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174 Cards in this Set
- Front
- Back
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When would a BPD ct be at highest risk of completed suicide?
a. They've attempted before b. When she has a major affective disorder, inordinate anger, impulsivity, and a family history of substance abuse c. After the death of a loved one d. At the termination of therapy |
b.
Research has NOT shown that those with previous attempts are more likely to be successful. |
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If a ct observes the cultural practice of rubbing hot stones on his body and I see he is covered in burns, what do I do first: educate myself on the culture and practice or seek consultation?
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First educate myself; then, if needed, seek consultation.
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I send my ct to get a psych eval because some of his statements don't sound like they're in reality. His psych eval comes back to me in the mail. I should:
a. Wait for him to come in and sign a release b. Call the psychiatrist's office and ask whether he signed a release c.Open it and check for a provisional diagnosis from the MSE d. Call the ct and ask for verbal permission to read the report |
c. Open it and check for a provisional diagnosis. Civil law says that MEDICAL info can be exchanged between professionals for the treatment and diagnosis of an individual.
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Does a psychodynamic therapist always examine and encourage the development of transference with clients?
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No, only when working with individuals; not with couples and families.
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A family comes in. Wife has returned to college and husband feels neglected; fears she's neglecting kids as well. Would a psychodynamic therapist
a. Be alert for projections and resulting misunderstanding between spouses b. Assume this pattern will soon show up as transference on the therapist c. Notice how childhood experiences may be replicated in couples' interactions with each other |
c.
This client seems to be at the beginning of therapy and this is often when therapist raises awareness of how FOO may have affected the expectations that one has of their interactions with each other in significant relationships. |
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If a man comes in because of marital problems and describes his wife with potentially depressive symptoms, how would I assess?
a. have man bring wife in since the presenting prob include their marriage; then look for underlying issues b. decline to see wife; tell husband to encourage her to go to dr. |
b. This is the first thing I'd want to do- suggest.
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Kaplan/sexual disorders
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fill in
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in the MSE, what is abstraction and registration?
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fill in
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How would a behavioralist explain the GAD symptom of free-floating anxiety?
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It is a feeling of fear of hypervigilance that seems to occur unpredictably, in response to a stimulus that can't be identified.
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To a structuralist a symptom is
a. a maladaptive reaction to change b. embedded in communication patterns and interactions |
a. correct- structuralists believe maturation and situational changes create stress, which a family can respond to in a healthy or unhealthy way
b. this is more how a strategic therapist would see it |
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Family comes in- latino mother, father, 10 year old son. dad says mom worries too much about son and doesn't discipline him enough. dad wants him to do chores but mom says he's too young. son sits close to mom in session and doesn't talk. what would a structural therapist do?
a. ask dad to sit close to son, invite other fam to next session, reframe mom's bx as love b. ask dad to sit near and speak directly to son, give homework for time together with parents without son, invite more fam to next session c. reframe mom's closeness as culturally normal, have dad sit near and talk to son, give parents hw to spend time together |
b. cultural comment doesn't fit- why would i want to tell them about their own culture? dad talking to son and hw for parent togetherness is structural intervention
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Teenage girl in an Asian family has moved to the US and has a lot of stressors. In facilitating their acculturation process, which is LEAST important?
a. the therapist's experience b. the therapist's skill c. the clients' social network d. her parents' preferences |
c. research has shown that social the social network ISN'T a huge factor in acculturation process because it develops naturally without intervention
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An MFT tells her colleague that she is having sex with one of her clients. What should the colleague do?
a. Report to BBS or CAMFT b. talk to other colleagues about it c. Encourage therapist to end relationship d. make sure "psychotherapy never includes sex" brochures are in waiting room |
c. encourage therapist to end relationship
Apparently there are no legal or ethical laws that say it should be reported. |
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A man calls me, a psychodynamic therapist, and says he's worked with several other psychodynamic therapists over the years and is still depressed He says, "I probably need more insight, huh?" What should I do?
a. Explain other treatment modalities to him b. Ask him what he's looking for c. Refer him to a non psychodynamic therapist d. Explore his thoughts and feelings |
b. Ask him what he's looking for
It's not clear yet what the problem has been- whether an issue of theoretical orientation or other. so assess by asking this question. |
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Question about a physically violent couple and my course of treatment. Between two choices:
a. refer them both to support groups and see them both as a couple if they commit to no violence b. refer them both to support groups, tell the wife about shelters, say it's not appropriate to see them now together, see them both individually |
I chose the former because seeing them individually is inappropriate, but apparently b. is the better answer overall despite that.
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I have a Borderline ct who I told I'd be away for a week. When I return, she is expresses anger. How do I interpret this?
a. She felt abandoned and is acting out b. She experienced abandonment depression |
b. She experienced abandonment depression
While both a and b may be true, it's likely the abandonment depression that led to acting out, so this is a more complete picture. |
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A 66 year-old ct with dementia said she was having sex with her last therapist. Do I
a. Give her the handout "psychotherapy never includes sex" and report to APS b. Give her handout, find out if it was consensual, and if not, report to APS and BBS |
a. the reason b is NOT the answer is that there is no rule that I have to report to BBS
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What are some of the diagnostic criteria or Adjustment Disorder?
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- Development of symptoms within 3 months after stressors started
- Symptoms last no more than 6 months after stressor or it's consequences end |
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Anorexic looking girl referred to me by school nurse. she says she doesn't know why anyone would be concerned about her. She doesn't want me to invite in parents. which should i be most concerned about the possibility of?
a. child abuse b. depression |
b. depression- most of the symptoms of depression overlap with those in eating disorders
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If I am "strongly sexually attracted" to a client, what should I do?
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Refer the client
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Which theory uses the empty chair technique?
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fill in
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Which theory uses intrusional phenomena?
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fill in
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Dysthymic disorder must be present how long in adults, adolescents, and children?
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Two years with adults, one year with kids/teens.
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What is stimulus barrier?
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fill in
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Ego autonomous symptoms (ego psychology term) are
a. involved in the resolution of conflicts b. similar to a defense mechanism c. conflict-free d. not under the control of the individual |
fill in
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Julie was in an accident, legs are paralyzed, she's been feeling unable to focus and concentrate on tasks. Boss is making discriminating remarks. Do I first refer her to a doctor or attorney?
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Doctor. Physical complaints are number one and could indicate a mental or physical disorder.
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I'm a therapist working from an experiential-communications approach. Family has difficulty identifying feelings and respecting each others differences. Do I want to first teach
a. Active listening b. I statements c. Family sculpting d. Family drawings |
first is I statements. this will help them identify their feelings and take responsibility for them as well as respecting those of others. I thought these were included in active listening, but apparently not.
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Couple in their 30s married five years. Both work, but wife has recently been promoted and is working long hours. From a systems point of view, do I want to
a. Have them separate temporarily b. Have the write down and define the current role they play in the family system c. Participate in an enjoyable activity together d. Have them sit down and discuss their feelings |
This change has caused a shift in the system which is requiring them to re-adjust their roles, which has not happened and instead resulted in arguing. This needs to be explicitly talked about.
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A client was raped and has had PTSD. Going to court, and defendant's lawyer subpoenas records. Do I
a. Refuse to release info b. Not respond because the info is privileged c. Release only a summary of relevant info |
This isn't the court subpoenaing records but the defense attorney. I should always respond to a subpoena but can refuse. Then the defense can go to the court, and if the court subpoenas them, then I have to release them. The ct can always give me permission to release. If the ct says raises her mental competence in the trial, then they must automatically be released.
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A client who has been doing depth work and has made a lot of progress leaves a sloppy note saying she is ending therapy. Do I
a. Interpret the premature termination as resistance and the behavior as avoidant; call to sched a termination session in which I can give her referrals b. Call and encourage the ct to come back, since she has made so much progress so far |
a. This is more all-inclusive, allowing me to find out the reason for the behavior, providing closure, and giving referrals
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Ct who I've been seeing for the past 6 months starts coming in over the past week with bruises and cuts which she has no recollection of receiving. She is perplexed. Is it substance abuse or dissociative disorder
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Dissociative disorder because there is no mention of other symptoms to make me suspect this and I've been seeing her for six months. Also, the fact that she's perplexed says something
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When treating someone from a minority group, I must assess how acculturated they are to the dominant culture. Acculturation is best defined as:
a. a process of psychologically and biologically adapting to the new environment b. A process of adopting the traits of the dominant culture with or without abandoning the traits of the native culture |
b. cultural traits- beliefs, attitudes, values, language
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Ct has psychic anxiety, has experienced panic attacks in last few months, and has bad insomnia. Ct is at highest risk for...
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Attempted suicide
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In crisis theory, during the second stage the person tries to use all of their coping mechanisms to deal with it, and when they don't work, the person moves into the third stage, which is feeling:
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anxious and agitated depression
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If ct goes to new therapist without paying his bill and then requests his records for new therapist,...
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Send records to therapist after receiving a request in writing and send ct a bill for unpaid amt and amt for copying files.
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Which factor is LEAST likely to determine whether an even becomes a crisis?
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The nature of the event (secondary to support, perceived competence, problem solving ability, cultural values around event)
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A person who is not my ct calls to ask about whether it's weird that her therapist allows her to do office work in exchange for therapy. I
a. Talk with her over the phone and talk to her about the ethical guidelines about dual relationships, give her info about possible actions (contacting license board, etc) b. report to licensing board c. Call therapist to tell that ct has made contact to express concerns d. See ct in a session to talk more |
a.
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What is the final and longest stage of psychoanalysis, what does it do, and how does it tie into how psychoanalysts see personality?
What components do they view as responsible for successful therapy? |
They see personality as the interplay of a person's internal opposing forces, last stage is working through- gradually working new insights into personality
Catharsis, insight, and working through are seen as the things that result in successful therapy. |
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How does sensate focus eliminate anxiety and what is it?
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Sensate focus eliminates anxiety by pairing pain with sexual pleasure.. it's called "counterconditioning", and it's the pairing of two incompatible responses to reduce one of the responses.
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Did Erikson ever prescribe symptoms or ordeals?
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Yes, he influenced Strategic therapy and would use these techniques to get rid of "stuckness" in families
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An unmarried couple want to pay for the woman's insurance to pay for therapy. The man has no insurance or mental health coverage. I tell them:
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She can use her insurance if she has a mental disorder and couple's therapy is an appropriate way to treat that mental disorder.
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What is reactive attachment, inhibited type, characterized by?
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hypervigilance, inhibited, or highly ambivalent or contradictory responses to social interactions
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What symptoms are associated with cocaine intoxication?
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Behavioral and psychological changes: euphoria or flat affect, hypervigilance, changes in sociability, interpersonal SENSITIVITY, anxiety, tension or anger; stereotyped behavior, impaired judgement; impaired social or occupational functioning.
For intoxication, two or more of the following must be present during or after intoxication: nausea or vomiting, sweating, dilated pupils, high or low blood pressure, chest pain, seizures, weight loss, psychomotor agitation/retardation. |
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The suggestions for the actual test-taking protocol really settled in with me - the idea of the timing of breaks, the use of all of the time scheduled, finishing every question in the first go around and then reviewing - and I applied all of them.
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suggestion
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Feminist therapy theory assumes
Development is a life long process rather than fixed at childhood Deterministic and personality traits are fixed at childhood Human development is a subjective process which depends on individual psychosocial environments Personality is a genetically determined attribute and not a development process |
Development is a life long process rather than fixed at childhood
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The hypotheses used by the Milan associates usually involved and related to:
Defining the problem Levels of differentiation Resistance to change Family alliances |
Family Alliances
The hypotheses used by the Milan associates usually involved and related to the family alliances or coalitions in the system. |
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Haley's approach gives particular importance to the rules surrounding the:
hierarchical structure triangles nuclear family family composition |
Haley's approach gives particular importance to the rules surrounding the hierarchical structure of the family
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In the Initial Interview, why would the counselor ask "why are you here?"
To enable the client to feel "in control of the interview." To establish the clients level of awareness and insight regarding his problem To allow the client to tell his story To elicit honest information without the need for intrusive questioning |
he correct answer: To establish the clients level of awareness and insight regarding his problem
Asking the client "why are you here?" is one means of establishing the clients level of awareness and insight regarding his problem. The client would probably indicate the referral source |
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Daughter brings in elderly mother. mother stands at window and cries but won't communicate, and daughter says she doesn't know what to do. Do I
a. ask the daughter to leave and interview mom separately b. continue to observe their interaction c. ask the daughter to stand next to the mother d. see the daughter alone |
a. may make mom more comfortable to talk
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Chronic use of an amphetamine, cessation of a sedative after chronic use and experiencing the sudden death of a child can result in all of the following except
a. hallucinations b. cognitive impairement c. depersonalization d. incoherent speech |
c.
with the death of a child, it's assuming there wil be a brief psychotic disorder |
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A ct lost a wife of 10 years suddenly. The MFT is least likely to do which of the following in the first session
a. encourage ct to resume normal friend and family relationships b. allow the ct to express feelings c. normalize the intense feelings d. help the ct accept his loss and pain |
a.
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A five year old is referred for therapy because he hasn't been speaking in school, which he started three weeks ago. He speaks in other settings. What is diagnosis?
a. Phase of life problem b. Selective mutism |
a. selective mutism has to last at least a month in a specific environment and doesn't count when it's the first month of school
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Some symptoms of father-daughter incest are all of the following EXCEPT:
a. parentification of teenaged daughter b. overprotectiveness of mother c. a rigid family environment d. antagonism between father and daughter |
b. often the mom is absent, passive, or unable to protect daughter
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I'm a psychodynamic therapist and my ct asks if I'll lower his fee. When I say no, he pouts, sits quietly, and has the look of a young child. What would I say as a psychoanalytic therapist?
a. you look ashamed right now b. you look how you do when you talk about your dad c. how are you feeling right now? d. what are you thinking right now? |
d.
we don't have enough info to say a or b and we already have a sense of what he's feeling |
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When working with battered women, what is often the biggest barrier to therapy?
a. denial that there is a problem b. passivity and lack of assertion c. distortion of reality and low self esteem d. excessive forgiveness |
c. cycling through cycles of violence can effect the woman's cognitive and emotional states. Confusion and helplessness lead to low self esteem. Therapy can be ineffective when sense of reality and self esteem are off.
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I see a divorced mother and her children; she has sole legal custody. the kids talk about how much they hate their dad and I write it in my notes. Later, the dad wants to see the notes. I:
a. am legally required to show him the notes b. don't believe it's in the best interest of the kids and refuse to show him the notes c. are ethically required to show him my notes d. would need a release from the mom to show him the notes |
b. The best interest o the kids supersedes the say of mom, so even if she signed a release, I wouldn't share bc it wouldn't be in kids' best interest.
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A client who presents with depression has been taking anti-depressants from his psychiatrist. He has been using steroids for over a year, including now as he recovers from an injury. He becomes emotional during session and has suicidal ideation. Do I call his dr. or psychiatrist?
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I call his dr. because the biggest issue is one of safety and he is suicidal. I can talk to his dr. next. the first thing i'd do, if there was another choice, would be to ask more questions about his suicidality.
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The goal of Gestalt therapy is to help a client to acknowledge and meet the needs and satisfy the polarities within her. They believe this is done by
a. congruence b. awareness c. positive regard d. restructuring |
Gestalt therapists believe that awareness of thoughts, emotions, and behaviors is enough to help us in the "here and now" and will elicit the desired change
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Congruence between self and experience is the goal of what therapy?
What therapy uses the term positive regard? |
Client centered
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When does Gestalt focus on- past, present, or future?
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Gestalt focuses on here and now
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A Structural Therapist has started seeing a mother, father, and daughter, 13. The daughter has recently started exhibing serious behavioral problems at home and school. The MFT is most likely to view this as
a. an attempt to maintain homeostatis b. a loss of power in the executive subsystem |
b. while a does talk about a common family therapy view, b is more specific to the view of a family therapist
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Person shows a bunch of symptoms and they could be the result of MDD, a personality disorder, social phobia, and dysthymic disorder. Which is most important to rule out first?
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MDD because it has the most serious immediate implications.
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What's the best way to connect with a new client- nodding, eye contact, using similar language, like slang, or agreeing with the client.
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Studies show eye contact is the best way to show someone I'm attending to them. Too much nodding, agreeing, or disingenuous use of their language isn't helpful.
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A woman makes an appt to discuss problems she's having with her daughter, 15. She says in the first session that her daughter has been going out too much and staying out too late. She begins to sob, saying she is so lonely since her husband's death. What would be my immediate, short term treatment goal?
a. Do a thorough assessment of the ct to develop an understanding of her and her situation b. To get a better understanding of the presenting problem by seeing the daughter along first and then seeing them together |
a. This is most important because I need to assess for depression. Even though the presenting problem is with the daughter, I need to care for my ct first. The daughter may come later.
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What behavioral characteristics would be most likely to happen in a DV relationship?
a coercive behavior and isolation b. coercive behavior and mutual dependence c. mutual dependence and isolation |
b. I originally picked a, but isolation is part of coercive behavior. In DV couple, there is most likely to be mutual dependence- the abuser often has emotional need.
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A Gestalt therapists views which to be a factor in helthy human growth
a. introjection, rejection, and confluence b. the presence of adequate role models c. the drive to maintain homeostasis d. striving for superiority |
c. the drive to maintain homeostatis
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What is the difference between an acute and chronic disorder and which of the below is most likely to be acute vs. chronic
a. a person already has dysthymia b. ct has recurring episodes of suicidality c. a ct has lost an immediate family member d. a ct has a number of episodes of major depression |
Acute disorders last a shorter time while chronic disorders last a long time. Answer is c: it's more likely to be acute and lessen over time. I had chosen b, but this is something that would probably remain chronic.
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Which of the following symptoms would MOST indicate a diagnosis of MDD?
a. weight loss, difficulty concentrating, hypersomnia b. loss of appetite, agitation, feelings of worthlessness c. loss of interest in normal activities, agitation, feelings of worthlessness d. sleeplessness, difficulty concentrating, loss of appetite |
There are 9 MDD criteria, and a person must have at least five of them. One of them must be either a depressed mood or loss of interest in pleasurable activities. C is the only one that mentions anhedonia.
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Can MFT make custody recommendations and what are some of the rules around it?
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Yes, they can. Before they make the decision, they must interview BOTH parents. If they only have access to one person, they can comment on that person without a recommendation.
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What are Mahler's stages of development? Outline
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Autistic 0-2 mo
Symbiotic 2 mo fused with mom Differentiating 5-10 mo. Infant can differentiate between what is and isn't mom Rapproachment- can have relationships that don't undermine the sense of self and ability to express pos and neg emotions Object Constancy |
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An mft's mom died last month of cancer, and now he's seeing a ct whose mom is dying of cancer.
Ethically, the MFT would a. refer the ct b. seek consultation c. refer all cts until grief was processed d. wait and see how it goes |
b. so this is a question about ethics. ethically i would want to seek consultation and then refer if it couldn't be worked out (there are no ethical statements that imply I must refer automatically)
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What are Bowlby's model of attachment stages for infants separated from attachment figures?
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protest: crying, kicking, fussing
depair: quiet, withdrawn, given up hope detached: no longer seems upset; attaching to others |
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A couple's infant son has been in the hospital 2 months due to an illness. they are concerned because after crying a lot, he recently has seemed to have "settled in" but has become withdrawn and listless. what stage of bowlby's model might he be in?
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Despair
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I'm a couple specializing in divorce mediation and a couple wants to meet with me before they get lawyers. They were married 15 years, there was an affair, and they have a 13 year old son. I should:
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Suggest they get a lawyer and have them individually tell me what they think are reasonable visitation rights.
I am still suggesting they get a lawyer but am willing to process with them the terms of visitations. |
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An 80 year old man and wife came in. Man has stomach ache and seems confused. wife says they were recently at dr. who prescribed medication. do I
suggest the wife call immediately for a dr. appointment or call the dr myself to see if the symptoms could be medication related? |
a. have wife call dr for appt immediately. this is potentially an emergency. I wouldn't want to wait to get a release and call myself.
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If a ct who has becoming increasingly suicidal suddenly says he's quitting therapy, what would I want to do?
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Encourage him to continue therapy and sign a no-suicide contract. If he does express serious intent and means, then 5150
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If I have a videotape of clients, can I use it in an educational lecture?
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Only with a signed consent form
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What is the timing in reporting child abuse?
The question answer choices were a. Call immediately and file written within 24 hours b. Call within 24 and writing within 36 c. Call as soon as possible and file written within 24 hrs d. Call immediately and file written within 48 |
Call immediately and follow-up with written report within 36 hours
Because none of the answers were exactly right, I want to choose the one that still meets the requirement. a. calling immediately and filing written within 24 hours meets requirements. "calling immediately" is ultimately more correct than calling "as soon as possible" (c). B and D do not meet requirements |
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What is the timing in reporting elder abuse?
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Report by phone immediately and in writing within 48 hours (two business days)
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A divorcing couple in the middle of a custody battle come for treatment. They are arguing back and forth about what they want the custody agreement to be. I have no history in custody cases. I should
a. suggest they see a lawyer b. refer to conciliation court c. see the couple but seek consultation d. do my best to address the custody issue as it's the presenting problem and needs the most immediate attention |
c. they have probably already been referred to conciliation court and have a lawyer. I can continue to see them but should seek consultation.
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When is it appropriate or encouraged by CAMFT to seek consultation?
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whenever it is needed "to improve and protect the health and welfare of the patient"
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Two 11 year old children are found in the bathroom involved in sexual play. what should their school therapist do?
a. Tell parents this is normal developmentally b. Assess for child abuse and proceed with caution c. Refer to a therapist d. Ignore the incident unless it's repeated |
b. I need to take into account the possibility that this is not consensual or involves coercion. a. could be true, but I need to rule out abuse first.
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A family comes in because their oldest son is being disrespectful, truant and has been shoplifting. How do I proceed
a. Redefine this as a family problem, vs just the son's b. do an analysis of the current sequence of behavior c. Take a careful family history and do a genogram |
b. other family therapies would chose a, but behavioral family therapist do not view problems systemically. they treat family probs similar to how they view individual problems. they would analyze the sequence of the son's behavior.
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Some theories believe that diagnoses are unnecessary and harmful. which of the following theories are NOT against diagnoses?
a. Existential b. Relationship oriented c. Family systems theory d. Behavioral |
d. Behavioral None of these theories rely on it a ton, but behavioral does the most because it relies on diagnosis to help understand the nature of the behaviors.
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A woman is separated from her husband and wants to take her son (his stepson) to get therapy under the husband's insurance. The husband calls and says he won't pay. Legally:
a. I may not need the husband's permission b. I need the dad's permission since the insurance is in his name c. I should call the insurance company to see what signatures they need for billing |
a. Because it is a stepson I'd be seeing, I don't need the husband's permission. The son may be listed on his insurance policy, hence I "may" not need the husband's permission
In regards to b, permission to treat a minor has to do with who the legal guardians are, not who is on the insurance |
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I find out that a minor is being incested through her boyfriend. Do I report or talk to her and assess more?
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I report. I am mandated, in my professional capacity, to report suspected child abuse even if I hear about it through a third party or hearsay.
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Symptoms of which of the following are diminished during sleep?
Enuresis Major Depression Tic Disorder Tic Disorder NOS |
Tic Disorder
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A client comes in with a presenting problem that her 21 year old daughter is taking advantage of living with mom, not paying rent, ct is giving her money but concerned she's spending it on drugs. What would I do?
a. Observe the ct to gain an understanding of how she perceives and handles the presenting problem b. find out more about daughter's drug use, provide psychoeducation, talk about codependency c. find out more about daughter's drug use and discuss strategies to address it d. Shift the focus off the daughter and onto the mom to gain a better understanding of how she views the situation and identify the actual problem |
a. Even though the question doesn't say, what would I do FIRST, I want to assume that this is what it's asking unless it says otherwise. A is correct because I want to gain a better understanding of the ct and how she perceives and handles the pp before moving forward. d is incorrect because it assumes that I may know better than the ct what her problem is. If the focus stays on her daughter, this may be important later, but it's not the FIRST step
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Goals in Satir's Experiential-Communication therapy?
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Therapy Goals - 4 items
*Raise self-esteem *Improve communication *Growth *Identify family roles and how they promote sxs |
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What are the Elements of Diversity:
SCAGSO "some cultures are getting so old" |
S - Socioeconomic
C- Culture/Ethnicity A- Age G- Gender S- Spiritual/Religion O- Other |
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In managing crisis, what are the five circles of support to draw on?
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Managing Crisis - 5 circles of support
"Crisis is best managed in community" Circles of support (5): 1. therapist and client 2. family and friends 3. Physicians, group facilitators, support groups 4. Hotlines, DV shelters, detox, case manager 5. Emergency response team - police, fire personelle, psych and hospital ER. *Therapist must have emergency referral numbers at hand in office, at all times. |
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Child is 13yo, in sexual activity with a 14yo or older. Are you mandated to report?
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yes.
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What's the difference between first and second order change?
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1st order change - Brief Therapy
- seeks to address & eliminate the symptoms in one family member, usually the IP 2nd order change - change rules, reorganize system - a chg in the system: comm, behaves to eliminate the pain & dysfunction |
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What is assimilation (with children's development)
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Assimilation The process of taking in new information and fitting it into and making it part of an existing mental idea about the world.
- Current psychological structures are used to interpret the external world - i.e. toddler seeing a cow for the first time and calling it "dog" |
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What is accommodation and what's an example
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Accommodation Refers to changing an existing mental idea in order to fit new information
- New psychological structures are created or old ones are adjusted upon noticing aspects of the environment that current psychological structures do not capture - i.e. Child imitating a parent's gestures |
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In Satire (Exp/Comm), what does Therapist use of self look like
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Satire (Exp/Comm)Therapist use of self
Spontaneous use of humor, sarcasm, teasing, self-disclosure |
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Token Economy
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Token Economy an operant conditioning procedure in which people earn a token of some sort for exhibiting a desired behavior and can later exchange the tokens for various privileges or treats
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Pseudomutuality
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Pseudomutuality Afacade of togetherness that masks conflict and blocks intimacy
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Schizophreniform Disorder
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Schizophreniform Disorder The time frame forSchizophreniform Disorder is at least 1 month, but less than 6 months. An episode of this disorder includes the prodromal, active, and residual phases. When a diagnosis must be made when there has been no recovery, it should be qualified as "provisional."
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Amphetamine and/or cocaine use symptoms
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Amphetamine and/or cocaine Amphetamine and/or cocaine use produces agitated behavior and impaired appetite; withdrawal involves depression, fatigue, and flu-like symptoms.
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Opiate symptoms
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Opiates tend to produce more apathy and psychomotor slowing
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Hallucinogens or inhalants symptoms
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Hallucinogens or inhalants produce more bizarre or erratic behavior, including fear of going crazy, slurred speech, tremors, perceptual difficulties, etc.
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California Evidence Code 1013
Holder of Privilege |
California Evidence Code 1013
Holder of Privilege The "holder" of the privilege is the patient unless the patient lacks legal capacity (e.g., is mentally incompetent), in which case the holder of the privilege is the legal guardian, or conservator. |
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Minors and Privilege
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California Evidence Code 1015
The parents of a minor client can claim and waive the privilege on their child's behalf, but the law maintains that minors do, in fact, hold the privilege when they are in therapy. The holder of the privilege, a person authorized to claim privilege by the holder of the privilege or the psychotherapist may assert privilege. |
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California Evidence Code 1017
Court Appointed Psychotherapist |
California Evidence Code 1017
Court Appointed Psychotherapist •There is no privilege if the psychotherapist has been appointed by the court to examine the patient. •This exception, however, does not apply when the court has appointed the psychotherapist, at the request of the defendant's lawyer in a criminal proceeding, for the purpose of determining whether the defendant should enter a plea based on insanity or base the defense on the defendant's mental or emotional condition. •court-appointed = court is the client, and individual is not entitled to a confidential relationship •court-ordered = the individual is the client and entitled to a confidential relationship |
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California Evidence Code 1024
Patient Dangerous to Self or Others |
California Evidence Code 1024
Patient Dangerous to Self or Others "There is no privilege...if the psychotherapist has resonable cause to believe that the patient is in such mental or emotinal condition as to be dangerous to him or hersself or to the person or property of another and if disclosure of confidential information is necessary to prevent the threatened danger." •Legally permitted, but not legally mandated to disclose |
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California Evidence Code 1027
Patient under 16 is a Victim of a Crime |
California Evidence Code 1027
Patient under 16 is a Victim of a Crime •Three is no privilege when the patient is under the age of 16 and pschotherapist has reason to believe that the patient has been the victim of a crime and that disclosure of confidential information is in the best interest of the patient. •in cases where child abuse reports are mandated, the Child Abuse and Neglect Reporting Law takes precedence over laws govering the psychotherapist-patient privilege (Penal Code 11171) |
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Can a person be held past the 72 hours of a 5150?
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Welfare and Institutions Code 5250 a person detained for 72 hours (WIC 5150) may be held for not more than 14 days of involuntary intensive treatment if the professional staff finds that the person is a danger to him or herself, others or gravely disabled as the result of a mental disorder or chronic alcoholism
Welfare and Institutions Code 5300 Someone who has threatened to take his or her own life may be held an additional 14 days beyond the original 14 days (WIC 5260) |
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Treatment of minor without parental consent
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Treatment of minor without parental consent - 12 or older
- Only outpatient or residential shelter - Minor must be mature enough to participate intelligently (in the opinion of the therapist) - Minor must present a danger of serious physical or mental harm to self or others without treatment or must be an alleged victim of incest or abuse |
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Emancipated Minor
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Emancipated Minor A person under 18 who is
1) married 2) in active duty with armed forces or 3) declared emancipated from a court |
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Legal vs ethical responsibility to report suicide risk
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Legal vs ethical responsibility to suicided risk - NOT legally responsible for reporting
- Ethically responsible to provide safety (i.e. help of family/friends, hospitalization) |
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Piaget stages of development
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0-2 years = Sensorimotor Stage
2-7 = Preoperational Stage 7-11 = Concrete Operational Stage 11+ = Formal Operational Stage |
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Erikson:Hope: Trust vs. Mistrust
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Erikson:Hope: Trust vs. Mistrust - Infants, 0-1
- Centers around the infant's basic needs being met by the parents - Coincides with Freud's Oral Stage |
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Erikson: Will: Autonomy vs. Shame and Doubt
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Erikson: Will: Autonomy vs. Shame and Doubt - Toddlers, 2-4
- Main Question: "Can I do things myself or must I always rely on others?" - Coincides with Freud's Anal Stage |
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Erikson: Purpose: Initiative vs. Guilt
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Erikson: Purpose: Initiative vs. Guilt - Preschool, 4-6
- Main Question: "Am I good or am I bad?" - Initiative adds to autonomy the quality of undertaking, planning and attacking a task for the sake of being active and on the move. - Related Elements in Society: ideal prototypes/roles - Coincides with Freud's Phallic Stage |
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Erikson: Competence: Industry vs. Inferiority
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Erikson: Competence: Industry vs. Inferiority - Childhood, 7-13
- Main Question: "How can I be good?" - Related Elements in Society: division of labor - Coincides with Freud's Latency Stage |
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Erikson: Fidelity: Identity vs. Role Confusion
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Erikson: Fidelity: Identity vs. Role Confusion - Adolescents, 14-24
- Main Question: "Who am I and where am I going?" - Go through identity experimentation and role confusion during this stage - Related Elements in Society: ideology - Coincides with Freud's Genital Stage -Identity crises: - Turning point in human development that ends with reconciliation between the person one has come to be and the person society expects one to become |
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Erikson: Love: Intimacy vs. Isolation
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Erikson: Love: Intimacy vs. Isolation - Young adults, 25-40
- Main Question: "Am I loved and wanted?" or "Shall I share my life with someone or live alone?" - Related Elements in Society: patterns of cooperation (often marriage) - Distantiation: - Readiness to isolate and if necessary, to destroy those forces and people whose essence seems dangerous to our own, and whose territory seems to encroach on the extent of one's intimate relations |
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Erikson: Care: Generavity (A sense of productivity and accomplishment) vs. Stagnation
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Erikson: Care: Generavity (A sense of productivity and accomplishment) vs. Stagnation - Middle adulthood, 45-65
- Main Question: "Will I produce something of real value?" - Related Elements in Society: parenting, educating, or other productive social involvement |
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Wisdom: Ego Integrity vs. Despair
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Wisdom: Ego Integrity vs. Despair - Seniors, 65+
- Main Question: "Have I lived a full life?" |
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Marital Skew
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Marital Skew one parent is dominant & abusive, the other weak & dependen
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What are Adjustment Disorders?
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What are Adjustment Disorders? *Negative Reaction 1. Development of emotional and behavioral symptoms in response to an IDENTIFIABLE STRESSOR within 3 months of stressor
2. The stressor does not meet criteria for another specific Axis I disorder and is not merely an exacerbation of a preexisting Axis I or Axis II disorder |
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What are the symptoms of Adjustment Disorders?
Can the stressor be Bereavement? No |
What are the symptoms of Adjustment Disorders? 1. marked distress in excess of what would be expected
2. significant impairment in social or occupational functioning |
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How long do symptoms generally last?
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How long do symptoms generally last? 6 months
Specify if 1. Acute (disturbance lasts LESS than 6 months) 2. Chronic (disturbance lasts MORE than 6 months) |
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Major Components of MSE:
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Major Components of MSE:
OBAPTA OBAPTA O - Orientation B - Behavior A - Appearance P - Perception T - Thinking A - Affect |
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Criteria for Acute Stress Disorder
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Criteria for Acute Stress Disorder
Criteria: MUST have had exposure to a traumatic/life threatening event, intrusive recollections, startle response, hyper-vigilance, nightmares. Duration: LESS THAN ONE MONTH (longer would be PTSD) |
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Criteria for Posttraumatic Stress Disorder (PTSD)
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Criteria for Posttraumatic Stress Disorder (PTSD)
Criteria: MUST have had exposure to a traumatic/life threatening event, intrusive recollections, startle response, hyper-vigilance, nightmares. Duration: ONE MONTH or logner. |
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California Evidence Code 1015
Psychotherapist claiming privilege |
California Evidence Code 1015
Psychotherapist claiming privilege Definition a psychotherapist "shall claim the privilege whenever his is present when the communication is sought to be disclosed and is authorized to claim privilege." |
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What was a main purpose of using a Satir spatial metaphor in session?
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For the family to get a sense of their roles
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I've been assigned by a court to examine an adolescent. What do I need before starting to see him?
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A signed consent form from the judge. The court is my client. There is no client privilege.
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What is the best way to establish rapport with a ct: eye contact, matching language, frequent nodding, agreeing with client
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eye contact
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If a ct is experiencing hallucinations while intoxication, what is she least likely intoxicated with? alcohol, cocaine, heroine, cannabis?
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alcohol. hallucinations may exist in alcohol withdrawal but not intoxication
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Best test for assessing mental retardation?
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Vineland
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A girl with BPD's parents died while away on vacation. How would I expect her to deal with therapy termination?
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Act out to sever therapy prematurely (acting out in response to real or imagined abandonment- typical of BPD cts and adolescents in general)
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I have met a ct once and made a provisional diagnosis. What thing would make me most likely to change my diagnosis?
a. Finding out new info about the etiology of the cts symptoms b. an increase in escalation of symptoms c. new info from adjunct professionals |
a.
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What's the best treatment for Tourett's Syndrome?
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medication, biofeedback, behavior modification
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A teacher calls me to say that one of her 11 year old students has been abused and wants me to see the child without the parents' permission. What do I do?
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Call CPS and report and encourage the teacher to do the same. Even though the student isn't my ct, I learned about the abuse in my professional capacity, so I am still mandated to report, even though it's 'hearsay'.
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If a minor is suicidal in my office with intent and plan, what is my next step?
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To breach confidentiality and tell the parents. if they weren't available, I could then do a 5150/pert team or call police.
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What is masked depression?
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Depression that manifests mostly as somatic symptoms without cognitive-affective problems.
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What is the difference between relabeling/reframing and positive connotation?
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Positive connotation is part of the Milan model and ascribes positive intentions to everyone's behavior. Reframing changes the way something is looked at by changing the context- conceptually or emotionally. Ie, a family describes an overprotective and nagging mom , and I say, "I'm impressed by your caring and conscientiousness" is positive connotation. Reframing might be, "So when you are protective of your son, you are attempting to give him the safety that you never had"
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If an employee is referred for therapy in an EAP by his supervisor, what info can be released to supervisor?
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Whether the employee kept the appt, whether he needs treatment, and whether he accepted treatment (ie. with an addict?) Any other info requires consent.
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What might the first few sessions be spent on when working with someone with Panic Disorder?
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Identifying the physical symptoms she experiences and how she misinterprets them?
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What is a common CBT intervention in the middle stage of therapy?
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Challenge irrational beliefs that arise
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What is the technique "shaping" and how does it compare with "chaining"?
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Shaping involves rewarding someone when they display closer and closer to what I'm looking for. ie. getting a kid to go from vocalizing anything to vocalizing anything to eventually vocalizations that match mine.
Chaining- learning involving the association of responses so that each response triggers the next response. |
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As far a premature termination, what is and isn't likely to affect this?
a. the therapist's experience b. the client's gender c. the client's socioeconomic status d. a client with high initial anxiety |
Clients with higher initial anxiety are NOT likely to end prematurely. poorer people tend to drop out. there's no gender difference. dropout is slightly lower with more experienced therapists.
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What is one of the interventions used in Transactional Analysis?
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Analyzing Life Scripts- identifying the life scripts a client has adopted and helping him/her to develop new, non-script behavior
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A Tarasoff situation happens, in which one of my clients says he wants to kill his wife. I tell the police and they do nothing because the ct hasn't said when he's going to and doesn't have a weapon. What do I do next?
a. assess more b. tell the wife |
b. tell the wife. i've already invoked tarasoff to tell the police; now finish it through and tell the wife
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Which of the following might you see in depression but not bereavement?
insomnia poor appetite transient hallucinations marked psychomotor retardation |
you would not expect to see market psychomotor retardation with bereavement. this is more a sx of depression
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Compare and contrast Piaget's assimilation and accommodation
A child learns the family pet is a "dog" and soon calls all four legged furry animals dogs. which is this? |
Assimilation is when a kid takes something new and incorporates it into an existing schema and accommodation is when a kids changes and existing schema based on something new.
Based on the example. She has assimilated the information she learned ("dog") but hasn't accommodated it yet- the fact that there is a diff name for each type of animal |
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In the active stage of schizophrenia, which is most likely to appear:
anhedonia olfactory hallucinations isolation perceptual distortions |
olfactory hallucinations- auditory hallucinations are more common
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Could a MSE help me diagnose schizophrenia?
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Yes. I would assess thoughts and perceptions as well as affect and behavior.
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What is a CBT therapist most interested in examining?
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The automatic thoughts one has about his own behavior and the world around him
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which would be most indicative of child abuse: regression, inattention, or aggressiveness?
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regression. While aggression could also result from this, it could also be the result of conduct disorder or something else. Regression apparently isn't explained by much else.
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With marital schism, your BEST intervention would be to
a. stop the couple from shouting out threats of divorce b. prescribe caring days |
Remember, stick the intervention you'd be most likely to use FIRST. First you would stop them from shouting divorce, then prescribe caring days. Therapy would be ineffective with out the first thing.
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A woman was in a car accident with her 10 year old son. He has become sullen and withdrawn and she is using guilt feelings to overindulge him. what would be helpful to tell her to tell him?
a. tell the son they won't have another accident b. tell the son it's not his fault c. tell the son her feelings about the accident |
b. this is in line with his developmental stage to need to be reassured that it isn't his fault
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What is the best course of action when working with a child in foster care?
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To include the foster family in treatment
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Is there ever a time where you break confidentiality regarding a crime?
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Yes, when a ct is 15 or younger and has been the victim of a crime, you may break confidentiality and report.
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What are some symptoms that are somewhat specific to emotional abuse?
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Conduct disorders, neurotic symptoms, regressive behaviors, over-concern about conforming to authority figures, self-deprecation, school problems, derogatory self-statements, habit disorders (nail bighting).
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What are some symptoms that are somewhat specific to sexual abuse?
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Sudden changes in behavior, fear, night terrors, regressive begaviors, promiscuity, oversophisticated knowledge about sex, social isolation, unwillingness to participate in physical activities, and suicide attempts
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What are some symptoms that are somewhat specific to physical abuse?
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Extremes in behavior, school problems, avoidance of physical activity, clinginess, hypervigilance, wariness of physical contact.
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What are some symptoms that are somewhat specific to physical abuse?
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Stealing or begging for food, falling asleep during class, missing school, vandalism, thievery, and statements that no one cares
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What's the premise of Gestalt therapy
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Each person is capable of taking responsibility for their thoughts, feelings, and behaviors and living as an integrated "whole". So the goal of therapy is to help people get to this point- to integrate the various parts of their self so they can be an integrated whole
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What would a gestalt therapist want to see before terminating therapy?
a. the client is aware of her moment-to-moment experience, has developed a subjective- rather than objective- view of her experience b. the client is aware of her moment-to-moment experience, and can take responsibility for his or her actions and feelings c.has developed a subjective- rather than objective- view of her experience, and can take responsibility for his or her actions and feelings d. the client is aware of her moment-to-moment experience,has developed a subjective- rather than objective- view of her experience, and can take responsibility for his or her actions and feelings |
b. aware of moment to moment experience and can take responsibility for her actions and feelings
increasing self awareness, helping live in the now, helping become aware of immediate sensations, helping gain intrinsic satisfaction and support rather than relying on external sources |
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What are the characteristics of a psychosomatic family (Minuchin- structural)
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enmeshment, rigidity, over-protectedness, lack of conflict resolution, weak parental coalition
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Sometimes a question may seem to be about the details in the question but may in fact more be about the big picture, such as "assessment". Ie, in an assessment question, the main point is that with anyone in a first session you want to cover certain areas... make sense?
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Tips
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Tip: SLOW DOWN enough to really read and take in each question
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tip
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Sometimes two answers may seem similar such as
"the couple is physically abusive to each other in front of the therapist" or "The couple cannot be in the same room because of destructive behaviors" ---> |
Both are troublesome, however the first one is more specific and therefore I can be more certain that it is the circumstance in which marital therapy wouldn't work well.
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Is there any ethical material about the circumstances in which and MFT will see a couple having an affair?
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NO
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who can typically waive a minor's privilege?
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an attorney or conservator is the one who usually would have the right to waive child/therapist privilege. A parent being able to do it is much for controversial. Think about it- the circumstance in which this would be needed would be in court, so it would make sense that it would be an attorney who would waive it.
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If I suspect domestic violence between a couple that I see, what would be a recommended course of action?
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First see them together and ask how they handle conflict- it will give me a sense whether there actually IS DV. If it does exist, it's recommended that I see the wife individually.
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Potential DV victim...
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send to dr if in need of medical attention; then help develop an escape plan
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Adler... a part of what type of therapy? Some main themes and beliefs?
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A type of psychodynamic theory. Believe that people are discouraged when they haven't found a place in the family. When they don't know what's expected of them, they feel incompetent, helpless, and inferior. Believes people are jockying to feel superior in a family- to find a position
- must be understood within context of social environment, which is the family for a child |
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what is sensate focus? what is squeeze technique? what is secondary impotence?
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Sensate focus- Johnson and Masterson's technique to focus on sensations and pleasure other than just orgasm and sex to become in touch with self and other. It is one treatment for impotency and decreases performance anxiety, taking focus off penis and sex.
Squeeze technique is to stop premature ejaculation. Squeeze penis right before ejaculation to learn to control and prolong Secondary impotence- erection can happen sometimes (primary is not at all- less common) |
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IF all symptoms of PTSD are present but they've been present less than 30 days, what is the diagnosis?
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Acute Distress Disorder
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