Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
180 Cards in this Set
- Front
- Back
|
A B C framework |
Activating event
Belief (cognition)
Emotional and behavioral consequences |
|
|
Development of cogntive behaviour therapy (CBT) |
Developed in the 1960s
By Albert Ellis, Aaron beck, Donald Meichenbaum
Considered 2nd wave of behaviour therapy
Grew out of concern that something was missing in behaviour therapy
Focus on thoughts more important |
|
|
Cognition |
Change your thoughts and your beliefs to change your emotions |
|
|
A B C plus D E F |
Activating event
Belief -disputing intervention -effective belief -new feelings
Emotional and beahviour consequences |
|
|
Activating event |
Any source that causes client stress |
|
|
Beliefs |
Clients beliefs about the activating event or thoughts that come to mind in response to the event |
|
|
Consequences |
Emotional and behavioral responses that the client experiences due to beliefs about the activating event |
|
|
Disputing irrational beliefs |
Intervention component
Therapist's challenge and debate the clients unrealistic beliefs in am effort to assist the client with thinking in more accurate, rational and postive ways |
|
|
Effective new thinking |
Disputing causes the client to develop the ability to replace irrational beliefs with more realistic and self affirming thoughts
Over time the client learns to monitor, dispute, and replace faulty thinking independently |
|
|
Feeling and behaving in new ways |
The client's application of effective new thinking influences the emotions and beahviours (consequences) the client's experiences in response to activating events |
|
|
Therapeutic techniques and procedures in Cogntive therapy |
Case formulation Dysfunctional thought record Labeling cogntvie distortions Thought challenging |
|
|
Case formulation |
Extensive intake needed to gather information on clients history, development and background
Purpose is for therapist's to gain an in depth understanding of clients before proceeding with treatment and cogntvie interventions
Informs the counseling plan and potential helpful interventions
Provides a through understanding of clients core beliefs and of cogntvie distortions |
|
|
Elements of a complete case formulation |
A list of clients problems and concerns
Hypothesizing about the underlying mechanisms (core beliefs/ schemas)
The relationship of the belief to problems
Precipitants of current problems
Background relevant to development of underlying beliefs
Potential obstacles to counseling |
|
|
Becks Cogntvie triad |
Represented by 3 thoughts arranged in a triangle with clockwise arrows between thoughts
Used for assessment of core beliefs and schemas
One of becks most significant contributions to the study and treatment of depression |
|
|
Cognitive triad includes |
Negative view of self
Negative view of the world
Negatvie view of the future |
|
|
Depression and cogntvie triad -Pattern that triggers depression is the following |
Clients gol negatvie views of themselves -l am a lousy person
Selective abstraction -client interprets life events through negative filter -the world is a negative place where bad things are bound to happen to me
Client holds a gloomy vision of the future -the world is bleak and it isn't going to improve |
|
|
Schemas -core beliefs or underlying assumptions |
Internal working models of the self in relation to the world, starting in early life
Can be adaptive or maladaptive
Reinforced by autonomic thoughts and cogntvie distortions |
|
|
Automatic thoughts |
Thoughts that arise automatically in response to certain situations or cues
Reflect the person's appraisal of the situation and not necessarily the situation itself
Provides clues to underlying schemas and congtvie distortions
Stream of cognitions that constantly flow |
|
|
Cogntvie distortions |
Systematic errors in reasoning that help people to fit new information into preexisting schemas
Link between schemas and automatic thoughts
Start in childhood |
|
|
How schemas, cognitive distortions and automatic thoughts link |
New information does not fit with the current schema
Cogntvie distortions help the new information fit into existing maladaptive schema below
New info now fits the schema
Creates and sustains automatic thoughts |
|
|
Different cogntive distortions |
Arbitrary inference Selective abstraction Over generalization Discounting the postives Magnification and minimization Personalization Dichotomous thinking Labeling and mislabeling Should and must statements |
|
|
Cogntivie inference |
Drawing conclusions without supporting evidence or in the face of contradicting evidence
-I'm going to fail my exam (even though I've gotten As on all my practice tests) |
|
|
Selective abstraction / jumping to conclusions |
Drawing conclusions based on an isolated detail of an event
-my friend didn't call when she said she would so she mist be mad at me |
|
|
Overgeneralization |
Holding extreme beliefs on the basis of a single incident and applying those beliefs to other dissimilar events or settings
-forgot my lines during dress rehearsal everyone must think om stupid. I should stay home in my room and never speak to anyone again so that I don't embarrass myself |
|
|
Discounting the postivies |
Ignoring postvie information while emphasizing negatives
-I cant believe I forgot the answer to that question on thr test (got 96%) |
|
|
Magnification and minimization |
Perceiving a situation or case in greater or lesser light than it truly deserves
-omg I have a stain on my shirt Today is a right off |
|
|
Personalization |
Relating external events to themselves even when there is no basis for making the connection
-my dentist is close to where the bank robbery took place, I could have been killed |
|
|
Dichotomous thinking |
Thinking and interpreting in all or nothing terms or categorizing experiences in either or extremes
Polarized thinking
-either I get As in all my courses or I'm a failure |
|
|
Labeling and mislabeling |
Portraying ones identity on the basis of imperfections and mistakes made in the past and allowing them to define ones true identity
-crap I forgot a pencil again, I'm an idiot |
|
|
Should and must statements |
Musturbating or shoulding on yourself
-i should have known better than to try out for the soccer team. I suck |
|
|
Dysfunctional thought records |
Self monitoring to identify and modify thoughts |
|
|
Key concepts of cogtvie therapy |
Relies on the belief that people's perception of a situation is more closely connected to their reaction than the situation itself
The more stress the more liky automatic thoughts are dysfunctional
Cogntvie restructuring by identifying evaluating and modifying automatic thoughts and core beliefs |
|
|
Core beliefs (schemas) |
Central ideas about ourselves, the world, and others |
|
|
Beahviour |
Change your actions and beahviour to change your emotions |
|
|
Behaviour therapy |
Increased focus on observable and objective ways to describe beahviour
Focuses on beahviours and behavioral change
Measurement, evaluation and research |
|
|
Albert Bandura |
One of most important developers of beahviour therapy and social learning theory
Applied principles of classical conditioning and operant conditioning to social learning therapy
Well known Bobo doll experiment that demonstrated observational learning
Writes extensively on aggression, violence and adolescence |
|
|
B F Skinner |
Developer of behavior therapy
Strict beahviourist
Uses a scientific approach rather than mental processes
Developed theory of operant conditioning -laid foundation for beahviour modification |
|
|
Development of beahviour therapy |
Developed during the 1950s and 1960s
Was a ridical departure from psychoanalysis |
|
|
Development elements of behavior therapy |
Beahviour is somthing that can be operationally defined
Included overt actions as well as internal processes
Goal is to modify Beahviour to make it more adaptive
Change can take place without insight into underlying dynamics and the origins of a psychological problem
Largely action oriented and educational -therapist teaches clients skills of self management |
|
|
Three main ideas of behavior therapy |
Focuses on observable rather than the unconscious
Focuses on present rather than the past
Focuses on short term treatment and clear goals |
|
|
Key concepts of beahvior therapy |
Beahviour is learned
All Beahviour has a purpose/ function
Beahviors must be viewed in context
Therapy should focus on understanding and changing Beahviour
Focus on present
Based on scientific method
Goals should be specific, Beahvioural and measurmeable
Teaching is important
Should be collaborative |
|
|
Beahvior is learned |
Relies on the assumption that people are shaped by experiences and learning
Genetics play a role but experiences are more important in individual differences |
|
|
Three fundamental theories to understanding beahviour therapy |
Classical conditioning Operant conditioning Social learning theory |
|
|
Classical conditioning |
Type of learning that happens over time when a repeated presentation of a certain stimulus causes a given response when paired with something else
Repeatedly pairing an uncomditional stimulus, and a conditional stimulus will eventually elicit the response with just the conditioned stimulus
Principles if classical conditioning can be used in beahviour therapy to change beahviour |
|
|
Extinction |
When the conditioned response decreases over time
Elimination when no longer paired |
|
|
Principles of classical conditioning |
Stimulus generalization Stimulus discrimination Systematic desensitization |
|
|
Operant conditioning |
Learning based on consequences in the environment -behavior changes by increasing or decreasing based on the postive or negatvie association of the consequence that follow
Beahviour modification techniques such as reinforcement, punishment or extinction can be used in therapy
More frequently the consequences happen the stronger the association of beahviour and consequences |
|
|
Counterconditioning |
Can reverse the habit
Pairing the beahviour with an incompatible response to the same cue |
|
|
Differences between operant and classical conditioning |
Classical conditioning -target response is automatic
-reinforcement is present regardless of response occurs
-beahviour depends on reflexive and physiological responses
Operant conditioning -target response is voluntary
-reinforcement is a consequences of the behavior
-beahviour depends on skeletal muscles |
|
|
Social learning theory |
Type of learning in which individuals learn by observing and modeling others
Similar to classical and operant conditioning but adds an additional focus on people's worldview, beliefs, perspectives, and other cognitive processes
These internal cogntvie appraisals or interpretations of events significantly influence people's beahviour |
|
|
Modeling |
When people imitate other people's beahviour
Can be postvie or negative |
|
|
Observational learning |
Changes in beahviour and knowledge that result from watching others
-cultural customs can spread through observation |
|
|
Processes supporting observational learning |
Attention to the act or beahviour -more likely to learn by seeking others rewarded than punished
Memory for it -there is often a delay from when we learn a new beahviour and when the need to preform arises
Ability to reproduce it -need thr Ability to reproduce beahviour -is most effective when we observe and immediately practice and continue to practice -helps to observer others through their process of learning (mistakes cause relection)
Motivation to do so |
|
|
Therapeutic process in beahviour therapy emphasizes |
Assessment and evaluation of objectvie beahviours
Identification of target beahviours
Identification of function of beahviours
Selection of interventions
Ongoing assessment and monitoring to determine effectiveness
Follow up assessments |
|
|
How can the therapeutic process be described |
Structural
Active
Learning oriented -unlearning maladaptive beahviours and replaced them with new adaptive beahviours |
|
|
Overall goal of beahviour therapy |
Is to help clients be more flexible and sensitive in their reactions to their environment and to establish tools that are effective in helping them meet their needs
-estiguish maladaptive beahviours and replace them with new and more adaptive beahviours
-learning skills that will help them improve their lives |
|
|
What type of goals should be set |
Goals should be clear, specific, measurable and collaborative
Goals must be concrete, understood, and agreed on by the client and the counselor |
|
|
Wide range of issues and goals of behavior therapy can address |
Reduction or abstinence from drugs and alcohol
Reduction of undesirable habits
Reduction in fears and phobias
Improvement in health and fitness habits
Reduction in undesirable beahviours |
|
|
Therapist's function and role in behavior therapy |
Therapist's take on many roles including consultants, teachers, architects, and problem solvers
Therapist's aim to develop a strong therapeutic alliance -Therapist's make the same amount of effort for rapport building as they do with assessment, evaluation and interventions |
|
|
Process beahvior Therapist's follow |
Assessment to collect data and conceptualize clients
Estabjsh individualized counseling goals
Monitor beahviour, assess effectiveness of intervention and modify goals as needed
Follow up assessments to determine counseling effectiveness |
|
|
Relationship between therapist and client in beahviour therapy |
String collaborative and postive therapeutic relationship is essential -view clients holistically -respect individual differences
Therapist's are directive and focused -focus on formalized treatment plans, goals and homework assignments -teach concrete skills
Clients are expected to do more than merely gather insights they need to be willing to make changes |
|
|
Therapeutic techniques and procedures of behavior therapy |
Assessment Operant conditioning techequies Classical conditioning techniques Skills training |
|
|
Assessment |
Gathering of initial information using variety of assessment approaches
Functional behavior assessments are used to identify the reasons for certian behaviors by identifying the relationships between the stimuli and responses |
|
|
Functional beahviour assessments are conducted using |
Antecedent - behavior - consequence (Abc) model
Antecedents -what happens before the beahviour, triggers, cues
Beahviour -behavior that happens
Consequences -what happens after the behavior, the response |
|
|
Operant conditioning techniques |
Reinforcement Punishment Extinction Shaping Contingency management Applied behavioral analysis |
|
|
Reinforcement |
Rewards that increase desirable beahviour
Postvie reinforcement -adds a favorable stimulus
Negatvie reinforcement -removing an aversive stimulus
More effective then punishment |
|
|
Punishment |
Used to decrease undesirable beahviour
Postive punishment -adding an aversive stimulus
Negatvie punishment -removing a favorable stimulus |
|
|
Extinction |
Withdrawing the payoff or rienforcmentent of an undesirable beahviour to decrease the likelihood of the beahviour recurring
Weakening of an operant response when rienforcmentent is no longer available |
|
|
Generalization |
Responding occurs to a stimulus thar resembles the original discrimination stimulus during learning |
|
|
Discrimination |
There is no response to a stimulus that resembles the original discriminative stimulus used during learning |
|
|
Similar phenomenons on classical and operant conditioning |
Discrimination Generalization Extinction |
|
|
Shaping |
The process of gradually reinforcing particular target behaviors to approximate the desired beahviour |
|
|
Contingency management |
Systematic delivery of reinforcing or punishing consequences contingent on the occurrence of a target response and the withholding of these consequences in the absence of a target response
Token economies
Giving a sticker each time they behave in a desirable way |
|
|
Token economies |
Providing a token to the person each time the target beahviour occurs
The tokens are then traded in for a reward |
|
|
Applied beahviour analysis (A B A) |
Treatment particularly helpful for those with autism which uses operant conditioning to elecit postvie beahviour change |
|
|
Primary reinforcers |
Consist of reinforcing stimuli that satisfy basic motivational needs
Needs that affect an individuals ability to survive and if possible reproduce
Motivation to satisfy basic needs is related to nucleus accumbens (active when processing rewards) -explan why some are prone to high risk beahviours |
|
|
Secondary reinforcers |
Consist of reinforcing stimuli that aquire their value through learning |
|
|
Classical conditioning techniques |
Exposure based interventions Relaxation techniques
(Used with people who experience anxiety, phobias, panic or trauma) |
|
|
Exposure based interventions |
People learn about their fear responses, Identify unhelpful cognitions, Confront the uncomfortable feelings without avoiding and achieve self efficacy |
|
|
Kinds of exposure based interventions |
Virtual reality therapy -use technology to provide exposure -level of exposure can be controlled
Imaginal exposure -imagining being exposed to feared stimulus
Flooding -highest does exposure -being exposed to most feared stimulus right away
Systematic desensitization -Gradual exposure to feared stimulus using relaxation exercises
Introspective exposure -exposure to feared bodily sensations |
|
|
Systematic desensitization |
Basic behavioral procedure developed by Josph Wolpe
Based on principles of classical conditioning
Entails relaxation training, development of a graduated anxiety hierarchy and the presentation of hierarchy items while the client is deeply relaxed |
|
|
Relaxation techniques |
Strategies used to reduce anxiety and stress and promote postvie beahvioural change
Often combined with exposure |
|
|
Kinds of relaxation techniques |
Progressive muscle relaxation -used to calm body and mind -clients tense muscles groups for 5 seconds then release to notice the state of relaxation
Diaphragmatic breathing -breathing technique that involves taking slow deep breaths using the diaphragm
Biofeedback -use instruments to monitor bodily functions such as heart rate and pulse rate -neurofeedback (brain wave patterns) |
|
|
Diaphragmatic breathing |
Can be used with all clients
Provides relaxation for clients and reduces anxiety and tension
Involves inhaling deeply for a count of 4 holding for 2 and then exhaling for 4
Used with children
Therapist use visuals |
|
|
Progressive muscle relaxation |
Used with almost all clients
Provides relaxation for clients and reduces anxiety and tension in the body
Involves tensing muscles and then relaxing and releasing them muscles to help clients see the difference between relaxed versus tense muscles
Can be used with children
Can use a relaxation script to teach clients |
|
|
Eye movment desensitization and reprocessing |
Exposure based therapy
Involves imaginal flooding, cogntvie restructuring and the use of rhythmic eye movements and other bilateral stimulation to treat traumatic stress disorders and fearful memories of clients |
|
|
Exposure/ response prevention |
Exposure based therapy
Involves exposure to obsessive worry and prevention of compulsive response for clients with obsessive compulsive disorder |
|
|
Exposure based CBT for hoarding |
Aimed to reduce stress and anxiety in those with hoarding disorder
Clients engage in relaxation when being exposed to parting with objects -relaxatiin is incompatable with fear
Guided imagery and rating scales can be used |
|
|
Steps used in exposure based CBT for holding |
Teach an effective relaxation strategy
Help the client identify cogntvie distortions that rienforce the horsing beahviours
Establish an anxiety hierarchy
Provide controlled exposure |
|
|
Skills training |
Helps clients develop and achieve skills in interpersonal competence -assertiveness training
May involve various behavioral procedures such as assessment, direct instruction and coaching, modeling, role playing and homework assignments -beahvioral rehearsal
Feedback and rienforcmentent clients recive assists them in conceptualizing and using new set of skills
Skills can be enhanced by bibliogherapy and observational learning
Taught in either an individual or group setting |
|
|
Beahvior therapy current use |
Effective for people with autism, mood disorders, anxiety disorders, trauma experiences, some personality disorders, eating disorders and substance use disorders
Effective for children with ODD, ADHD, selective mutism and conduct disorder
Used in fields of Developmental disabilities, mental illness, education, community psychology, sports, medicine
Used with individuals, families and groups |
|
|
Behavioral therapy is most helpful with |
Depression and anxiety
Interventions such as activity scheduling and systematic decision making target depression
Exposure based interventions target anxiety, phobias and trauma |
|
|
Applications of Behavior therapy |
Applicable to diverse populations due to wide variety of interventions and respect of individual differences
Some clients may be uncomfortable with directive and active approach |
|
|
Strengths of beahviour therapy |
Easily integrated with other approaches
Provided foundation for variety of other approaches
Specific and concrete
Collaborative
Focus on behavior rather than insight and emotions
Focuses on environmental, social and political conditions that contribute to a client's problems
Have been subject to rigorous evaluation |
|
|
Limitations of beahviour therapy |
Does not focus on feelings
Some believe that the therapist's role as a teacher deemphasizes the important relational factors in client therapist relationships
Does not help clients gain insight
Strategies are superficial and may lead to symptom substitution
Focus on symptoms rather then underlying causes
Potential to manipulate the client
My find directive approach imposing |
|
|
Key concepts of congtvie beahvioural therapy |
Causes of distress is thoughts rather than environmental factors
-well being results when clients change thoughts which will change emotions and behaviors |
|
|
CBT therapeutic processes |
Holistic view but focus is primarily on thoughts -emotional experiences and beahs are also important
Structural sessions and clients are educated on the purpose and process of CBT |
|
|
5 stages of CBT sessions |
Structure the session and set an agenda with clients
Review previously learned content and skills and process weekly homework assignments
Introduce new material, psychoeduction and practicing of techniques or skills
Collaborative processing and feedback of the session provided by both therapist's and clients
Assign new homework based on session content and new skills |
|
|
Therapy is seen as an educational process where clients learn to |
Identify the interplay of their thoughts, feelings and beahviours
Identify and dispute irrational beliefs that are maintained by self indoctrination
Replace ineffective ways of thinking with effective and rational congtions
Stop absolutistic thinking, blaming and repeating false beliefs |
|
|
Goals of CBT |
Overall goal is for people to again awareness and change their information processing systems
Engage in healthy, functional and adaptive behaviors
Specific goals for each client is determined collaboratively |
|
|
Therapist function and role in CBT |
Most essential role is to develop a string therapeutic alliance and a safe, affirming atmosphere -trust is important due to the therapist challenging and comforting thoughts which may feel threatening Therapists are active, collaborative, goal oriented, and problem focused Therapist are considered experts on the cogntvie process and client's take responsibility for progress Therapists use psychoeducation to inform client's of the process Therapist use guided discovery to collaboratively assess validity of thoughts and provide evidence for and against thoughts |
|
|
CBT counselling applications |
Wide range of people, problems and settings One of the most empirically supported approaches Effective with mood disorders, anxiety disorders, OCD, anger, sexual difficulties, low self esteem, substance abuse, PTSD, eating disorders, schizophrenia Trauma focused CBT is practically helpful for addressing trauma Can be used with groups, children, families and couples |
|
|
CBT application to multicultural groups |
Culturally sensitive and takes worldviews into consideration
Acceptance of cultures without judgment
Need for tailoring approach to fit needs of diverse clients
Directive approach may not fit well with cultural values of all clients |
|
|
CBT Application to group couselling |
Due to educational approach it lends itself will to group couselling Relies on empirical support and tends to be brief Emphasizes self management skills and thought restructuring |
|
|
Strengths of CBT |
Focus on cognitions as a cause of mental health epcierneces and a wah to address concerns Clear and logical approach Time limited Easily integrated with other approaches Collaborative and respectful Focus on teaching clients how to be own therapist's Wide range of application |
|
|
Limitations of CBT |
Comorbidity may not be effectivelyrics addressed Some clients may not be helped by time limited approach Taking responsibility and active role of clients can be challenging Less focused on insight and feelings May not be a good fit for all therapist's Confrontational nature can be invalidating to clients |
|
|
acceptance based approaches |
Emphasizes limits for behavioral therapists include mindfulness, acceptance, the therapeutic relationship, spirituality and values |
|
|
Five interrelated core themes of acceptance based approaches |
Psycholgocial health Acceptable outcomes in therapy Acceptance Mindfulness creating a life worth living |
|
|
Mindfulness |
The awareness that emerges through having attention on purpose, in the present monemnt |
|
|
Acceptance |
Is a process involving receiving one's present experience without judgment or preference |
|
|
4 major acceptance based approaches |
Dialectical behavior therapy Mindfulness based stress reduction Mindfulness based cogntvie therapy Acceptance and commitment therapy |
|
|
Development of dialectical beahviour therapy |
Developed in 1980s as a type of cogntive beahviour therapy Created by Marsha Linehan Treat people with borderline personality disorder -can be used with depression, trauma and relationships Balance between acceptance and change Technique heavey and structured approach |
|
|
Marsha Linehan |
Diagnosed with BPD which led her to depevelop approach to help people with emotion regulation, mindfulness, and suicidal ideation PhD in social and experimental personality psychology |
|
|
Borderline personality disorder |
A pattern of instability in personal relationships, intense emotions, poor self image and impulsively People may go to great lengths to avoid being abandoned, have repeated suicide attempts, display in appropriate intense anger or have feelings of emptiness Have emotional dystrgulation as a result og trauma, attachment wounds, genetics |
|
|
What is dialectical beahviour therapy |
Blend of behavioral and psychoanalytic techniques for treating borderline personality disorders and other issues
Includes both acceptance oriented and change oriented strategies
Skills are taught in 4 modules |
|
|
4 modules of dialectical beahviour therapy |
Mindfulness Interpersonal effectiveness Emotional regulation Distress tolerance |
|
|
Key concepts of dialectical beahviour therapy |
Dialectics -art of investigating the relative truth of principles, opinions and guidelines
-arriving at the truth by examining the argument and resolving the two into a rational synthesis
- two things that appear opposing can actually work together
Emotional regulation -the ability to respond to emotions in healthy ways to have a healthier life |
|
|
Use of dialectics helps clients to |
Develop a broader perspective of their problem
Learn to look for the dialectic pole
Condier more options and possibilities
Get unstuck and develop a sense of efficacy and competence |
|
|
Overall goal of DBT |
Develop dialectical thinking and practice skills that result in emotion regulation, reduce suffering and bett3r relationships |
|
|
DBT Therapeutic process stages include |
Reducing and eliminating life threatening behaviors
Experience emotions
Work to accomplish goals
Discover and engage in ways to feel complete |
|
|
DBT therapeutic process |
Therapeutic relationship is reciprocal and collaborative, therapist's are active Applied in a pure way involves 1 year of 1 hourly weekly individual therapy sessions ans 2 hour weekly group therapy Therapist is always on call Can be applied to a wide range of populations |
|
|
Therapeutic techniques and produres in DBT |
Emotional regulation (most critical task) -promotes clients ability to understand distressing emotions
Mindfulness -present moment awareness without judgment
Distress tolerance -assists with letting go of or coping with distress -self soothing and distraction skills
Interpersonal effectiveness -skills necessary to make requests or convey wants to others, manage and resolve conflicts, establish and maintain postive relationships and self respect |
|
|
DBT skills |
Validation is most important -acceptance before change
Assessment of situation and which skill group is needed
Identify and practice a skill in the moment
Assess effectiveness -identify and practice another skill if needed |
|
|
Assessment of situation and which skill group is needed -4 skill groups |
Mindfulness Distress tolerance Emotional regulation Interpersonal effectiveness |
|
|
Application and current use of DBT |
Helpful for people with suicidal ideation, hospitalization, anxiety and anger Reduces the symptoms of borderline personality disorder -expecially self injurious and suicidal symptoms Helpful for substance use and disordered eating Effective with trauma, depression, bipolar and personality disorders |
|
|
3 things Mindfulness skill |
Look around and name 3 things you see, hear, and feel Repeat with 2 things and 1 thing Once person is grounded focus on what is needed in order to deal with or tolerate the situation |
|
|
Self soothe Distress tolerance |
Self soothing has to do with comforting, nurturing and being kind to yourself Instead of doing somthjng that hurts you, try self soothing with something that gives you pleasure and comfort Self soothe using 5 senses |
|
|
Opposite action Emotion regulation |
Used when you want to change your current emotional state Engage in opposite action, we act in a way that is opposite and more postvie than the way they feel |
|
|
3 important areas of cultural competence |
Self awareness of any biases Knowledge and understanding of cultures Ability to use culturally appropriate interventions |
|
|
Value imposition |
Refers to counselors directly attempting to define a client's values, attitudes, beliefs and beahviours
Counselors should avoid imposing their own values, attributes, beliefs and beahviours
Counslorers should not refuse to render services to clients because of differing values |
|
|
Development of acceptance and commitment therapy (ACT) |
Developed by Steven Hayes Primary focus is on acceptance of thoughts Assumes that avoidance of emotions and thoughts make problems worse Acceptance and experiencing thoughts and emotions leads to mental health |
|
|
Steven Hayes |
Creator of relational frame theory Earned PhD in clinical psychology Focused on treatment of anxiety disorders Contextual beahvioural science focus |
|
|
Main concepts of Act |
Involves fully accepting present experience and mindfully letting go of obstacles This is little emphasis on changing the content of a client's thoughts Instead the emphasis is on acceptance of congtions Uses acceptance and mindfulness strategy to increase psychological flexibility |
|
|
Key concepts of ACT |
Experiential avoidance Relational frame theory |
|
|
Experiential avoidance |
Avoidance of distressing thoughts, emotions, interactions, and events which may lead to increased distress that serves as barriers to development Goal is to instead observe and process distressing thoughts and experiences without attempting to control or change these inner experiences, distress becomes desensitized and easier to accept |
|
|
Relational frame theory |
Behavioral therapy of human language and cognitions that helps people recognize how they become entangled in thoughts and words and use those entagles in internal struggles against themselves Goal is to engage in delusion Once clients gain psychological flexibility they can engage in committed action -valued enriched ways of living |
|
|
Defusion |
Setting back and separating thoughts and language |
|
|
Therapeutic processes of ACT |
Overall goal is to help clients accept cognitions and emotions that are outside of their control, encourage clients to make a commitment to creating a life that value
Involves fully accepting present experience and mindfully letting go of obstacles
Little emphasis on changing the content of clients thoughts (acceptance)
Mindfulness, present moment awareness, staying centered in body and acceptance are used Goal is to allowed for increased psychological flexibility Therapeutic alliance is bidirectional and therapists are empathetic, encouraging, compassionate and reassuring |
|
|
The steps of ACT |
Is to allow for increased psychological flexibility Counselling initially focuses on acceptance of distress through psychoeducation and metaphors Client then uses skills and interventions including acceptance, delusion and mindfulness Then counselling gains are solidified and a plan for relapse is developed |
|
|
Hexaflex model 6 processes of healthy flexible living |
Present moment -strengthen influence of contextual factors Acceptance -learn to accept that one's mind cannot be controlled -aware and accepting of thoughts and feelings rather than push away Defusion -undermine excessive language targeting thoughts and feelings -repeating thought over and over instead of trying to change it Self as context -recognize the self as tye stable context Values -clarify what ine wants their life to be about Committed action -commit to doing things that move in valued directions -engage in activities they used to enjoy but have withdrawn from |
|
|
Aspects of ACT |
Creative hopelessness -disrupting the beahvioural stream of more, better, try harder and creating variability in beahviour Control is the problem -disrupting ongoing control beahviours as people see what they have been doing Letting go -shaping acceptance repertoires Defusion -duetupt verbal relations manipulate content in which words mean things Orienting to values -persons cannot be psycholgocial present to their values and not moving toward them Commitment and beahviour change -in vivo exposure to what happens when you attempt to move toward what you value |
|
|
Application and current use of ACT |
Effectiveness with a variety of disorders
Helpful particularly with anxiety (social anxiety)
Effective with phobias, PTSD, panic
Helpful for OCD, depression, psychosis, heroin addiction, substance abuse, chronic pain and BPD |
|
|
Development of Mindfulness based cogntvie therapy (MBCT) |
John Kabat Zinn -developed mindfulness based stress reduction -studied meditation with Buddhist teachers -focus I'd on mindfulness to decrease stress Zindel Segal, Mark Williams, and John Teasdale worth with Zinn to develop MBCT emphasizes mindfulness and congtive process |
|
|
Mindfulness based stress reduction MBSR |
not a form of Psychotherapy but is can be adjunct to therapy Assists people in learning to live more fully in the present Skills taught include sitting medication and mindful yoga amind at cultivating mindfulness Didactic instruction is minimized and experimental learned and self discovery are emphasized |
|
|
Mindfulness based cogntvie therapy MBCT |
8 week group treatment program of 2 hour weekly sessions that includes components of cogntive behavior therapy Aim is to change clients awareness of and relation to their negatvie thoughts, rather than merely challenging the content of thoughts Clients learn to respond in skillful and intentional ways to their automatic negatvie thought patterns Experimental learning, in session and out of session practice, learning from feedback, and homework assignments are emphasized |
|
|
Acceptance |
A willingness to experience psychological events without having to avoid them or let them unduly influence beahviour |
|
|
The being mode |
Being mode is in direct experience, moment by moment, recognizing bodily sensations as they arise, without agendas or judgments and letting go of thoughts An openness to new experience rather than ruminating on how to solve a problem |
|
|
Principles of mindfulness |
Observing inner experiences Acting with awareness Non-judgment of inner experience Describing or Labeling inner experience Nonreacitvity |
|
|
Mindfulness skill development |
Mindfulness teaches clients how to become aware of what's happening in the present moment without judgment First step is to use a psychoeducational approach about what mindfulness is Consider individual differences |
|
|
psychoeducational approach about what mindfulness is |
Important to meet clients where they are at Introducing deep breaking in sessions may be the frist step If client has had experience with mindfulness introducing more complex mindfulness experiences may be helpful -body scan, mindfulness walk, awareness of surroundings and senses |
|
|
MBCT goals |
Overall goal is assist clients in moving away from obsessing and perseverating on thoughts and feelings of their concern and instead teach them to be more present in the here and now |
|
|
Therapeutic process of MBCT |
Therapeutic relationship is important -therapist's listen deeply and stay in the present moment Manualized and highly structured -8 group sessions 2 to 2.5 hours in length and one all day session, follow up sessions are needed |
|
|
MBCT week 1-4 |
Developing skills Mindfulness training Prednt moment awareness Recognition of thoughts Emotions Beahviours Bodily sensations |
|
|
MBCT week 5-8 |
Shifting toward recognition of more challenging thoughts and feelings
Working on acceptance |
|
|
Techniques and procedures MBCT |
Conscious thought processing -clients are encouraged to acknowledge thoughts and feelings that exist and allow them to pass and not control them Mindfulness -focused attention and open monitoring Decentering (diffusion) -maintaining a degree of separation from inner experiences and viewing experiences as mental processes rather than facts |
|
|
Application and current use of MBCT |
Helpful for depression and reducing relapse of depression Helpful for anxiety, bipolar, panic disorder and adjustment disorders Can be effective for OCD, addiction, ADHD and emtion dystrgulation |
|
|
Compassion focused therapy -Paul Gilbert |
Amins to help clients feel safer and more capable
Teaches clients hoe to be more compassionate and kind to themselves
Kindness and self compassion can also be essential components of MBCT |
|
|
Jeffrey Young |
Specialized in personality disorders, relationship issues and self esteem Worked with Aaron Beck and learned about cogntvie therapy Founder of schema therapy institute |
|
|
Development of Schema therapy |
Integration of psychodynamic, interpersonal, attachment, and experiential techniques to target emotional and cogntvie change Belief thar schemas develop in childhood Focuses more on ingrained problems |
|
|
Key concepts of schema therapy |
Early maladaptive schemas -self defeating emotional patterns from childhood -can be thought of a child's needs left unmet Schema domains -categorizing maladaptive patterns |
|
|
5 schema domains |
Disconnection and rejection Impaired autonomy and performance Impaired limits Other directedness Overvigilance and inhibition |
|
|
Overall goal of schema therapy |
Overall goals are to help people achieve and maintain a healthy adult mode of functioning and to help clients develop and sustain a healthy adult schema and stop engaging in madlaptive coping styles |
|
|
Therapeutic process of schema therapy |
Generally longer in duration -typically 2 weekly individual sessions over the course of 3 years Assessment is important and can be done through experiential exercises and schema inventories Therapeutic relationship is core element -empathetic, warm, caring and flexible -balance between empathic attunement and caring confrontation |
|
|
Schema therapy techniques and procedures |
Limiter reparenting -using therapeutic alliance to provide connection, warmth and nurturance -clients depend on therapists by regulating emotions Empathic confrontation -challenge clients maladaptive schemas in warm and respectful manner Cogntivite interventions -using homework assignments, challenging beliefs, and modifying maladaptive behaviors (changing schemas) Schema flashcards -examples of healthy ways clients can respond to activating schema triggers Experiential interventions Beahviour interventions |
|
|
Application and use if schema therapy |
Effective in treating people with borderline personality disorder and relational problems Helpful for avoidant personality disorder Combined with CBT to treat personality disorders, substance abuse, depression, anxiety, and eating disorders Helpful for pain management and sexual disorders |
|
|
Strengths of third wave CBTs |
Fits needs of culturally diverse clients because of the emphasis on values and context Mindfulness is effective for a wide variety of people ACTs experimental focus may fit will with people who have a difficult time letting go Schema therapy proposed that early madadaptive schemas play a role in mental help DBT effects are long lasting Collaborative nature |
|
|
Laminations of third wave CBTs |
Concern over spiritual aspects of mindfulness based approaches DBT may be too narrow and focused on BPD however it can be adapted to fit needs of other populations Demanding of therapist's and extensive training is required Misunderstanding of theories can lead to misuse of approach |
|
|
Society of the exploration of Psychotherapy intergration (SEPI) |
Aim is to promote the development and evaluation of approaches to Psychotherapy that are not limited by a single orientation Aimed to promote, examine and intergrarate diverse approaches to bring together the strengths and orientations in out field |
|
|
Integrative therapies are growing for many reasons |
No single theory have been found to affress needs of all clients Due to variation in experiences and cultural backgrounds, adhering to only one approach can cause harm No single theory has been shown most effective Most theories overlap |
|
|
Sound eclectic approachs have |
Build on strengths of exciting theories Coherent combination that creates unified whole Understanding of human beahviour and development Philosophy of change Guidelines for adopting the approach Inclusion of commonalities of effective couselling |
|
|
Challenges of integrated approaches |
Demands more of therapist then choosing one theory Therapist's must set limits on their scope of practice Therapist's must carefully consider their approach while working with various clients |
|
|
Benefits of integrated approaches |
Bring flexibility to counseling Tailoring of approach to fit diverse needs of different clients Can work with a broader range of clients Allows therapist's to adopt approaches that fit with their view of human development and their personality Focus on empirical research and a scientist practitioner role |
|
|
What can influence choice of counseling theory choice |
Course of work Beginning counselors more lilky to choose one theory Length of therapy experiences Perception of work and philosophy of life Personalities and worldviews |
|
|
4 most common pathways toward intergration |
Technical eclecticism Theoretical intergration Common factors approach Assimilative intergration |
|
|
Technical eclecticism |
Aims at selecting the best treatment techniques for the individual and the problem Doe not necessarily subscribe to tye theoretical positions of the techniques No necessary connection between conceptual foundations and techniques |
|
|
Theoretical intergration |
Refer to the theoretical creation beyond mere blending of techniques Aims to create a conceptual framework that synthesizes the best aspects of two or more theoretical approaches under the asim that the outcome will be richer than either theory alone Emphasizes integrating the underlying theories of each therapy alone with techniques from each |
|
|
Common factors approach |
Searches for common elements across different theoretical systems A recognizable core of counselling practice is composed of nonspecific variables common to all therapies |
|
|
Assumilative integration |
Grounded in a particular school of Psychotherapy Openness to selectivity incorporate practices from other therapeutic approaches |
|
|
Multimodal therapy -complex personality of human beings can be divided into seven major areas of functioning (BASIC ID) |
Behavior Addictive responses Sensations
Imagery Cognitions Interpersonal relationships Drugs, biological functions, nutrition and exercise |
|
|
Four factors that account got change in therapy |
Clients factors (40%) Alliance factors (30%) Expectancy factors (15%) Theoretical models and techniques (15%) |
