable response to a stimulus. (Rarely applicable to psychotropic meds)
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Stimulus-Response Specificity
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process of impulse movement along axon
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Conduction
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Transmission
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passage of impulse across synaptic space
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Basic Pharmacokinetic Factors
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• absorption
• distribution • biotransformation • excretion |
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Primary Sites of Drug Excretion
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• kidneys
• gastrointestinal tract • respiratory system • sweat • saliva • breast milk |
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Steady State
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• when concentrations of a drug in the bloodstream have reached a plateau (i.e., amt administered is equal to amt being eliminated)
• usually achieved after 4 half-lives for most drugs |
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Primary Types of Medication Effects
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• pharmacological effects
• side effects • idiosyncratic effects • allergic reactions • discontinuance syndrome |
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• dry mouth
• constipation • urinary retention • blurred vision • memory impairment • confusional states |
anticholinergic effects
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• Acute dystonic reactions
• Akathisia • Pseudoparkinsonism |
Extrapyramidal Symptoms
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Parkinson-like Side Effects
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• rigidity
• shuffling gait • tremor • flat affect • lethargy |
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Phases of Schizophrenia
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• Prodromal: mostly negative Sx
• Active: increased positive Sx • Residual: return to negative Sx |
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Examples of Drugs
with HIGHER risk of abuse |
• Benzodiazepines
• Seroquel • Stimulants |
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Negative symptoms of schizophrenia
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• anhedonia
• apathy • blunted affect • poverty of thought • amotivation |
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• Insomnia
• reduced appetite • stomach aches • nervousness • mild dysphoria • lethargy |
Common side effects of stimulants
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Side Effects of Lithium
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• Increased thirst, urination
• nausea, diarrhea • headache • tremor • weight gain |
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Three Levels
of Neuronal Messaging |
• communication across the synapse
• changes in the internal biochemistry of the cell • activation of MRNA (messenger ribonucleic acid), translating protein into new brain structures. |
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Brain Anatomy:
similar to the cerebrum in that it has two hemispheres and has a highly folded surface or cortex. This structure is associated with regulation and coordination of movement, posture, and balance. |
Cerebellum
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Brain Anatomy:
sensory and motor functions. Almost all sensory information enters this structure where neurons send that information to the overlying cortex. |
Thalamus
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Brain Anatomy:
regulates homeostasis, emotion, thirst, hunger, circadian rhythms, and control of the autonomic nervous system |
Hypothalamus
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Brain Anatomy:
important for learning and memory . . . for converting short term memory to more permanent memory, and for recalling spatial relationships in the world about us |
Hippocampus
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Brain Anatomy:
deals with autonomic, involuntary functions, such as breathing, heart rate and blood pressure. |
Medulla
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Brain Anatomy:
• involved in motor control and initial analysis of sensory input • It has parts that are important for the level of consciousness and for sleep. |
Pons
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Layers of the Triune Brain
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• Reptilian Brain
• Paleo-Mammalian Brain (Limbic) • Neomammalian Brain (Neocortex) |
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the process whereby the brain radically reduces the number of synapses it maintains during adolescent brain growth.
It appears that the rapid brain development in infancy results in activity that can be subsequently discarded in order to achieve greater speed and efficiency in the adult brain. |
Synaptic Pruning
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the ability of the brain to change the structure and function of many of its parts to meet different needs over time. The brain is particularly capable of this change when it is in childhood.
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Plasticity
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Cass Model of Coming Out
--Stages-- |
• Identity Confusion
• Identity Comparison • Identity Tolerance • Identity Acceptance • Identity Pride • Identity Synthesis |
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Helm’s White Racial Identity Development Model
--Stages-- |
• Contact
• Disintegration • Reintegration • Pseudo-Independence • Immersion/Emersion • Autonomy |
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Cross: Black Racial Identity Development Model
--Stages-- |
• Pre-encounter
• Encounter • Immersion/Emersion • Internalization • Internalization-Commitment |
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Coleman Model of Coming Out
--Stages-- |
• Precoming out
• Coming out • Exploration • First relationships • Integration |
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Social Identity
Development Model --Stages-- |
• Naïve/ No Social Consciousness (Curiosity)
• Acceptance (Complacence/ Resignation) • Resistance (Anger/Shame) • Redefinition • Internalization |
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Downing and Roush Feminist Identity Model
--Stages-- |
• Passive Acceptance of trad. sex roles
• Revelation – open questioning of self – men perceived as negative • Imbeddedness–Emanation – connectedness with select women • Synthesis – development of authentic, positive feminist identity • Active commitment to meaningful action, men considered equal, different |
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IDENTITY DEVELOPMENT MODEL
1. Ethnic Awareness 2. White Identification Stage – realization of differentness 3. Awakening to Social Political Consciousness 4. Redirection – reconnection with one’s Asian American heritage and culture 5. Incorporation – development of comfortable identity as Asian American. |
Kim's Asian-American Identity Development Model
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Family Life Cycle Model
--Stages-- |
• Leaving Home
• Single Young Adults • Forming Partnerships • families w/young children • families w/adolescents • families w/adult children • families in later life |
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Masters and Johnson: Four Phase model of sexual response
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• Excitement (initial arousal)
• Plateau (full arousal, not orgasm) • Orgasm • Resolution (after orgasm) |
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PLISSIT Model
of Sex Therapy |
• P = permission: give clients permission to discuss sexual issues, normalize thoughts, feelings, Bx
• LI= limited information: involves psychoeducation i.e., impact of medical or medications on sexual functioning • SS= specific suggestions: homework assignments • IT = Intensive Therapy: used if the first three levels don’t work |
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Kaplan's Three-Stage Model of the Human Sexual Response Cycle
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• DESIRE: Neuro- and psychological sensation for initiating sexual activity and upon which sexual stimulation then builds.
• EXCITEMENT: Similar to Masters and Johnson • ORGASM: Similar to Masters and Johnson’s model orgasm + resolution phase eg. reversal of vasocongestion, release of muscular tension |
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CERTS: Necessary Conditions for Positive Sexual Experiences for Survivors of Sexual Abuse
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Consent
Equality Respect Trust Safety |
