Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key

image

Play button

image

Play button

image

Progress

1/121

Click to flip

121 Cards in this Set

  • Front
  • Back
Eight criteria used to evaluate a theory
Importance
precision and clarity
parsimony
Comprehensiveness
Operationality
Empirical verifiability
Fruitfulness
Practicality
Cultural identity development (Thomas and Cross)
naivete
Encounter
Naming
Reflections on self as a cultural being
Multiperspective internalization
Recognition of diversity issues as a therapist (Ponterotto)
Pre-exposure
Exposure
Response-Zealotry/Defensiveness
Integration
Freud's Drive theory
-Major role of the unconscious
-Psychic determinism-internal things cause you to do things-
-Focus on biology
Freud's topographical model of Personality
Conscious-aspects of mental life of which we are currently aware
Preconscious-aspects of mental life that we arent currently aware of but could bring into conscious awareness
unconscious-Aspects of mental life of which we are not currently aware and cannot easily bring into awareness, vast majority of the mind is unconscious
Id, ego, superego
Id- uses primary process thinking, operates under the pleasure principle, is unconscious
Superego-introjection of parents, societies morals values, and standards. Conscious and unconscious. Contains the "conscience", and the "ego ideal"
Ego- uses defense mechanisms and secondary process thinking, mediates between the demands of the id and superego
Freud- types of anxiety
Neurotic- demands from the id
Moral- demands from the superego
Realistic- anxiety based on an actual threat
Freud defense meachanisms
Repression
Denial
Displacement
Projection
reaction formation
Regression
Rationalization
Freud-Mature defenses
Identification
Sublimation
Freuds Personality Stages
Oral
Anal
Phallic
Latency
Genital
Freud's treatment goals
Making suffering easier to bear
Individuals leading constructive work and love lives
Freud's therapeutic Strategies
1) free healthy impulses, make superego less punitive
2) Make unconscious conscious
3) Strengthen relaity-based ego functioning (coping strategies)
Jungian
Theory of balance and fusion- different sides of ourselves must come together for our psychological health, the goal is to become complete
Jungian and psychic energy
Equivalence- energy used towards one intention is balanced by energy fueling the opposite intention
Entropy-equalization of differences to bring about balance
Self- who you will be when you recognize that within you which is unique, as well as that which is common and unite them
Jungian and structure of personality
Psyche- all non-somatic capacities
Conscious Ego-pt of the psyche that we are aware of:
-memories
-thoughts
-feelings
-attitiudes (readiness to act in a part. direction, extroversion vs introversion)
-functions
Unconscious- contains:
-Personal unconscious, just below awareness but can move into awareness contains complexes (personal trauma related to an archetypal image)
-Collective Unconscious, part of psyche that is shared with other people (transpersonal), contains archetypes
Jungian and development
Early Childhood- parents
Youth and Young Adulthood-learning the outside world and fitting in
Middle Adulthood-learning the inside world and fitting in
Older age- a state of wholeness
Jungian and psychopathology
imbalance
Jungian goal of therapy
finding a personalized balance and individuation
Jungian Therapy
-Less sessions
-focus on the importance of work done between therapy sessions
Includes four stages:
Catharsis
Elucidation-bringing out issues and recognizing what is going on
Education-learning how to work through the issue
Transformation- lifelong process, done in the real world, as you move through your life experiences
Pavlovian Classical Conditioning
Extinguishing
Habituating
Generalizing
Differentiating
Modern behavior therapy (Wolpe)
Counterconditioning- ex. pairing feared stimulus with food
Inhibition- cannot have two competing physiological responses at the same time
Systematic Desensitization-hierarchy of feared situations
In vivo- live exposure
Flooding- going straight to the top of the hierarchy
Skinner and Operant Conditioning
Reward Structures
Positive reinforcement
Negative Reinforcement
Punishment
Bandura and social learning theory
Important learning takes place by observing others
Triadic model- environment, personal factors, and behavior
Behavior therapy
-Behavioral Assessment includes: identifying target behavior, frequency, severity, antecedants, and consequences
-Systematic Desensitization
-Flooding
-Modeling
-Role playing
-Reinforcement
Cognitive REBT (Ellis)
Irrational beliefs that are rigid/inconsistent with reality contain absolutist demands (musterbations):
I must do well
You must treat me well
The world must be easy
-Therapist is responsible for change
-Patient doesn't have to like the therapist
-Inferential change needed to alter beliefs about about a situation
-Philisophical change is needed to alter belief structure
Cognitive (Beck)
-People engage in cognitive errors which are systematic errors in reasoning that result from biased information processing
-Cognitive errors occur automatically
-Errors derived ultimately from cognitive schemas
Cognitive Schemas
important beliefs and assumptions about people, events, and the environment
Cognitive Errors
Dichotomous thinking
Selective Abstraction
Arbitrary Inference
Overgeneralization
Personalization
Cognitive and Psychological Dysfunction/ beck
Beck- Early Childhood experience=>develop schemas=>critical incidents=>activation of schemas=>automatic thoughts=>emotiona/behaviors/physiological responses
Cognitive Psychological Dysfunction/ Ellis
Ellis-ABCDEF
A activating event
B belief
C consequences
D disputing intervention
E Effective philosophy
F new feeling
Ellis vs. Beck
Ellis- disputes and destroys "musts". Therapist is an educator
Beck- Collaborative Empiricism: clients and therapists test beliefs together through logical scrutiny and real life experiments
Cognitive Therapy and phases of therapy
First Phase:
1) listing and prioritizing clients problems
2) Educating clients about theory
3) Identifying cognitive errors
4) Immediate Symptom Relief
Second Phase:
1) Identifying links among cognitive errors
2) Overcoming cognitive errors
3) Monitoring Progress
4) Relapse Prevention
Client-Centered Conditions of the therapeutic process
Congruence-Genuiness
Unconditional Positive Regard
Empathy
Client Perception of conditions
Client Centered- Subception
Unconscious awareness
Conditions of Worth
values placed on you from the outside world
Organismic Valuing Process
natural values true to yourself without conditions of worth
Unconditional Positive self regard
Comes from Unconditional Positive Regard- How Rogerian Therapy works, allows you to become more fully aware of yourself and more accepting
Time-limited Therapy and benefits
-Managed Care
-Addresses drop out rates (time limited)
-Most benefit comes early in treatment
Time-limited brief Dynamic Therapy: Client match
1) moderate emotional discomfort
2) basic trust and hope, a sense of optimism
3) will consider conflicts in interpersonal terms
4) Willing to examine feelings
5) Capacity to relate to therapist in a meaningful way
Tenets of TLDT
1) Dynamic, transferentially based
2) The healthy model
3) Experiencing the patient
4) Present Focused
5) New Experience and New understanding
6) Basis of therapy is trust
Tenet 1 TLDT-Dynamic Transferentially based model
Carry styles of interacting that we learned in childhood into adult relationships
CMP- when these styles of interacting are harmful. Expectations of how people will relate to us/ how to relate to others not based in reality.
Patterns expected to replicate in therapy
Tenet 2 TLDT-The healthy part
Each person has a healthy component in addition to an unhealthy one- They are coping the best way they know how
Resistance is a way to continue to use the only coping mechanisms that they know how to use
Tenet 3 TLDT- Experiencing the patient
How the therapist experiences the client is representative of how others experience the client.
Countertransference includes conscious and unconscious reaction
Tenet 4 TLDT-Present focus
Present experiences are more important than discussing earlier experiences. Places more importance on experiential change rather than understanding
Tenet 5 TLDT- New Experience and New Understanding
Goal of therapy is to provide 1) A new experience (required)- new experience of an adaptive way to relate interpersonally, different from their old one
2) A new understanding (optional)- It helps if the patient has some insight into the origins of the old CMP
Procedural memory is involved bc clients don't just know the difference, they experience something differently
TLDT Basis of therapy is trust
Without a capacity for trust, the patient cannot be helped, trust helps the client change
TLDT treatment
Focuses on CMPs includes:
Identifying Information
Acts of self
Expectations of others
Acts of others towards the self
Acts of the self towards the self
Countertransference reactions
TLDT Countertransference
Parallel Process (How do you feel in the room?)
If the countertransference seems inconsistent with the information, it could be coming from the therapist OR the CMP needs more information
Termination in TLDT
Very important, bc the patient should be able to continue the change on his or her own!
-Shift from parent-child type dynamic to an adult-adult one
Existential Therapy (Frankl)
Focus: Basic issues of existence including death, choice, isolation, meaningfulness
-Attitudinal approach to issues of living vs. a specific therapeutic method
-Emphasizes individuals uniqueness and subjective experience
-Focuses on the human capacity for authenticity, courage, and creativity
Existential- Four ways of being in the world
Umwelt-around world
Mitwelt- the with world (relationships)
Uberwelt-overworld (spiritual)
Eigenwelt- the own world (knwoing oneself, "I am" experience)
Time and Being in the World- Existentialism
Past- plp either want to escape or live in the past
Present- some plp focus on clock time, instead of the present
Future-some plp are unable to connect to the immediate future, only the remote future
Existentialism and anxiety
Normal-
1)Appropriate to the situation
2)Not repressed
3)Potentially useful for facing and confronting dilemmas
Neurotic-
1) Inappropriate to the situation
2) Rarely constructive
3) Result of feeling unfulfilled with how one deals with problems in life
Sources of Existential anxiety
1) Life & death
2) Love and isolation-Interpersonal, intrapersonal, existential
3) Meaning & meaninglessness
4) Freedom, Responsibility, & Choice
-We can transcend anxiety by using our creativity and imagination
-We can go beyond ourselves and reflect on our being and others even when in highly stressful situations
Goal of Existential Therapy
Authenticity in facing:
1) Oneself and one's world
2) One's self-deception
3) Responsibility for one's life and one's choices
Therapeutic relationship in Existential Therapy
-Emphasize "I thou" authentic relationship
-Therapist offers non-possessive therapeutic love
-Resistance occurs when a client does not take responsibility, is alienated, is unaware of feelings. Reflects a fear of authenticity (attempt to protect the self)
Transference- form of resistance, a way of avoiding an authentic relationship
Existentialism and Death anxiety
Individuals attempt to avoid or deny issues of death through a belief in their specialness, & belief in the ultimate rescuer
Existentialism and Freedom, Responsibility & Choice
-In therapy clients have a safe place to explore fears of freedom and accept responsibility
-Clients may have difficulty making choices due to a lack of awareness of ones wishes, fear of wanting something, and fear of accepting the consequences of ones decisions
Existentialism and Love and Isolation
-Therapists provide clients with a model of healthy, caring, authentic love combined with good boundaries
-Can help clients to tolerate both closeness and separation
Existentialism and Meaning and meaninglessness
-lack of a "will to meaning" can result in an "existential vacuum".
-"Will to meaning" becomes the primary focus of therapy
-Society may promote the existential vacuum through materialistic values
Meaning can be discovered through:
1) experiental values (our own experiences of things and plp)
2) Creative values (creating a work or doing a deed)
3) Attitudinal Values (attitude we take towards unavoidable suffering)
Logotherapy (Frankl's version of existential therapy)
-Focus on noetic issues and noogenic neuroses
Noetic issues: issues related to the spiritual dimension
Noogenic neuroses: responses to the existential frustration and vacuum, due to lack of meaning
Logotherapy goals
Help clients discover their ultimate values and pursue them/ suggest what their values might be. Help clients to connect with their will to meaning
Logotherapy and "will to meaning"
-Therapist helps client to achieve this through Self-Transcendence (focusing on the world)Finding meaning outside oneself, and not just through achievements
-Self-actualization is a by-product of this process, although it is not fully possible.
Techniques of Logotherapy
1) Paradoxical Intention- used for anticipatory anxiety and compulsions
2) Dereflection- used for excessive self-consciousness. Have the person focus on something outside themselves, something meaningful in the world
3) Attitudinal Modulation- replacing neurotic motivations with healthy ones. Gives the client a reason for what they do beyond justification
4) Socratic Dialogue-Involves engaging a client in examining his or her assumptions through probing questions
Object-relations vs. Freudian
-Plp are motivated to seek relationships rather than pleasure or sex
-Focus is more on the ego than the id
-Key defense is splitting vs. repression
Object-relations and Assumptions
-Anxiety and conflicts are related to significant others (objects)
-Mind consists of internal representations of the self and others (internal objects)
-Individuals "split" internal objects into good and bad parts in order to tolerate dependency on others while still maintaining a sense of self as "good"
-Psychological difficulties develop in preoedipal stages, and are often due to extreme splits
Characteristics of internal objects
1) made up of past experiences
2) Conscious or unconscious
3) Cognitive affective impulses that evoke ways of thinking, feeling, and behaving
Melanie Klein and Object Relations
-First conflicts revolve around the mother's breast (infant's first part-object), as the breast is loved for it's nourishing qualitites, and hated for it's disappointing ones
-Infant's underdeveloped ego cannot pull the conflicting experiences together , and internalizes a split representation of the breast (good breast, bad breast)
-Good breast strengthens the ego
-part of "normal" development
Melanie klein- Object Relations- view of the infant
Autistic-Contiguous
1) Autistic Objects: harder and protective, separate
2) Autistic Shape: comfort and protection
Paranoid-Schizoid Position (3-4 mo)
1) Child feels perceuted and attacked
2) Splits to reconcile conflicting impulses about the breast
Depressive Position (4-12 mo)
1) mom is seen as a whole object, with both good and bad parts
2) Child must admit that she has negative feelings towards the mother, leading to fears about hurting the mother. Fears about being alone
Melanie Klein- Object relations- Infant Development
Follows the three positions:
1) No realization
2) Realization, but no discrimination between objects
3) Recognition of objects as similar to you (give and take)
Fairburn and Object relations
-The good part of the mother involves the comforting, rewarding parts, and when internalized the child feels lovable/ loved
Fairburn and "Bad Objects"
Ungratifying/bad object can be either:
1) Exciting object-based on interactions with a mother who teases, tantilizes, and tempts, and gives rise to the infant libidinal ego (a part of the psyche that feels frustrated, empty, deprived, and thirsting, striving for success but cannot achieve it)
2) Rejecting object-based on interactions with a hostile, rejecting mother, gives rise to the anti-libidinal ego (full of bitterness and hate; yearns for connectedness, but is dominated by the fear that it is unlovable. It is associated with rage, cynicism, and rejection of feelings of dependency.
-The "infantile libidinal ego" and the "anti-libidinal ego" are all around the "central ego"
Object Relations and Psychological dysfunction
-Children split off the more disturbing aspects of the bad objects
-Abnormal behavior derives from extremes in splitting. Ex., children with bad parents find a way to keep their parents "good" so they split off and repress the bad parts
-Repression of "bad objects" leaves the inner world fragmented. Painful pts of the self are not accessible to consciousness and experienced as inner feelings of frustration, persecution, and self-hatred.
-Affects relations with external objects, person may respond with neediness or rage
John Bowlby and Attachment Theory
Based on the idea that individuals naturally seek and and form close, affectional bonds from which they derive a sense of security and safety
-Helps us to survive until reproductive age
John Bowlby and attachment
Attachment can serve as:
1) a secure base from which individuals can safely explore the world
2) a safe haven when individuals feel threatened
-The attachment system operates with a self-regulating, self-correcting mechanism similar to a thermostat. The set goal is a certain proximity to the caregiver, or a certain amount of "felt security"
John Bowlby and Attachment- What sets off the attachment system
-Most strongly activated in times of distress
-When activated, we attempt to seek contact with the attachment figure through a variety of behaviors
-Attachment system functions from the "cradle to the grave", but expresses itself differently in different pts of the lifespan
John Bowlby and Attachment- What sets off the attachment system
-Most strongly activated in times of distress
-When activated, we attempt to seek contact with the attachment figure through a variety of behaviors (two types of distress)
-Functions from the "cradle to the grave", but expresses itself differently in different parts of the lifespan
John Bowlby and Attachment- wrote about two types of distress
Alarm- from a perception of a possible threat to ones safety
Anxiety- from a threatened or actual separation from one's attachment figure
Internal Working Models of attachment
-Over repeated interactions with attachment figures, we develop expectations and beliefs about the self and them that guide our interactions: Internal working models of attachment relationships (like internal objects)
-IWMs are resistent to change as one gets older but they are updated on the basis of new experiences with attachment figures and other significant others
Attachment Theory and Pathology
-Much of what causes problems based in disruptions in attachment relationships (actual or threatened abuse & abandonment)
-Children need to feel safe and secure with caregivers, so may distort experience with poor caregivers
-Disruptions lead individuals to develop IWMs that provide the basis for poor interpersonal functioning later in life
-Evidence that even temporary separations could be terribly painful to children and cause them to develop attachment anxiety (i.e. hospitalization)
Attachment and Mary Ainsworth
-Devised the strange situation to investigate infants attachment behavior
-Found differences among infants in their behavior with their mothers
-Linked these behaviors to differences in parenting behaviors at home
Attachment and Mary Main
Mary Main went one step further:
-Noted that these differences among infants were related to the way their mothers remembered their own childhoods. IWMs may influence parenting behaviors
Mary Ainsworth and Infant strange situation reunion behavior
Secure: Cries, quickly soothed
Anxious-ambivalent (Preoccupied): Is hard to soothe, clingy, angry
Anxious-Avoidant (dismissing): Shows no distress, ignores mom
Mother's attachment & Memories, Mary Main
Secure: Can focus on pos and neg, discuss in coherent
Anxious-ambivalent: Overwhelmed by emotional memories
Anxious-Avoidant: Can't access negative memories, idealizes past
Insecure Attachment
An anxious-ambivalent infant may have the bast chance of capturing the attention of an inconsistent, self-involved parent
-Dissmissing infant may have the best chance of not driving away a parent who is uncomfortable with closeness
-These strategies do not promote well-being in the long run
Goals of Object Relations and Attachment Therapies
-Understand current behavior and feelings in light of past relationships, particularly early parental issues, early object issues
-Understand misinterpretations of others behaviors in light of past relationships
-Develop a relatively positive, integrated work of internal objects (or IWM)
Therapeutic relationship in Object-relations Therapy
-Viewed as the curative mechanism
-Helps the client in at least 2 ways:
1)Provide the client with an experience of a relationship with a sensitive, caring, caregiver, which can form the basis for new good internal objects
2) Therapist can be the object of the client's transference and help the client integrate dissociated, split-off parts of the self
Attachment theory and projective identification
-Process by which individuals project disowned parts of the self into others
-Watch for introjective identification- the person projecting unconsciously identifies with it and feels subtle, unconscious interpersonal pressure to be and act like the projection
Object Relations and stages of therapy (Cashdan)
Engagement- emotional linking, offering advice
Projective Identification- look for issues of dependency, power, sexuality, ingratiation
Confrontation- discuss in a straightforward manner, do not interpret or attempt to smooth things over
Termination- effects of project identification on others, interpretation, issues of separation
Systems theory (family therapy)
-Concerned with ways that complex systems maintain themselves
System-any set of two or more elements that interact in a patterned stable manner despite fluctuations in in their environment
-Every human can be viewed as a system, in both a biological and psychological sense.
-Groups of humans can be viewed as systems
Systems theory applied to counseling
-Shift from an individual to a system level- problems viewed as residing in a system, not an individual. The individual who is the focus of the problems is referred to as the "identified patient"
-Shift from linear to circular causality- problems viewed as resulting from mutual processes rather than unidirectional processes
Stability and change in systems
Homeostasis- tendency of systems to seek stability ; tendency of patterns to maintain themselves
Negative feedback- communication that maintains patterns in a system (system can be either good or bad)
Positive feedback- communication that changes patterns in a system (changes can be both positive or negative)
Equifinality- ability to achieve a particular goal via a number of different routes
Minuchin
Founder of structural family therapy
Family structure
Rules that families develop regarding who interacts with whom in what ways (roles)
-Focus on power and affiliation
-Structure changes over time
-Healthy families have a hierarchical structure
-Grouping of family members called "subsystems" includes rules about which members are supposed to work together for a common purpose
Family structure & Minuchin
-Boundaries around subsystems vary in how permeable they are
-In healthy families, boundaries are open enough to encourage belongingness and flexibility, and strong enough to encourage a sense of identity in a subsystem
Structural perspective on problems
-Psychological problems of family members means:
1) Problems in subsystem boundaries
2) Problems in subsystem functions
Structural Perspective & Boundaries
-Families with overly permeable boundaries are "enmeshed". There are no real roles
-Families with rigid boundaries are "disengaged". No knowledge of individual roles
Structural Perspective & Functions
-Dysfunctional families often have subsystems with inappropriate tasks or functions
Axioms of structural therapy
-Psychic life is not all internal; there are interactions with others and the environment
-Changes in the family structure can result in internal changes
-The therapist becomes part of the system
Goals of structural family therapy
1) Reduce symptoms of dysfunction
2) Alter the current family structure by:
-Changing inappropriate alliances, coalitions, and tasks
-Establish boundaries that are neither too rigid nor too flexible
-Create an effective hierarchical structure
Structural Family therapy and Insight Techniques
Joining- Involves building an alliance with the family, accomodating to the family's way of interacting and communicating
Family mapping- using graphs to illustrate current boundaries (Bowen used genograms, these were less focused on family dynamics and more developmental)
Structural Family therapy and Techniques
Enactment- involves having a family act out a typical conflict situation
Changing boundaries- by having members sit in a new location or assigning tasks that require members to interact in a new way
Reframing- involves framing an event or situation in a new way, figuring out the families understanding of a problem
Limitations of structural family therapy
-Some clients may have problems that do not appear to be closely related to current family dynamics (Axis I disorders)
-Requires a commitment of the whole family
-"Respect for culture" may involve accepting culturally based norms regarding gender, sexual orientation, childbearing.
-Minuchin accused of "mom blaming"
Bowenian therapy
-Sees family patterns continuing across generations
-Emphasis on triangulation within families (stress between two plp, and a third is brought in to allieviate stress)
Differentiation & Bowenian
-Between thoughts and feelings is vital to well-being, and results in a strong sense of self
-Undifferentiated family members are most susceptible to triangulation
Triangulation and Bowenian
-Helpful if the 3rd person is able to be objective and to help solve the problem
-If the 3rd person is less differentiated, they will have trouble being objective
-Role the therapist takes in therapy
-Bowen is not optimistic about adequate differentiation existing within the family
Bowenian & issues within families
-Plp who are poorly differentiated project stress onto others
-One way to handle undifferentiation is emotional cutoff, which increases as a function of dependence and anxiety
-Difficulties are transmitted across generations
Bowenian therapy and techniques
1) Evaluation interview: should be comprehensive (relationships)
2) Pay attention to level of differentiation
3) Genograms
4) Interpretation: emphasized a focus on the thoughts and differentiation, direct comments through the therapist
5) Detriangulation: the goal is to stop this and help people resolve difficulties between each other directly
Hayley's Guidelines for therapy
1) Avoid meanings of life
2) Avoid the past
3) Avoid thinking problems are identical
4) A young therapist should try not to be wiser than they are
5) Avoid leaving goals unformulated
6) Ask explicitly but not necessarily directly
7) Multiple therapists can make change difficult
8) Avoid allowing irreversible positions
Factors affecting group therapy
1) length of time (time-limited vs. ongoing)
2) Amount of structure
3) Degree of focus or the issue of the group
4) Open vs. closed group
Yalom and group therapy
-Focus is on the therapeutic factors, he believes to be effective across different types of groups (some mechanisms for change are the same as some conditions for change)
-Emphasizes the importance of the scientific method in determining what works
Yalom's 11 factors
1) Instillation of hope
2) Universality
3) Imparting Information (Didactic information or direct advice)
4) Altruism
5) Corrective Recapitulation of the primary family group (while still remaining present focused)
6) Development of socializing techniques (corrective vs. reconstructive)
7) Imitative Behavior
8) Interpersonal learning (through parataxic distortions, transference issues)
9) Catharsis
10) Group Cohesiveness
11) Existential factors- recognizing the reality of life's injustices, facing the reality of pain and death in life, learning to take responsibility for one's own life regardless of how much you go to others for guidance and support
Yalom and insight
It is essential, although there is no "best" level of insight, sees it as categorical (there are different levels)
Yalom and levels of insight
-Go in order of degree of inference
1) Interpersonal interpretation of how others see you
2) Understanding your own complex behaviors
3) See your motivations
4) Genetic insight- how did your motivations develop
-Big events in therapy as well as insight are other important things besides the 11 factors
Tasks of the therapist in Group Therapy
1) Creation: sending out fliers, talking to patients, etc.
2) Gatekeeping: who is allowed in and out of the group
3) Maintenance of stability: Most important thing, Dealing with scapegoating, subgrouping, absences, plp arriving late, etc.
4) Decentralizing: change in a pattern over time in which members first talk to the leader, and then to one another
5) Culture Building: Shaping the social system with the purpose of developing a safe therapeutic environment; therapist is the initial model for the rules of the group
6) Accepting the premises:
-Only I can change the world I have created for myself
-There is no danger in change, it is worth it
-To attain what I really want I must change
-I can change, I am potent
How a therapist accomplishes tasks of group therapy
1) Direct instruction
2) Reinforcement (by therapist and other members)
3) Modeling
4) Therapist should be transparent
5) Self-disclosure
6) Focus on the present
7) Managing transference (not really going for the genetic level of insight)
8) deal with resistance to group
Choosing grp members
-Plp who can and will contribute
-Should not have plp on the opposite ends of psychological extremes or of very different problems
-How will the client fit in? (Don't want them to be too dissimilar)
-Try to get someone who can tolerate a moderately high level of discomfort
Stages of the group
1) Forming and norming-(first one is the only one that happens in order, the others are fluid) dependency on the group leader, rule development
2) Conflict-around interpersonal dominance when the leader isn't central
3) Harmony and cohesiveness-differences are managed
4) Mature Group development-high cohesiveness, interpersonal and intrapersonal investigation, and commitment to the group task and member tasks
Average Effect Size of therapy
.85-.89. The average person in therapy did better than 80% of the control group
Types of therapy and client suitability
-CBT better for depression
-Client Centered better for self-esteem
Main conclusions of psychotherapy outcome study
-Different types of therapy do not produce different types or degrees of benefit
-Differences in how psychotherapy is conducted make very little difference in how effective it is
-Psychotherapy is "scarcely" any less effective than drug therapy in the treatment of serious psychological disorders