Lcsw Direct & Indirect Practice

Front 1

Crisis Intervention Theory:
What is it?

Back 1

treatment for indivl, groups, and families faced with stressful events beyond their coping abilities

Front 2

Crisis Intervention Theory:
Definition

Back 2

upset in a steady state that poses an obstacle and the indivl cannot overcome through usual methods of problem solving.

Front 3

Crisis Intervention Theory:
(3) Types of crises:

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1.) Situational: a stressful event (seeing someone die)
2.) Maturational: developmentally-based (starting school)
3.) Crisis due to cultural values or societal facors (homosexuality in a hetero-oriented society)

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Crisis Intervention Theory:
Goals of Crisis Intervention

Back 4

-reduce the impact of the crisis in the immediate moment
-assist indivl in more effective ways to respond to crisis or stressful event (mobilization of indivls internal(psychological) and external (finanical) resources)
-return to at least pre-crisis level of functioning

Front 5

Crisis Intervention Theory:
Stages experienced by indivl

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1.) indivl experiences crisis
2.) indivl expresses increased tension and shock and fails to cope
3.) indivl experiences rapid escalating tension, and feeling of being overwhelmed
4.) indivl attempts to use different ways of coping.
-dysfunctional/malapdative: may result in emotional collapse or suicide
-adaptive: may result in indivl returning to pre-crisis level or higher.

Front 6

Crisis Intervention Theory:
Phases of Crisis Intervention

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Phase I: Formulation of Problem (often completed in 1st interview, immediate focus is on crisis situation, what happened)
-SW determines the nature and duration of vulunerable state (early efforts to cope)
-SW assesses present/active state of crisis
-develops a contract of joint activities and goals and tasks to be completed (working plan of activities)
Phase II: Implementation Phase: (1st to 4th interview)
-finds out how client has coped in past and how those coping skills worked out
-immediate goals and tasks my be obtained
-short term goals are developed
-as are specific action-oriented and thinking-oriented tasks to achieve goals.
Phase III: Treatment Phase (last interview or two)
- SW and client make decision to terminate treatment
-SW summerizes tasks completed, goals achieved, and work yet to be obtained
-Future activities are planned
-Discussing clients plans for future
-and options that are available to client

Front 7

Task-Centered Treatment:
What is it?

Back 7

short term treatment
-based on learning and cognitive theories
-used to achieve concrete goals

Front 8

Task-Centered Treatment:
Stages of treatment

Back 8

-engagement
-problem-centered assessment
-development of problem-solving tasks/planning implementation
-performing problem-solving tasks
-at start of each session, review progess of tasks
-SW and client plan a new task or deal with obstacles
-evaluation
-termination

Front 9

Behavioral Therapy:
Classical Coniditioning Model

Back 9

-helping indivl unlearn dysfunctional responses to environmental stimuli (fear of riding in car after accident)
-works with conditioning indivl to associate pleasant feelings with a stimulus that has been axiety-producing (learning to feel relaxed rather than anxious when flying)

Ex: Child is harassed at school,Child feels bad when harassed,Child associates being harassed and school, Child begins to feel bad when she thinks of school

Solution: In order to stop the association of feeling bad & thinking of school, the connection between school & being harassed must be broken.

THINK DWIGHT

Hint 9

THINK DWIGHT

Front 10

Behavioral Therapy:
Systematic Desensitization

Back 10

counter-conditioning intervention frequently used in treating phobias involving relaxation training, construction of the anxiety heirarchy, and desensitization in imagination (pairing relaxation and mental images of items from the least to the most anxiety-producing images until the person can visualize all images w/o becoming anxious)

Front 11

Behavioral Therapy:
In Vivo Densensitization

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Pairing relaxation and real-life experience with what causes the anxiety and doing this until the person no longer responds to the experience with anxiety.

Front 12

Behavioral Therapy:
Assertiveness Training

Back 12

training an indivl to tell their feelings in a direct and honest manner.
-behavioral rehearsal is important with this

Front 13

Behavioral Therapy:
Sensate Focus & Nondemand Pleasuring (in Sex therapy)

Back 13

used in treatment for performance anxiety/spectator role.
-initially have couples focus on pleasuring each other from massages,hugging, kissing and refraining from having intercourse or caressing privates.
-overtime rebuilding their sexual repertoire while continueing to fouce on sensual pleasure rather than on achieving an erection or orgasm.

Front 14

Behavioral Therapy:
Operant Conditioning: What is it?

Back 14

focuses on behaviors that operate or act on the environment (operants) with the goal of obtaining some response (reinforcing behavior that will be repeated or withheld so a behavior is not repeated)

ex: use of reinforcement & punishment

Front 15

Behavorial Therapy - Operant Conditioning:
Reinforcer:

Back 15

a consequence that increase the likelihood that a preceding behavior will be repeated.
-the reinforcer needs to be immediately following the target behavior.

Front 16

Behavorial Therapy - Operant Conditioning:
Primary Reinforcer

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-a stimuli required to sustain life or to satisfy physciological needs
-natually reinforcing

ex: water food sleep

Front 17

Behavorial Therapy - Operant Conditioning:
Secondary Reinforcer

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a stimuli that the organism learns to value

Front 18

Behavorial Therapy - Operant Conditioning:
Positive Reinforcement

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When the results of the
behavior increase the
frequency of the
behavior- also known as reward training

Ex: cookie to a child to stop
him from whining. The
cookie reinforces whining

Repetition of a behavior because the behavior is followed by a pleasant stumulus

Front 19

Behavorial Therapy - Operant Conditioning:
Negative Reinforcement

Back 19

When a behavior
increases because it is
followed by withdrawal of
an unpleasant stimulus- also known as active aviodance training.

Ex:

the repetition of a behavior because of the behavior's power to turn off negative stimuli.

Front 20

Behavioral Therapy - Operant Conditioning:
Premack Principle

Back 20

pairing rewards with things or behaviors you would rather not do.

ex: allowing a child to play video games for 30mins after cleaning room. or running while the TV is on.

Front 21

Behavioral Therapy - Operant Conditioning:
Differential Reinforcement for Alternative Behaviors

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alternative behaviors are reinforced while the target behaviors are not.

Front 22

Behavioral Therapy - Operant Conditioning:
Shaping

Back 22

a technique of reinforcing successive approximations to the desired behavior.

Front 23

Operant Conditioning - Schedules of Reinforcements:
Continuous

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reinforcing every occurance of the target behavior.
-usually an early learning process.

Front 24

Operant Conditioning - Schedules of Reinforcements:
Intermittent

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reinforcing only some occurances of the target behavior.
-useful in maintaining behavior

Front 25

Operant Conditioning - Schedules of Reinforcement:

Fixed Interval

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reinforcement occurs after a specific perdetermined time period has elapsed following the occurrence of the desired behavior.

ex: quizzes in class weekly

Front 26

Operant Conditioning - Schedules of Reinforcement:

Variable Interval

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reinforcements occurs at varying (unpreducted) times afte occurances of the desired behaviors

-5 mins after the 1st occurance; 10 mins after the 2nd occurance; 3 mins after the 3rd occurance.

ex:pop quiz-never know when it is.

Front 27

Operant Conditioning - Schedules of Reinforcement:

Fixed Ratio

Back 27

reinforcement is given on a non-varying basis

(after 5 occurances of the behavior)

Front 28

Operant Conditioning - Schedules of Reinforcement:

Variable Ratio

Back 28

reinforcement is given on a varying basis

(after 5 occurances of the behavior; then after 10 occurances of the behavior)

Front 29

Behavioral Therapy - Operant Conditioning:

Punishment

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following a behavior with an aversive stimulus

-the use of punishment oftern creates resentment towards the punisher and does not teach appropriate behavior.

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Behavioral Therapy - Operant Conditioning:

Extinction

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failing to reinforce the target behavior which results in the disappearance of the behavior.

Front 31

Behavioral Therapy - Operant Conditioning:

Responce Cost

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withdrawin a specific positive reinforcer each time an undesirable behavior is performed

(the child loses a token earned previously for appropriate behavior)

Front 32

Behavioral Therapy - Operant Conditioning:

Verbal Clarificaiton and Prompts

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helpful aids in the development of a new behavior

Front 33

Behavioral Therapy - Operant Conditioning:

Contingency Contract

Back 33

treatment contract that makes a specfied consquence, pleasant or unpleasant, contingent on a specific behavior or behaviors

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Behavioral Therapy - Operant Conditioning:

Token Economy

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reinforcing desirable behaviors that involves rearding these behaviors with tokens that can be redeemed for reinforcers

(special one-on-one time with the teacher, or a candy bar)

Front 35

Reality Therapy:

Back 35

William Glasser

-believes that all human behavior is purposeful and comes from within the person. Also that the person is responsible for their behavior.
-goal of therapy is to enable clients to take better control of their lives. It focuses on current behaviors instead of past.
-transference is viewed as harmful to the therapy process.
-seeks to teach clients to evaluate their behavior and see if it enables them to satisfy their needs without interfering with the needs of others.

Front 36

Cognitive-Behaviroal Therapies:

What is it?

Three CB perspectives?

Back 36

our thoughts/beliefs control how we feel and behave. (great treatment choice for depression)

Thee Perspectives:
1.) Cognitive Therapy-Aaron Beck
2.) Rational Emotive Therapy (RET)- Albert Ellis
3.) Self-Management/ Self-Instruction- Donald Meichenbaum

Front 37

CB perspectives - Cognitive Therapy:

Common thinking Errors:

Back 37

Aaron Beck
-He believed depression was a bias of negative thought and most mental illnesses were based on pervasive negative thoughts.

Common thinking Errors:
-all or nothing thinking (black and white)
-emotional reasoning (you believe it because you feel strongly about it not because of fact/evidence)
-overgeneralization (indivl arrives at broad principle from minimal information-all blacks are in gangs)
-magnification and minimalization (person magnifies the negative and minimizes the postive in evaluations of themself)
-personalization (when a person assumes that someone elses negative behavior is the result of something they have done)
-catastrophizing (assuming the worst will happen)
-mind reading (assuming you know another persons thoughts about something)

due to limited time the therapy has a strict structure, and emphaisizes relapse prevention.
-client is taught to identify, evaluate, and change dysfunctional thought/beliefs

Front 38

CB perspectives - Cognitive Therapy:

Cognitive Methods

Back 38

Collaborative Empiricism- the client and SW was as a team to test the validity of the client's beliefs

Socratic Dialogue- the use of questions to lead the indivl to discover a reality

guided discovery- interventions are structured (progression of questions), to enable client to discover inaccuracies in their thinking.
decatastrophizing-help clients see that events are not really the end of the world, even if they are difficult
Reattribution Training- id cognitive errors and distortions in thinking followed by the consideration of alternate beliefs
Decentering- helping clients to break their pattern of seeing self as the reference point for all life events.

Front 39

Cognitive Therapy - Rational Emotive Therapy (RET)

Back 39

Albert Ellis believes irrational beliefs, not unconcious conflicts from early childhood were the root of neurotic behavior.
-directly attacks the clients belief system to challenge their own beliefs unlike beck

A=activating events B=belief system of indivl C=consequences

Front 40

Cognitive Therapy - Self-Instruction Training

3 phases

Back 40

Donald Meichenbaum focus was on the clients self-statements. Dysfunctional self-statements often underlie problems.

3 Phases:
1.) SW and client make an assesment of the clients self- statements and a conceptualization of the problem
2.) Client instructed to imagine a difficult situation and to identify the exhisting self-statements. they discuss the impact of those statements on client. Client is directed to self-monitor
3.) SW and client work as a team to develop self-statements that result in greater enjoyment of life

Front 41

Cognitive Therapy - Dialectical Behavioral Therapy

Back 41

-works mainly with clients diagnosed with Borderline Personality Disorder

-combo of behavorial and cognitive therapy.

an idivl component focusing on skill-building and a weekly group therapy

Front 42

Cognitive Therapy - Dialectical Behavioral Therapy

Four modules

Back 42

Mindfulness- buddhist tradition, involves observing, describing, and participating. Cts are taught to practice mindfulness skills of nonjudegementally, one-mindfully, and effectively

Interpersonal effectiveness- teaching and learning of skills that allow a person to be assertive in asking another to do something or problem soliving with someone without damaging the relationship or persons self esteem

Distress Tolerance- ability to accept reality of circumstances that cannot be changed. identifying postives and negatives.

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Cognitive Therapy - Solution-Focused Therapy

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short term strengths based treatment model which emphasizes empowerment strategy to allow the client to take action themself.

-the client is capable of change and growth

Components:
-describing problem
-developing well-formulated goals
-working cooperatively to identify solution to problems
-end of session feedback
-evaluation of client progress

Miracle Question (if you wake up tomorrow...what would it look like)

Exception-Finding Questions: Helps the client to identify what has previously workied concerning the problems. ....except this time...

Presuppositional Questions: help the client conceptualize goal attainment (5 w's) how will your relationship with bill be different?

Compliments: SW compliments the client on successful problem-solving or coping strategies used in past.

Listening: include further responses reflective listening and summerizing

Empathy: understanding and demonstarting that understanding

Sealing questions: used to figure out a quanitative measure from the client on different issues. "on a scale of 1 to 10 how would you rate your problem?