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180 Cards in this Set

  • Front
  • Back
...............CLINICAL
PSYCHODYNAMIC TX - types
1. Freudian Psychoanalysis
2. Adler's Individaul Psych
3. Jung's Analytical Psychotherapy
4. Mahler's Object Relations Theory
...............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
...............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
...............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)
...............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
...............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
...............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
...............CLINICAL
PSYCHODYNAMIC - Freud
- personality theory - what does anxiety mean
= unpleasant feeling linked with excitement of ANS
- functions to alert ego to internal/external threats
...............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
...............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
...............CLINICAL
PSYCHODYNAMIC - Freud
- therapy - goal
to bring uncon into concs and integrate previously repressed material into personality
...............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
...............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
...............CLINICAL
PSYCHODYNAMIC - Freud
- therapy - current status
- replace Freud's focus on interpretations to more therapist-patient relshp
- new re-concept of transference/countertrans
...............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
...............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
...............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
...............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
...............CLINICAL
PSYCHODYNAMIC - Adler
- therapy - goal
get collaborative relshp with client; help him to id style of life and consequences; reorient goals
...............CLINICAL
PSYCHODYNAMIC - Adler
- therapy - techniques
- lifestyle investigation - on family constellation, fictional goals, basic mistakes
...............CLINICAL
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
...............CLINICAL
PSYCHODYNAMIC - Jung
- same/diff from Adler and Freud
- more like Adler
- beh determined by future goals and aspirations NOT by past events
...............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
...............CLINICAL
PSYCHODYNAMIC - Jung
- personaity theory - whats types of unconscious
PERSONAL UNCONS=exp repressed or forgotten
COLLECTIVE UNCONS=latent memory passed from generations (such as ARCHETYPES)
...............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)
...............CLINICAL
PSYCHODYNAMIC - Jung
- types of attitudes
EXTRAVERSION
INTROVERSION
...............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
...............CLINICAL
PSYCHODYNAMIC - Jung
- maladaptive beh - how seen
are unconscious messages to person that something is awry with him
...............CLINICAL
PSYCHODYNAMIC - Jung
- therapy - goal
rebridge gap bet cons and personal/collective uncons
...............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
...............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)
...............CLINICAL
PSYCHODYNAMIC - object relations - personality theory
- focus on process where child assumes own physical/psycho id
...............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
...............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
...............CLINICAL
PSYCHODYNAMIC - object relations - goals
to provide client with support, acceptance which restore his ability to relate to others in meaningful ways
...............CLINICAL
HUMANISTIC "third force" - types
1. Roger Person-Centered therapy
2. Gestalt therapy
3. Existential therapy
4. Reality therapy
...............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
...............CLINICAL
HUMANISTIC - person-centered therapy Roger - assumes
all people have self actualizing tendency as major mot to guide them to positive healthy growth
...............CLINICAL
HUMANISTIC - person-centered therapy Roger - personality theory
- to grow to self-act, self must remain unified, organized and whole
...............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
...............CLINICAL
HUMANISTIC - person-centered therapy Roger - therapy - goal
help client achieve congruence bet self and experience to see self as self actualizing
...............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
...............CLINICAL
HUMANISTIC - Gestalt - assumes
each person is able to assume personal responsibility for own thoughts/feel/act and living is integrated whole
...............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
...............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
...............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
...............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
...............CLINICAL
HUMANISTIC - Gestalt - therapy - goals
help client integrate aspects of self to become unified whole
...............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
...............CLINICAL
HUMANISTIC - existential - theory
- focus on human conditions of depersonalization, loneliness, isolation
- assume people not static but constant state of becoming
...............CLINICAL
HUMANISTIC - existential - maladaptive beh
- natural human condition
- anxiety=normal response to constant threat of nonbeing
...............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
...............CLINICAL
HUMANISTIC - existential - therapy - techniques
- most NB tool=therapist-client relship
...............CLINICAL
HUMANISTIC - Reality therapy Glaser - theory
- influence by control theory
- beh is purposeful and comes from within person
- assumes one can control own life
...............CLINICAL
HUMANISTIC - Reality therapy Glaser - personality theory
- people have 4 psycho needs (belonging, power, freedom, fun) and 1 physical need (survival)
...............CLINICAL
HUMANISTIC - Reality therapy Glaser - maladaptive beh
- when person gratifies needs (psycho/physical) in irresponsible ways and then assumes failure identity
...............CLINICAL
HUMANISTIC - Reality therapy Glaser - goal
help client id responsible and effective ways to satisfy needs and dev successful id
...............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
...............CLINICAL
BRIEF THERAPIES - types
1 Interpersonal Therapy
2 Solution-focused therapy
3 Transtheortical Model
4 Motivational Interviewing
...............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
...............CLINICAL
BRIEF THERAPIES - Interpersonal - developed for originally
treatment of depression
...............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
...............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
...............CLINICAL
BRIEF THERAPIES - Interpersonal - therapy - techniques
- encourage affect
- communication analysis
- model/role-playing to get new ways of interacting
...............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
...............CLINICAL
BRIEF THERAPIES - Solution-Focused - maladaptive beh - how seen
understanding mal beh NOT NB
...............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
...............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?
...............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
...............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
...............CLINICAL
BRIEF THERAPIES - transtheoretical - focus of therapy
- on factors that facilitate beh change
...............CLINICAL
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
...............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)
...............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
...............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
...............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
...............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)
...............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)
...............CLINICAL
FAMILY THERAPY - Commun/Interaction Family - therapy- goal
to alter interacational patterns of symptoms
...............CLINICAL
FAMILY THERAPY - therapy - techniques
-direct tech (point out problems in comm as they occur)
-paradoxical strategies (prescribe symptom and reframing)
...............CLINICAL
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
...............CLINICAL
FAMILY THERAPY - Extended Family Systems (Bowen) - maladaptive beh - how seen
due to multigenerational transmission process - lower diff levels tranmitted from 1 generation to next
...............CLINICAL
FAMILY THERAPY - Extended Family Systems (Bowen) - therapy - goal
increase diff between family members
...............CLINICAL
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
...............CLINICAL
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
...............CLINICAL
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
...............CLINICAL
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
...............CLINICAL
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
...............CLINICAL
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
...............CLINICAL
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)
...............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
...............CLINICAL
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
...............CLINICAL
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
...............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
...............CLINICAL
FAMILY THERAPY - Milan Systemic Family - good for which client
anorectic children
...............CLINICAL
FAMILY THERAPY - Milan Systemic Family - assumes
in fam system there are circular patterns of action and reaction
...............CLINICAL
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
...............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
...............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
...............CLINICAL
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
...............CLINICAL
FAMILY THERAPY - Behavioral family - theory based on
principles of operant conditioning, social learning, social exchange theory
...............CLINICAL
FAMILY THERAPY - Behavioral family - maladaptive beh - how seen
beh is learned and maintained by its consequences
...............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
...............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
...............CLINICAL
FAMILY THERAPY - Object Relations Family - goal
resolve each fam mem's attachment to family introjects
...............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)
..........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
..........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
..........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
..........CLINICAL
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
..........CLINICAL
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
..........CLINICAL
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
..........CLINICAL
GROUP THERAPY - which client NOT good for group
- extreme depressed
- withdrawn
- paranoid
- acute psychosis
- brain damage
- sociopathy
..........CLINICAL
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
..........CLINICAL
FEMINIST THERAPY - maladaptive beh - theory
- assume personal is political - women's circum reflect women's pos in society
..........CLINICAL
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
..........CLINICAL
FEMINIST THERAPY - goals
- id and alter oppressive forces in society
- goal=empowerment or help client be more self-defining and self-determining
..........CLINICAL
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
..........CLINICAL
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
..........CLINICAL
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
..........CLINICAL
HYPNOTHERAPY - research says
- NOT consistently linked to any neurobeh or psychophysiological process
- complaince under hypo does NOT always occur
..........CLINICAL
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
..........CLINICAL
CRISIS INTERVENTION - crisis means
a precipitating situational or maturational even that is time limited and disrupts person's usual coping and prob-solving capabilities
..........CLINICAL
CRISIS INTERVENTION - goal
to reach client in acute state of stress and provide them with support to prevent becoming "chronics of the future"
..........CLINICAL
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
..........CLINICAL
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
..........CLINICAL
COMMUNITY PSYCHOLOGY - focus on
prevention of disease
..........CLINICAL
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
..........CLINICAL
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
..........CLINICAL
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
..........CLINICAL
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
..........CLINICAL
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
..........CLINICAL
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
..........CLINICAL
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)
..........CLINICAL
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
..........CLINICAL
CONSULTATION - types of evaluations
FORMATIVE EVAL- periodically done to assess consult process
SUMMATIVE EVAL-done at end of consult process
..........CLINICAL
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
..........CLINICAL
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
..........CLINICAL
CONSULTATION versus SUPERVISION
SUPERVISION
-same prof as supervisee
-is admi responsible for and position of power over supervisee
..........CLINICAL
SUPERVISION - what is PARALLEL PROCESS
- when a supervisee replicates problems and symptoms with the supervisor that are manifested by the supervisee's client
..........CLINICAL
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)
..........CLINICAL
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
..........CLINICAL
PYSCHOTHERAPY RESEARCH - OUTCOME STUDIES - what is better psychotherapy
- cog-beh tx more effective for some disorders like phobias, panic, compulsions
..........CLINICAL
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
..........CLINICAL
PYSCHOTHERAPY WITH OLDER ADULTS - what % of older adults meet crit for mental dis
20-25%
..........CLINICAL
PYSCHOTHERAPY WITH OLDER ADULTS - most common mental health prob
in order
- anxiety
- severe cog impairment
- depression
..........CLINICAL
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
..........CLINICAL
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
..........CLINICAL
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
..........CLINICAL
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
...............CLINICAL
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
...............CLINICAL
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
...............CLINICAL
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
...............CLINICAL
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
...............CLINICAL
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
...............CLINICAL
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
...............CLINICAL
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
...............CLINICAL
CULTURAL ISSUES - do ethnic diff ppl benefit from tx
yes in general they do, regardless of culture or ethnic background
...............CLINICAL
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
...............CLINICAL
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
...............CLINICAL
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
...............CLINICAL
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
...............CLINICAL
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
...............CLINICAL
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
...............CLINICAL
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
...............CLINICAL
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
...............CLINICAL
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
...............CLINICAL
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
...............CLINICAL
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)
...............CLINICAL
CULTURAL ISSUES - what is ACCULTURATION
=degree to which ethnic minority accepts and adheres to values/att/bel of his own group and dominant group
...............CLINICAL
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
...............CLINICAL
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
...............CLINICAL
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-
...............CLINICAL
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
...............CLINICAL
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
...............CLINICAL
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
...............CLINICAL
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
...............CLINICAL
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
...............CLINICAL
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
...............CLINICAL
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