Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
112 Cards in this Set
- Front
- Back
- 3rd side (hint)
|
define "Culture"
|
-customs, rituals, traditions, food etc. passed down through generations.
-includes values and beliefs. Is the sum total of how you live. |
|
|
|
define "Ethnicity"
|
Oldest remembered ancestors & where they came from.
|
|
|
|
define "Race"
|
-No real agreed upon definition because there is no biological basis.
-<i>sort of</i> based on eternal physical characteristics. -has a lot of social connotations and implications. |
|
|
|
What are the two parts to being a culturally responsive therapist?
|
1) <b>Personal work</b>-knowing yourself.
|
2) <b>Interpersonal work</b>-learning about and from other cultures.
|
|
|
What is the biggest obstacle to being culturally responsive?
|
Defensiveness.
|
|
|
|
What are some ways to prevent defensiveness? Name 3.
|
1) Be aware of the physical feelings related to it
2) Take a deep breath/focus on breath 3) Refrain from defensive behaviors 4) ** Ask yourself why this person's views need to match your own 5) Reframe annoyances as opportunities for growth 6) Recognize the need for additional expertise 7) Discuss the limitations of your knowledge 8) Use humor (if appropriate) |
|
|
|
What are some physical signs of defensiveness?
|
-feeling hot
-upset stomach -increased heart rate -short of breath -stiff -crying -raised volume |
|
|
|
What are some defensive behaviors?
|
-raising voice
-cutting off -not listening -body language -being argumentative |
|
|
|
define "Mainstream"
|
An idea or concept in the center, not in the periphery. Highly regarded, accepted, and considered normal.
|
|
|
|
define "Margin"
|
An idea or concept seen as on the periphery, possibly abnormal. Has little value, power, or rank.
|
|
|
|
What is a term for marginalized people?
|
non-dominant or minority
|
|
|
|
Describe the idea of mainstream vs. margin
|
Looks like a big circle inside of a slightly larger circle. Smaller circle is the mainstream. Everyone is mainstream in some ways and marginalized in others.
|
|
|
|
define "Privilege"
|
The advantages of being in the mainstream.
|
|
|
|
What do the letters in the mnemonic ADDRESSING stand for? What do they apply to?
|
Age/generational
Developmental disabilities Disabilities acquired Religion/spirituality Ethnic/racial identity Socioeconomic status Sexual orientation Indigenous heritage National origin Gender These are categories/ways in which someone could be marginalized. Should try to be aware of all when initially interacting with someone. Can use it to inform CLIENTS and FID in an intake interview. |
|
|
|
What are two questions you can ask about culture at an intake assessment?
|
How did your cultural identity inform your symptoms?
|
How can it guide treatment?
|
|
|
What is one reason it is important to talk about culture?
|
It can be a resource to help heal or help one's self.
|
|
|
|
What are two questions you could ask in relation to office setup and comfort?
|
Door open or closed?
|
Would a larger space be more comfortable?
|
|
|
What is a strengths-oriented approach?
|
Looking for a person's strength's/supports as a way to guide treatment, rather than flaws or problems.
|
|
|
|
If a person is having trouble coming up with self-strengths, what could you ask?
|
What would your parent/partner/kids/friends say are your strengths?
|
|
|
|
What is one way to tell if a behavior is pathological vs. nonpathological?
|
What do others in the client's life think?
Is it socially appropriate coping behavior? How long has it been going on? (nonpath = usually short) |
|
|
|
What do the acronyms CLIENTS and FID stand for? When would you use them?
|
Cause (can you think of any possible cause or triggering event)
Length (how long has it been going on) Impairment Emotional impairment Noticed (have other people noticed it) Tried (what have you tried to fix it) Stopped (was there ever a time it was not present? what was going on when it stopped?) Frequency Intensity Duration of symptoms. |
Both used at an intake interview.
|
|
|
What is the difference between a mood episode and a mood disorder?
|
A mood episode is a period of time where a person shows DSM classified symptoms of mania or depression. It is part of a mood disorder diagnosis.
|
A mood disorder is the diagnosis a person receives when they have more than one mood episode along with other DSM diagnosis criteria.
|
|
|
True/False: It is possible to diagnose someone with a manic or depressive episode.
|
FALSE! The episode is a <i>criteria</i> for a diagnosis of a mood <i>disorder</i>.
|
|
|
|
What is the required frequency/duration of symptoms present for a diagnosis of depression?
|
Most of the day, nearly every day.
|
|
|
|
What are the "magic numbers" for a diagnosis of depression?
(how many symptoms need to be present and for how long) |
at least 5 symptoms for at least 2 weeks
|
|
|
|
What is the code # for depression?
|
296
|
Fun fact: it is also the code for bipolar, but with different numbers after the decimal point.
|
|
|
What does the 4th digit of a depression code stand for?
|
type (recurrent or not)
|
.2 = single episode
.3 = recurrent |
|
|
What does the 5th digit of a depression code stand for?
|
severity or remission status
|
._1 = mild
._2 = moderate ._3 = severe ._4 = with psychotic episode ._6 = partial remission ._7 = full remission ._0 = unspecified |
|
|
What is the F:M ratio for depression?
|
2:1 F:M
|
|
|
|
How long does a person need to not meet full criteria for a depressive episode in order to be considered in partial remission? Full remission?
|
partial-at least 2 months with some, but not all signs or symptoms
|
full-at least 2 months with no significant signs or symptoms
|
|
|
What is the median number of episodes someone with clinical depression will have in his/her lifetime?
|
4
|
|
|
|
What is the cognitive triad?
|
Negative thoughts about
-self -future -what others think about me |
|
|
|
What is considered the best treatment for depression?
|
CBT + meds (has less relapse)
|
|
|
|
Describe criteria for diagnosis with Persistent Depressive Disorder.
|
2 symptoms present for at least 2 years, with no remission for more than 2 months at a time. Usually mild severity.
|
|
|
|
How many symptoms does one need for PMDD?
|
5
|
|
|
|
define "affective lability"
|
mood swings
|
|
|
|
What are the main differences between hypomania and mania?
|
Hypomania does not cause marked impairment or psychotic/delusional features. It is of shorter duration.
|
|
|
|
Why is it bad to give antidepressants to someone who has bipolar disorder?
|
Can trigger a manic episode.
|
|
|
|
Difference between bipolar 1 and 2?
|
Bipolar 1 MUST have mania, CAN have hypomania.
|
Bipolar 2 must NOT have mania, MUST have hypomania.
|
|
|
Delusion vs. hallucination
|
delusion = misperceiving ACTUAL stimuli.
|
hallucination = imagining stimuli.
|
|
|
What does "with mixed features" specifier mean in bipolar diagnosis?
|
With full criteria for mania/hypomania and depression symptoms at the same time.
|
|
|
|
what are grandiose delusions?
|
belief of self-importance or excessive power/skill. Often religious.
|
|
|
|
what are paranoid delusions?
|
belief others are watching them.
|
|
|
|
define "Incidence" and "Prevalence".
|
Incidence: number of new cases of something in a given time period.
|
Prevalence = number of TOTAL cases of something in a population at one time.
|
|
|
Criteria for cyclothymic disorder?
|
symptoms are present for >2 years, but not enough to be a full episode. Never been >2 months symptom free.
|
|
|
|
What are the 2 phases of bipolar treatment?
|
1) Acute pharmacological treatment with goal of stabilization.
|
2) Maintenance treatment with goal to minimize symptoms and prevent recurrence.
|
|
|
What drugs can be used to treat bipolar disorder?
|
Mood stabilizers (e.g. lithium)
Anticonvulsants (e.g. Depakote) Atypical antipsychotic medication (e.g. Risperdol, Seroquel, high doses of Abilify) Sometimes antidepressants, though can have dangers. |
|
|
|
Bipolar disorder shows medication noncompliance rates up to ___ %
|
60 %
|
|
|
|
What psychotherapeutic treatments are widely used to treat bipolar disorder?
|
Family focused psychotherapy to educate patient and family and enhance communication and problem solving.
CBT-psychoeducation, activity management, stabilize wake/sleep, cognitive restructuring, etc. |
|
|
|
define Suicide, suicide attempt, suicidal ideation
|
Suicide-self inflicted death where person intended to die.
Suicide attempt-self injurious behavior, person intended to die, non-fatal. Suicidal ideation-thoughts about suicide. |
|
|
|
True/false: Drugs and alcohol play a big role in suicides.
|
True.
|
|
|
|
True/false: asking someone about their suicidal ideation/intent makes it more likely they will kill themselves.
|
FALSE. In fact it can decrease risk by lowering anxiety and opening up communication.
|
|
|
|
What are you responsible for as a clinician when treating a suicidal client?
|
1) assess risk factors and precipitating events.
2) evaluate the level of risk/lethality (e.g. do they have access to the means) 3) implement a PLAN to protect and treat the person 4) DOCUMENT EVERYTHING. |
|
|
|
Number one thing to do when you have a suicidal client (after documenting everything)?
|
Consult with other clinicians. Supervisor, colleagues, etc.
|
|
|
|
HIDE the Bullet CLIPS acronym- H?
|
History
|
family history, anniversary, self previous suicide attempts, precipitants/consequences/responses to past suicide attempts
|
|
|
HIDE the Bullet CLIPS acronym- I?
|
Ideation and Intention.
|
FID of thoughts, what are thoughts, how severe, who has been told, what is stopping them?
|
|
|
HIDE the Bullet CLIPS acronym- D?
|
Diagnosis.
|
Do they have a mental health diagnosis? Depression, substance abuse, psychotic symptoms?
|
|
|
HIDE the Bullet CLIPS acronym- E?
|
Emotional state.
|
Particularly be aware of HOPELESSNESS or abrupt improvement (often precedes an attempt).
|
|
|
HIDE the Bullet CLIPS acronym- B?
|
Behavior.
|
Giving away prized items, severing relationships.
|
|
|
HIDE the Bullet CLIPS acronym- C?
|
Communication.
|
Suicide notes, indicative language (e.g. you won't have to worry about me anymore)
|
|
|
HIDE the Bullet CLIPS acronym- L?
|
Lack of support.
|
Estrangement, withdrawal, breakup, INCARCERATION (huge trigger)
|
|
|
HIDE the Bullet CLIPS acronym- I (second I)?
|
Inability to see alternatives.
|
Cognitive rigidity, only option, death = end of pain.
|
|
|
HIDE the Bullet CLIPS acronym- P?
|
Precipitants.
|
Events. Losses ($$, job, person), physical illness/pain, impending incarceration.
|
|
|
HIDE the Bullet CLIPS acronym- S?
|
Statistics/Standardized scale.
|
e.g. high risk demographics, scores on suicidality scales/tests.
|
|
|
What is the HIDE the Bullet CLIPS acronym used for?
|
Assessing suicide risk.
|
|
|
|
Define ego syntonic vs. ego dystonic.
|
Ego syntonic = the feelings feel good (e.g. I am so glad I am thinking of suicide, it will make everything better).
|
Ego dystonic = the feelings feel bad or worrisome or wrong (e.g. I am really worried because I keep thinking about shooting myself. Something must be terribly wrong for me to think that. Make it stop.)
|
|
|
What is the SLAP acronym and when is it used?
|
Used to assess details if a client mentions there is a suicide plan.
|
S-specificity (how detailed is the plan? higher details=higher risk.)
L-lethality (how likely/quickly will the plan result in death?) A-availability (how readily available to them is their plan?) P-proximity (are there friends/neighbors/family/etc. nearby who can keep an eye on them?) |
|
|
What are some things you can do if you believe there is a suicide risk in a client?
|
1) Suspect depression, no immediate danger-refer to psychiatrist.
2) Refer client to a crisis response center. 3) Consider inpatient hospitalization (possibly unwilling if you believe very high risk). 4) increase frequency or length of visits 5) engage support people w/ client's consent 6) Boost coping skills w/ CBT/DBT 7) Develop a plan to have someone trusted REMOVE THE MEANS. 8) Develop a crisis plan 9) Identify reasons for living 10) Develop a "hope box" (longer term) or coping card |
|
|
|
What is the code number for an involuntary committal?
|
302
|
|
|
|
What should a crisis plan include?
|
-triggers
-support people and phone numbers -action plans (coping skills for the moment) -phone numbers for crisis centers/hotlines -be READILY ACCESSIBLE -with consent, tell the support people about the plan. |
|
|
|
What is the name of the case that led to the duty to warn rule?
|
Tarasoff.
|
|
|
|
What determines if you have a duty to warn?
|
If there is a threat to harm an IDENTIFIABLE victim.
|
|
|
|
What is the HIDE the Bullets Gun and Poison acronym used for?
|
Assessing a person's risk of doing harm to others.
|
|
|
|
HIDE the Bullets Gun and Poison-H?
|
History.
|
Does the person have a past history of violence? Head injuries (which affect judgment and impulsivity)?
|
|
|
HIDE the Bullets Gun and Poison-I?
|
Intent.
|
FID of thoughts of harming others? Do they have a plan?
|
|
|
HIDE the Bullets Gun and Poison-D?
|
Diagnosis.
|
Do they have a diagnosis (particularly antisocial personality disorder, substance abuse-esp. multiple substances, active psychosis, ODD in children)
|
|
|
HIDE the Bullets Gun and Poison-E?
|
Emotional lability.
|
Are they having mood swings/lots of mood changes?
|
|
|
HIDE the Bullets Gun and Poison-B?
|
Behavioral impulsivity.
|
Are they impulsive, find it hard to control their behavior?
|
|
|
HIDE the Bullets Gun and Poison-G?
|
Growing up around violence.
|
Did they grow up around violence?
|
|
|
HIDE the Bullets Gun and Poison-P?
|
Precipitants.
|
Has anything happened recently that might trigger violence?
|
|
|
Tips for personal safety?
|
-Stay alert
-have access to a door -don't be blocked by a desk -no items in room that could be weapons -if concerned, conduct session in a public place -know agency protocol for emergencies -avoid sitting too close to clients (2 steps away) |
|
|
|
What are some signs of possible impending violence in a session?
|
pacing, verbally threatening.
|
|
|
|
What to do if a client becomes violent or threatening?
|
-maintain a relaxed, calm tone
-if you're sitting and they are standing, stand up. -point out the consequences of a violent action in a calm and nonthreatening way. |
|
|
|
What group of people wrote the DSM?
|
White American male Psychiatrists.
|
|
|
|
Which version of the DSM started including research for classification?
|
DSM IV
|
|
|
|
Which version of the DSM introduced the multiaxial system?
|
DSM III
|
|
|
|
What changes are there from DSM-IV TR to DSM V?
|
-no more multiaxial system
-reorganization of chapters- used to separate childhood disorders, now are separated by type and listed in chronological order of first usual appearance. -included structure to gain info about culture. |
|
|
|
What is the SUDS scale?
|
Subjective Units of Distress Scale- scale from 1-10 how distressed a person is, using verbal descriptors.
|
|
|
|
What are the purposes of clinical assessment?
|
-understand the individual
-predict behavior -plan treatment -evaluate treatment outcome |
|
|
|
What is the "funnel approach"?
|
Starts broad, is multidimensional in approach, and narrows to specific problem areas.
|
|
|
|
Procedures used in clinical assessment:
|
intake interview
physical exam behavioral assessment psychological testing neuropsychological testing |
|
|
|
2 types of intake interviews
|
Structured and Unstructured
|
|
|
|
4 objectives of intake interviewing?
|
1) identifying evaluating and exploring the client's chief complaint and associated therapy goals.
2) obtain data related to client's interpersonal style, skills, and personal history. 3) Evaluate client's current life situation & functioning 4) develop initial diagnostic impressions. |
|
|
|
What is the DSM definition for a "Mental Disorder"?
|
-Causes SIGNIFICANT DISTRESS in SOCIAL, OCCUPATIONAL or OTHER important activities.
-it is not an explicable or culturally approved response to a common stressor or loss. -socially deviant behavior and individual vs society conflicts are NOT mental disorders. |
|
|
|
Questions to ask when evaluating behavior?
|
1) how does it impact others
2) is functioning or self care impaired? 3) is the reaction typical for those in client's community? (age group, culture) |
|
|
|
What year was DSM 1 made?
|
1952
|
|
|
|
Mainstream values in psychotherapy
|
-emotional expressiveness
-individualism & independence -assertiveness -self-disclosure -verbal skills -insight |
|
|
|
Why is a strengths oriented approach good?
|
-dominant culture frequently assumes the worst of marginalized groups
-provides a fuller picture of context -provides important info about naturally occurring supports or coping skills. |
|
|
|
Average length of a major depressive episode (when untreated)
|
4-9 months
|
|
|
|
What are some factors that contribute to a poorer prognosis in depression?
|
-less recovery
-chronic medical condition -pre-existing pervasive depressive disorder -early onset (before age 20) -personality disorder |
|
|
|
Clinical features of depression?
|
-Rumination
-Avoidance -Negative thought patterns -Hopelessness/Helplessness -Interpersonal issues -Poor view of self |
|
|
|
Types of antidepressants
|
SSRIs
MAOIs TCAs |
|
|
|
Frequency of sexual side effects when on antidepressants:
|
40%
|
|
|
|
Empirically supported depression therapies:
|
-behavior therapy
-cognitive behavior therapy -interpersonal therapy |
SOME evidence:
-problem solving therapy -short term psychodynamic therapy |
|
|
When are PMDD symptoms present?
|
the week before menstruation for at least 2 consecutive cycles. Symptoms improve w/in a few days after onset of menses, then disappear completely.
|
|
|
|
Symptoms of manic episode? Length?
|
3 or more...
-inflated self esteem or grandiosity -decreased need for sleep -more talkative -racing thoughts -distractibility -increase in goal-directed activity -excessive involvement in pleasurable activities w/ high potential for bad consequences |
1 week
|
|
|
Symptoms of hypomanic episode? Length?
|
3 or more...
-inflated self esteem or grandiosity -decreased need for sleep -more talkative -racing thoughts -distractibility -increase in goal-directed activity -excessive involvement in pleasurable activities w/ high potential for bad consequences |
4 consecutive days, most of the day, nearly every day.
|
|
|
What is rapid cycling bipolar disorder?
|
>=4 episodes in a year
|
|
|
|
What percentage of people with cyclothymia are later diagnosed with bipolar 1 or 2?
|
15-50%
|
|
|
|
Varying severity of suicidal ideation?
|
1) thought
2) plan 3) plan, intent, and means |
|
|
|
How many people who die from suicide are suffering from a major psychiatric illness?
|
90%
|
|
|
|
Highest risk of suicide population?
|
White males over 65
|
|
