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455 Cards in this Set
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- Back
- 3rd side (hint)
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Strategic Therapy - Key Theorists
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Jay Haley and Cloe Madanes
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Strategic Therapy
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Strategic Therapy - Key Concepts
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Symptoms Serve a Purpose
Hierarchy Family Development Communication and Control Love and Violence |
Strategic Therapy
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Strategic Therapy - Goals
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Interrupt the covert hierarchical structure and covert alliances
Change the style of interaction in the social unit |
Strategic Therapy
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Strategic Therapy - Structure of Therapy
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Highly structured initial session divided into 4 states - social, problem, interaction, and goal-setting
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Strategic Therapy
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Strategic Therapy - Assessment
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Conceptualizing the Problem:
Voluntary vs Involuntary Helplessness vs Power Metaphorical Meaning vs Literal Meaning Hierarchy vs Equality Personal Gain vs Altruism |
Strategic Therapy
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Strategic Therapy - Techniques
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Directives
Metaphoric Task Paradoxical Injunction Ordeal Therapy Pretend Techniques Restraining and Going Slow Positioning |
Strategic Therapy
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Hierarchy
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Strategic Therapy
The natural organization and distribution of power within any organizational system -- or -- repetitive sequences of who tells whom what to do |
Strategic Therapy
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Family Life Cycle States
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Strategic Therapy
1. Courtship Period 2. Marriage 3. Childbirth and young children 4. Middle Marriage 5. Weaning parents from children 6. Retirement and old age |
Strategic Therapy
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Family problems develop around four basic intentions according to Madanes
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1. To dominate and control
2. To be loved 3. To love and protect others 4. To repent and forgive |
Strategic Therapy
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Social State
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Therapist observes family interaction, mood, relationship dynamics, and organization of the family members
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Strategic Therapy
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Problem Stage
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Therapist gathers information about the problem situation
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Strategic Therapy
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Interaction Stage
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Family discussion about the problem, providing therapist with opportunity to observe communication patterns, organization, and power hierarchies
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Strategic Therapy
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Goal-Setting Stage
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* Conclusion of initial session
* highlight and clarify problem situation while addressing therapeutic goals and precisely defining the presenting problem * problem defined in "operational" terms |
Strategic Therapy
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Directives
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Assignments to be performed inside and outside of the therapeutic session; key intervention for SFT
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Strategic Therapy
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Metaphoric Task
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A statement or activity that represents or resembles something else
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Strategic Therapy
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Paradoxical Injunction
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Directive or extended message that is apparently inconsistent with itself or with the purpose of therapy; prescribing the symptom changes the behavior from a spontaneous act to a conscious act
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Strategic Therapy
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4 Basic types of Paradoxical Injunction
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*Compliance-based
*Defiance-based *Exposure-based *Control-based |
Strategic Therapy
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Compliance-Based Paradoxical Injunction
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Hoping for compliance, i.e. instruct a worrier to worry for set period each day
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Strategic Therapy
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Defiance-Based Paradoxical Injunction
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Hoping for defiance, i.e. ineffective parents are instructed to ask permission from child before setting rules
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Strategic Therapy
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Exposure-Based Paradoxical Injunction
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Revealing covert alliances, i.e. father gives daughter a quarter each time she defies mother in situation where father and daughter have coalition against mother
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Strategic Therapy
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Control-Based Paradoxical Injunction
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Aims at Gaining control of behavior, i.e. Instruct couple to argue for 20 minutes each day to gain more awareness of how they start and stop an argument
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Strategic Therapy
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Ordeal Therapy
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Assist in alleviating the symptom by making it more trouble to maintain the symptom than to give it up
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Strategic Therapy
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Pretend Techniques
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Techniques that (a) allow the system to maintain homeostasis without the person genuinely suffering from the symptom, (b) often have a paradoxical effect of highlighting the control one actually has over the symptom, and (c) serve to disrupt problem patterns in the family
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Strategic Therapy
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Positioning
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Therapist addresses resistance by exaggerating it to hopelessness and the illusion of no alternatives. Serves to encourage the client family to prove to the therapist that they are as good as other people
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Strategic Therapy
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Structural Family Therapy - Key Theorists
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Aponte, Fishman, Minuchin, Montalvo
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Structural Family Therapy
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Structural Family Therapy - View of Families
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Views the family as a system structured according to set patterns and rules that govern family interactions
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Structural Family Therapy
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Structural Family Therapy - Structure/Subsystems
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Family is composed of multiple subsystems that function within the whole; therapist looks at the family as more than an aggregate of differentiated subsystems and considers it as an organism in itself
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Structural Family Therapy
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Structural Family Therapy - Focus of Treatment
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therapist must be aware of other relevant data and systemic processes that may be affecting the situation, not just the identified presenting problem by the patient
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Structural Family Therapy
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Diffuse Boundaries
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Lead to Enmeshment
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Structural Family Therapy
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Rigid Boundaries
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Lead to disengagement
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Structural Family Therapy
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Covert Coalition
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members establish a destructive coalition, which serves as a source of conflict
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Structural Family Therapy
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Subsystems
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individual, spousal, parental, sibling, etc
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Structural Family Therapy
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In Structural Family Therapy, Family Structure is influenced by...
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cultural norms
interactional patterns family history intergenerational rules |
Structural Family Therapy
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In Structural Family Therapy, the therapist works with the family by educating and assisting them to become aware of ....
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structure, boundaries, patterns, rules, and detrimental familial processes
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Structural Family Therapy
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Structural Family Therapy Goals
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Obtain assurance that the structural process will provide benefits for the entire family
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Structural Family Therapy
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Structural Family Therapy - Goals
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Alter the dysfunctional structure to promote problem solving and facilitate growth of the system and to resolve symptoms
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Structural Family Therapy
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In Structural Family Therapy, restructured family systems include:
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generational hierarchy, parental coalition, spousal subsystem, and clear boundaries between all individuals and subsystems
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Structural Family Therapy
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Structural Family Therapy - Results in....
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Subsystems are restructured and reorganized to eliminate the presenting complaint
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Structural Family Therapy
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Structure of Structural Family Therapy (3 Phases)
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(a) joining and accommodating
(b) mapping family structure (c) intervening |
Structural Family Therapy
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Joining & Accommodating
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therapist enters the family system in a hierarchical stance as the "leader"
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Structural Family Therapy
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Family Map
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% Structural Family Therapy %
a static entity that identifies each family member's position in the family while highlighting interaction patterns, conflicts and coalitions Through the process of family mapping, the therapist devises an initial hypothesis, compiles diagnostic information, and begins intitial goal setting procedures |
Structural Family Therapy
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Intervening
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% Structural Family Therapy %
Therapists uses techniques that strengthen and clarify structure and boundaries |
Structural Family Therapy
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Structural Family Therapy Assessment of Systems Structure Includes:
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boundaries
complementarity hierarchy conflict management |
Structural Family Therapy
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Boundaries in Structural Family Therapy are ...
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Clear
Diffuse or Rigid |
Structural Family Therapy
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Complementarity Problems in Structural Family Therapy are ...
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pursuer-distancer
active-passiv dominant-submissive |
Structural Family Therapy
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Hierarchy in Structural Family Therapy is ...
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determined and maintained by the systems rules, boundaries and interactional patterns; refers to the arrangement and structural delineation of power within the system
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Structural Family Therapy
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Conflict Management in Structural Family Therapy is ...
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The system's ability to resolve conflict and negotiate solutions.
Disengaged families - members avoid contact to avoid conflict Enmeshed families - cross-generational coalitions develop to manage conflict |
Structural Family Therapy
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Spontaneous Behavioral Sequences
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Similar to enactments, except behaviors are spontaneous rather than directed by the therapist
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Structural Family Therapy
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Challenging Family Assumptions
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Discover the family's narrowed perception of reality and challenge their reality be educating them on appropriate family structure
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Structural Family Therapy
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Challenging the Symptom
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Challenging the family structure, and challenging the family reality
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Structural Family Therapy
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Reframing
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Enacting, focusing, and intensity
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Structural Family Therapy
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Affective Intensity
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"When did you divorce your husband and marry your son"?
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Structural Family Therapy
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Shaping Competence
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Highlighting the positive, strengths, and progress
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Structural Family Therapy
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Boundary making
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Done by physically or verbally intervening, altering spatial proximity, or recognizing and highlighting inappropriate boundaries
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Structural Family Therapy
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Unbalancing
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* Broadening the focus
* involves temporarily taking sides to change family interaction * by expanding the problem beyond the family focus the therapist raises hope that a different way of looking at the problem will bring a solution |
Structural Family Therapy
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Structural Family Therapy - Techniques
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Joining
Planning Family Mapping Enactments |
Structural Family Therapy
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Joining
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* more an attitude than a technique
* therapist tracks interaction and communication, adapts and accommodates to their style, rules, and patterns * joining involves mimesis which includes using, matching, and acknowledging the system's metaphors and themes |
Structural Family Therapy
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Planning
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* therapist theorizes about the family structure while remaining curious about is structural reality
* Initial hypothesis is tested in joining with the family and observing the structure and then is altered or discarded. |
Structural Family Therapy
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Family Mapping
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Constructed through observations and interactions with the family
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Structural Family Therapy
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Family Mapping - 6 Areas to Assess For when observing Interaction
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1. family structure and transactional patterns
2. Flexibility and the ability to restructure 3. Resonance (sensitivity to the individual members' actions) 4. Family life context (support and stress) 5. Family life developmental stage 6. Ways the problem issue is maintained through family interactions |
Structural Family Therapy
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3 Components of Enactments
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1. recognize sequences by observing the spontaneous transactions of the family and decides which dysfunctional areas to highlight
2. directs the enactment by directly aksing to family to reenact a specific problem conversation or event 3. directly intervenes and redirects the interactions |
Structural Family Therapy
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Milanic Systemic Approach - Key Theorists
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Boscolo
Cecchin Palazzoli Prata Hoffman Tomm Penn |
Milanic Systemic Approach
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Milanic Systemic Approach - History
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Attempted to put into practice the systemic ideas of Gregory Bateson, viewing family interaction as a set of rules the is best intervened upon with paradox
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Milanic Systemic Approach
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Milanic Systemic Approach - Key Concepts
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*Epistemology and Epistemological Error
*Games *Meaning Versus Action *Tyranny of Linguistics |
Milanic Systemic Approach
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Epistemology
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Study of knowledge and knowing
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Milanic Systemic Approach
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Epistemological Errors
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Erroneous set of beliefs or distinctions that an individual or family uses to make sense of the world (i.e. one individual's behavior can be the "cause" of another's behavior)
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Milanic Systemic Approach
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Games
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Unacknowledged strategies and destructive patterns of family interaction in which members attempt to control each other's behavior.
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Milanic Systemic Approach
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Meaning Versus Action
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Therapist distinguishes between meaning and action to help correct epistemological errors
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Milanic Systemic Approach
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Tyranny of Linguistics
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The therapist uses language to create new interpretations of the situation (i.e. he shows depression, acts depressed, or appears to be depressed, rather than he is depressed)
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Milanic Systemic Approach
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Milan Systemic Approach - Goals of Therapy
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Focus of Treatment - New Meaning
* focus on providing new meanings and distinctions that will alter unproductive rules for family behavior and the family game |
Milanic Systemic Approach
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Milan Systemic Approach - Structure of Therapy
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* Long-Term Brief Therapy
* highly structured * relatively few sessions (generally 10) are held approximately once a month * time between sessions is required for interventions to take effect |
Milanic Systemic Approach
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Milan Systemic Approach - Five Segments of Therapy Session
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Pre-session
Session Intervention Intersession Intervention Discussion |
Milanic Systemic Approach
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Milan Systemic Approach - Techniques
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A Learning Process
Team Approach Hypothesizing Circular Questioning Neutrality Positive Connotation Counterparadox Rituals Invariant Prescription |
Milanic Systemic Approach
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A Learning Process Technique
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Through the process of trial and error and the resulting feedback, additional information is acquired and used to formulate new interventions
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Milanic Systemic Approach
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Team Approach Technique
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1 or 2 of the team members work directly with the family and the others watch behind a one-way mirror; results in a collective mind that is self-correcting
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Milanic Systemic Approach
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Hypothesizing (Technique)
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therapist continually develops hypothesis about family interaction patterns and games and modifies them as the family presents additional information
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Milanic Systemic Approach
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Circular Questioning
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Serve to highlight systemic interaction patterns in the family; focus on specific behaviors rather than feelings or interpretations
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Milanic Systemic Approach
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Types of Circular Questioning
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Relational and interaction pattern questions ("What does your father do when you argue with your mother')
Future oriented questions ("If your mother stopped worrying, what would your father do") Comparisons and Rankings Questions ("Who gets the most upset when you fail") Before and after change questions ("What were the fights like before versus after father's heart attack") |
Milanic Systemic Approach
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Relational and Interaction Pattern Questions (Circular)
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"What does your father do when you argue with your mother"
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Milanic Systemic Approach
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Future-oriented questions (Circular)
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"If your mother stopped worrying, what would your father do"
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Milanic Systemic Approach
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Comparisons and Ranking questions (Circular)
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"Who gets most upset when you fail"
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Milanic Systemic Approach
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Before and After Change Questions (Circular)
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"What were the fights like before versus after father's heart attack"
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Milanic Systemic Approach
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Neutrality Technique
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Therapist remains allied with all family members and avoids involvement in family coalitions. Milan therapists maintain a strictly neutral manner and attempt to avoid blaming anyone for anything
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Milanic Systemic Approach
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Positive Connotation (Technique)
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Symptomatic behavior is reframed with a positive connotation.
Assist in establishing that all family members are on the same level, highlights the system's homeostatic tendency, and prepares the way for the paradox |
Milanic Systemic Approach
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Counterparadox (Technique)
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Request that the family not change although they came to therapy in order to change, referring to the dysfunction as "right and legitimate"
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Milanic Systemic Approach
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Rituals (Technique)
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Assigned as an intervention that helps provide clarity and consistency in family relationships; highly structured events that are prescribed by the team
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Milanic Systemic Approach
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Invariant Prescription (Technique)
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The prescription requires that the parents forma tight alliance and reestablish their relationship as a couple by having them engage in activities that are kept secret from the children; consists of 4 parts
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Milanic Systemic Approach
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4 Parts of Invariant Prescription (Technique)
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1. Therapist directs the parental unit to maintain a sense of secrecy about the therapy session to which the children are not invited
2. Parental unit is told to go on secret outings 3. Maintaining secrecy from the children even when asked about the outings 4. Directs parental unit to keep a personal diary or notebook that will contain a record of every piece of verbal or nonverbal behavior from children and others that may have resulted from the prescription. |
Milanic Systemic Approach
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Mental Research Institute Approach (MRI) - Key Theorists
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Theoretical Background:
Bateson Erickson von Foerster Clinical Application Risch Jackson Watzlawick Weakland |
Mental Research Institute Approach (MRI)
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MRI founding director
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Don Jackson
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Mental Research Institute Approach (MRI)
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MRI - Key Concepts
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Problem
The Interactional View The Problem is the Attempted Solution More of the Same First and Second order Change Communication Report and Command Functions Metacommunication Double Bind Symmetrical and Complementary Relationships |
Mental Research Institute Approach (MRI)
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MRI - Problem (Key Concept)
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Persistent failed attempts to change some distress; created and maintained through the mishandling of difficulties
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Mental Research Institute Approach (MRI)
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MRI - Interactional View (Key Concept)
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Therapist focuses on current behavioral patterns and sequences
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Mental Research Institute Approach (MRI)
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MRI - The Problem is the Attempted Solution (Key Concept)
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Problems arise and are maintained as the result of:
1. mistaken attempts at changing an existing difficulty 2. Initiating changes when they are not necessary 3. Not taking action when change is necessary, and/or 4. Making changes at the wrong level |
Mental Research Institute Approach (MRI)
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MRI - More of the same (Key Concept)
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Therapist focuses on reversing the "more of the same" solutions
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Mental Research Institute Approach (MRI)
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MRI - First Order Change (Key Concept)
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A change in the system's interactional patterns; occurs when the system itself remains unchanged
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Mental Research Institute Approach (MRI)
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MRI - Second Order Change (Key Concept)
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Requires change in the organization of the system and is characterized by a change in the client's perspective and assumptions, a change in the system, and is referred to as "change of change"
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Mental Research Institute Approach (MRI)
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MRI - Communication (Key Concept)
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* All behavior is communication at some level
* MRI therapists closely observe the various levels of communication between people and identify how these patterns contribute to the maintenance of problems |
Mental Research Institute Approach (MRI)
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MRI - Report and Command Functions (Key Concept)
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Every communication has 2 aspects: report (content) and command (relationship). Report = literal message and Command = action that cues the message recipient on how to interpret the message and thereby defines the present relationship.
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Mental Research Institute Approach (MRI)
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MRI - Metacommunication (Key Concept)
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Refers to the command aspect (or action or behavior) of communication; it is the communication about the communication. Includes non-verbal clues
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Mental Research Institute Approach (MRI)
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MRI - Double Bind (Key Concept)
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Destructive form of paradoxical communication.
Examples of double bind messages: "be spontaneous", "love me". Therapist intervenes upon double binds by addressing the metacommunication. |
Mental Research Institute Approach (MRI)
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MRI - Symmetrical and Complementary Relationships (Key Concept)
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symmetrical interactions - participants mirror each other's behavior
complementary interactions - one person assumes a position and the other assumes the opposite position. Symmetrical relationships risk becoming competitive, while complementary relationships can become oppressive. Therapist assesses for extremes in either form of relationship |
Mental Research Institute Approach (MRI)
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MRI - Goals of Therapy
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Focus on interrupting attempted solutions that are maintaining the problem;
Break the operationalized goals into small, concrete steps to help the family achieve a sense of confidence and progress as early as possible. Therapists asks "at a minimum, what change would indicate to you that a definite step forward has been made?" |
Mental Research Institute Approach (MRI)
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MRI - 5 questions in Case Planning
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1. What is (are) the attempted solutions? What command (metacommunication) is common to the solution used bye the client? What are the minefields to avoid?
2. What would be a 180-degree shift from the attempted solution 3. What specific behavior would operationalize this shift? 4. Given the family's position, how can the therapist "sell" the behavior? 5. What might the client report that would signal that the intervention has been successful and the case is ready for termination? |
Mental Research Institute Approach (MRI)
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MRI - Structure of Therapy (4 stages)
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1. Identify and explore the problem
2. Identify attempted solutions and the results of such solutions 3. Formulate a concrete goal 4. Intervene utilizing MRI techniques and the client's language |
Mental Research Institute Approach (MRI)
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MRI - Assessment (4 step procedure)
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1. Define the problem and identify how it is a problem
2. Determine which solutions have been tried and identify the outcome of such attempts 3. Obtain a clear description of the concrete change to be achieved 4. Formulate and implement a plan to produce change |
Mental Research Institute Approach (MRI)
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MRI - 4 Ways Solutions can be Mishandled
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1. Attempting to be deliberately spontaneous
2. Seeking a no-risk method when some risk is inevitable 3. Attempting to reach interpersonal accord through opposition 4. Confirming the accuser's suspicions by defending onself |
Mental Research Institute Approach (MRI)
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MRI - Techniques
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Initial Interview questions
Reframing Prescribing the Symptom Relabeling Dangers of Improvement "Go Slow" Making the Covert Overt Advertising Rather than Concealing the Problem Bellac Ploy |
Mental Research Institute Approach (MRI)
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Initial Interview Questions (Technique)
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1. What is the problem that brings you here today
2. How is it a problem 3. What does it stop you from doing or make you do that you do not want to do? |
Mental Research Institute Approach (MRI)
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Reframing (Technique)
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Change the conceptual and/or emotional setting or viewpoint in relation to which a situation is experienced and place it in another frame which fits the facts of the same concrete situation equally well or even better, thereby changing its entire meaning.
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Mental Research Institute Approach (MRI)
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Reframing (Technique)
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Emphasize the importance of using the client's language when reframing the problem for the reframe to have significance to the client
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Mental Research Institute Approach (MRI)
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Prescribing the Symptom (Technique)
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Therapeutic double bind - therapist encourages the client to engage in symptomatic behavior. Engaging consciously in previously spontaneous behavior renders resistance unnecessary.
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Mental Research Institute Approach (MRI)
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Relabeling (Technique)
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"withdrawal" = needing personal space or needing time to think. The situation does not change, but the meaning attributed to it changes
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Mental Research Institute Approach (MRI)
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Dangers of Improvement "go slow" (Technique)
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Clients are paradoxically instructed to "go slow" so that assignments are carried out carefully.
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Mental Research Institute Approach (MRI)
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Making the Covert Overt (Technique)
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Therapist prescribes behaviors in such a way that covert processes are highlighted.
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Mental Research Institute Approach (MRI)
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Advertising Rather than Concealing the Problem (Technique)
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Have the client advertise a socially inhibiting or embarrassing handicap, which has the paradoxical effect of reducing anxiety
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Mental Research Institute Approach (MRI)
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Bellac Ploy (Technique)
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Complimenting another with the paradoxical result of making that person so (i.e. complimenting a stranger about his/her kindness, that person is more likely to act in that way)
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Mental Research Institute Approach (MRI)
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Communications Approach - Key Theorists
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Banmen
Gerber Gomori Satir |
Communications Approach
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Communications Approach - History
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Satir argued that the power of warmth and love was essential in therapy
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Communications Approach
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Communications Approach - Key Concepts
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Four Primary Assumptions
Primary Survival Triad Body, Mind, and Feelings Communication Self-Worth Survival Stances |
Communications Approach
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4 Primary Assumptions (Key Concept)
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1. People naturally tend toward positive growth
2. All people possess the resources for positive growth 3. Every person and every thing or situation impact and are impacted by everyone and everything else 4. Therapy is a process which involves interaction between therapist and client and in this relationship each person is responsible for him/herself |
Communications Approach
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Primary Survival Triad (Key Concept)
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Consists of the child and both parents. Has a significant impact on both self-worth and survival stances
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Communications Approach
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Body, Mind, and Feelings (Key Concept)
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Methods of communication and form the second triad in Satir's theory.
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Communications Approach
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Communication (Key Concept)
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All forms of behavior are considered communication. Discrepancies between verbal and non verbal cues contribute to interpersonal dysfunction and are referred to as "incongruent communication".
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Communications Approach
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Self-Worth (Key Concept)
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Satir's approach strives to acknowledge and validate each person's inherent worth
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Communications Approach
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Survival Stances (Key Concept)
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People adopt survival stances to protect their self-worth against verbal and nonverbal, perceived and presumed threats.
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Communications Approach
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5 Survival Stances (Key Concept)
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Placater (say yes to everything, disregard our own feelings of worth)
Blamer (blaming stance to ward of perceived threat) Superreasonable (computerlike, rigid, devoid of feelings) Irrelevant (reflects unrelated and distracting behaviors) Congruence (words and feelings match) |
Communications Approach
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Communications Approach - Goals of Therapy
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Focus is on growth at the individual and systemic levels based on the assumption that growth will result in symptom reduction.
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Communications Approach
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Communications Approach - 3 Goals for Improved Communication in the Family System
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1. Congruence
2. High Self-Esteem 3. Personal growth |
Communications Approach
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Communications Approach - Structure of Therapy (6 Stages)
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1. Status Quo
2. Introduction of a Foreign Element 3. Chaos 4. New Possibilities/New Options and Integration 5. Practice/Implementation 6. Goal Attainment/The New Status Quo |
Communications Approach
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Communications Approach - Assessment
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Assessment of (a) family system's symptomatic behavior, (b) communication patterns and stances, and (c) the influence and exploration of family of origin issues
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Communications Approach
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Communications Approach - Symptomatic Behavior
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Serves as the system's homeostatic mechanism and attempts to maintain homeostasis or the status quo
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Communications Approach
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Communications Approach - Communication and Survival Stances
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Exploration of the family's congruent/incongruent communication patterns and each person's survival stance
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Communications Approach
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Communications Approach - Family of Origin
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Reviews and assesses family of origin issues for a better understanding of the current situation and may create a family life fact chronology to record information
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Communications Approach
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Communications Approach - Techniques
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Role of Therapist
Modeling Communication Family Life Fact Chronology Family Sculpting Metaphors Self-Mandala Parts Party Ingredients Intervention Transforming Rules Temperature Reading Family Reconstruction |
Communications Approach
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Role of Therapist (Technique)
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The therapist is an equal, unique individual whose role is to assist in the process of facilitating change; therapist is a "change agent"
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Communications Approach
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Modeling Communication (Technique)
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Therapist models congruent communication by following 3 guidelines:
1. Must speak in the first person by communicating and responding with "i" messages 2. Must express thoughts and feelings directly while avoiding statements or declarations about what others may think or feel 3. Must be honest with others |
Communications Approach
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Family Life Fact Chronology (Technique)
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Depicts important events in the life of the family; charting technique that involves 3 complete generations of the family system; used as preparation for family sculpting and family reconstruction
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Communications Approach
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Family Sculpting (Technique)
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Clients and/or therapist physically place family in a position that symbolizes their role in the family system (from the sculpter's perception)
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Communications Approach
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Metaphors (Technique)
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Metaphors are powerful tools for promoting change; used to communicate ideas that language cannot directly describe or to introduce threatening material
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Communications Approach
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Self Mandala (Technique)
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Consists of an innermost circle with the phrase "I am" and eight concentric circles arranged in the following order: physical, intellectual, emotional, sensual, interactional, nutritional, contextual, and spiritual; used to discuss clients strengths, resources, and challenges
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Communications Approach
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Parts Party (Technique)
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Identifies, transforms, and integrates inner resources and assists in the process of identifying and acknowledging one's wholeness and parts
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Communications Approach
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Ingredients Intervention (Technique)
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6 questions increase awareness and address exploration of one's interaction with others:
1. What do i hear and see? 2. What meaning do I make of what I hear and see? 3. What feelings do I have about the meaning I make? 4. What feelings do I have about these feelings? 5. What defenses do I use 6. What rules for commenting do I use? |
Communications Approach
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Transforming Rules (Technique)
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3 steps involved in transforming a rule into a more functional guideline:
1. Change the should to a can 2. Expand from never to sometimes 3. Identify possibilities of I can |
Communications Approach
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Temperature Reading (Technique)
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Client and/or family share specific information about:
*Appreciations and Excitements *Worries, Concerns, and Puzzlements * Complaints and Possible Solutions * New Information * Hopes and Wishes |
Communications Approach
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Family Reconstruction (Technique)
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Implemented in a large group setting that takes several hours to complete. Phase 1, family shares its life story, followed by:
* Sculpting the family of origin * Sculpting mother and father's family of origin * Sculpting Parents' Meeting and Marriage * Resculpting the family of origin |
Communications Approach
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Panic Disorder
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At least 2 panic attacks in order to be considered panic disorder
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Parasomnias
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Abnormal behaviors during sleep
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Genital State
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Freud: final stage of psychosexual development
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Cyclothymic disorder
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Long-term depressed mood alternating with mood elevation (less severe than major depressive or manic episode)
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Conduct Disorder
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Cruelty to animals, lying and arson
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Autism
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Pervasive development disorder that includes social impairment, communication impairment and limited range of interests
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Erickson
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Ego psychology: development of ego identity, 8 stages of development (theoretical background development of MRI)
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Alzheimer's disease
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Most Common type of dementia
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Displacement
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Unacceptable emotions are redirected from dangerous objects or safer ones with this defense mechanism
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Dissociative fugue
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Loss of memory and identity confusion accompanied by sudden travel away from home
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Hallucinations
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Things are sensed (seen, heard, felt, smelled, tasted) that are not present; a psychotic symptom; auditory hallucinations are most common
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Client-centered therapy
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Empathy, unconditional positive regard and genuineness are needed
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DSM-IV axes
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Five of them
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Classical conditioning
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According to Pavlov, a behavior is learned when a stimulus is paired with an unconditioned stimulus to bring about a conditioned response
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Anhedonia
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Inability to feel pleasure
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Types of panic attacks
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Unexpected, situationally bound, and situationally predisposed
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Collective unconscious
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Carl Jung theorized that humanity has an understanding of human history through this
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Alfred Adler
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Individual psychology: overcoming feelings of inferiority, developing social interest.
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Magnitude
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Strength of correlation, expressed as a numerical value of "r"
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Dependent personality disorder
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People want to find others to take care of them, tendency to be compliant, passive, and irresponsible; fearful of abandonment; do not like to be alone.
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Examples of depressants
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Sedatives (barbiturates and benzodiazepines), alcohol
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Treatments for delirium
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Treat medical conditions, benzodiazepines for drug withdrawal, psychosocial treatments
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Effects of long-term alcohol abuse
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Anxiety, hallucinations, insomnia, hand tremors, vomiting, delirium
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Informal or emergency civil commitment
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Two doctors can sign a commitment order for a short length of time (24 hours to 20 days)
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Schizoid personality disorder
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Prefer to be alone, low levels of emotion
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Agoraphobia
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Anxiety about being somewhere from which escape is difficult or embarrassing, sometimes in regard to a panic attack
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Schizophreniform disorder
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Schizophrenic symptoms have duration of less than 6 months
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Obsessive-Compulsive personality disorder
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Perfectionistic, controlling, excessively orderly
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Effects of Alcohol Use
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Neurotransmitter systems are affected, loss of inhibitions, motor coordination impaired, speech impaired, decision-making impaired, blackouts, seizures, hallucinations
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Sleepwalking disorder
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Complex motor behavior during sleep
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Reaction formation
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"Wrong" feelings are converted into their opposites with this defense mechanism
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Alzheimer's disease
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Onset is gradual, damage is irreversible, memory loss, inability to learn new information
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Axis IV
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Environmental and psychosocial problems (DSM-IV)
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Control group
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Independent variable is not manipulated in this group
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Systematic desensitization
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Form of counterconditioning developed by Wolpe
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Depersonalization disorder
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Reoccurring episodes of depersonalization, such as feeling like a robot or living in a dream
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Catatonic schizophrenia
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Motor disturbances
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Operant conditioning
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Skinner: Reinforcers and punishments will affect the learning of behaviors and their maintenance
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Affect
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Displayed emotions
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Generalized Anxiety Disorder
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Chronic anxiety and worry for at least six months
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Agnosia
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A symptom of dementia in which an individual cannot name or recognize objects
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Acute pain disorder
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Pain has lasted less than 6 months
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Effects of nicotine
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Dependence, withdrawal, cancer, heart disease, high blood pressure, confusion and convulsions (high doses)
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Counterconditioning
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Stimulus response is replaced by another response
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Moral Anxiety
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Guilt and shame that results from immoral behavior
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REBT
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Rational Emotive Behavior Therapy (Ellis)
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Sensorium
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Awareness of the environment
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Validity
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Test measures what it says it measures
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Omen formation
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Belief that disturbing events may be foretold
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CS
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Conditioned stimulus is a neutral stimulus that is paired with an unconditioned stimulus (Example: Pavlov's bell)
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Etiology of dementia
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Substance abuse or medical conditions (examples are Huntington's disease or Alzheimer's disease)
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How amphetamines work
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Increase norepinephrine and dopamine activity in the body
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Statistical significance
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Probability that a relationship happened by chance
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Opiate withdrawal symptoms
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Nausea, diarrhea, muscle pain, insomnia; may last a week
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Dependent variable
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Variable measured in an experiment
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Research
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Obsessive-Compulsive Disorder and insight
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Individual who has OCD realizes the irrationality and excessiveness of the obsessions/compulsions
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DSM-IV-TR
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Common OCD obsessions
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Contamination, sexual, aggressive, bodily complaints, order, perfection
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DSM-IV-TR
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Negative symptoms of schizophrenia
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Behavior deficiencie, including speech deficits, flat affect, motivational deficits
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DSM-IV-TR
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Independent variable
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Manipulated in an experiment
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Non-purging
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Bulimics who fast or exercise and do not regularly purge
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DSM-IV-TR
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Moderate mental retardation
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IQ is 40-55, 10% of mentally retarded population
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DSM-IV-TR
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Pedophilia
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Sexual arousal in regard to children
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DSM-IV-TR
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Situational sexual dysfunction
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Dysfunction that occurs at certain times, places or with certain partners
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DSM-IV-TR
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Latent content of dreams
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Unconscious desires that are masked by symbols in dreams
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Developmental coordination disorder
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Motor skills disorder
Significantly interferes with academic achievement or activities of daily living * Manifested in marked delays in achieving motor milestones, dropping things, clumsiness, poor performance in sports, or poor handwriting |
DSM-IV-TR
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Symptoms of low sexual desire
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Infrequent masturbation or sexual relations, few sexual fantasies
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Scientific statements
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Testable, based on observations, linked to measurable outcomes
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Research
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Anorexia nervosa, restricting type
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Restricts amount of food, exercises, does not binge
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DSM-IV-TR
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Psychoanalytic therapy
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Resolving childhood conflicts and removing repression
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Treatments for sexual dysfunction
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Education, alleviation of performance anxiety
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UCR
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Unconditioned response that is naturally produced by a stimulus (example: salivation of Pavlov's dogs in response to meat)
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Conversion symptoms
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May include paralysis, blindness, hallucinations, deafness, seizures, among others; a neurological condition is suggested
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Histrionic personality disorder
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Attention-seeking, excessive emotionality, easily influenced; may be inappropriately sexual and vague in speech
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DSM-IV-TR
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Social learning theory
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Bandura theorized that we learn by watching and imitating people
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Cognitive-Behavioral Therapy
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Rett's disorder
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Pervasive developmental disorder that appears after the first 5 months of normal development and before 48 months.
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DSM-IV-TR
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Insanity defense
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Not usually successful; used in about 2% of trials
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Dyssomnias
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Sleep disorders that include:
* Primary Hypersomnia * Narcolepsy * Breathing-Related Sleep Disorder * Circadian Rhythm Sleep Disorder |
DSM-IV-TR
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Gestalt therapy
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Insight therapy that holds the view that people are basically good, emphasizes our needs and wants, unfinished business, personal responsibility (Perls)
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Symbolic/Experiential Therapy Approach
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Projection
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Unacceptable desires are attributed to other people as a defense mechanism
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Insanity defense
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Not usually successful; used in about 2% of trials
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Substance dependence
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Addiction: increased tolerance, history of relapses, withdrawal symptoms, much energy used in procuring and recovering from substances
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Projection
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Unacceptable desires are attributed to other people as a defense mechanism
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Substance dependence
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Addiction: increased tolerance, history of relapses, withdrawal symptoms, much energy used in procuring and recovering from substances
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Disorganized speech in schizophrenia
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Incoherent, illogical, loose associations
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DSM-IV-TR
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Speech and cognition
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Cognition judged by content, rate, and continuity of speech
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Sexual masochism
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Pain or humiliation causes sexual arousal; a paraphilia
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DSM-IV-TR
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Cognitive-Behavioral Therapy
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Learning, storing and retrieving information; structuring experiences; techniques include cognitive restructuring, modeling, and counterconditioning
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Cognitive-Behavioral Therapy
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Natural environment type of phobia
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Childhood onset, fear of natural disasters and the environment
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DSM-IV-TR
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Depersonalization
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Feelings of detachment from self
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Genuineness
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Therapist honestly communicates emotions and experiences
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Biopsychosocial approach
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Psychopathology is caused by biological, psychological and social factors
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Sleep terror disorder
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Waking up from sleep and feeling intense fear, individual has limited memory of the event
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DSM-IV-TR
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Oedipus complex
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Child in the phallic stage sexually desires opposite-sex parent and fears same-sex parent. The fear is ameliorated by identification with same-sex parent.
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Hallucinations
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Things are sensed (seen, heard, felt, smelled, tasted) that are not present; a psychotic symptom; auditory hallucinations are most common
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Victims of incest
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Most likely victims are daughters
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Facial agnosia
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Inability to recognize familiar people
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DSM-IV-TR
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Axis I
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All mental disorders, except developmental disorders and personality disorders (DSM-IV)
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Schizophrenia, residual subtype
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Major symptoms have subsided
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Hallucinations
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Things are sensed (seen, heard, felt, smelled, tasted) that are not present; a psychotic symptom; auditory hallucinations are most common
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Victims of incest
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Most likely victims are daughters
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Facial agnosia
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Inability to recognize familiar people
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DSM-IV-TR
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Axis I
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All mental disorders, except developmental disorders and personality disorders (DSM-IV)
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DSM-IV-TR
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Schizophrenia, residual subtype
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Major symptoms have subsided
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DSM-IV-TR
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Paraphilias
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Disorders in which sexual arousal is inappropriately caused: voyeurism, exhibitionism, fetishism, sexual sadism, sexual masochism, pedophilia
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Etiology of GAD
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Individuals appear to be more aware of threats at an unconscious level
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Insight therapy
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Helps people understand their motivations
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Individual psychology
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Alfred Adler's model of psychology in which people struggle against feelings of inferiority and develop social interest
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Panic attacks
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Period of intense fear that includes at least 4 out of 13 symptoms listed in DSM-IV Derealization Feelings of unreality
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DSM-IV-TR
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Transvestites
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Achieve sexual arousal by wearing clothes of the opposite gender
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DSM-IV-TR
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Secondary process thinking
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Ego uses it to plan and make decisions
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Bulimia nervosa symptoms
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Binge eating, compensatory behaviors to prevent weight gain; self-esteem depends on body weight and shape
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DSM-IV-TR
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Manic episode
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At least 1 week; symptoms may include hyperactivity, flight of ideas, elevated mood, inflated self-esteem, decreased need for sleep
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DSM-IV-TR
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Medical model
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Abnormal behavior is diagnosed as a disease
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Childhood disintegrative disorder
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Regression appears after 2 years of normal functioning and before 10 years
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DSM-IV-TR
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Onset of social phobia
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Usually in mid-adolescence
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DSM-IV-TR
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Standardization
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Similar procedures are used each time test is administered
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Research
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Unconditional positive regard
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Client is treated with dignity and respect
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Obsessive-Compulsive Disorder and insight
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Individual who has OCD realizes the irrationality and excessiveness of the obsessions/compulsions
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DSM-IV-TR
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Conduct disorders
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Infringes on the rights of others and/or break social rules
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DSM-IV-TR
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Erikson
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Development of ego identity
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Axis V
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Global adaptive functioning (DSM-IV)
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DSM-IV-TR
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Projection
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Unacceptable desires are attributed to other people as a defense mechanism
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Fixation
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Freud: Stuck at a stage of development
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Insomnia
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Problem of not getting enough sleep
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Empathy
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Understanding the perspective of clients
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Disorganized speech in schizophrenia
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Incoherent, illogical, loose associations
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DSM-IV-TR
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Hypochondriasis
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Fear of having a serious disease, the fear often becoming an important part of the individual's self-concept; no medical basis found
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DSM-IV-TR
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Treatments for mood disorders
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Medications, ECT, cognitive therapy, interpersonal therapy
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ECT
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Electroconvulsive therapy in which seizures are produced by sending electrical impulses through the brain
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Antisocial personality disorder
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"Psychopathy" or "sociopathy"; disregard for the rights of others; tendency to be aggressive, dishonest, impulsive, irresponsible and unlawful
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DSM-IV-TR
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Chronic sexual dysfunctions
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"Lifetime" dysfunctions, not starting after a period of normality
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DSM-IV-TR
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Examples of opiates
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Opium, heroin, morphine, codeine, methadone
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Dissociative Identity Disorder
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Identities or personality states (alters) in an individual, formerly known as multiple personality disorder
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DSM-IV-TR
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ECT
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Electroconvulsive therapy in which seizures are produced by sending electrical impulses through the brain
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Korsakoff syndrome
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Alcohol abuse or vascular illnes causes brain (thalamus) damage that results in amnestic disorder
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Kleine-Levin Syndrome
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Individuals may sleep 18-20 hours
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Rational-emotive therapy
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Clients substitute rational thoughts for irrational thoughts
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Learning disorders
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Reading disorder, disorder of written expression, mathematics disorder
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DSM-IV-TR
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Jung
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Founder of analytical psychology; libido as general life energy, collective unconscious, spiritual needs, masculine and feminine traits in each person, personality traits, self-actualization)
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Obsessions
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Thoughts and urges that are irrational or intrusive
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Patterson and antisocial behaviors
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Patterson theorized that they were caused by lack of parental monitoring, failure to teach social and academic skills, and inconsistent parenting
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DSM-IV-TR
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Dissociative amnesia
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Inability to remember important personal information, reversible, may follow stressful events
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DSM-IV-TR
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Effects of depressants
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Central nervous system slows down; person feels calmer
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Prevalence of Alzheimer's disease
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In the U.S., approximately 4 million, most are 60 years old and older
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Polysubstance use
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Use of various psychoactive drugs
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Crack
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Form of cocaine that is hard
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Prevalence of schizophrenia
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1 out of 100 lifetime prevalence
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Risk factor
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Condition that increases the likelihood of getting a disorder
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Rorschach inkblot test
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Most widely used projective test
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Hypoactive sexual desire
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Lack of sexual desire
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DSM-IV-TR
|
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Correlational method
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Research that examines relationships among factors, does not determine cause and effect
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Displacement
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Unacceptable emotions are redirected from dangerous objects or safer ones with this defense mechanism
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Reliability
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Test gives consistent results over time
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Sensitivity training groups
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Purpose is to improve empathy skills and promote personal growth
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Risk factors for substance abuse
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Availability of drugs, stressors, mental disorders, genetic factors
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IQ score
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IQ tests measure the ability to do some cognitive tasks
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DSM-IV-TR
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Shared psychotic disorder
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Individual develops a delusion similar to person's with whom there is a close relationship
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DSM-IV-TR
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Enuresis
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Voiding of urine in inappropriate places
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DSM-IV-TR
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Sensorium
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Awareness of the environment
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Content of clinical interview
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Life history, family, education, culture, sexual history, religion, mental status exam, current problems, affect, mood
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Origin of opiates
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Poppies
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Learning approach
|
Bandura: we learn through modeling and seeing models being rewarded and punished
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Cognitive-Behavioral Therapy
|
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Severe retardation
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IQ is 25-40
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DSM-IV-TR
|
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Alleviation of withdrawal symptoms
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Use of the same or similar drug
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Axis II
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Personality and developmental disorders (DSM-IV)
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DSM-IV-TR
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Paranoid personality disorder
|
Distrustful, suspicious, jealous and may want to harm others and be hostile
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Compulsions
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Time-consuming and ritualistic actions (physical or mental) that a person feels driven to do
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DSM-IV-TR
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Panic disorders and medication
|
Benzodiazepines and tricyclic antidepressants, relapse is common when medication is stopped
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DSM-IV-TR
|
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Obsessive-Compulsive Disorder and insight
|
Individual who has OCD realizes the irrationality and excessiveness of the obsessions/compulsions
|
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Avoidant personality disorder
|
Feelings of inadequacy, fear of negative evaluation and social situations, fear of being shamed, may lead very restricted lives.
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DSM-IV-TR
|
|
|
Symptoms of fetal alcohol syndrome
|
Learning disabilities, cognitive disorders, behavior disorders, skin folds at corner of the eye, small head, and thin upper lip--Pregnant women should not consume any alcohol
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DSM-IV-TR
|
|
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Origin of cocaine
|
Coca plant
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Exhibitionism
|
Sexual arousal associated with exposure of genitals; element of risk important to the arousal
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DSM-IV-TR
|
|
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Disruptive behavior disorders
|
Include oppositional defiant disorder and conduct disorder--behaviors are negative, hostile, and defiant, and infringe on the rights of others
|
|
|
|
Former name of gender identity disorder
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Transsexualism
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DSM-IV-TR
|
|
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Cluster B personality disorders
|
Dramatic or emotional cluster: borderline, antisocial, narcissistic, histrionic
|
DSM-IV-TR
|
|
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Generalized Anxiety Disorder
|
Chronic anxiety and worry for at least six months
|
DSM-IV-TR
|
|
|
Stereotyped body movements
|
Repetitive movements and rigid behaviors
|
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Post-traumatic stress disorder
|
After a traumatic event, symptoms are intrusive memories, avoiding emotional triggers, emotional numbness, and arousal
|
DSM-IV-TR
|
|
|
Symbolic-Experiential Family Therapy - Key Theorists
|
David Keith
Walter kempler Thomas Malone August Napier Laura Roberto John Warkentin Carl Whitaker |
Symbolic-Experiential Family Therapy
|
|
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Symbolic-Experiential Family Therapy - History
|
Grew out of humanistic psychology and Gestalt Therapy; focused on change occurring through the growth process
|
Symbolic-Experiential Family Therapy
|
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Symbolic-Experiential Family Therapy - Key Concepts
|
Person of the Therapist
Existential Encounter Therapy of the Absurd Individuation Family Interaction |
Symbolic-Experiential Family Therapy
|
|
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Symbolic-Experiential Family Therapy - Focus
|
Focuses on the growth of all individuals involved and completion of developmental tasks
|
Symbolic-Experiential Family Therapy
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Symbolic-Experiential Family Therapy - Goals of Therapy
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Symptom Relief
Cohesion Creating Transgenerational Boundary Growth |
Symbolic-Experiential Family Therapy
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Symbolic-Experiential Family Therapy - Structure of Therapy
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Phases of Treatment
1. Creating alternative interactions 2. Replacing key players in certain conflicts with one's self 3. Increasing the focus on others besides the scapegoat 4. Avoiding blaming the caretaking parent or spouse In the late phase, the family operates as a mobile milieu therapy unit within the family co-therapist suprasystem |
Symbolic-Experiential Family Therapy
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Symbolic-Experiential Family Therapy - Assessment
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* Competency-Based Assessment - focuses on competencies rather than problems
* Shells of context (outermost - extended family to innermost - identified patient) * Trial of Labor (assessment interview) * Consider the following characteristics: disorganized boundaries, coalitions to avoid conflict, conflict, role rigidity, delegates, pseudomutuality/emotional cutoff, and parental empathy |
Symbolic-Experiential Family Therapy
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Symbolic-Experiential Family Therapy - Techniques
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Battle for Structure
Battle for Initiative Expanding Distress to include Each Member Activating Constructive Anxiety Redefining Symptoms Fantasy Alternatives Separating Interpersonal and Intrapersonal Stress Affective Confrontation Co-Therapist "Craziness", Play and Humor |
Symbolic-Experiential Family Therapy
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Battle for Structure (Technique)
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* Therapist's responsibility to establish the rules and working atmosphere at the beginning of treatment; therapist must be firm and unyielding
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Symbolic-Experiential Family Therapy
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Battle for Initiative (Technique)
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* Must be won by the family
* may involve encouraging the family to state the agenda for each session, not forcing the therapist's agenda for change, waiting in silence for the family to take the initiative, not working harder than the family, or allowing the family to determine how change is to happen |
Symbolic-Experiential Family Therapy
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Expanding Distress to Include Each Member (Technique)
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* Shifts tension and anxiety
* Encourages cohesion, avoids blame, and demands group solution * Augmenting distress forces member to break from covert ultimatums |
Symbolic-Experiential Family Therapy
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Activating Constructive Anxiety (Technique)
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* Positively reframing symptoms as efforts toward competence and by overtly addressing the life-cycle transitions each family member is facing
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Symbolic-Experiential Family Therapy
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Redefining Symptoms (Technique)
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* Symptoms are redefined as efforts toward growth in order to expand the family's sense of freedom. Often, metaphors, or stories are used to redefine symptoms or to help families view symptoms in a new perspective
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Symbolic-Experiential Family Therapy
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Fantasy Alternatives (Technique)
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* "What if..."
* Absurd fantasy alternatives (if you took your son's clothes he couldn't go out and buy drugs) |
Symbolic-Experiential Family Therapy
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Separating Interpersonal and Intrapersonal Stress (Technique)
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* Distinguish actual relational problems from individual reactivity to these problems
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Symbolic-Experiential Family Therapy
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Affective Confrontation (Technique)
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* Therapist confronts the family with the therapist's subjective emotional experience of working with the family (i.e. bored, angry, etc). By speaking subjectively at times, the therapist induces family members to allow their own subjectivity to emerge.
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Symbolic-Experiential Family Therapy
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Co-Therapist (Technique)
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* Co-therapists can be useful in maintaining and broadening perspective
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Symbolic-Experiential Family Therapy
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"Craziness", Play and Humor (Technique)
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* May take the form of play, humor, drama, or any other form that makes sense with the family.
* Encouraged as a means to discovering solutions and promoting growth |
Symbolic-Experiential Family Therapy
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Intergenerational Family Therapy - Key Theorists
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Murray Bowen
Betty Carter Thomas Fogarty Edwin Friedman Philip Guerin Michael Kerr Monica McGoldrick Daniel Papero |
Intergenerational Family Therapy
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Intergenerational Family Therapy - History
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aka Bowen Family Systems, evolved from psychoanalytic principles
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Intergenerational Family Therapy
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Intergenerational Family Therapy - Key Concepts
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Togetherness and Individuality - the two counterbalancing life forces that the differentiated person is able to successfully balance.
* Differentiation of Self * Triangles * Nuclear Family Emotional Process * Undifferentiated Family Ego Mass * Family Projection Process Multigenerational Transmission Process * Sibling Position * Emotional Cutoff * Societal Emotional Process |
Intergenerational Family Therapy
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Togetherness and Individuality (Key Concept)
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* Togetherness - person's ability to engage in meaningful connection with another
* Individuality - person's ability to maintain a clear sense of self and identity |
Intergenerational Family Therapy
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Intergenerational Family Therapy - Goals of Therapy
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* Decrease anxiety
* Increase differentiation in one or more family members |
Intergenerational Family Therapy
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Intergenerational Family Therapy - Structure of Therapy
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3 Phases:
Initial Assessment Genogram Differentiation |
Intergenerational Family Therapy
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Intergenerational Family Therapy - Assessment
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Assesses togetherness and individuality through
(a) family of origin (b) triangles (c) level of differentiation |
Intergenerational Family Therapy
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Intergenerational Family Therapy - Assessment - 10 Basic Questions
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1. Who initiated therapy
2. What is the symptom and which family member or family relationship is symptomatic 3. What is the immediate relationship system of the symptomatic person 4. What are the patterns of emotional functioning in the nuclear family 5. What is the intensity of the emotional process in the nuclear family 6. What influences that intensity 7. What is the nature of the extended family systems 8. What is the degree of emotional cutoff from each extended family member 9. What is the prognosis 10. What are the important directions for therapy |
Intergenerational Family Therapy
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Intergenerational Family Therapy - Techniques
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Detriangulate
Nonanxious Presence Genogram Process Questions Supporting Differentiation "Going Home Again" Displacement Stories Coaching |
Intergenerational Family Therapy
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Detriangulate (Technique)
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* Dissolve dysfunctional triangles and reduce fusion
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Intergenerational Family Therapy
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Nonanxious Presence (Technique)
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* The idea that the therapist must maintain a nonanxious presence when engaging with the family, even in the face of heated conflict
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Intergenerational Family Therapy
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Genogram (Technique)
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* used as an assessment tool and as a technique to provide insight and introduce the possibility for a calm, rational discussion.
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Intergenerational Family Therapy
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Process Questions (Technique)
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* involve exploring family emotional processes and are designed to decrease reactive anxiety and help people think rationally about their situation
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Intergenerational Family Therapy
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Supporting Differentiation (Technique)
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* Focusing on the family member who is most motivated to work toward differentiation
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Intergenerational Family Therapy
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"Going Home Again" (Technique)
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* Encourages clients to go home and re-experience their nuclear family without emotional reactivity
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Intergenerational Family Therapy
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Displacement Stories (Technique)
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* Stories about other families with similar problems that therapists share with the clients in order to help the family gain a clearer understanding of its own process
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Intergenerational Family Therapy
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Coaching (Technique)
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* Therapist works as a coach in regard to teaching families about the family process
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Intergenerational Family Therapy
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Cognitive-Behavioral Therapy - Key Theorists
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Albert Bandura
Aaron Beck Albert Ellis Norman Epstein Neil Jacobson Gerald Jones Arnold Lazarus Robert Liberman Donald Meichenbaum Gerald Patterson Ivan Pavlov B.F. Skinner Richard Stuart Joseph Wolpe |
Cognitive-Behavioral Therapy
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Cognitive-Behavioral Therapy - History
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Developed as a reaction to the psychodynamic approach
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Cognitive-Behavioral Therapy
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Cognitive-Behavioral Therapy - Key Concepts
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Classical Conditioning
Operant Conditioning Reinforcement Primary and Secondary Reinforcements and Punishments Extinction Premack Principle Social-Exchange Theory Social-Learning Theory A-B-C Theory Family Schema Parent-Skills Training Behavioral Marital Therapy Conjoint Sex Therapy Functional Family Therapy |
Cognitive-Behavioral Therapy
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Cognitive-Behavioral Therapy - Goals of Therapy
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Cognitive Behavioral change; to alter unproductive behavior and cognitive patterns to alleviate the problem and maladaptive symptoms
* little emphasis placed on "growth" or "insight" * possible general goals are: 1. increase desired behavior/cognitions 2. decrease undesirable behavior/cognitions 3. improve problem-solving skills |
Cognitive-Behavioral Therapy
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Cognitive-Behavioral Therapy - Structure of Therapy
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1. Baseline Assessment
2. Intervention 3. Extinction |
Cognitive-Behavioral Therapy
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Cognitive-Behavioral Therapy - Assessment
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Therapists asssess for the relational dynamics in relation to the problem issue by doing the following:
1. Behaviorally define the problem 2. Functional Analysis 3. Baseline 4. Contract |
Cognitive-Behavioral Therapy
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Cognitive-Behavioral Therapy - Techniques
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Therapeutic Contracts
Contracting (quid pro quo, good-faith) Functional Analysis Modeling Systematic Desensitization Reinforcement Schedule Shaping Charting Time Out Token Economy Disputing Irrational Beliefs Psychoeducation Sensate Focus Technique |
Cognitive-Behavioral Therapy
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Classical Conditioning
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Food Bell Salivate
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Cognitive-Behavioral Therapy Key Concept
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Operant Conditioning
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* Desired behavior is voluntarily performed and controlled by reinforcement
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Cognitive-Behavioral Therapy Key Concept
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Reinforcement
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* event or behavior designed to increase or decrease a specific response
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Cognitive-Behavioral Therapy Key Concept
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Positive Reinforcement
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* aims at increasing the frequency of a behavior (aka reward)
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Cognitive-Behavioral Therapy Key Concept
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Negative Reinforcement
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* increases the frequency of a desired behavior by removing adverse stimuli when the desired behavior is elicited (parent stops nagging when child cleans room)
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Cognitive-Behavioral Therapy Key Concept
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Punishment
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* distinguishes itself from negative reinforcement in that it decreases undesirable behavior
* can take the form of aversive consequences such as yelling or spanking, or the removal of positive consequences such as losing tv privileges |
Cognitive-Behavioral Therapy Key Concept
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Intermittent Reinforcement
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* refers to not consistently reinforcing a behavior; behaviors that are intermittently reinforced are the most difficult to extinguish
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Cognitive-Behavioral Therapy Key Concept
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Contingencies of Reinforcement
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* when and how behaviors are reinforced
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Cognitive-Behavioral Therapy Key Concept
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Reciprocal Reinforcement
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* refers to family situations where the behaviors of each member serve as the stimuli and reinforcements for the others, resulting in a complex series of interlocking behaviors
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Cognitive-Behavioral Therapy Key Concept
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Primary and Secondary Reinforcements and Punishments
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* Primary reinforcement/punishment = biologically determined reinforcements (food/sex)
* Secondary reinforcement/punishment = learned association (praise, criticism, and attention) |
Cognitive-Behavioral Therapy Key Concept
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Extinction
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* process in which a behavior is diminished by not reinforcing it; person has no motivation for continuing the behavior
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Cognitive-Behavioral Therapy Key Concept
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Premack Principle
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* high probability behavior can be used to reinforce low probability behavior; watching tv is contingent upon doing homework
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Cognitive-Behavioral Therapy Key Concept
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Social-Exchange Theory
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* in Interpersonal interactions people attempt to maximize rewards and minimize costs
* 2 people rewarding each other at equitable rates is called reciprocity |
Cognitive-Behavioral Therapy Key Concept
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Social-Learning Theory
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* people learn not just from doing, but also from watching others do
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Cognitive-Behavioral Therapy Key Concept
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A-B-C Theory
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* (A) activating events do not cause the problem (C) consequence, but rather the intermediary believe (B) about A causes C
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Cognitive-Behavioral Therapy Key Concept
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Family Schema
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* set of similarly held beliefs about family and life
* provides the template or set of rules that organize a family's behaviors and interactions |
Cognitive-Behavioral Therapy Key Concept
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Parent-Skills Training
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* therapist provides educational information to parents and often serve as a consultant to the parent
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Cognitive-Behavioral Therapy Key Concept
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Behavioral Marital Therapy
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* recognizes that the behavior of each is the antecedent and consequence of the other
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Cognitive-Behavioral Therapy Key Concept
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Conjoint Sex Therapy
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* therapist serves as an educator on sexual physiology and techniques; interventions address maladaptive behavior patterns and cognitions
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Cognitive-Behavioral Therapy Key Concept
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Functional Family Therapy
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* Aims at achieving cognitive and behavioral changes in the family system by challening negative traits attributed to others in the family
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Cognitive-Behavioral Therapy Key Concept
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Therapeutic Contracts
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* written and specify the goals of therapy and obligations of the client and therapists
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Cognitive-Behavioral Therapy Technique
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Contracting
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* Quid pro quo contracts - one person agrees to a change after the other has made a requested change
* Good faith contracts - 2 people mutually agree to make changes |
Cognitive-Behavioral Therapy Technique
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Functional Analysis
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* involves figuring out what stimulus conditions control the targeted behavior while identifying the precise contexts in which the problem is likely to be most and least prominent
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Cognitive-Behavioral Therapy Technique
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Modeling
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* new behaviors are learned by observing the behavior of others
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Cognitive-Behavioral Therapy Technique
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Systematic Desensitization
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* Introduced by Joseph Wolpe
* Used as a procedure to address various forms of anxiety and phobias * Process involves altering a person's physiological response to a specific stimulus (person slowly exposed to the feared stiumulus in incremental states) * reciprocal inhibition is often part of the process and involves pairing the anxiety arousing stimulus with a relaxation response |
Cognitive-Behavioral Therapy Technique
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Reinforcement Schedule
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* defines the contingencies for reinforcement of a behavior and established the relationship between a behavior and its consequences
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Cognitive-Behavioral Therapy Technique
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Shaping
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* based on operant conditioning; refers to the process in which a complex behavior is divided into subparts
* contingencies of reward and punishment are provided to these subparts until all the behaviors comprising the whole are elicited |
Cognitive-Behavioral Therapy Technique
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Charting
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* asking the client to keep a record of the targeted problem behavior between sessions; can be used to obtain a baseline and monitor progress
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Cognitive-Behavioral Therapy Technique
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Time Out
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* Used to alter problem behaviors
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Cognitive-Behavioral Therapy Technique
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Token Economy
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* a system of rewards using points, which can be exchanged for reinforcing items or behaviors
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Cognitive-Behavioral Therapy Technique
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Disputing Irrational Beliefs
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* Challenge client's irrational beliefs about the problem situation that may be causing or exacerbating the situation
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Cognitive-Behavioral Therapy Technique
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Psychoeducation
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* Educating clients on various topics
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Cognitive-Behavioral Therapy Technique
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Sensate-Focus Technique
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* early phase sex therapy technique; couple focus on enjoying basic touch without the pressure of having to perform sexually
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Cognitive-Behavioral Therapy Technique
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Solution-Focused Therapy - Key Theorists
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Kim Insoo Berg
Steve de Shazer Patricia Hudson Eve Lipchik Scott Miller William O'Hanlon Jane Peller Michelle Weiner-Davis John Walter |
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Solution-Focused Therapy - History
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Evolved from de Shazer's work with the MRI problem-focused approach
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Solution-Focused Therapy - Key Concepts
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Solution and Future Focus
Strengths and Resources Beginner's Mind Change is Constant Language and Meaning Hope |
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Solution-Focused Therapy - Goals
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Solution Focus
Goals and Goal Setting |
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Solution-Focused Therapy - Structure of Therapy
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Define the problem in client's language
Identify exceptions Establish Goals |
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Solution Focused Therapy - Assessment
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Motivation
Solvable Problems What Worked Exceptions Strengths and Resources |
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Solution Focused Therapy - Techniques
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Formula first Session Task
Miracle Question Exception Question Compliments Scaling Questions "on track" Eliciting Strengths and Resources Inspiring Solutions and Solution Building |
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Narrative Therapy - Key Theorists
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David Epston
Michael White Jeff Zimmerman John Winslade Gene Combs Vicki DIckerson Robert Doan Jill Freedman Stephen Madigan Gerald Monk Alan Parry |
Narrative Therapy
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Narrative Therapy - History
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1990 Book "Narrative Means to a Therapeutic Ends" by White & Epston
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Narrative Therapy
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Narrative Therapy - Key Concepts
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The Textual and Narrative Metaphors
Unique Outcomes Dominant and Subjugated (local) Knowledges Language Politics The Problem is the Problem Therapist Positioning |
Narrative Therapy
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Narrative Therapy - Goals
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Alter the problem-saturated story to reflect a preferred narrative
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Narrative Therapy
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Narrative Therapy - Structure of Therapy
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* Begin with a unique outcome
* Make sure the unique outcome represents a preferred experience * Plot the story in the landscape of action * Plot the story in the landscape of consciousness * Ask about a past experience that has something in common with the unique outcome or its meaning * Ask questions that link the past episode with the present * Ask questions to extend the story into the future |
Narrative Therapy
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Narrative Therapy - Assessment
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Knowing the person apart from the problem
Unique Outcomes Mapping Effects |
Narrative Therapy
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Narrative Therapy - Techniques
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* Deconstructive Listening
* Deconstructive Questions * Externalizing the Problem * Relative Influence Questioning * Plotting Narratives in the Landscapes of Action and Consciousness * Preference and Permission Questions * Exploring Specifications for Personhood * Situating Comments * Letters and Certificates * Audience/Witnesses |
Narrative Therapy
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Unique Outcomes
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Narrative Therapy
Experiences that would not be predicted by the plot of the problem-saturated narratives |
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Deconstructive Listening
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Narrative Therapy
Listening that opens up space for new meaning and understandings |
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Deconstructive Questions
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Narrative Therapy
Help people unpack their stories or see them from different perspectives |
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Externalizing the Problem
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Narrative Therapy
Linguistically separating the problem from the person * Involves personifying the problem * defining the problem to be externalized and using externalizing questions |
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Relative Influence Questioning
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Narrative Therapy
Process of mapping the influence of the problem and mapping the influence of the person |
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Plotting Narratives in the Landscapes of Action and Consciousness
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Therapist first gets specifics on the actions that occurred to bring about the unique outcome, then transitions to inquire about the meaning the person attributes to these events
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Narrative Therapy
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Preference and Permission Questions
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Narrative Therapy
Ensure that the unique outcome is consistent with the client's preferred reality and not the therapists. |
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Psychoanalytic Theory - Key Theorists
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Sigmund Freud
Erickson |
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Psychoanalytic Theory - Goals
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* Resolution of clients' problems to enhance the clients' ability to cope with life changes
* Working through unresolved developmental states * Become able to cope more effectively with the demands of society in which they live |
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Psychoanalytic Theory - Techniques
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Free Association
Analysis of Dreams Analysis of Resistence Interpretation |
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Jungian Analytical Theory - Key Theorists
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Carl Jung
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Jungian Analytical Theory - Four functions that determine Perception
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Sensation
Thinking Feeling Intuition |
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Myers-Briggs Type Indicator
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A popularized adaptation of Jung's principles of typology
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Jungian Analytical Theory - Goals
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Individuation and Personality Unification
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Jungian Analytical Theory - Interventions
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Dream analysis
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Adlerian Theory (Individual Psychology) - Key Theorists
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Alfred Adler
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Adlerian Theory (Individual Psychology)
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A cognitive, goal-oriented social psychology interested in a person's beliefs and perceptions, as well as the effects that person's behavior has on others.
* Not a set of techniques, but a comprehensive philosophy of living |
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Adlerian Theory (Individual Psychotherapy) - Fundamental Principles
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1. Behavior is Goal Oriented
2. Humans are fundamentally social, with a desire to belong and have a place of value as an equal human being 3. The individual is indivisible and functions with unity of personality (all 3 are aka purposiveness, social interest, and holism) |
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Adlerian Theory (Individual Psychotherapy) - Interventions
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Lifestyle analysis
Encouragement |
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Existential Theory - Key Theorists
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Kierkegaard
Nietzsche Camus Sartre Heidegger Buber |
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Existential Theory - Major Constructs
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Approaches to Existentialism
Death Freedom Isolation Culture Meaninglessness and Meaningfulness Authenticity and Vulnerability (Two sides of the existential self) Existential Relationships Hazards on the Journey |
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Existential Theory - Focus
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A developmental perspective
A focus on potentials A worldview |
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Existential Theory - Goals
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Confront anxieties about the givens of existence
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Existential Theory - Interventions
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Understanding the client's world
Sharing existence in the moment Fostering a centered awareness of being Encouraging self-responsibility Working with Dreams Confronting Existential Anxiety Learning to put closure on Relationships Centered Awareness of Being Self-Responsibility Disclosing and Working through Resistence |
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Person-Centered Theory (Rogerian Theory) - Key Theorists
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Carl Rogers
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Person-Centered Theory (Rogerian Theory) - Major Concepts
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* The autonomous self
* Reliance on One's own unique Experiences * The Desire and ability to make positive personal changes * Movement toward the actualization of potentials |
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Person-Centered Theory (Rogerian Theory) - Techniques
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Empathic Understanding
Confidence in the Client Client's unique perspective Congruence of the person |
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Person-Centered Theory (Rogerian Theory) - Goals
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Movement from incongruence to congruence
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Person-Centered Theory (Rogerian Theory) - Techniques
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Being Genuine
Active Listening Reflection of Content and Feelings Immediacy Appropriate self-disclosure Personalized Counselor or Therapist Actions |
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Gestalt Theory - Key Theorists
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Fritz Perls
Max Wertheimer Wolfgang Kohler Kurt Koffka Sandor Ferenczi Paul Goodman |
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Gestalt Theory - Key Concepts
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Awareness is the key to Gestalt
* Focus is not on facilitating behavioral changes in the client, but on helping the client to develop insight and interpersonal awareness * Individual cannot be understood in isolation, must be understood within his/her social and historical context and unqiueness |
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Gestalt Theory - Main Constructs
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Phenomenological Field
Differentiation and Contact Boundaries Dichotomies and Polarities Foreground and background |
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Gestalt Theory - Goals
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* Identify themes that are central to client's self-organization
* Conceptualizing the issues and concerns * Establishing and maintaining a safe professional environment * Providing an atmosphere that invites contact between client and counselor |
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Gestalt Theory - Intervention Strategies
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* Clarify and sharpen what the client is already aware of
* Bring into focal awareness what was previously known only perphierally * Bring into awareness that which is needed but is systematically kept out of awareness * Bring into awareness system of control |
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Gestalt Theory - Specific Intervention Strategies
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* Location of Feelings
* Confrontation and enactment * Empty chair or two-chair strategy * Making the rounds * Dream work * Unfinished business * Rehearsal * Minimization * Exaggeration * Reversal * Exposing the obvious * Explicitation or translation * Retroflection (playing the projection) * Let the little child talk * Say it again * I take responsibility for ... * I have a secret * Contact and withdrawal * Can you stay with this feeling |
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Rational Emotive Behavior Therapy - Key Theorists
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Albert Ellis
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Rational Emotive Behavior Therapy - Goals
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Help clients develop a rational philosophy that will allow them to reduce their emotional distress and self-defeating behaviors
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Rational Emotive Behavior Therapy - Interventions
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* Disputing
* Rational-emotive imagery * Rational role-laying * Bibliotherapy * Shame attack exercies * Rational coping self-statements |
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Rational Emotive Behavior Therapy - Key Construct
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Emotional distress results from dysfunctional thought processes
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Rational Emotive Behavior Therapy - Change Occurs
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Change occurs as counselors help clients work through the A-B-C model of emotional disturbance; irrational beliefs are replaced with rational alternatives that result in more moderate healthy emotions and self-enhancing behaviors.
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Reality Therapy Theory - Key Theorists
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William Glasser
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