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180 Cards in this Set
- Front
- Back
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...............CLINICAL
PSYCHODYNAMIC TX - types |
1. Freudian Psychoanalysis
2. Adler's Individaul Psych 3. Jung's Analytical Psychotherapy 4. Mahler's Object Relations Theory |
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...............CLINICAL
PSYCHODYNAMIC TX - shared assumptions |
1 human beh motivated by unconscious processes
2. early dev has effect on adult f(x)g 3. universal princ explain personality dev and beh 4. key to psychotherapy is insight into unconscious |
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...............CLINICAL
PSYCHODYNAMIC - Freud - theory of personality and approach to tx |
- worldview is pessimistic, deterministic, mechanisity, reductionistic
- humans determined by irrational forces, uncons mot, bio and instinctual needs/drives, psychosexual events in the 1st 5 years |
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...............CLINICAL
...............CLINICAL PSYCHODYNAMIC - Freud - personality theory - structural (drive theory) - ID |
- at birth; life/death instincts; serve all psychic energy; pleasure principle (imm grat of drives to avoid tension)
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...............CLINICAL
PSYCHODYNAMIC - Freud - personality theory - structural (drive theory) - EGO |
at 6 mos; on reality principle (defer grat of it until appropriate object available in reality); uses 2ndry process thinking (realistic, rational thinking & planing); primary task=mediate bet id and reality and superego
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...............CLINICAL
PSYCHODYNAMIC - Freud - personality theory - structural (drive theory) - SUPEREGO |
at 5 years; is internalizatin of society's values and standards conveyed by parents thru reward/pun; tries to block id permanently
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...............CLINICAL
PSYCHODYNAMIC - Freud - developmental theory |
- focus on sexual drives of id
- personality formed in childhd due to exp in 5 psychosexual stages - oral, anal, phallic, latency, genital - at each stage, id focused on 1 body part - personality formed when over/under grat at 1 of these stages |
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...............CLINICAL
PSYCHODYNAMIC - Freud - personality theory - what does anxiety mean |
= unpleasant feeling linked with excitement of ANS
- functions to alert ego to internal/external threats |
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...............CLINICAL
PSYCHODYNAMIC - Freud - personality theory - what are defence mechanisms and types |
= when ego cant ward off danger in rational way
= operate on uncons and serve to deny/distort reality - types: REPRESSION - most basic DM - when id's drives/needs are excluded from cons by keeping them in uncons REACTION FORMATION - avoiding anxiety by expressing the opposite |
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...............CLINICAL
PSYCHODYNAMIC - Freud - maladaptive beh - how seen |
- stems from uncons, unresolved conflict in childhood
- phobia=displacement of anxeity onto object involved in conflict - depression=object loss + anger toward obj turned inward - mania=defense against libidinal or agg urges that threaten ego |
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...............CLINICAL
PSYCHODYNAMIC - Freud - therapy - goal |
to bring uncon into concs and integrate previously repressed material into personality
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...............CLINICAL
PSYCHODYNAMIC - Freud - therapy - techniques |
- primary = analysis (assumes all beh meaningful and serve psych function)
- main targets of anal = free associations, dreams, resistances, transferences - slips of tongue (parapraxes)= expression of uncon motives |
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...............CLINICAL
PSYCHODYNAMIC - Freud - therapy - analysis of free assoc, dreams, resistances, transferences involves doing what |
1. confront - make statmts to help client see beh in new way
2. clarify - restate client's statmt/feeling to clearer terms 3. interpret-less anxiety provokg/resistence; better to get uncons/cons connectn 4. catharsis-emot relese from getg uncons 4. work thru-assimulate new insights into personality |
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...............CLINICAL
PSYCHODYNAMIC - Freud - therapy - current status |
- replace Freud's focus on interpretations to more therapist-patient relshp
- new re-concept of transference/countertrans |
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...............CLINICAL
PSYCHODYNAMIC - Adler - same/diff with Freud |
- agree-all beh purposeful
- dis - on Freud's focus of uncons and past events - instead focus on - social forces - teleological approach - beh motivated by future goals |
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...............CLINICAL
PSYCHODYNAMIC - Adler - theory of personality |
1 INFERIORITY FEELINGS - dev in child due to real/per bio/psy/social weaknesses
2. SUPERIORITY - inherent tendency to perfect completion 3. STYLE OF LIFE - way person chooses to compensate for inferiority and get superiority - unifies personality |
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...............CLINICAL
PSYCHODYNAMIC - Adler - theory of personality - types of life styles |
- unhealthy/mistaken=goals are self centered, competitive, personal power
- healthy=goals are optimistic, confident, welfar of others - diff bet unhealthy/heal = SOCIAL INTEREST -pampered child=no social feelings; neglected child=need for revenge |
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...............CLINICAL
PSYCHODYNAMIC - Adler - maladaptive beh - how seen |
= are mistaken style of life with maladaptive attempts to compensate for inferiority and preoccup with personal power and no social trust
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...............CLINICAL
PSYCHODYNAMIC - Adler - therapy - goal |
get collaborative relshp with client; help him to id style of life and consequences; reorient goals
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...............CLINICAL
PSYCHODYNAMIC - Adler - therapy - techniques |
- lifestyle investigation - on family constellation, fictional goals, basic mistakes
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PSYCHODYNAMIC - Adler - application - STET (Systematic Training for Effective Teaching) |
- assumes all beh goal-directed and purposeful
- misbeh of child seen as goal of attention, power, revenge or display deficiency - each has goal to belong |
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...............CLINICAL
PSYCHODYNAMIC - Jung - same/diff from Adler and Freud |
- more like Adler
- beh determined by future goals and aspirations NOT by past events |
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...............CLINICAL
PSYCHODYNAMIC - Jung - personality theory |
- due to cons and uncons
- cons = oriented to extrnal world; governed by ego; is thoughts/feelings/sensory/memories - uncons=personal and collective uncons |
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PSYCHODYNAMIC - Jung - personaity theory - whats types of unconscious |
PERSONAL UNCONS=exp repressed or forgotten
COLLECTIVE UNCONS=latent memory passed from generations (such as ARCHETYPES) |
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...............CLINICAL
PSYCHODYNAMIC - Jung - personality theory - what are archetypes |
=primoridal images that cause person to exp and understand phenomena in univeral way
- include = SELF (unity of diff parts of personality), PERSONA (public mask), SHADOW (dark side), ANIMA (female), ANIMUX (male parts of personality) |
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...............CLINICAL
PSYCHODYNAMIC - Jung - types of attitudes |
EXTRAVERSION
INTROVERSION |
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...............CLINICAL
PSYCHODYNAMIC - Jung - development |
- continuing thruout lifespan
- most intersted in growth after mid30s - INDIVIDUATION = integration of cons and uncons leading to dev of unique identity - outcome is wisdomw - when turning to spiritual/philos |
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...............CLINICAL
PSYCHODYNAMIC - Jung - maladaptive beh - how seen |
are unconscious messages to person that something is awry with him
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...............CLINICAL
PSYCHODYNAMIC - Jung - therapy - goal |
rebridge gap bet cons and personal/collective uncons
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...............CLINICAL
PSYCHODYNAMIC - Jung - therapy - techniques |
- primarily interpretations
- dream analysis key to therapy - TRANSFERENCES are projections of uncon and crucial to therapy - focus on optimism, healthy part of client's personality; here and now focus |
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...............CLINICAL
PSYCHODYNAMIC - object relations - theory |
- object-seeking (relshp with others) basic inborn drive
- focus on child's early relshp with objects and their internalization of these objects (relshps) |
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...............CLINICAL
PSYCHODYNAMIC - object relations - personality theory |
- focus on process where child assumes own physical/psycho id
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...............CLINICAL
PSYCHODYNAMIC - object relations - development phases |
1 1st mos - status of normal autism; oblivious to environ
2 2-3 mos - normal symbiosis - child fused with mother and cannot dis bet I and not-I 3 4 mos - SEPARATION-INDIVIDUATION phase - substages a sensory/physical explorg b conflict bet independ and depend = separation anxiety 4 3 yrs - permanent sense of object and self |
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...............CLINICAL
PSYCHODYNAMIC - object relations - maladaptive beh - how seen |
- due to abnormalities in early object relations
- inadequate resolution of mental splitting of others as either good or bad |
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...............CLINICAL
PSYCHODYNAMIC - object relations - goals |
to provide client with support, acceptance which restore his ability to relate to others in meaningful ways
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...............CLINICAL
HUMANISTIC "third force" - types |
1. Roger Person-Centered therapy
2. Gestalt therapy 3. Existential therapy 4. Reality therapy |
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...............CLINICAL
HUMANISTIC - shared characteristics |
1 need to understand client's subjective exper
2 focus on current beh 3 believe in his pot for self determination/self-actualization 4 therapy-authentic, collective, egalitarian relshp with PSY and client 5 reject trad assess tech and disgnostic labels |
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...............CLINICAL
HUMANISTIC - person-centered therapy Roger - assumes |
all people have self actualizing tendency as major mot to guide them to positive healthy growth
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...............CLINICAL
HUMANISTIC - person-centered therapy Roger - personality theory |
- to grow to self-act, self must remain unified, organized and whole
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...............CLINICAL
HUMANISTIC - person-centered therapy Roger - maladaptive beh |
when self becomes disorganized due to incongruence bet self and exp - leading to anxiety which is signal that self is being threatened and then use defensive maneuvers to distort/deny
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...............CLINICAL
HUMANISTIC - person-centered therapy Roger - therapy - goal |
help client achieve congruence bet self and experience to see self as self actualizing
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...............CLINICAL
HUMANISTIC - person-centered therapy Roger - therapy - techniques |
- give right environ to client via 3 FACILITATIVE CONDITIONS:
1 UNCONDITIONAL POSITIVE REGARD-affirm worth, accept with no evaulation; no judge 2 GENUINENESS - honest of own feelings 3 ACCURATE EMPATHETIC UNDERSTANDING - see world as client- nod, eye contact, reflection of feeling |
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...............CLINICAL
HUMANISTIC - Gestalt - assumes |
each person is able to assume personal responsibility for own thoughts/feel/act and living is integrated whole
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...............CLINICAL
HUMANISTIC - Gestalt - theory |
1 people seek closure
2 one's gestalts (percption of parts as wholes) reflect current needs 3 beh is whole greater than sum of parts 4 beh understood in own context 5 person exp world with principle of figure/ground |
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...............CLINICAL
HUMANISTIC - Gestalt - personality theory |
- personality is SELF and SELF-IMAGE
- self =promotes inherent tendency for self-act - self-image=darker side; hinders growth/self-act by imposing external standards |
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...............CLINICAL
HUMANISTIC - Gestalt - maladaptive beh |
- a growth disorder
- abandonment of self for self-iamge and no integration - disturbance in boundary bet self and external environ |
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...............CLINICAL
HUMANISTIC - Gestalt - maladaptive beh - 4 types of boundary disturbance bet self and environ |
1 INTROJECTION-psycho swallows concepts without understanding them; cant dis bet i and not i; are compliant in therapy
2 PROJECTION - disown self by assigning them to others; paranoia 3 RETRFLECTION- doing to self what you want to do to others 4 CONFLUENCE-no boun bet self and environ; underlies guilt and resentment |
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...............CLINICAL
HUMANISTIC - Gestalt - therapy - goals |
help client integrate aspects of self to become unified whole
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...............CLINICAL
HUMANISTIC - Gestalt - therapy - techniques |
- only current beh
- see transference as counterproductive - AWARENESS - help understand one's thought/feel/beh in the present - use empty-chair, game of dialogue |
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...............CLINICAL
HUMANISTIC - existential - theory |
- focus on human conditions of depersonalization, loneliness, isolation
- assume people not static but constant state of becoming |
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...............CLINICAL
HUMANISTIC - existential - maladaptive beh |
- natural human condition
- anxiety=normal response to constant threat of nonbeing |
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...............CLINICAL
HUMANISTIC - existential - therapy - goal |
- help client overcome troublesome feelngs to live in more committed, self-aware, meaningful ways
- help client recognize freedom and accept responsibility to change self |
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...............CLINICAL
HUMANISTIC - existential - therapy - techniques |
- most NB tool=therapist-client relship
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...............CLINICAL
HUMANISTIC - Reality therapy Glaser - theory |
- influence by control theory
- beh is purposeful and comes from within person - assumes one can control own life |
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...............CLINICAL
HUMANISTIC - Reality therapy Glaser - personality theory |
- people have 4 psycho needs (belonging, power, freedom, fun) and 1 physical need (survival)
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...............CLINICAL
HUMANISTIC - Reality therapy Glaser - maladaptive beh |
- when person gratifies needs (psycho/physical) in irresponsible ways and then assumes failure identity
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...............CLINICAL
HUMANISTIC - Reality therapy Glaser - goal |
help client id responsible and effective ways to satisfy needs and dev successful id
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...............CLINICAL
HUMANISTIC - Reality therapy Glaser - techniques |
- reject medical model/mental illness
- focus on current beh/belief - tranferences not good - look at consc processes - focus on value judgements (what client sees as right/wrong) - teach client beh to fulfill needs |
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...............CLINICAL
BRIEF THERAPIES - types |
1 Interpersonal Therapy
2 Solution-focused therapy 3 Transtheortical Model 4 Motivational Interviewing |
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...............CLINICAL
BRIEF THERAPIES - shared characteristics |
1 time-limited therapy (6-30)
2 focus on presenting concerns 3 PSY has active role and encrouage client to be active |
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...............CLINICAL
BRIEF THERAPIES - Interpersonal - developed for originally |
treatment of depression
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...............CLINICAL
BRIEF THERAPIES - Interpersonal - maldadaptive beh - how seen |
related to problems in social roles and interpersonal relshps which are traced to lack of strong attachments early in life
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...............CLINICAL
BRIEF THERAPIES - Interpersonal - therapy - goal |
- focus on social relshps
- primary goal=symptom reduction & improve interpersonal functioning - sympt red - by education of sympt; instill hope; meds - intrprsl functg - by address 1 of 4 probems: grief, interperonsal role disputes, role transtions, interpersonal deficits |
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...............CLINICAL
BRIEF THERAPIES - Interpersonal - therapy - techniques |
- encourage affect
- communication analysis - model/role-playing to get new ways of interacting |
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...............CLINICAL
BRIEF THERAPIES - Solution-Focused - assumption which leads to goal |
that you get more of what you talk about - therefore goal is to focus on solutions not the problems
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...............CLINICAL
BRIEF THERAPIES - Solution-Focused - maladaptive beh - how seen |
understanding mal beh NOT NB
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...............CLINICAL
BRIEF THERAPIES - Solution-Focused - therapy - techniques |
- client is the expert
- PSY is consultant who asks ? to help client see and use his strengths and resources to get goals |
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...............CLINICAL
BRIEF THERAPIES - Solution-Focused - therapy - ? therapists asks |
MIRACLE ? - if you wake up how will know a miracle happened where your problem solved
EXCEPTION ? - do you know time in past where you didn't have problem SCALING ? - from 1-10 how did you feel last week? 1-10 how motivated are you? |
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...............CLINICAL
BRIEF THERAPIES - Solution-Focused - therapy - steps of session |
1st session:
- 1 client ids therapy goals; answers 3 questions (miracle, exceptions, scale) - 2 PSY compliments and gives homework to notice when problem less Later sessions - ask what is better since last time |
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...............CLINICAL
BRIEF THERAPIES - transtheoretical - how dev and theory |
- dev - analysis of 18 leading approaches to therapy, which led to 10 change processes
- theory - change is same regardless of beh - best tx=which match stage of change - orginally dev for smoking and addictive beh |
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...............CLINICAL
BRIEF THERAPIES - transtheoretical - focus of therapy |
- on factors that facilitate beh change
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BRIEF THERAPIES - transtheoretical - stages of change |
1 PRECONTEMPLATIVE-no insight/need to change
2 CONTEMPLATIVE-aware need to change; will change in 6 mos; no commit 3 PREPARATION-intent to change; will in 1 mos 4 ACTION-takg steps to change 5 MAINTENANCE-change lasted for 6 mos; and steps to prevent relapse |
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...............CLINICAL
BRIEF THERAPIES - mot interviewing - for which client; which theory background |
-for clients ambivalent on changing beh
-believes in 5 stages of change -derived from Roger (client-centered), Bandura (self-efficacy) |
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...............CLINICAL
FAMILY THERAPY - types |
1 Commun/Interaction Family
2 Extended Family Systems (Bowen) 3 Structural Family 4 Strategic Family 5 Milan Systemic Family 6 Behavioral Family 7 Object Relations Family |
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...............CLINICAL
FAMILY THERAPY - all influenced by what |
GENERAL SYSTEMS THEORY
-system maintained by interactions of its components; actions best understood by studyg them in context; family=OPEN system-continually receives input from and gives output to envir; adaptable to change; HOMEOSTASIS=family acts same to maintain family equilibrium or status quo CYBERNETIC - relates to family communication - as a feedback loop where system gets info; NEG feedback=reduces deviation; aids system in status quo; POS feedback=amplifies deviation/change; disrupts system; promotes change in dysfun family system |
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...............CLINICAL
FAMILY THERAPY - Commun/Interaction Family - original research found what |
-a link bet double-bind communication and schizo
-which involves negative injuctions - do that and you're punished; dont do that and you're punished (one verbal; other nonverbal) and child not able to comment or seek help |
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...............CLINICAL
FAMILY THERAPY - Commun/Interaction Family - assumptions |
1 people always communicating
2 commun has REPORT (content of comm) and COMMAND function (nonverbal; states relshp bet communicators)- problem when report and command contradictory 3 comm patterns are SYMMETRICAL (equal in communicators; each compete with other) or COMPLEMENTARY (inequal; max diff bet communicators-dominant/submissive) |
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...............CLINICAL
FAMILY THERAPY - Commun/Interaction Family - maladaptive beh - how seen |
- accepts a circular model of causality where symptom is both cause and effect of dysfunctional communication patterns (blaming, criticizing, overgeneralizing)
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FAMILY THERAPY - Commun/Interaction Family - therapy- goal |
to alter interacational patterns of symptoms
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...............CLINICAL
FAMILY THERAPY - therapy - techniques |
-direct tech (point out problems in comm as they occur)
-paradoxical strategies (prescribe symptom and reframing) |
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FAMILY THERAPY - Extended Family Systems (Bowen) - theory |
DIFFERENTIATION SELF
=person's ability to separate intellectual and emotional functing; lower diff=more at mercy of emotions; more fused with emot of family; undiff family ego mass=family members highly emot fused EMOTIONAL TRIANGLE = when 2 ppl have stress with each and recruit 3rd to increase stability; lower the diff in the famiy, the more trianglation FAMILY PROJECTION PROCESS =when parental conflicts/emot immaturity transmitted to child (oldest/special)-> child has lower diff than parent |
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FAMILY THERAPY - Extended Family Systems (Bowen) - maladaptive beh - how seen |
due to multigenerational transmission process - lower diff levels tranmitted from 1 generation to next
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FAMILY THERAPY - Extended Family Systems (Bowen) - therapy - goal |
increase diff between family members
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FAMILY THERAPY - Extended Family Systems (Bowen) - technique |
-2 family member with PSY as 3rd in therapeutic triangle
- 1st id hx of family problems and construct GENOGRAM (=relshp bet family mem; sign dates/events) -sessions are educ, cog, controlled -fam mem talk to PSY not each other -can also send fam to family of origin to detriangle fam mem and increase diff |
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FAMILY THERAPY - Structural Famiy - why developed |
due to work on disorganized, lower SES fam which suggested fam respond best to tx using here&now, directive, concrete approach
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FAMILY THERAPY - Structural Famiy - theory |
-all fam have implicit structure which determine how mem relate to each other
-POWER HIERARCHIES=shows how mem combine forces during conflict -family defined by BOUNDARIES=barriers/rules of amount of contact allowed bet mem -when bondry rigid-fam disengaged/isolated from 1 another -when bondry diffused/permeable-mem enmeshed/depended/close |
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FAMILY THERAPY - Structural Famiy - theory - 3 boundary problems (RIGID TRIADS) |
DETOURING-overprotect/blame child
STABLE COALITION-parent & child form bond and gang up on other parent TRIANGULATION (unstable coal)=each parent demands child to side with him against other parent |
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FAMILY THERAPY - Structural Famiy - maladaptive beh - how seen |
-due to inflexible family structure that prohibits family from adapting maturational and situational stressors in healthy way
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FAMILY THERAPY - Structural Famiy - therapy - goals & assumption |
- goal = restructuring family and short term goal is relief of symptom
- targets changing beh and transactions that foster insight - assume-action precedes understanding |
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FAMILY THERAPY - Structural Famiy - therapy - techniques - 3 steps |
JOINING-PSY join fam in leadership role; TRACK (id fam values/sign events) and MIMESIS (adopt fam affective and comm style)
EVALUATING FAM STRUCTURE-construct fam map to get goals of therapy RESTRUCTURING FAM-unbalance fam homoestasis; ENACTMENT (role play); REFRAMING (relabel beh in pos way) |
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...............CLINICAL
FAMILY THERAPY - Strategic Family - maladaptive beh - how seen |
-role of comm in mal beh - how used to increase one's control in a relshp
-most mal beh when person denies he is controlling other person |
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FAMILY THERAPY - Strategic Family - therapy-goal |
alleviate current symptoms by altering fam's transactions and org - esp its hierarchies and generational boundaries
-insight is counterproductive as it increases resistance |
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FAMILY THERAPY - Strategic Family - therapy-techniques - 1st session - 4 stages |
1st session - highly structured - 4 stages
1 SOCIAL-obs fam interacting; encourage all mem to be involved 2 PROBLEM-get info on why fam in therapy 3 INTERACTION-fam id problems and PSY obs interactions 4 GOAL-SETTING-PSY/fam agree on goals of tx |
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...............CLINICAL
FAMILY THERAPY - Strategic Family - therapy-PYS role and techniqus |
-PSY active, take-charge role
-tech: - direct -tell fam to stop doing beh - paradoxical intervention (use client's resistence in pos way): types - ORDEALS=client does unpleasant task when syptom occures - RESTRAINING=encourage fam not to change - REFRAMING=place symp in another frame of reference - POSITIONNG=exaggerate symp - PRECRIBE SYMP=tell fam to engage in sympt |
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FAMILY THERAPY - Milan Systemic Family - good for which client |
anorectic children
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...............CLINICAL
FAMILY THERAPY - Milan Systemic Family - assumes |
in fam system there are circular patterns of action and reaction
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FAMILY THERAPY - Milan Systemic Family - maladaptive beh |
when fam patterns of action/reaction become so fixed that mem cant act creatively or make new choices on their own lives
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...............CLINICAL
FAMILY THERAPY - Milan Systemic Family - goal |
help family mem see their choices and help them exercise their prerogoative for choosing
- done by focus on fam understanding their relshp and prob in diff ways to find new solutions/make new choices |
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...............CLINICAL
FAMILY THERAPY - Milan Systemic Family - technique - which team does it have |
THERAPEUTIC TEAM - 1 or 2 team mem meet with family and rest obs in 1-way mirror
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FAMILY THERAPY - Milan Systemic Family - different techniques used |
HYPOTHESIZING-test by team and fam of hypothesis of fam fucntioning-revised thruout tx
NEUTRALITY-PSY ally to ALL mem PARADOX-counterparadox (therapeutic double-bind) and positive connotation (reframing)-DO NOT elicit resistance (like strategic PSY) CIRCULAR QUES-help fam see diff in their perceptions |
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FAMILY THERAPY - Behavioral family - theory based on |
principles of operant conditioning, social learning, social exchange theory
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FAMILY THERAPY - Behavioral family - maladaptive beh - how seen |
beh is learned and maintained by its consequences
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...............CLINICAL
FAMILY THERAPY - Behavioral family - goals |
1 increase couples recognition and initiation of pleasure interactions
2 decrease aversive interctns 3 teach problem-solve/comm skills 4 teach contginency contract to resolve persisting prob |
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...............CLINICAL
FAMILY THERAPY - Object Relations Family - maladaptive beh - how seen |
due to both intrapsychic and interpersonal factors
-PROJECTIVE IDENTIFICATION=when fam mem projects old introjects onto another mem and reacts to this person as he has projective char or provokes person to act same as projected char |
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...............CLINICAL
FAMILY THERAPY - Object Relations Family - goal |
resolve each fam mem's attachment to family introjects
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...............CLINICAL
FAMILY THERAPY - Object Relations Family - technique |
-interpreting tranferences, resistences to foster INSIGHT (NB in tx)
-address MULTIPLE TRANSFERENCES (trans each mem to PSY and trans of whole fam to PSY) |
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..........CLINICAL
GROUP THERAPY - Yalom's 1st few mos of stages of group therapy |
1 ORIENTATION, HESITANT PART, SEARCH FOR MEANING, DEPENDENCY-id group structure; stereotype/rigid comm; look for sim group mem; advise seeking/giving
2 CONFLICT, DOMINANCE, REBELLION-est own power/control; pecking order; criticize; hostile to PSY 3 DEVELOPMENT OF COHESIVENESS-morale; trust; more self disclose; more attendnc; cohesiveness critical to group therapy as PSY-client relshpis to individual therapy |
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..........CLINICAL
GROUP THERAPY - Yalom - benefits to group therapy |
1 more opport for multiple transferences
2 group is a social microcosm 3 mem rate interpersonal input carthasis, self-uderstanding; cohesiveness MORE NB than family re-enactmet, guidance, identification |
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..........CLINICAL
GROUP THERAPY - Yalom - role of therapist |
1 CREATE/MAINTAIN GROUP-org group; min threats cohesiveness
2 CULTURE BUILDING-give directives to foster good bev norms; be both technical expert and participant/model; ok for self-disclosure 3 ACTIVATION/ILLUMINATION OF HERE&NOW |
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GROUP THERAPY - Yalom - what he says of concurrent group and individual therapy |
-not necessary or beneficial UNLESS if client in crisis or needs ind sessions to ensure he doesnt drop out
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GROUP THERAPY - what is drop-out rates for group therapy and how to avoid |
- 10-35% of group members drop out of therapy during first 12-20 sessions
- do pre-sreening and after provide clarification for misconcepts and unreal expectations; increase productive interaction of mem |
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GROUP THERAPY - which client is best for group |
- problems related to interpersonal issues
- motivated to change - positive view of group tx - verbally sophisticated - likes getting into tx slow - likes peer sup/feedback |
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GROUP THERAPY - which client NOT good for group |
- extreme depressed
- withdrawn - paranoid - acute psychosis - brain damage - sociopathy |
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FEMINIST THERAPY - diff bet this and other therapies |
focu on power diff bet women and men and how that differential impacts on men and women's beh
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FEMINIST THERAPY - maladaptive beh - theory |
- assume personal is political - women's circum reflect women's pos in society
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FEMINIST THERAPY - maladaptive beh - how seen |
symptoms are:
1 related to nature of trad fem role or conflicts that are inherent to those role 2 survival tactics or way of personal power 3 arbituary labels to beh done to impose sanctions or exert social control |
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FEMINIST THERAPY - goals |
- id and alter oppressive forces in society
- goal=empowerment or help client be more self-defining and self-determining |
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FEMINIST THERAPY - techniques |
STRIVE FOR EGALITARIAN RELSHP-acknowledge power dif bet PSY and client; min by promoting power with; make self disclose; demystify tx process; client set own goals and client eval tx process
AVOID LABELS-no label to beh or feelings and no diagnosis AVOID REVICTIMIZATION-no blame client for current problems INVOLVE SOCIAL ACTION-by social/political activist |
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FEMINIST THERAPY - diff from nonsexist therapy |
- both - see impact of sexism and avoid gender-biased tech
- fem - prioritize role of sociopolitical factors on client's psych functiong and need for social change - nonsexist - focus on individual factors and change personal beh |
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FEMINIST THERAPY - combo with object relations theory - how? |
- see as contributors of beh:
1 sexual division of labor-parenting mainly fem task due to social norms 2 mother-child relshp- gender diff due to m-daugher and m-son relshp - son taught to seperate from m and opposite for daughter --> this accounts for gender diff in self esteem, values, achievment orient |
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HYPNOTHERAPY - research says |
- NOT consistently linked to any neurobeh or psychophysiological process
- complaince under hypo does NOT always occur |
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HYPNOTHERAPY - what does research say of repressed memories |
1 hypo does NOT enhance ACCURACY of memories
2 hypo may produce MORE psychomemories 3 hypo may exaggerate client's confidence in validity of uncertain memories (esp for inaccurate mem) 4 mem from hypo reflect issues and exp relevant for tx 5 recall of events/exp in hypo can improve client's symptoms |
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CRISIS INTERVENTION - crisis means |
a precipitating situational or maturational even that is time limited and disrupts person's usual coping and prob-solving capabilities
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CRISIS INTERVENTION - goal |
to reach client in acute state of stress and provide them with support to prevent becoming "chronics of the future"
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CRISIS INTERVENTION - techniques |
- relieve symptom
- restore to prev level of functng - id precipitating factors - apply remedial measures - connect current stress to past exp - dev adaptive coping skills for future |
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CRISIS INTERVENTION - research on crisis intervention call centers |
1 most freq prob - depression, sub abuse, suicide att, marital maladjust
2 suicide hotlines - best for young while females |
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COMMUNITY PSYCHOLOGY - focus on |
prevention of disease
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COMMUNITY PSYCHOLOGY - types |
PRIMARY-decrease incident of new cases (immunization prog, prenatal nutrition, meals on wheels, public educ on drugs)
SECONDARY-early detection and intervention (screening tests) TERTIARY-reduce duration and consequences (rehab, prog for alternative to hospital; educ com attitudes of mental patients |
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COMMUNITY PSYCHOLOGY - strategies |
EDUC-goal (reduce incidence by increase prev activities; improve care of ill by educ public on nature of ill)
PREVENTATIVE HEALTH CARE-models include Health Belief Model and Health Locus of Control Model |
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COMMUNITY PSYCHOLOGY - what is research on AIDS education |
- perceived peer norms better predictor of AIDS risk than educ of AIDS for heterosexual high school and college
- BUT homosexual men's educ of AIDS does correlate with ADIS risk |
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COMMUNITY PYSCHOLOGY - what is Health Belief Model |
- preventive health care
=says health beh influced by: 1 person's readiness to take action which is related to his perceived susceptibility to illness and severity of its consequences 2 person's eval of cost/ben of taking action 3 internal/external cues to action - model says health beh can be modified by targetting ppl's knowledge and mot to change |
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COMMUNITY PYSCHOLOGY - what is Health Locus of Control Model |
- preventive health care
- health beh reflect locus of control beliefs - ppl may believe they have ability to control their health or that it depends on luck/uncontrolled factors - drs should promote patient's sense of personal responisblity and control |
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CONSULTATION - what does consultation mean |
process in which a human services prof helps consultee with work-related probl with a client systrem, with goal of helping both consultee and client system
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CONSULTATION - types of consultation |
ORGANIZATIONAL CONSULT- whole org is consultee
ADVOCACY CONSULT-adopt explicit value orientation to best foster goals for a disenfranchised group (eg ppl with disabilities) |
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CONSULTATION - stages of consultation |
ENTRY-id needs; contract; enter system; resistence most common now
DIAGNOSIS-get info; define prob; set goals; get solutions IMPLEMENTING-choose intervention; formulate & do DISENGAGEMENT-evaluate; reduce involvmt; follow up; terminate |
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CONSULTATION - types of evaluations |
FORMATIVE EVAL- periodically done to assess consult process
SUMMATIVE EVAL-done at end of consult process |
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MENTAL HEALTH CONSULTATION - 4 types |
CLIENT-CENTERED CASE-help consultee dev plan to work more effectively with specific client
CONSULTEE-CNTRD CASE-enhance cons's perf to work with spcfc pop; focus on cons's skills, know, abilities PROGRAM-CNTRD ADMINISTRATIVE-work with 1or more administrators to resolve prob of existing program CONSULTEE-CNTRD ADM-help adm functing so they can do prog dev, implement, eval in future |
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MENTAL HEALTH CONSULTATION - what is theme interference |
type of transference when a past unresolved conflict related to a particular client is evoked by and interferes with the PYS's current sit
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CONSULTATION versus SUPERVISION |
SUPERVISION
-same prof as supervisee -is admi responsible for and position of power over supervisee |
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SUPERVISION - what is PARALLEL PROCESS |
- when a supervisee replicates problems and symptoms with the supervisor that are manifested by the supervisee's client
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PYSCHOTHERAPY RESEARCH - OUTCOME STUDIES - what did Eysenck say and how he is criticized |
- said effects of psychotx small or nonexistent
- results just spontaneous remission - 72% of non-tx recover after 2 years - 66%/44% of tx group show improvement -criticized-method; no-tx and tx group not same on severity of symptoms; and no-tx get some attention (medical, support) |
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PYSCHOTHERAPY RESEARCH - OUTCOME STUDIES - what did Smith, Glass, Miller say |
-did meta-analysis
-found effect size=.85 (80% of tx group better than no-tx group) -effect size for psychotx equal or better to educ or medial intervention |
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PYSCHOTHERAPY RESEARCH - OUTCOME STUDIES - what is better psychotherapy |
- cog-beh tx more effective for some disorders like phobias, panic, compulsions
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PYSCHOTHERAPY RESEARCH - OUTCOME STUDIES - what does Lambert & Bergin say |
-positive change in tx may be due to what various tx share in common - catharsis, pos relshp, advice, beh regulation, cog learning
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PYSCHOTHERAPY WITH OLDER ADULTS - what % of older adults meet crit for mental dis |
20-25%
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PYSCHOTHERAPY WITH OLDER ADULTS - most common mental health prob |
in order
- anxiety - severe cog impairment - depression |
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PYSCHOTHERAPY WITH OLDER ADULTS - which most effective with older |
- older clients respond to well to ALL types of tx BUT at a slower pace of responding
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PYSCHOTHERAPY WITH OLDER ADULTS - what is Gatz research say |
1 beh and envir tx good for older with beh problems assoc with demenia
2 memory and cog retraining probably efficacious for older with dementia 3 cog, beh, brief psycho therapys probably efficacious for depression |
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EFFECTS OF TREATMENT LENGTH - when best time length of tx called DOSE-DEPENDENT EFFECT |
at about 26 sessions
- 75% show improvement after 26 sessions - 85% show improv after 52 sessions |
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EFFECTS OF TREATMENT LENGTH - what is phase model of therapy |
- says benefits of tx vary, depending on # of sessions
- say there are 3 stages of tx related to tx length: REMORALIZATION-1st few sessions - client's feelings of hopelessness&desperation lifted-measure well-being REMEDIATION-in 16 sessions-focus on symptoms-measure symptoms REHABILIATION-# of sessions depend on prob-unlearning mal beh and get new ways of coping-measure life functng |
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2 ways to measure tx effects/benefits |
EFFICACY
-clinical trials -best for if tx has/not effect EFFECTIVENESS -correlational/quasi-exp design studies -best for clincial utility (tx generalizing, feasible, cost-effctv |
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Consumer Reports Survey - what public said about tx effectivenss |
-effectiveness study, mailed to 41000 of subscribers of mag
-90% say tx helped -say long-term tx better than short -dont say which tx type best -no diff bet tx alone and tx+meds -less tx gain if limited by insurance or managed care |
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what is PLACEBO EFFECT |
=inert substance/tx
=providing subj w/ attention/support -found subj in placebo grp show > improve than no tx or on wait-list |
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what is DIASNOSTIC OVERSHAWDOWING |
=originally when health prof say ALL beh, social, emo prob of mental retardation due to this diagnosis
-now seen with other diagnoses also -vocational overshadowing=overlook voc problems due to co-existing personal problem |
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PSY DISTRESS in survey -most stress client beh -most stress aspect of duties -most ethical problem |
in survey of PSY:
-75% had personal distress in last 3 years -38% said pers dis decreased quality of their duties -5% said due to this tx inadequate -most stressful client beh =suicidal statements -most stress aspect of duty=no tx success -most ethical dilemma=isues of confidentialty |
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what is prevalence rates of psychiatric hospitalizations |
-higher mental ill in females
-higher psy admissn in males due to males have more acting out beh that are threatening to society -higher ratio of male to female since 1960 due to shift from psychopathology to perceived dangerous |
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what is psychatric hospital admissions for male/female in terms of: -marital status -race -age -diagnosis |
-marital status-highest for never married, then married/divc/sep, then widowed
-race-highest#=white; but overrep by other races -age-higest for 25-44 -diagnosis=most common-Schizophrenia at 18-44; organic dis then affective dis for ppl over 65 |
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CULTURAL ISSUES - do ethnic diff ppl benefit from tx |
yes in general they do, regardless of culture or ethnic background
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CULTURAL ISSUES - who shows best GAS (Global Assess Scale) in ethnic groups |
- all races show improv
- best by Hispanic, then Anglo, then Asian then African |
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CULTURAL ISSUES - who has highest premature termination |
-higher if any race than Anglo
-BUT African have higher than Anglo -Asians have lower than Anglo -Hispanics have same as Anglo |
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CULTURAL ISSUES - how does therapist-client matching with race help |
-matching
- increases duration of tx - does NOT help for premature termination among African - best tx benefits for Hispanics |
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CULTURAL ISSUES - Sue& Zane - what 2 processes critical to working with ethnic groups |
CREDIBILITY-client sees PSY as expert&trustworthy
GIVING-client sees tx as getting something (esp for Asian); useful for client involvment & mot in initial sessions; eg reduce anxiety, normalize prob, skills acquis, goal setting |
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CULTURAL ISSUES - Sue&Sue - 3 types of COMPETENCE |
AWARENESS-aware of their assumptns, values, beliefs
KNOWLEDGE-undrstnd worldviews of ethnic groups SKILLS-use tx appropriate for ethnic groups |
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CULTURAL ISSUES - what is CULTURAL EXCAPSULATION |
-BAD - when PSY
1 define all problems according to their own assmpts and stereotypes 2 disregard cultural diff 3 ignore evidence disconfirming their beliefs 4 use only techniques to solve problems 5 disregard own cultural biases |
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CULTURAL ISSUES - what is diff of HIGH vs LOW CONTECT COMMUNICATION |
-HIGH-grounded in situation; depends on group undrstndg; relies on nonverbal cures, unifies culture; slow to change - char of ethnic groups
-LOW-relies on verbal; less unifying; changes quickly-char of Euro-American cultures |
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CULTURAL ISSUES - what is consequences of RACIAL oppression on African |
1 INTERNAL OPPRESSION-system beating/blaming, against system, avoid white; escape with drug use; try to earn acceptance; educ to incr self worth
2 CONCEPTUAL INCARCERATION-adopt white view 3 SPLIT-SELF SYNDROME-polarize self into good/bad components with bad is African 4 reduce to see or use internal/external resources |
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CULTURAL ISSUES - what diff of CULTURAL PARANOIA & FUNCTIONAL PARANOIA |
-CULTURAL PARA-healthy; due to fear of being hurt/misundrstd
-FUNCTNAL PARA-pathology; unhealthy;will not disclose to any PSY; due to mistrust and suspicion |
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CULTURAL ISSUES - 4 types of DISCLOSURE MODES |
1 INTERCULTURAL NONPARANOIC DISCLOSURE (LOW FUC; LOW CUL)-disclose to African/white
2 FUNCTIONAL PARANOIAC (HIGH FUC; LOW CUL)-NOT discls to African or white; pathology 3 HEALTHY CULTURAL PARA (LOW FUC; HIGH CUL)-discls to African; not to White due to past racism or white PSY attitude-best to confront meaning of his paranoia and correct prob 4 CONFLUENT PARA (HIGH FUC; HIGH CUL)-due to pathology and effects of race; NOT discls to African or white-best to have same ethnic PSY |
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CULTURAL ISSUES - what is diff of SEXUAL PREJUDICE & HETEROSEXISM |
SEXUAL PREJUDICE-neg attitudes based on sex orientation of "particular" group
HETEROSEXISM-an ideological system that denies, denigrates or stigmatizes nonheterosexual forms of beh, id, relshp, community (eg vio against gays) |
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CULTURAL ISSUES - what is ACCULTURATION |
=degree to which ethnic minority accepts and adheres to values/att/bel of his own group and dominant group
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CULTURAL ISSUES - (Berry) - 4 categories of ACCULTURATION |
INTEGRATION (biculturalism)-maintn own cult but incomporate parts of domoninant cult
ASSIMILATION-accept dom cult and give up own cult SEPARATION-withdraw dom cult; keep own cult MARGINALIZATION-does not ID with own or dom cult |
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CULTURAL ISSUES - what is RACIAL/CULTURAL (MINORITY) IDENTIFY DEVELOPMENT MODEL |
1 CONFORMITY-want dom cul; hate own cult; want PSY of dom cul
2 DISSONANCE-confused on own contradictory info; want PSY of own cul; see prob due to race id prob 3 RESISTANCE/IMMERSION-reject dom cult; see prob due to oppression 4 INTROSPECTION-unsure of rigidity of 3; want PSY of own cult but more open if PSY share same worldview 5 INTEGRATIVE AWARENESS-want to stop all oppression; want PSY sharing same worldview |
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CULTURAL ISSUES - what is BLACK RACIAL (NIGRESCENCE) IDENTIFY DEVELOPMENT MODEL |
1 PREENCOUNTER-white is ideal; want white PSY
2 ENCOUNTER-has event leading to race awareness; want race PSY 3 IMMERSION/EMERSION-struggle of old/new ideas of race; idealize African at 1st then internalize new id 4 INTERNALIZATION/COMMITMNT- |
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CULTURAL ISSUES - what is WHITE RACIAL IDENTIFY DEVELOPMENT MODEL |
1 CONTACT-no aware of race
2 DISINTEGRATION-contace with race; aware of being white; ambivalent; overid with race or retreat into white 3 REINTEGRATION-accept racist views 4 PSEUDO-INDEPENDENCE-event->? racist view ans see white cause of racism 5 IMMERSION/EMERSION-explore what it means to be white 6 AUTONOMY-positive nonracist white id -research says PSY's stage pos corr with tx success best if PSY in autonomy stge |
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CULTURAL ISSUES - what is HOMOSEXUAL IDENTITY DEVELOPMENT MODEL |
1 SENSITIZATION-feel diff; mid-child
2 SELF-RECOGNITION-attract to same sex ppl; confused; onset of puberty 3 ID ASSUMPTION-certain of homosexuality 4 COMMITMENT-adopt homo way of life; out of closet |
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CULTURAL ISSUES - what are GENERAL GUIDELINES IN WORKING WITH ETHNIC GROUPS |
-ensure lang not barrier
-id client's stage od race id dev, degree of acculturation, worldview -acknowledge cult diff and have client talk about his feelings |
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CULTURAL ISSUES - best approach with Africans |
-worldview = inter-connectedness of all things
-focus on group welfare -family=nuclear&extended; church NP -roles of families flexible -relshp bet male/female egalitarian may show healthy cultural paranoia -best tx=multisystems approach (empower fam by incorporating its strenths); family therapy, exp extended family tx -tx should be time limited, problem solving; directive; egalitarian approach |
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CULTURAL ISSUES - best approach with American Indians |
-have spiritual/holisitic approach to life; focus on harmony with nature; see illness as disharmony
-focus on extended fam and tribe; adhere to collateral social org and decision-making -see time in terms of personal and seasonal rhythms; more present-oriented than future -have strong sense of cooperation and generosity -see listening more NB -PSY be familiar with hx -tx-focus on building trust and credibility by showing you know hx/cult -tx should be problem-slving; client-centered; use elders & trad healing -avoid directive techn |
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CULTURAL ISSUES - best approach with Asians |
-focus on group
-adhere to hierarchical family structure and gender roles -focus on harmony, interdependence, loyalty and obligation in relshp -value restraint of emot -mental illness expressed as somatic complaints -tx - should be directive, structures, goal-orient, prob-solvg; alleviating symptoms -tx - give concrete advise, see PSY as expert (show competence/credibility) -tx - have formalism (respect fam status); be aware of role of shame/obligation -modesty&self-deprecation not signs of low self-esteem -give immediate benefit |
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CULTURAL ISSUES - best approach with Hispanics |
-focus on family
-see interdependence as healthy & necessary; value connectedness & sharing -discussing personal problem is unacceptable; probl should be handled in fam -adopt concrete, tangible approach to life (not long-term) -see control of events due to luck, supernatural,acts of God, external factors -fam are patriarchal and sex roles are inflexible -mental illness expressed as somatic complaints -tx-active; directive; multimodal approach, family tx |
