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422 Cards in this Set

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  • Back
  • 3rd side (hint)
An acronym to remember the symptoms of depression. Think of prescribing an energy pill. (Affective/Mood Disorder)

S - Sleep
I - Interest
G - Guilt
: - (Colon can refer to bowel complaints as this is a common presentation of depression, but not official)
E - Energy (decreased)
C - Concentration (difficult, decreased)
A - Appetite (decreased)
P- Psychomotor agitation
S - Suicidal ideation
C Gasp Die
An acronym to remember the symptoms of depression

Concentration decreased
Sleep disturbance
Psychomotor agitation or retardation
Death or suicide (thoughts or acts of)
Interests decreased
Energy decreased
words ending in "ing". It is believed that using gerunds can help reinforce the positive behavior a teacher would like to see rather than attacking a bad behavior. For example, a teacher might see students running down the hall and calmly say "walking" rather than yell "stop running" in an agitated voice. He might say "gently" instead of yelling "calm down!"
An acronym to remember the symptoms of Dysthymia

Energy loss or fatigue
Self-esteem is low
2 years minimum of depressed
mood most of the day, for more
days than not (1 year adolscent)
Sleep is increased or decreased
Appetite is increased or decreased
Decision-making or concentration
is impaired
An acronym to remember the symptoms of Mania

Flight of ideas
Activity increase
Sleep deficit
Tad High
An acronym for symptoms of Hypomania (affective disorder). I'm a "tad high"

Attention deficit
Decreased need for sleep
High self-esteem/grandiosity
Ideas that race
Goal-directed activity increased
High-risk activity
DeTeR the HIGH
An acronym for symptoms of Mania (affective disorder) Shut up! You're deterring my high!

Reckless behavior
Hyposomnia (reduced sleep)
Ideas that race
An acronym for remembering the symptoms of Generalized Anxiety Disorder (Anxiety Disorder)

Wound up
An acronym for remembering the symptoms of PTSD (anxiety disorder).

Traumatic event
Unable to function
Month or more of symptoms
Arousal increased (e.g. easily startled)
Physical Diseases That Have
Commonly Appeared Anxious
A way to remember the medical conditions associated with Anxiety disorder due to a general medical condition (anxiety disorder)

Pheochromocytoma (rare tumor)
Diabetes mellitus(insulin deficiency)
Temporal lobe epilepsy (seizures)
Hyperthyroidism (overactive thyroid)
Carcinoid (tumor in gas. tract)
Alcohol withdrawal
Arrhythmias (abnormal heartbeat)
Overactive thyroid disorder that has symptoms such as extreme restlessness, confusion, and emotional swings or psychosis that can look like a mental illness.
An acronym to remember Generalized anxiety disorder (anxiety disorder)

Tension in muscles
Concentration difficulty
Hyperarousal (or irritability)
Energy loss
Sleep disturbance
An acronym to remember Posttraumatic stress disorder/PTSD (anxiety disorder)

Disinterest in usual activities
Event preceding symptoms
M onth or more of symptoms
Sympathetic arousal
An acronym to remember symptoms of Paranoid personality disorder (Personality Disorder)

Spousal infidelity suspected
Unforgiving (bears grudges)
Perceives attacks (and reacts
Enemy or friend? (suspects
associates and friends)
Confiding in others is feared
Threats perceived in benign
An acronym to remember symptoms of Schizotypal personality disorder (Personality Disorder)

Magical thinking
Experiences unusual perceptions
Paranoid ideation
Eccentric behavior or appearance
Constricted or inappropriate affect
Unusual thinking or speech
Lacks close friends
Ideas of reference
Anxiety in social situations
Rule out psychotic or pervasive
developmental disorders
An acronym to remember the symptoms of Borderline personality disorder

Paranoia or dissociation under stress
Unstable self-image
Labile intense relationships
Suicidal gestures
Inappropriate anger
Vulnerability to abandonment
Emptiness (feelings of)
An acronym to remember symptoms of Schizoid personality disorder

Detached or flattened affect
Indifferent to criticism or praise
Sexual experiences of little interest
Tasks done solitarily
Absence of close friends
Neither desires nor enjoys
close relationships
Takes pleasure in few activities
An acronym to remember the symptoms of Antisocial Personality Disorder

Cannot conform to law
Obligations ignored
Reckless disregard for safety
Underhanded (deceitful)
Planning insufficient (impulsive)
Temper (irritable and aggressive)
An acronym to remember the symptoms of Borderline Personality Disorder

Disturbance of identity
Emotionally labile
Suicidal behavior
Paranoia or dissociation
Abandonment (fear of)
Relationships unstable
Emptiness (feelings of)
Rage (inappropriate)
An acronym to remember the symptoms of Histrionic personality disorder

Provocative or seductive behavior
Relationships considered more
intimate than they are
Attention (need to be the center of)
Influenced easily
Style of speech (impressionistic,
lacking detail)
Emotions (rapidly shifting, shallow)
Make up (physical appearance
used to draw attention to self)
Emotions exaggerated
An acronym to remember symptoms of Narcissistic personality disorder

Requires attention
Need to be special
Dreams of success and power
Interpersonally exploitative
Others (unable to recognize
feelings/needs of)
Sense of entitlement
An acronym to remember the symptoms of Dependent personality disorder

Reassurance required
Expressing disagreement diffi cult
Life responsibilities assumed by others
Initiating projects diffi cult
Alone (feels helpless and
uncomfortable when alone)
Nurturance (goes to excessive
lengths to obtain)
Companionship sought urgently
when a relationship ends
Exaggerated fears of being left
to care for self
An acronym to remember symptoms of Histrionic personality disorder

Appearance focused
Center of attention
Relationships (believed to be
more intimate than they are)
Easily infl uenced
Seductive behavior
Shallow emotions
Speech (impressionistic and vague
An acronym to remember symptoms of Avoidant personality disorder

Criticism or rejection preoccupies
thoughts in social situations
Restraint in relationships due to
fear of shame
Inhibited in new relationships
Needs to be sure of being liked
before engaging socially
Gets around occupational activities
with need for interpersonal contact
Embarrassment prevents new
activity or taking risks
Self viewed as unappealing or inferior
An acronym to remember symptoms of Obsessive-compulsive personality

Cannot discard worthless objects
Rule obsessed
Excludes leisure due to devotion
to work
Reluctant to delegate to others
An acronym to remember symptoms of Substance dependence (addiction disorder)

Activities are given up or reduced
Dependence, physical: tolerance
Dependence, physical: withdrawal
Intrapersonal (Internal)
consequences, physical or
Can’t cut down or control use
Duration or amount of use is greater
than intended
An acronym to remember symptoms of Substance abuse (addiction disorder)

Work, school, or home role
obligation failures
Interpersonal or social consequences
Legal problems
Dangerous use
An acronym to remember symptoms of Alcohol abuse (Addiction Disorder)

Have you ever felt you should
CUT DOWN your drinking?
Have people ANNOYED you
by criticizing your drinking?
Have you ever felt bad or
GUILTY about your drinking?
Have you ever had a drink first
thing in the morning to steady
your nerves or get rid of a
hangover (EYE-OPENER)?
An acronym to remember the Causes of Delirium

Acute metabolic
CNS pathology
Hypoxia (reduction of oxygen)
Acute vascular
Toxins or drugs
Heavy metals
An acronym to remember the life threatening Causes of Delirum

Wernicke’s encephalopathy
Hypertensive crisis
Hypoperfusion/hypoxia of the brain
Intracranial process/infection
Status epilepticus
Wernicke’s encephalopathy
impairment of short term memory which can cause confusion. Associated with Delirium
Identity Problem
Identity Problems are characterized by severe distress and uncertainty about issues related to identity, such as long-term goals, career choice, friendship patterns, sexual orientation and behavior, moral values, and group loyalties. The debilitating feature of Identity Problem is succinctly summarized by the question, Who Am I?...[A]cademic, social, and occupational functioning are impaired, with varying degree of severity, for a period of more than three months.
Anxiety Disorders
Generalized Anxiety Disorder
Anxiety Disorder due to a general medical condition
Panic disorder (with and without a history of agoraphobia), Agoraphobia (with and without a history of panic disorder)
Phobia (largest category of AD)
Social Phobia and Specific Phobia
Obsessive-compulsive disorder
Acute stress disorder
Personality Disorders
BADASSPiHaNOplayer will help remember.
There are 10 listed in the DSM IV:

Borderline Personality Disorder
Antisocial Personality Disorder
Dependent personality disorder
Avoidant Personality Disorder
Schizotypal Personality Disorder
Schizoid Personality Disorder
Paranoid Personality Disorder

Histrionic personality disorder
Narcissistic personality disorder
Obsessive-compulsive personality
disorder (not same as obsessive compulsive disorder which is an AD)
Affective Disorders
Affective/Mood Disorders
Bipolar Disorder
Cyclothymic Disorder
Dysthymic Disorder
Major Depressive Disorder
Disassociative Disorders
Depersonalization Disorder
Dissociative Amnesia
Dissociative Fugue
Dissociative Identity Disorder (MPD)
Dissociative Disorder Not Otherwise Specified (NOS)
Pervasive Developmental Disorders
Autistic disorder
Rett's Disorder
Childhood Disintegrative Disorder
Asperger’s Disorder
Pervasive Developmental Disorder NOS
Sexual Disorders
Erectile Dysfunction (ED)
Female and Male Orgasmic Disorders
Female Sexual Arousal Disorder
Gender Identity Disorder
Hypoactive Sexual Desire Disorder
Male Erectile Disorder
Premature Ejaculation
Sex Addiction (not a recognized diagnostic category at this time)
Sexual Masochism and Sadism
Transvestic Fetishism
Sleep Disorders
Circadian Rhythm Sleep Disorder
Hypersomnia, Primary
Nightmare Disorder
Sleep Terror Disorder
Sleepwalking Disorder
Childhood Disorders
Asperger's Disorder
Attention Deficit/Hyperactivity Disorder (ADHD/ADD)
Autistic Disorder (Autism)
Conduct Disorder
Disorder of Written Expression
Expressive Language Disorder
Mathematics Disorder
Mental Retardation
Oppositional Defiant Disorder
Reading Disorder
Rett's Disorder
Rumination Disorder
Selective Mutism
Separation Anxiety Disorder
Stereotypic Movement Disorder
Tourette's Disorder
Transient Tic Disorder
Psychotic Disorders

Brief Psychotic Disorder
Delusional Disorder
Schizoaffective Disorder
Shared Psychotic Disorder
Somatoform Disorders
Somatization disorder
Undifferentiated somatoform disorder
Conversion disorder
Pain disorder
Associated with both psychological factors and a general medical condition
Associated with psychological factors
Body dysmorphic disorder
Somatoform disorder NOS
The DSM IV Axis/Dimensions
Axis I: Clinical, the diagnosis
Axis II: Developmental and Personality Disorders
Axis III: Physical conditions
Axis IV: Psychosocial stressors
Axis V: Highest level of functioning, a score is provided
Adjustment Disorders
Adjustment Disorder Unspecified
Adjustment Disorder with Anxiety
Adjustment Disorder with Depressed Mood
Adjustment Disorder with Disturbance of Conduct
Adjustment Disorder with Mixed Anxiety and Depressed Mood
Adjustment Disorder with Mixed Disturbance of Emotions and Conduct
Frotteurism (nc rubbing)
Sexual masochism
Sexual sadism
Transvestic fetishism (crossdress)
Paraphilia NOS (not otherwise specified)
Factitious disorders
conditions in which a person acts as if he or she has an illness by deliberately producing, feigning, or exaggerating symptoms.

Manchausen syndrome (own illness faked)
Manchausen by proxy (other's illnesses faked)
Ganser syndrome(gives absurd answers to simple questions)
Rett's Disorder/Syndrome
a deceleration of the rate of head growth and small hands and feet. Head grows smaller, loses skills already learned. Stereotypic, repetitive hand movements such as mouthing or wringing are also noted. Symptoms of the disorder include cognitive impairment and problems with socialization, the latter during the regression period. Socialization typically improves by the time they enter school. Usually caused (95% or more) by a de novo mutation in the child (so it is NOT inherited from either parent.

Can look like autism and cerebral palsy. Symptoms include:
* screaming fits
* panic attack
* inconsolable crying
* avoidance of eye contact
* lack of social/emotional reciprocity
* general lack of interest
* markedly impaired use of nonverbal behaviors to regulate social interaction
* loss of speech
* Balance and coordination problems, including losing the ability to walk in many cases
a brain development disorder characterized by impaired social interaction and communication, and by restricted and repetitive behavior. These signs all begin before a child is three years of the five pervasive developmental disorders.

he manifestations of autism cover a wide spectrum, ranging from individuals with severe impairments—who may be silent, mentally disabled, and locked into hand flapping and rocking—to high functioning individuals who may have active but distinctly odd social approaches, narrowly focused interests, and verbose, pedantic communication.Sometimes the syndrome is divided into low-, medium- or high-functioning autism based on IQ thresholds, or on how much support the individual requires in daily life; these subdivisions are not standardized and are controversial.
Tertiary Prevention
takes place after an illness has already been treated to prevent recurrence of the problem.
Secondary Prevention
refers to early detection and treatment of problems
Primary Prevention
aimed at preventing problems before they occur in the first place
Exposure in vivo
Exposed to germs
Socratic Questioning
Disciplined questioning that can be used to pursue thought in many directions and for many purposes, including: to explore complex ideas, to get to the truth of things, to open up issues and problems, to uncover assumptions, to analyze concepts, to distinguish what we know from what we don’t know, and to follow out logical implications of thought.

e.g.,what would happen next?
Impulse Control Disorders
Intermittent Explosive Disorder


Pathological Gambling


Trichotillomania (pull out hair)
Frotteurism (nc rubbing)
Sexual masochism
Sexual sadism
Transvestic fetishism (crossdress)
Paraphilia NOS (not otherwise specified)
Factitious disorders
conditions in which a person acts as if he or she has an illness by deliberately producing, feigning, or exaggerating symptoms.

Manchausen syndrome (own illness faked)
Manchausen by proxy (other's illnesses faked)
Ganser syndrome(gives absurd answers to simple questions)
Rett's Disorder/Syndrome
a deceleration of the rate of head growth and small hands and feet. Head grows smaller, loses skills already learned. Stereotypic, repetitive hand movements such as mouthing or wringing are also noted. Symptoms of the disorder include cognitive impairment and problems with socialization, the latter during the regression period. Socialization typically improves by the time they enter school. Usually caused (95% or more) by a de novo mutation in the child (so it is NOT inherited from either parent.

Can look like autism and cerebral palsy. Symptoms include:
* screaming fits
* panic attack
* inconsolable crying
* avoidance of eye contact
* lack of social/emotional reciprocity
* general lack of interest
* markedly impaired use of nonverbal behaviors to regulate social interaction
* loss of speech
* Balance and coordination problems, including losing the ability to walk in many cases
a brain development disorder characterized by impaired social interaction and communication, and by restricted and repetitive behavior. These signs all begin before a child is three years of the five pervasive developmental disorders.

he manifestations of autism cover a wide spectrum, ranging from individuals with severe impairments—who may be silent, mentally disabled, and locked into hand flapping and rocking—to high functioning individuals who may have active but distinctly odd social approaches, narrowly focused interests, and verbose, pedantic communication.Sometimes the syndrome is divided into low-, medium- or high-functioning autism based on IQ thresholds, or on how much support the individual requires in daily life; these subdivisions are not standardized and are controversial.
Tertiary Prevention
takes place after an illness has already been treated to prevent recurrence of the problem.
Secondary Prevention
refers to early detection and treatment of problems
Primary Prevention
aimed at preventing problems before they occur in the first place
Exposure in vivo
Exposed to germs
Socratic Questioning
Disciplined questioning that can be used to pursue thought in many directions and for many purposes, including: to explore complex ideas, to get to the truth of things, to open up issues and problems, to uncover assumptions, to analyze concepts, to distinguish what we know from what we don’t know, and to follow out logical implications of thought.

e.g.,what would happen next?
Impulse Control Disorders
Intermittent Explosive Disorder


Pathological Gambling


Trichotillomania (pull out hair)
Life (or Childhood) Script
* Script is a life plan, directed to a reward
* Script is decisional and responsive; i.e., decided upon in childhood in response to perceptions of the world and as a means of living with and making sense of the world. It is not just thrust upon a person by external forces.
* Script is reinforced by parents (or other influential figures and experiences).
* Script is for the most part outside awareness.
*Script is how we navigate and what we look for, the rest of reality is redefined (distorted) to match our filters.
the flow of communication, and more specifically the unspoken psychological flow of communication that runs in parallel.

There are basically three (3) kinds of transactions:
1. Reciprocal/Complementary (the simplest)
2. Crossed
3. Dublex/Covert (the most complex)
The Contract
an agreement entered into by both client and therapist to pursue specific changes that the client desires. Unhealthy childhood experiences could damage the Adult or Parent ego states, which would bring discomfort to an individual and/or others in a variety of forms, including many types of mental illness.

Associated with TA and Eric Berne
The recognition, attention or responsiveness that one person gives another. Strokes can be positive (nicknamed "warm fuzzies") or negative ("cold pricklies"). A key idea is that people hunger for recognition, and that lacking positive strokes, will seek whatever kind they can, even if it is recognition of a negative kind. We test out as children what strategies and behaviours seem to get us strokes, of whatever kind we can get.
Three Ego States
At any given time, a person experiences and manifests their personality through a mixture of behaviours, thoughts and feelings. Typically, according to TA (Berne), there are three ego-states that people consistently use:

1) Parent ("exteropsyche"): a state in which people behave, feel, and think in response to an unconscious mimicking of how their parents (or other parental figures) acted, or how they interpreted their parent's actions. For example, a person may shout at someone out of frustration because they learned from an influential figure in childhood the lesson that this seemed to be a way of relating that worked.

2) Adult ("neopsyche"): a state of the ego which is most like a computer processing information and making predictions absent of major emotions that cloud its operation. Learning to strengthen the Adult is a goal of TA. While a person is in the Adult ego state, he/she is directed towards an objective appraisal of reality.

3) Child ("archaeopsyche"): a state in which people behave, feel and think similarly to how they did in childhood. For example, a person who receives a poor evaluation at work may respond by looking at the floor, and crying or pouting, as they used to when scolded as a child. Conversely, a person who receives a good evaluation may respond with a broad smile and a joyful gesture of thanks. The Child is the source of emotions, creation, recreation, spontaneity and intimacy.
Associated with TA and Berne
a series of transactions that is complementary (reciprocal), ulterior, and proceeds towards a predictable outcome. Games are often characterized by a switch in roles of players towards the end. Games are usually played by Parent, Adult and Child ego states, and games usually have a fixed number of players; however, an individual's role can shift, and people can play multiple roles.

Berne identified dozens of games, noting that, regardless of when, where or by whom they were played, each game tended towards very similar structures in how many players or roles were involved, the rules of the game, and the game's goals.

Each game has a payoff for those playing it, such as the aim of earning sympathy, satisfaction, vindication, or some other emotion that usually reinforces the life script. The antithesis of a game, that is, the way to break it, lies in discovering how to deprive the actors of their payoff.

Associated with TA and Berne
Karpman's Drama Triangle
The model posits three habitual psychological roles (or roleplays) which people often take in a situation (Persecutor, Victim and Rescuer):

* The person who is treated as, or accepts the role of, a victim
* The person who pressures, coerces or persecutes the victim, and
*The rescuer, who intervenes out of an ostensible wish to help the situation or the underdog.

Associated with Stephen Karpman, Eric Berne and Transactional Analysis
Transactional Analysis
A neo-freudian theory of personality and a systematic psychotherapy for personal growth and personal change. Developed by Eric Berne.

Believes each person has validity, importance, equality of respect.

The aims of change under TA are autonomy (freedom from childhood script), spontaneity, intimacy, problem solving as opposed to avoidance or passivity, cure as an ideal rather than merely 'making progress', learning new choices.

Associated with the contract, life (or childhood) script, games, strokes, the three ego states (PAC model)
Rational Emotive Behavioral Therapy
Developed by Albert Ellis. One of 1st CB theory therapies.

Views behavior as a chain of events - A-B-C where A is the external event to which the individual is exposed; B is the belief that the individual has about A, and C is the emotion or behavior that results from B. An emotional response to an external event is due to beliefs about the event rather than the event itself. Neurosis is caused by repetition of irrational beliefs.

Techniques used: modeling, behavior rehearsal, problem-solving, in-vivo desensitization, rational emotive imagery, and cognitive homework assignments. Works well with anxiety disorders/phobias
Basic Human Needs (Attachments)
1) Physical supplies necessary to life (e.g. oxygen, food)

2) A sense of personal identity

3) mutually supportive & close relationship w/ min 1 other person

4) membership in at min. 1 group that accepts us

5) 1 or more roles that promotes a sense of self-respect and allows us to perform with dignity

6) Financial security

7) a value system that helps us determine our goals and understand ourselves and the world.
disruption of a person's normal or stable state.
Origins of Crisis
there are three categories:

1) Situational Crises
2) Maturational Crises
3) Crises due to cultural values/social factors
Situational Crises
involve a non anticipated event beyond a person's control.

They can arise from 1)physical or personal (disability, diagnosis of serious illness), 2) social or interpersonal (e.g. death of family member), 3) material or environmental (natural disaster)
Maturational Crises
anticipated crises during normal phases of change. a crisis can develop when 1) the person is unable to cope with the natural process of development, 2) already vulnerable due to normal changes, the ind. experiences an unanticipated traumatic event that overwhelms their ability to cope (e.g. an adolescent experiences death of a parent).

Both universal and nonuniversal transitions can produce a MC.
Crises due to cultural values/social factors
come from factors related to race, gender, age. e.g, crises arising from aberrant behavior of others like crime, infidelity, incest, or residential relocation
Universal Life Cycle Transitions
Transitions experiencing normal changes in roles and attitudes about self and the world

e.g. moving from prenatal to infancy, infancy to childhood, childhood to adolescence, adolescence to adulthood, etc...During each transition, ind. are challenged by specific dev tasks.

associated with crisis
Nonuniversal Transitions
transitions from one role status to another. e.g., student to worker, worker to retiree

associated with crisis
The Stages of Crisis
1) The Hazardous Event
2) The Vulnerable State
3) The Precipitating Factor
4) The Active Crisis State
5) Reintegration
The Hazardous Event
a stressful circumstance that disrupts a person's equilibrium and initiates a series of actions and reactions. The event may be anticipated or unanticipated. A threat, a loss or a challenge.

The first stage of crisis.
The Vulnerable State
The person's reaction to the hazardous event. Characterized by an increase in tension that one will or will not cope with successfully.

The 2nd stage of crisis
The Precipitating Factor
an event that converts a vulnerable state into a crisis state. Can be the same as the hazardous event or follow it. "The Last Straw" before a break.

The 3rd stage of crisis
The Active Crisis State
characterized by disequilibrium. Involves physical and psychological agitation, preoccupation with events that led to crisis, and gradual return to equilibrium.

The 4th stage of crisis
restoration of equilibrium

the 5th stage of crisis.
Assessment of a crisis
Focus of assessment should be on the immediate problem. No time or need to explore client's past hx in great depth. See IIE-DI (I Die). Can also include:
-recent medical/psych hx
-assess MH status
-assess for substance abuse
-assess for suicide risk
-assess for danger to others
(I Die)
Acronym to remember tasks of crisis assessment:

Identify precipitating factor
Identify client's response to crisis
Evaluate client strengths/coping
Determine resources
Identify goals/targets of intervention
Active and Directive Treatment
as a therapist. be very active and directive in developing activities that will help resolve the crisis.

u should give specific directions for action if the client's thinking/bx is chaotic

associated with crisis intervention
Crisis Treatment Techniques
Direct Influence
Person-Situation Reflection
Dynamic and Developmental Understanding
San Diego Police Department (SDPD)
engendering catharsis, providing reassurance, and sympathetic listening.

Used in the first stages of crisis intervention to lower the client's tension, anxiety and guilt.
Direct Influence
Encourage a specific course of action and access the client's support systems. This often includes contacting other agencies as well as including significant others in the intervention plan.

Technique used in crisis intervention
Person-Situation Reflection
Help the client understand and manage specific personal and situational aspects of the crisis. This can entail using exploring questions..

Technique used in crisis intervention
Dynamic and Developmental Understanding
Explore the client's role in the crisis. Later in the intervention. Takes place only when client is able to cognitively and emotionally confront the deeper issues.

Technique used in crisis intervention.
Brief Psychotherapies
Goal oriented, circumscribed, focused, and directed towards specific problems or symptoms. Specific goals and number of sessions are predetermined. Primary goal is removal of specific symptoms. Focuses on the genetic past. At times confused with crisis intervention but is different because it has roots in psychoanalytic psychotherapy and crisis intervention focuses on genetic present.

The basic techniques and goals include addressing specific symptoms, assess of past, and focus on unconscious issues.
Working Through
the process by which the client is helped to assimilate these insights into her personality.
Psychodynamic Theories
Classical Psychoanalysis
Ego Analyst therapeutic approach
Object Relations
Adler's Individual Psychology
Jung's Analytical Psychotherapy
"CE-JOAN- run"
Assumptions of Psychodynamic Theorists
1) They view human bx as motivated by unconscious processes
2) They regard early development as having a profound affect on adult functioning
3) They propose that there are general (universal) principals that explain personality development & behavior
4) They consider insight into unconscious processes to be a key component of psychotherapy.
A "general" and a "principle" walk into a bar talking about "personality development and behavior". They are trying to gain "insight" into why there is an "unconscious" "adult" following them.
Orphan Annie's a Pretty Little Girl
An acronym to remember Freud's Psychosexual Stages and the order.

Oral (0-18 months)
Anal (18 months-3 1/2 years)
Phallic (3 1/2-6 years)
Latency (6 years-puberty)
Genital (puberty to death)
Perceiving people as inherently selfish, impulsive, and irrational, Freud saw human beings in a negative context. He viewed behavior as a result of unconscious biological and instinctual needs. According to Freud, behavior is determined by sex drives, and adult action is influenced by psychosexual states. A finite quantity of libido is stored in the id.

Freudian psychoanalysis aims to enable the client to discover unconscious conflicts and, once revealed, respond to such conflicts rationally, thus controlling and abating neurotic behaviors. The personality disorder that is characterized by instability, irritability, impulsive anger, and external mood shifts is known as borderline. In the Freudian view, borderline and narcissistic disorders tend to be rooted in traumatic events occurring during the separation/individuation phase of development.
"Working through"
the repetition of interpretations and the overcoming of resistance so that clients can resolve neurotic patterns rooted in their pasts.
Defense Mechanisms
the means to deal with unacceptable feelings connected to events (physical or mental). 10 identified by Freud:

1. Compensation
2. Denial
3. Displacement
4. Projection
5. Rationalization
6. Reaction formation
7. Regression
8. Repression
9. Sublimination
10. Suppression
A defense mechanism. Defined as the substitution of a rewarding activity for an anxiety-producing one.
A defense mechanism. Defined as a refusal to acknowledge something that causes anxiety or distress.
A defense mechanism. Defined as transference of emotion felt toward an individual or object to another similar person or thing.
A defense mechanism. Defined as an unconscious assignment of unacceptable personal thoughts and behaviors to another.
A defense mechanism. Defined as an assignment of a socially-acceptable motive to behavior.
Reaction formation
A defense mechanism. Defined as behavior that is directly opposed to unconscious desires.
A defense mechanism. Defined as a retreat to an earlier stage of development.
A defense mechanism. Defined as the exclusion of desires and impulses from consciousness while they remain in the unconscious.
A defense mechanism. Defined as the channeling of socially-inappropriate impulses into socially-acceptable behaviors.
A defense mechanism. Defined as the conscious effort to force painful memories and events into the unconscious.
Personality Structure
1. Ego--grounded in reality, the ego mediates between the id and the super-ego.

2. Id--the primitive, selfish aspect which demands immediate gratification.

3. Super-ego--the internalization of parental interjections.
Motivational Instincts
1. Libido--sexual and ego drives found in the id.
2. Aggression--death instincts.

Motivated by the search to gain pleasure and avoid pain, individuals respond to their environments. These responses are most determined by early development. With internal conflict arising from desire to achieve pleasure and avoid pain, neurosis results when the super-ego imposes guilt on the ego to limit the impulses of the id. Neurosis demonstrates the result of childhood conflicts and the imbalance between the libido and the ego.
Oral Stage of Development
Lasting from birth to about 18 months of age, the oral stage of development is marked by libidinal gratification through the lips, mouth, and tongue. When maladaptive, produces personality traits such as passivity, dependence, envy, and manipulativeness. Can waver from one pole of emotion to the other...optimism to pessism, e.g.
Anal Stage of Development
In the anal phase, from about 18 months to 3 1/2 years of age, such gratification is accomplished through the retention and passing of feces. Maladaptive bx/fixation at this stage produces anal retentive bx such as stinginess, selfishness, obsessive-compulsive bx or anal expulsive bx such as cruelty, destructiveness, messiness.
Phallic Stage of Development
In the phallic phase, the genitals become primary to libidinal drives. Maladaptive bx/fixation can produce a phallic character that is sexually exploitative.
Latency Stage of Development
During the latency period, the id (representing the effects of libido and aggression), the ego (standing for self-identity), and the superego (or conscience), dominate. Adolescence is shaped by education and socialization with significant others.
Four Stages of Freudian Therapy
1) Opening
2) Development
3) Working through
4) Resolving.
Transference in Freudian Therapy/Psychoanalysis
Transference is central to psychoanalysis because it allows clients to relive their pasts in therapy, and this analysis is necessary to the process. In transfer the therapist encourages the client's feelings and expectations by engaging him in the therapy process and allowing the client to cast the therapist in a role suited to the client's needs. When the therapist's needs become entangled with those of the client, counter transference has occurred. If a therapist actively likes or dislikes a client, Freudians warn that counter transference is a likely cause.
Stressing the significance of racial and historical influences on personality, Carl Jung believed that individuals are moving toward wholeness and individuation. Because of this, Jungians believe that culture has a great influence on personal development and see therapy as a healing process. The Myers-Briggs test is based on Jung.
Associated with Jung. The psyche is comprised of the conscious ego, the personal unconscious and the non-personal unconscious
Jungian Archetypes
Feminine/masculine principles
The hero.
Julian Rotter
Associated with CBT/Social Learning Theory of Personality. Influenced by Adler.

Core concepts:
*ILC (internal locus of control)
*ELC (External Locus of control.
*Behavior Potential
*Functionally related behaviors
The personal unconscious
accessible elements that were once conscious
The non-personal unconscious
archetypes that influence behavior but are not available to consciousness).
Internal Locus of Control
Locus of control refers to the extent to which individuals believe that they can control events that affect them. Individuals with a high internal locus of control believe that events result primarily from their own behavior and actions.

For example, college students with a strong internal locus of control may believe that their grades were achieved through their own abilities and efforts,
External Locus of Control
Those with a high external locus of control believe that powerful others, fate, or chance primarily determine events.

For example, those with a strong external locus of control may believe that their grades are the result of good or bad luck, or to a professor who designs bad tests or grades capriciously; hence, they are less likely to expect that their own efforts will result in success and are therefore less likely to work hard for high grades.
Classical (Freudian)Psychoanalysis
Associated with:
*structural personality theory(id,ego,superego)
*Psychosexual stages of development
*Anxiety and the defense mechanisms
*views maladaptive bx as stemming from unconscious, unresolved conflict that occurred during childhood
Structural Theory (Freud)
views the personality as having three structures -the id, the ego and the superego.
*present at birth
*consists of the person's life and death instincts=source of all psychic energy
*operates on pleasure principle
*uses primary process thinking
Life Instincts (EROS)
Drive for self preservation and sexual gratification
Death Instincts(THANATOS)
The destructive, aggressive aspects of the personality. urge to restore to an earlier state.
Pleasure Principle
seeks immediate gratification of its instinctual drives and needs in order to avoid tension.
Reflex Actions
Actions that relieve tension in the id. e.g. blinking, sneezing
Primary Process Thinking
Thinking that involves forming a dream, hallucination, or other mental image of an object that would satisfy the needs of the id
*mediates the often conflicting demands of the id and reality, and once developed, the superego
* develops at age 6 mos.
* operates on reality principle
* uses secondary process thinking
*alerted by anxiety of threats
*when ego is unable to ward off threats, will resort to defense mechanisms
Reality Principle
Defers/postpones gratification of the id's instincts until an appropriate object is available in reality.
Secondary Process Thinking
Thinking characterized by realistic, rational thinking and planning.
*attempts to perm. block the id's socially unacceptable behaviors
*develops at age 4 &5
*represents an internalization of society's values and standards as conveyed thru reward/punishment by parent
*associated w/ ego ideal and conscience
distinguishes whether one's actions are right or wrong. It leads to feelings of integrity or remorse when one does or does not do things that go against his/her moral values,

It is also the attitude which informs one's moral judgment before performing any action.
Ego ideal
an image of the perfect self towards which the ego should aspire.
Anxiety and Freud
*essential component of Freud's personality theory.
*Anxiety is described as unpleasant feeling linked with excitement of the nervous system
*feels it alerts the ego of impending internal or external threats
Hierarchy of Defense Mechanisms
Begins with least adaptive DMs to the higher functioning "mature" DMs:

1) Psychotic DM
2) Immature DM
3) Neurotic DM
4) Mature DM
Psychotic Defense Mechanisms
Common in psychosis, dreams and childhood. The least adaptive(most malapadaptive defenses)

*delusional thinking
Immature Defense Mechanisms
Common in severe depression, personality disorders, and adolscence.

*passive-aggressive bx
*acting out
Neurotic Defense Mechanisms
Common in all people.

*reaction formation
Mature Defense Mechanisms
Common in "healthy" adults

Technique of Psychoanalytic Theory
Analysis (Psychoanalytic)
the primary technique of psychoanalytic theory. The main targets of analysis are the client's:
*free associations
Free Association
client says whatever comes to mind withoug censure. Freud believes this allows unconscious material to surface into consciousness.
Dream Analysis
The client relates a dream's manifest content (what happens in a dream) and then free associates to the elements of the dream to identify its latent (unconscious) content.

Helps uncover unconscious conflicts and motives.
As client begins to become aware of previously unconscious material, they may resist further confrontation with that material in order to avoid anxiety
The therapist's neutrality allows the client to project onto the therapist feelings she originally had for a parent or other significant person in the past.

This can involve neg. or pos. feelings and can take many forms. e.g., sexual advances, extreme dependency, competitiveness.

*viewed as a form of resistance
*associated with psychoanalysis
Transference Neurosis
Most intense level of client transference. The client actually confuses the therapist with another person.
describes a therapist's inappropriate emotional reactions to a client.

Freud felt it was detrimental to psychoanalysis and believed a therapist must always be aware of any feelings of CT.
Process of Analysis
The way in which the analysis' targets are analyzed. Uses a combo of:

*working through
Psychic Determinism
Belief that all behaviors are meaningful and serve some psychological function. Associated with psychoanalysis and Freud.
restating the cleint's remarks and feelings in clearer terms
making statements that help the client see her behavior in a new way.

e.g. "I wonder if the reason you missed your last appt has anything to do with what we were talking about during the last session?"
explicitly connects current bx to current processes.

e.g. "Is it possible that your workaholism is a way to
make sure you dont have to face being rejected by men?"
*less likely to elicit anxiety and resistance
emotional release resulting from the recall of unconscious material. Paves the way for insight
Freud's Developmental Theory
proposes that an ind. personality is formed during five psychosexual stages of development. During each stage, the id's libido (sexual energy) is centered in a different part of the body.
Sexual Energy

associated with Freud's psychosexual stages and ID. The Id has a libido
the most basic defense mechanism and is the goal of all defense mechanisms and the basis of all neuroses.
Ego Analysts
Ana Freud
Heinz Hartmann
Ernest Kris
Erik Erikson
David Rapaport

Ego Analysts view on personality development/theory
view personality development as continuing throughout the lifespan rather than considering personality to be relatively fixed through childhood.

*emphasizes impact of the ego on personality development
*distinguishes between 2 ego functions: ego defensive functions and ego autonomous functions
Ego Defensive Functions
resolves conflicts. Similar to ego functions of Freud.
Ego Autonomous Functions
adpative functions such as speech, learning, memory, and perception.

represents the "conflict free eho sphere".
Ego analysts view of maladaptive behavior
Believe healthy behavior is under the conscious control of the ego. Pathology ensues when ego loses its autonomy from the id or reality.
Ego Analysts Therapy Goals/Techniques
Place greater emphasis on present. Rely less on transference. Work on increasing client's awareness of and conscious control over the events underlying current problems.
Ego Analysts vs. Classical Psychoanalysis
*EA focus more on than present rather than the past.
*EA focus on neurotic and non-neurotic (adaptive) aspects of client's personality
*EA relies less on transference, more on providing the client opportunities for "reparenting"
Which psychodynamic theory has the most direct influence on social work practice?
Ego Analysts/Ego Psychology. It is one of the major theories underlying the psychosocial approach
Object Relations Theorists
Margaret Mahler
Ronald Fairbairn
Melanie Klein
Otto Kernberg
Keinz Kohut

Oh no! (M)y (F)riend is in the (K)(K)(K)!
Object Introject
A mental representation of a person
*associated with Object Relations.
A mental image of self.
*associated with Object Relations.
A mental image of another person (beginning with the mother)
*associated with Object Relations.
Margeret Mahler
Key figure in the development of the Object Relations approach. She emphasized the processes by which an infant assumes her own physical and psychological identity.
Mahler's Stages of Development (Object Relations Approach)
1) Normal Autism
2) Symbiotic Phase
3) Differentiation/Separation-Individuation
4) Integration/Rapprochement
Normal Autism
*Stage 1 - Mahler's stages of dev.
*occurs in the first month of life
*infant is oblivious to the external environment
*infant incapable of interaction w/ others, relying instead of internal experiences to satisfy her needs.
Symbiotic Phase
*Stage 2 - Mahler's stages of dev.
*Occurs if the infants needs were met in the normal austism phase.
*Occurs from the 2nd to 8th mo. of life
*infant is fused with mother and doesn't differentiate between "I" and "not I".
*Confusion of self and other
*over time, comes to see diff. between pleasure/pain of her experiences with others
*Stage 3 - Mahler's stages of dev. (OR)
* occurs at about 7 mos.
*self and object becomes separated
*child recognizes differences between herself and others
*Stage 4- Mahler's stages of dev. (OR)
*occurs at about 2 years of age
*By about age 3, child develops permanent sense of self and object (object constancy) and is able to perceive others as both separate and related.
*Becomes prototype for mature relationships
Object Constancy
the child develops a permanent sense of self and object
Psychological Birth
Occurs during the first three years of life. During these years the core of the child’s personality is formed.

Related to Object Relations
Object Relations and maladaptive behavior
*When a child fails to develop appropriate object introjects it is maladaptive.
*When an ind. experiences deficient early caretaking, it may "split" their representations of other people and themselves which can produce immature, unconstrained aggressive feelings.
*Borderline/narcissictic diagnosis usually associated with OR and deficient object relationships in the client's childhood/disturbances during the differentiation phase.
Thinking purely in extremes, e.g. good versus bad, powerful versus defenseless and so on. he separation of the things the child loves (good, gratifying objects) and the things the child hates (bad, frustrating objects). Klein refers to these things as the good breast and the bad breast.

Associated with OR and Klein
Object Relations Techniques
*provide client w/ support, acceptance
*Mirroring (clnt can see own positive reflection)
*Parallel process-special type of mirroring that occurs when dynamics from client's life are repeated in therapeutic relationship
Harry Stack Sullivan
Karen Horney
Erich Fromm

"Sullivan is a Horney Fromm"

Neo-Freudians emphasize the role of interpersonal and social influences.
Horney's focus/Neo-Freudian
*focused on interpersonal relationships
*anxiety is basis of neurosis
*anxiety direct result of child's interpersonal relationshops
*parental bxs added to child's anxiety (indifference, overprotectiveness, rejection)
*to relieve anxiety, child will move toward or away from people
Sullivan's focus/Neo-Freudian
*focused on the importance of relationships throughout the lifespan
*recognized the role of cognitive factors in personality dev.
*distinguished 3 modes of cognitive experience: prototaxic, parataxic, syntaxic
*feels maladaptive bx is attributable to parataxic distortions
Fromm's focus/Neo-Freudian
focused on the impact of the structure and dynamics of society on personality development
Parataxic Distortions
misperceptions that involve responding to a person as though he or she were a significant person from the past and are due to arrest or persistence in the parataxic mode.
Prototaxic Mode
a discrete series of momentary states. characterizes the first few months of life.

*associated with neo-freudian, Sullivan
Parataxic Mode
*follow the prototaxic mode
*entails seeing causal connections between events that occur at about the same time but are actually unrelated.

*associated with neo-freudian, Sullivan
Syntaxic Mode
*emerges at end of 1st yr of life
*characterized by logical, sequential, internally-consistent, and modifiable thinking.

*associated with neo-freudian, Sullivan
Sullivan - Neo Fruedian
*of the neo freudians, had the greatest impact on therapy
*described the therapist as both a participant/observer and expert in interpersonal relationships
*founder of the interpersonal school of psychotherapy
*interpersonal relationships!
Adler's Individual Psychology
*originally followed Freud, but disagreed with some assumptions
*adopted a telelogical approach
*each person has a set of motives, traits, values, interest, etc.
*any individual can be fully understood only by seeing with her eyes and listening with her ears.
*idiographic approach to study of personality
regards behavior as being largely motivated by a person's future goals rather than determined by past events

*associated with Adler
Idiographic approach
intensive investigation (case study) of an individual in order to understand her personality

*associated with Adler
Nomothetic approach
studying a variety of people to derive general principles about personality and behavior
Key Concepts in Adler's personality theory
*Inferiority Feelings
*Striving for Superiority
*Style of Life
*Social Interest
Inferiority Feelings
develop during childhood as a result of real and perceived biological, psychological, or social weaknesses.
Striving for Superiority
inherent tendency toward "perfect completion"

*associated with Adler
Style of Life
specific ways an individual chooses to compensate for inferiority and to achieve superiority. Can be healthy or unhealthy "mistaken"

*provides a unity of personality so that all parts or aspects of personality are in the service of the whole person
*SOL affected by early experiences, especially family exp
*associated with Adler
Healthy style of life
a lifestyle marked by goals that reflect optimism, confidence and entail contributing to the welfare of others

*associated with Alder
Mistaken Style of life
characterized by goals reflecting self-centeredness, competitiveness, and striving for personal power.

*associated with Alder
Adler's Individual Psychology and maladaptive behavior
mental disorders represent a mistaken style of life which is characterized by attempts to compensate for feelings of inferiority, a preoccupation with achieving personal power, and a lack of social interest.
Adler's Techniques
1) Paradoxical intention
2) Giving encouragement and advice
3) Lifestyle Investigation
4) Interpretation of resistance/transference
5) Study of Dreams
6) Acting "as if"

(P)retty (G)irl named LISA
Lifestyle Investigation
Used to identify the nature of a client's style of life. Obtain info about the client's family constellation, fictional (hidden) goals, "basic mistakes" (distorted beliefs), and earliest memories.
*lifestyle of person fixed by age 6?
*associated with Adler
Study of Dreams
Adlerian's believe that dreams are a source of info about a client's lifestyle and progress in therapy. Dreams are seen as rehearsals for future courses of action.

*associated with Adler
Paradoxical Intention
makes use of resistance by asking client to pay closer attention to or exaggerate undesirable thoughts or behaviors.
Systematic Training for Effective Parenting and Systematic Training for Effective Teaching

*programs based on Adler's approach
* Assume that all behavior is goal directed and purposeful
*misbehavior is children has one of four goals: attention, power, revenge, or to display deficiency
Jung Analytical Psychotherapy
views personality as the consequence of both conscious and unconscious factors

*personal unconscious
*collective unconsious
*two attitudes: extraversion and introversion
*four basic psych. functions: thinking, feeling, sensing and intuiting
Distress Tolerance Skills
onstitute a natural development from mindfulness skills. They have to do with the ability to accept, in a non-evaluative and nonjudgmental fashion, both oneself and the current situation. Although the stance advocated here is a nonjudgmental one, this does not mean that it is one of approval.

Acceptance without pushing for change
Potential Reflection Errors
1) Depth Error
2) Timing Error
3) Stereotyping Error
4) Language Error
Therapeutic Alliance
Most closely linked to successful outcome of therapy. Developing an alliance early in session is associated with a successful outcome.
Universal Goals of Treatment
*Decrease Presenting Problem
*Increase Coping Skills
*Increase Social Support & Community Support
Bipolar Disorder
(Iceberg analogy to remember 4 episodes of BD)
Mania - BP1 (Severe) - think of the tip of the iceburg.

Hypomania - BP2 (+2)(Cyclothymia) - think of treading just above the water line

Minor Depression (Dysthymia) (+2) - person is just below the surface, chronic, long term

Major Depressive episode - BP2- this person immediately and just recently sunk deep in the depression.
Psychotic Disorders (timelines for symptoms to dx)
Brief Psychotic (1 day-1 mo)
Schizo somatoform (1mo-6mos)
Schizophrena - 6mos and on....
Bipolar I
symptoms of depression and then mania. One or more manic or mixed episodes, usually, but not always, accompanied by a hx of major depressive episodes.
e.g. client has been suffering"on and off for about a year w/ depression and suddenly develops symptoms of mania"
Bipolar II
characterized by at least one major depressive episode and one hypomanic (not manic) episode.
Close ended questions
those that limit how a client can respond. Good when u need specific info or when a client is so overwhelmed that a high level of structure is needed.

e.g. how long have u been married?
Open ended questions
questions that give clients the opportunity to say whatever they think is important.

e.g. "Tell me about your husband?"
Carl Rogers
*believes if the therapist provides the "right" environment, the client will develop congruence between self and experience and be carried toward self-actualization.
*to achieve it, therapist must be genuine
Lack of genuineness
incongruence between words and behaviors. a lack of genuineness will undermine a client's trust.
*associated with Rogers
The Right Environment
*associated with Rogers
*consists of three facilitative conditions: (1) accurate empathic understanding (2) unconditional positive regard (3) genuineness (congruence)

refers to the act of making gestures. one of best forms of non verbal communication
Subtypes of Schizophrenia
"Parents Don't Really Understand Children"

Antisocial Personality Disorder
Cannot be diagnosed to someone under the age of 18. An adolescent must be given conduct dx diagnoses
What theorist is considered client centered?
Carl Rogers - the right environment
Reality Therapy
confrontive form of therapy, e.g. RET. models responsible bx for clients. views transference as detrimental to therapy process
Humanistic theorists
*emphasize current bxs rather than past conflicts stemming from past experiences
*blocked or distorted personal growth contributes to maladaptive bx.
*emphasis on uniqueness/wholeness of the indiv
Severe mental retardation
*IQs 20-25 to 35-40 are associated with a severe level of retardation.

*has basic self care skills and ability to perform simple tasks in a supervised setting
*not able to work, live w/o supervision
Moderate mental retardation
*IQs 35-40 to 50-55 are associated with moderate level of retardation.
*person has basic self care skills and can work in an unskilled/semiskilled job in a protected setting
*Academic skills up to 2nd grade level
*Can live in a supervised community setting
Mild mental retardation
*IQs 50-55 to 70 are associated with mild retardation.

*academic skills up to 6th grade level
*ability to work a unskilled/semiskilled job.
Erickson's 8 Stages of Man
(T)ina (A)sked the 4 (Is) to got to (I)celand...

Trust v.s Mistrust (0-1)
Autonomy vs. Shame and Doubt (1-2)
Initiative vs. Guilt (2-6)
Industry vs. Inferiority (6-12)
Identity vs. role confusion (13-18)
Intimacy vs. Self-absorbtion (19-39)
Generativity vs. stagnation (40-65)
Integrity vs. Despair (65-death)

*coincides w/ freud's psychosexual stages
Negative Feedback
maintains homeostasis in systems theory
The regulation of a system similar to setting a thermostat on a furnace.
Positive feedback
upsets homestasis and permits a more functional balance to emerge
Tendency for any system to react toward the restoration of the status quo in the event of any change.
Classical Conditioning
reflexive behaviors that are automatically elicted by stimuli. Occurs when an Unconditioned stimulus (US) is paired with a Conditioned Stimulus (CS) until the CS comes to elicit the same response that is naturally elicted by the US. The response elicted by classical conditioning is called the CS
Conditioned response
elicited by classical conditioning
application of operant conditioning. reinforces target bx until the bx is learned
Operant Conditioning
concerned with voluntary behaviors that are under the control of environmental consequences.
Respondent behaviors
bxs automatically stimulated by certain stimuli
operant behaviors
bxs that are voluntarily emitted as a result of how they operate on the environment

negative reinforcement
application of operant conditioning. performance of a bx increases because it is followed by termination (removal) of an unpleasant stimulus.
Kohlberg's Three levels of moral development
There are 3 levels and each are divided into 2 stages

1) preconventional morality
stage 1: punishment & obedience orientation
stage 2: instrumental hedonistic orientation
2) conventional morality
stage 3: good bod-good girl/social relations orientation
stage 4: authority and social order-maintaining orientation
3) postconventional morality
stage 5: social contract & ind. rights orientation
stage 6: universal ethical principles orientation
Preconventional Morality
moral reasoning is extremely governed. Behaviors that are punished are thought of as bad and behaviors that are rewarded are thought of us good.

Encompasses stage 1 (punishment & obedience orientation) and stage 2 (instrumental hedonistic orientation)
Punishment and Obedience Orientation
Stage 1 in preconventional morality. In this stage, children focus on avoiding punishment when making moral decisions.
Instrumental Hedonistic Orientation
Stage 2 in proconventional morality.
That which satisfies their own needs is moral.
Conventional Morality
Maintenance of the social order is the determining factor when making moral judgements.
Glasgow Coma Scale
measures motor and verbal response to stimuli. Used as a tool on a MSE (mental status exam)
respondeat superior doctrine
"vicarious liability" defines legal liability of supervisors for the job related actions of their supervisees. Both held accountable.
provisional dx
diagnosis when there is insufficient information to make a firm diagnosis but sufficient info to make a tentative "working" diagnosis. Provisional dx should only be made if ur sure that the full criteria for the suspected disorder will be met when u get the missing info.
NOS (Not Otherwise Specified)
a diagnosis made when:

*uncertain about the etiology of a client's mental disorder. e.g. whether it's primarily due to a medical condition or substance abuse.

*in a situation u were unable to collect all the info, but symptoms clearly fit a particular diagnostic class.

*when symptoms are below diagnostic threshold for a specific disorder & there is atypical or mixed presentation.
Feminists Views on therapy
Diagnosis is usually frowned upon. avoid labels, avoid revictimization, They like self-disclosure.
Cuento Therapy
The word "cuento" means folk tale in spanish. CT involves reading cuentos and then leading a group discussion about them.
Product Data
emphasizes "output variables" or the outcome of program services. Also called summative data.
Input variables
In program evaluation, they are factors related to the agency's structure and resources.
Throughput variables
factors such as what happens to the client as a result of his or her contact with the program. Also known as process variables.
Process Data
also called formative data. used to evaluate the processes of a program

e.g. info from questionnaires, interviews...
Stress Inoculation
A CB technique that consists of three phases:

1) education - help client understand his responses in stressful times
2)Skill acquisition - help client acquire & rehearse coping skills

3) application - have client apply the skills
MDD vs. Dysthymia
In MDD, a depressed mood is present for most of the day, nearly everyday, for a period of at least 2 weeks. At least one episode of depression diff from normal bx

In Dysthymic disorder, the symptoms are present for more days then not over the course of at least 2 years (1 yr in adol/children). chronic and less severe depressive symptoms than MDD that have been present for many years.
Defense Mechanisms associated with OCD
Reaction formation, isolation of effect, and undoing
Behavior Theory
*Places less emphasis on the client-therapist relationship than other models.
*view maladaptive bx as resulting from previous learning that can be unlearned.
*maintenance and generalization of change
*antecedents, response, consequence
Acute stress disorder vs. PTSD
ASD - symptoms start within 4 weeks of the trauma & last for at least 2 days but no longer than a month.

If symptoms persist beyond 4 weeks (1 month) then it is PTSD.

"a few weeks" of symptoms would be ASD
Bowlby vs. Piaget
re: separation
Cognitive Dissonance
when ind. have two incompatible cognitions, they experience dissonance, which they attempt to relieve by changing one of their cognitions, or adding dissonance reducing cognitions.
Arab client bx
*more likely attribute his illness to an external cause, e.g., supernatural elements.
*dont want to divulge aspects of personal lives
*will complain about physical symptoms moreso than mental health issues
*wont want to discuss mental illness for fear of shaming self and family.
Time out
associated with social learning theory. a behavior technique taught as an alternative to physical discipline.
Schizoid Personality Disorder
*pervasive pattern of detachment from social relationships and a restricted range of emotional expression in interpersonal settings.
Schizotypal Personality Disorder
peculiarities in behavior, thinking, communication and appearance.

has deficits in interpersonal relationships as well as cognitive and perceptual distortions
Fugue/Disassociative Fugue
disassociative disorder involving sudden, unexpected travel away from home w/ an inability to recall some or all of one's past.
Ego-Syntonic Traits
feelings, behaviors, values, ideas. They are traits consistent with the ego. they feel real and acceptable to the consciousness.
Marlatt's Relapse Prevention Model
A CB theoretical model that emphasizes the role of cognitions (especially attributions) and the situational factors that precede relapse.
*abstinence violation effect
*successful recovery from relapse is associated with blaming external factors rather than internal
Goals of Tx of Schizophrenia in stable phase
*sustain system remission/control
*maintain or improve his level of functioning & quality of life
*ensure that any relapses, symptoms, medication side-effects,etc are properly treated
*social skills training has been proven effective during stable phase
Phases of Schizophrenia
There are three phases:

1) Prodromal (beginning) - can last weeks or months.
2) Active (acute illness episode)
3) Residual
Prodromal Phase
*beginning phase of schizophrenia
*can be detected up to 30 months b4 onset of symptoms
*symptoms start to appear
*withdraw, lose interest, lose concentration,
Active Phase
*usually takes place after the prodomal phase
*can start suddenly
*people start to experience delusions, hallucinations, distortions
Positive symptoms of Schizophrenia
symptoms that most individuals do not normally experience. They include delusions, auditory hallucinations, and thought disorder, and are typically regarded as manifestations of psychosis.
Negative symptoms of Schizophrenia
are so-named because they are considered to be the loss or absence of normal traits or abilities, and include features such as flat or blunted affect and emotion, poverty of speech (alogia), inability to experience pleasure (anhedonia), and lack of motivation (avolition).
Stable phase of schizophrenia
the period during which psychotic symptoms are less severe and may even be absent. the overall goal of the stable phase is "to optimize functioning and minimize the risk and consequences of relapse." This goal includes monitoring the patient's progress to ensure that he is maintaining or improving his level of functioning and quality of life; treating relapses or exacerbations of symptoms to return the patient to optimal functioning; and monitoring for adverse effects, including tardive dyskinesia, at least every 6 months.

The APA Guideline recommends at least 1 year of maintenance treatment with antipsychotic medications to lower the risk of relapse.
the feeling that one is an outside observer of one's mental processes or body
disruption in the usually integrated functions of consciousness, memory, identity, or perception of the environment.
Traditional (Typical) Antipsychotics
e.g. Haldol
*more effective for treating positive symptoms (hallucinations, delusions, etc.) of schizophrenia
*induced a neuroleptic state
Newer "atypical" antipsychotics
e.g. clozapine, risperidone
*alleviates both positive and negative symptoms of schizophrenia
Neuroleptic State
Characterized by:

1)psychomotor slowing
2) emotional quieting
3) affective indifference
Tardive dyskinesia
involuntary, repetitive movements) manifesting as a side effect of long-term or high-dose use of antipsychotics.
*have difficulty not moving
Types of typical antipsychotics
1) Chlorpromazine (Largactil, Thorazine)
2) Fluphenazine (Prolixin)
3) Haloperidol (Haldol, Serenace)
4) Molindone
5) Thiothixene (Navane)
6) Thioridazine (Mellaril)
7) Trifluoperazine (Stelazine)
8) Loxapine (Loxapac, Loxitane)
9) Perphenazine
10) Prochlorperazine (Compazine, Buccastem, Stemetil)
11) Pimozide (Orap)
12) Zuclopenthixol (Clopixol)
Types of atypical antipsychotics
1) Amisulpride (Solian)
2) Aripiprazole (Abilify)
3) Asenapine (Saphris)
4) Clozapine (Clozaril, Leponex, Fazaclo, Froidir, Denzapine, Zaponex, Klozapol, Clopine)
5) Iloperidone (Fanapt, Fanapta, Zomaril)
6) Melperone (Buronil, Burnil, Eunerpan)
7) Olanzapine (Zyprexa, Zyprexa Zydis, Zalasta, Zolafren, Olzapin, Rexapin, Symbyax)
8) Paliperidone (Invega)
9) Perospirone (Lullan)
10) Quetiapine (Seroquel, Ketipinor)
11) Risperidone (Risperdal, Ridal, Sizodon, Riscalin, Rispolept, Belivon, Rispen)
12) Sertindole (Serdolect, Serlect)
13) Sulpiride (Meresa, Sulpirid, Bosnyl, Dogmatil, Eglonyl, Sulpiryd)
14) Ziprasidone (Geodon, Zeldox)
The Conners Rating Scale-Revised
identifies hyperactivity and other behavioral problems in children age 3 to 17. Evaluates problem bx by obtaining reports from teachers and parents. For adolescents, the instrument also includes a self-report scale.
The Bender-Gestalt II
brief measure of visual-motor integration and a screening tool for neuropsychological impairment for inds. 3 and older.
The Standford Binet
an intelligence test
The Vineland Adaptive Behavior Scales, second edition (Vineland II)
designed to evaluate personal and social skills of individuals with mental retardation, autism spectrum disorders, ADHD, brain injury, or dementia. Also assists in the development of educational and tx plans.

*used for individuals from birth to age 90.
graphic representation of patterns showing which members of the group are drawn to one another, which ones do not interact, and which ones have a one-way attraction, mutual attraction, or aversion to each other.
*associated w/ a group and can meaure whether alliances are growth-oriented
Substance abuse diagnosis
1) early full remission

2) early partial remission

3) sustained full remission

4) sustained partial remission

*remission = absence of disease activity
"Early" remission
More than 1month but less than 12 months of remission in re: to substance abuse

1mo > 12 mos
"Sustained" remission
12 months or more of remission.

12 +
"Full" Remission
person no longer meets criteria for dx for sub. ab. or sub. dep.
"Partial" remission
one or more of the diagnostic criteria for substance dep. are still met but the full criteria are no longer met.
Measuring variables
there are 4 systems/measurement scales used:

1) nominal
2) ordinal
3) interval
4) ratio

each scale provides a measurement of diff info and permits diff mathematical operations to be formed.
= observations
Nominal Scale
*simplest scale
*divides observations into UNORDERED categories
*only compares (counts) the observations, any #s provided are just labels for the items we are comparing/counting.
Ordinal Scale
*divides observations into categories
*but puts them in ORDER
*does not allow u to tell difference between scores
Interval Scale
*performs math equations (add & subtract.) with the data
Ratio Scale
*most mathematically sophisticated
*absolute zero means complete absent of characteristic being measured.
*can multiply and divide ratio scores
*determines how much more or less of a characteristic one subject has compared to another.
Anorexia Nervosa, binge eating/purging type
when the person has regualrly engaged in episodes of binge eating and/or purging during the current anoretic episode.
Proloxin (Fluphenazine )
very potent antipsychotic. Seizures are most dangerous side effect.
Neuroleptic malignant syndrome (NMS)
a life-threatening neurological disorder most often caused by an adverse reaction to neuroleptic or antipsychotic drugs. It generally presents with muscle rigidity, fever, autonomic instability and cognitive changes such as delirium, and is associated with elevated creatine phosphokinase (CPK). Treatment is generally supportive.

To avoid a fatal outcome, medication must be stopped immediately when symptoms are noticed.
Gorksi relapse prevention model
based on a sequence of warning signs that start long before a recovering alcoholic takes his 1st drink. focus on what leads to relapse.
Steps to plan a social program

1) Define and state the target (P)roblem
2) formulate (P)olicies and goals
3) analyze (R)esources
4)select (O)bjectives
5) (D)efine and (D)esignate how the program will be carried out
6) (E)valuate the program
Program Evaluation
Process used to determine whether a particular change effort was worthwhile.

Evaluations are classified as:
1) Formative (monitoring)
2) Summative (impact)

In social work, the primary focus is on formative.
Formative Evaluations
*performed during the implementation stage of a program and are designed to improve the change effort. They seek to describe what the program does and what is happening during the service delivery process.

e.g. is the program serving as many clients as intended? Is the program achieving its goals?
Summative Evaluations
measure the consequences of services that were provided. They evaluate existing programs and compare them to other existing programs.
What is the most important factor to consider when selecting compatible group members to be in a group?
Intelligence level, according to most research.

Group members should be general in terms of type of problem/conflict

age matters more for children (shouldnt generally be more than 2 yrs apart), adults, it matters less
Shows up around age 3-4 and most speech therapists feel that stuttering before age three is normal childhood dysfluency.

When a parent is concerned about stuttering around that time period, provide parent education.
eligibilility is determined by reaching age 65 and not on a person's need.
Typical bx in sexually abuse child
*says abused
*fear/mistrust of adults
*psychosomatic illness
*night terrors, fear states
*sudden unexplained change in bx
*withdrawal into fantasy world
*antisocial "delinquent" bx
*social isolation, poor peer relshps.
*overly sophisticated know. of sex
*sub. abuse
*suicide attempts
Macro-change effort
1st step: Assessment and planning - identify the problem(s)
2nd step: Prioritize the problems
3rd step: translate problems into needs & which ones to address
4th step: evaluate factors that will effect change in a + or - way
5th step: establish primary goals
6th step: identify resources
7th step: costs and benefits
8th step: evaluate potential success of change effort
Hospice Care
cares for people with terminal illness as the end stage with curative tx no longer and option and death is near.

pts admitted must have a family member or friend willing to be designated as a primary caregiver. gives respite and convalescent care to caregivers too.
aka Clozaril. Pts on it must have a blood test every one or two weeks because of a serious side effect of agranulocytosis (a serious blood disorder).

*inconvenience and cost has made it difficult for pts but continues to be drug of choice for pts whose symptoms have been resistant to conventional (typical) antipsychotics
MBO - Management by Objective
*formulation of specific objectives for depts/individuals within an agency
*emphasizes establishing objectives and linking them to measurable outcomes
*participation of all parts (people) is needed in forming of objectives, not just managers.
Concerns of MBO (Management by Objective)
*inputs - goals, objectives, resources, related operations
*activities - action toward achieving goals and objectives)
*outputs - results (were the goals achieved?)
modified version of MBO. Stands for Management Objectives and Results. Focuses on key results areas. Evaluates job output and personal development
Living Will
enables pts to document in advance the kind of care they want to receive or not receive at the end stage of their lives in the event that they are no longer able to communicate their preferences at that time.
*associated with durable powers of attorney (a spokesperson) and self-determination (1991 self determination act that says pts have a right to advance directive
Benadryl in kids
will keep them awake at night
What reduces obsessions in individuals with obsessive compulsive disorder?
antidepressants (SSRI), tx of choice for OCD along with exposure to response prevention. drugs are rarely used alone cuz associated with high risk for relapse once drug is discontinued.
What is drug of choice to treat bipolar disorder?
Lithium. it reduces manic symptoms and represses mood swings,

Carbemezapine is used for pts with bipolar II disorder or when lithium was ineffective or pt doesnt like lithium
Benzos (Benzodiazepines)
*an anxiolytic, e.g. xanax, valium, ativan
*prescribed primarily to relieve anxiety but are also used to treat sleep disturbances, seizures, cerebral palsy, and other disorders involving muscle spasms and alcohol withdrawal.
*time-frame to achieve a steady state is 1-20 days
Holmes and Rahe's Scale
*measures the severity of psychosocial stressors
*aka life events scale/social readjustment scale
*highest stressor, death of a spouse/child, then divorce, then marital separation, imprisonment, personal injury...
*includes over 40 life changes.
Psychosocial model
*based primarily on ego psychology
*believe change is produced by insight
*emphasis is on importance of therapeutic relationship
*ego functioning is improved through working with client and his environment
The Ecological Perspective
transactional view of the relationship between a person and their environment.

* a person and his environment are believed to engage in circular exchanges in which each reciprocally effects the other over time
*believes both problems and needs result from these exchanges.
normal development of speech in a child
First words are spoken between 10 and 16 months of age
E-therapists help treat areas of concern not related to a mental disorder. Would not treat MDD, Bipolar,etc...
*dont diagnose
Nonlinguistic Programming
how people perceive and understand the world
*sensory representations for self-expression and learning

"i see", "I hear you"
relating to body sensations.

all kinds of feelings including tactile, visceral and emotional
What are the three steps in structural family therapy?
1st) Joining
2nd) Evaluating/Diagnosing
3rd) Restructuring

(J)oin me, (E)at and (R)elax
What are methods used to join a family in structural family therapy?
Tracking and Mimesis
Adopting the family's affective and behavioral style
Identifying and using the family's values, life themes
What are the techniques used in restructuring in structural family therapy?
Reframing and Relabeling
Why is a family map used in structural family therapy?
to facilitate the diagnosis of the family
Technique used in structural family therapy to facilitate diagnosis and restructuring in the family.
What does Ego Psychology emphasize?
focuses on adult development, tasks that people must master during each developmental stage and dealing with social reality.
*social environment helps or prevents mastery of dev. stages
*more focused on present than past
*does not deal with the unconscious
Ego Autonomous Functions
*associated with ego psychology
*memory, language, judgment, decision making,& other reality-oriented functions.
Kubler Ross' Theory of Death and Dying
Stages pass through as they move toward death
1) Denial
2) Anger
3) Bargaining
4) Depression
5) Acceptance

(D)anny (A)sked (B)arbara to (D)ance (A)t the party
Premack Principle
A low probability bx is likely to reinforce high probability bx.

e.g. is you eat your vegetables, you will get ice cream
HIV can cause...
What are the 6 types of social power according to social psychologists?
*associated with French and Raven

1) Coercive
2) Expert
3) Reward
4) Referent
5) Legitimate
6) Informational

(C)andy (E)njoys (R)ich (R)occo because he's (Loaded) and (I)talian
Folie a Deux
*translated as a madness shared by 2
Shared Psychotic Disorder...develops in a person as a result of a close relationship with someone who already has an established delusion
Persecutory Delusion
indiv. believes they are being followed, tricked or spied on
Referential Delusion
ind. believes that passages from books, newspapers, or other messages as specifically directed at him or her
Dissociative Identity Disorder (DID)
The existence in one ind. of two or more distinct identities or personality states known as alter egos

*used to be called multiple personality disorder in DSM II
Outcome model
*associated with program evaluation
*evaluates expected results and may include studying a client's perceptions of a program
Systems Analysis Model
studies the impact of other organizations and the environment on a program and investigates variables that may be related to program changes
Sustainment Interventions
e.g. support and reassurance
*effective in reducing anxiety/guilt and increasing self esteem and instilling hope. Makes client's mental/emotional energies more available for problem-solving
Dual Diagnosis
means client has more than one diagnosis on Axis 1
What is considered the most dangerous drug in overdose?
Benzos..e.g. Xanax, Valium
Ecstasy, a hallucinogenic. may induce dreamy state, and delusions, hallucinations
Dialectical Behavioral Therapy (DBT)
Has 4 priorities of behavioral change:

1) decrease suicidal bxs/ideation
2) decrease bxs that interfere w/ tx
3) - bx that interferes w/ quality of life
4) increase coping and relational skills
Dialectical Behavioral Therapy (DBT) Group of skills
1) Distress Tolerance Skills
2) Core Mindfulness skills
3) Interpersonal Effectiveness skills
4) Emotion modulation (regulation) skills
Distress Tolerance Skills
perceiving environment without having to change it
Core Mindfulness skills
teach client to attend to the moment w/o judgment or impulsiviy
Interpersonal Effectiveness Skills
client will learn effective way of achieving her goals with other people
Emotion Modulation Skills
help client change distressing emotional states and increase positive emotional states
What is most associated with a positive outcome in therapy?
Therapeutic Alliance
self report inventory for the assessment of personality. Provides info about a client's characteristic traits and bxs. One of the most widely used.
Aversion Therapy
Used for pedophiles but not usually incest cases.
Child Abuse tx/intervention
most believe the perps can be rehabilitated. Goal is to strengthen and preserve family system ind., marital, and group therapy.
Side Effects of SSRIs (antidepressants)
*Gastrointestinal Probs
*frequent urination
*headaches, dizziness, tremors
*sexual Dysfunction

e.g. Prozac, Zoloft, Paxil
ind. employed by an agency to investigate illegal/unethical activities
Gestalt Pattern
Organized according to relationship between figure and ground.

Figure = what stands out in a person's experience & is regulated by his or her needs

Ground = entire context of phenomenologically relevant variables from which a figure emerges
Zero Based Budgeting
an agency starts from scratch or with a clean slate at the beginning of each yr

(encourages close scrutiny)
precipitating event. significant changes in a person's life situation.
Parasympathic Nervous System
associated with the stimualtion of smooth muscles;

*asthma, causes bronchioles to narrow
Autonomic Nervous System
regulates the activities of the visceral muscles and glands
*associated with involuntary movements
*consists of parasympathic and sympathic branches
Sympathic Nervous System
associated with the inhibition of smooth muscles

*it would cause relaxation of the bronchioles
Central Nervous System
consists primarily of the brain and spinal cord
Peripheral Nervous System
includes autonomic and somatic nervous systems
Somatic Nervous System
associated with activities that are considered voluntary
In Vivo Exposure with Response Prevention
Also known as Flooding
*forces the client to stay in the feared situation and preventing the from carrying out the rituals
*considered most effective tx for panic attacks and agoraphobia that ends by offering the client a form of ongoing support (e.g. group therapy)
Panic Control Treatments (PCT)
*the pt is exposed to bodily sensations associated with panic attacks, e.g. pt exercises in session to increase his heartrate
*brief treatments directly targeting panic symptoms used with pts continuing to experience panic/anxiety after behavioral tx.
Transference in psychoanalysis
*a form of resistance
*it is an unwillingness to relinquish the fantasy that one's infantile wishes will be gratified
Peer Group Supervision
group of professionals in the same agency meet regularly to review cases and treatment approaches without a leader, share expertise, and take responsibility for their own and eachother's professional development.
An individual and other living systems
Ecosystem Theory
The study of individuals and other living systems and the transactions between them
*influences bx throughout entire lifespan
How are beginning social workers most commonly supervised?
Using a teaching supervision. observing a session in progress
6 Levels of Advocacy
(A)(I)(G)(G)oes (O)out (L)ate
1) Make a direct (A)ppeal for the denied resource (assertive request)
2) Make efforts to (I)nfluence the situation by using your knowledge of an agency or other agency's policies and procedures
3) Appeal to someone of (G)reater authority in the target org.
4) use target org.'s (G)rievance procedure
5)Appeal to an (O)utside authority
6) take (L)egal action (last resort)
The person in situation system
associated with the psychosocial model
Tx for Conduct Disorder
more effective when family is included
*parent training programs
*cognitive problems solving skills trning
*multisystemic therapy
*parent management training
*functional family therapy
Wernicke-Korsakoff's Syndrome
life threatening alcohol related disorder resulting in persistent memory loss. Caused by malnutrition & thiamine deficiency.

The most fatal alcohol related disease
Mental Status Exam
*measures appearance, activity, mood and affect, speech and language, thought content, perceptual disturbances, insight and judgment, & neuropsychiatric functions
Sustainment Interventions
used in the first phase of therapy, uses relationship building techs
*empathic responding
What types of drugs are also referred to as "major tranquilizers"?
antipsychotics...especially in the 1st two weeks of taking them.
what is the drug of choice to treat OCD?
antidepressants (SSRI) such as prozac.
Who is the "gatekeeper"?
The primary care physician in managed health care (HMO). He is the one who decides to refer out to a specialist for pts.
Asian American's like direct counseling services?

True or False?

They are more accepting of direct counseling services such as vocational and academic counseling as opposed to unstructured counseling.
Circular Questioning
*an indirect form of reframing
*ask each family member to describe specific feelgs, bxs, and relationships & pointing out differences within the family
*increases flexibility in viewing their problems
Brief Therapy Model
adopts the strength's perspective
Response Cost
Removal of a prespecified reward each time a target bx is performed

e.g. reduce a child's allowance each time the child engages in target misbehavior
form of positive punishment. Involves applying a penalty following an undesirable bx each time it occurs in order to eliminate the bx.
focuses on eliminating opposition to a cause, plan, or organization by assimilating into the group favoring the plan, cause, or org.

"if u can't beat em, co-opt them!"

co-opting inds = informal
co-opting org. groups = formal
High Context Communication
*relies heavily on restricted codes (ebonics), culturally defined meanings and nonverbal messages
*characteristic of minority groups
*self-image/worth tied to the group (collectivism)
Low Context Communication
*emphasizes verbal messages and elaborated codes
*characteristic of anglo-americans
*self-image/worth tied to the individual (individualism)
In HIV infected people, what is the most common cause neuropsychological impairment?
Direct infection of the HIV virus into the brain tissue. This produces cognitive, personality and motor symptoms
In what therapeutic approach does a therapist intentionally stay neutral?
What is the primary role of a social worker?
being a resource
refers to a fixed amount of money per person. Physicians are paid a specific dollar amt per pt. per month
no matter how many times a pt sees them

paid "by the head" (de)capitation-get it? 8)
informal organization
relationships among agency personnel are voluntary
abbreviation for twice daily (to take medication)
abbreviation for "every"
abbreviation for "daily"
abbreviation for "bedtime" in medication instructions
abbreviation for "instructions"
abbreviation for "as needed"
abbreviation for "three times daily"
abbreviation for "four times daily"
provides payment for medical and hospital services to indivs. who cant afford them.

uses pts financial resources and health factors to determine eligibility