Ch. 11 - Counseling Families, Diagnosis, & Advanced Concepts Flashcards
When counseling families, who is the patient?
- the family
Cybernetics
- concept used by family therapists
- associated with work of Norbert Wiener
Experiential conjoint family therapy is related to work of
- Virginia Satir
- conjoint means two or more family members are in therapy session at same time
Carl Whitaker
- Dean of experiential family therapy
- experience, not education, changes families
- access unconscious symbolically
Bertalanffy
- systems theory model
- connectedness of all living things
Psychotherapy of the absurd
- Carl Whitaker
David Premack’s principle or law
- family member must complete an unpleasant task (LPB) before allowed to engage in pleasant task (HPB)
Psychoanalytic term object means…
- A significant other with whom a child wishes to bond
Psychoanalytic term introjects means
- unconsciously internalizes the positive and negative characteristics of the objects within themselves
When a family changes the structure of their family system…
- second-order change is more desirable than first-order change
- Watzlawick, Weakland, Fisch
Second-order change
- involves an actual change in the family structure that alters an undesirable behavioral pattern
First-order change
- superficial change that only ameliorates symptoms temporarily
Nathan Ackerman, James Framo, Robin Skynner
- psychoanalytic family therapists
Cloe Madanes and Jay Haley
- associated with the strategic school of family counseling
- strategic therapy comes from Milton Erickson
- design a strategy for each specific problem
Jay Haley
- had a degree in arts and communication rather than the helping professions
A double bind
- no-win situation characterized by contradictory messages such as never smoke again and then smoke as much as you want
- constitutes a paradox when told to do the thing one is trying to stop
Directive
- therapeutic task or command
Paradox
- direct antithesis of common sense
Strategic family counselors often rely on
- relabeling or reframing
- reframing occurs when you redefine a situation in a positive context 0 make the situation or behavior seem acceptable to the client
Symptoms serve a function coined by
- Cloe Madanes
Incongruous hierarchy
- a symptom controls a situation when everything else has failed
- i.e., acting out for attention
- control of situation shifts to one of less power (i.e., daughter knocking over a glass to get depressed mother’s attention
Restraining
- therapist may warn the family or individual about the negative consequences of change
- helps overcome resistance by suggesting it might be best if the family does not change
Positioning
- occurs when therapist accepts the client’s predicament and then exaggerates the condition
- i.e., it’s possible your depression is hopeless
Cultural encapsulation
- (Gilbert Wrenn)
- results in a counselor imposing goals from their own culture on people from another culture
Best approach for working with African American families
- Bowen’s family therapy; Minuchin’s structural family therapy; Haley’s strategic family therapy
Best approach for working with Asian American families
- Solution–focused/problem-focused modalities
Morphostasis
- family’s stability
Morphogenesis
- family’s change
A primary goal of Bowen’s intergenerational family therapy
- Differentiation
- Differentiation is the extent that one can separate one’s intellect from one’s emotional self
Genogram is associated with
- Bowen
Salvador Minuchin
- Structural family therapy
Mimesis
- the therapist copies the family style and join the family to help family accept them as helper
Boszormenyi-Nagy
- intergenerational family therapist
- relational ethics
- coined term family legacy
Relational ethics
- a healthy family can negotiate imbalances and preserve a sense of fairness and accountability
Who was a pioneer in the early history of family therapy?
- Alfred Adler
Which therapist could be described as atheoretical?
- Carl Whitaker
- believed that theory is often used as an excuse to keep therapists emotionally distant from the family
- promoted “craziness” and creativity of family members
Narrative therapy is work of
- Michael White, Cheryl White, David Epston
Tom Anderson
- postmodernist
- disenchanted with traditional family therapy
- began using one0way mirror and a reflecting treatment team
Postmodernism
- assumes there are no fixed truths in the world
- only people’s individual perceptions of what constitutes reality or the truth
Constructivism
- stresses that therapy should be less hierarchical
- a helper does not treat a client, instead the client and the therapist have a conversation to work together in a collaborative effort
Feminist therapy
- strive for equality in human relationships and the counselor can help in this area by avoiding complex clinical jargon
- tend to be person-centered
Term skeleton keys
- Steve de Shazer
- brief solution-focused therapy (BSFT)
- skeleton keys = a standard or stock intervention that will work for numerous problems
Integrative psychotherapy
- utilizing multiple theoretical modalitites
- a Lotta no-no
Ecosystem approach
- in family counseling, looking at the larger systems impacting client/family functioning
Letters for experimental design
- X = treatment (IV)
- O = measurement, score, observation (DV)
- E = experimental gropu
- C = control group
- R = random sampling
- NR = no random sampling
Solomon four-group
- true experimental design with one control and one experimental group receiving a pretest and the other 2 groups not receiving a pretest
John Gottman
- known for creating a paradigm to predict which marriages would likely end in divorce
Gottman’s 6 predictors of divorce
- marriage got off to harsh start
- relationship is characterized via negativity which includes criticism, contempt, defensiveness, stonewalling
- there is flodding in the sense that the negativity comes on suddenly and is overwhelming
- body language changes such as pulse rate drastically increasing
- lack of fond memories from the early days of the relationship
Dr. Ellen Langer
- demonstrating that physical biomarkers of older adults can be reversed if they are placed in an environment from the past and told to act like they are living in the past
Propinquity
- exposure effect
- the more you are around a person, the greater the likelihood you will become attracted to them
Newest career theory
- constructivist and cognitive approaches
TWA =
Theory of Work Adjustment
Rene V. Dawis
- TWA focusing on person, environment, correspondence (PEC)
- the person must fit the job
- work must meet needs of the person
- higher work satisfaction lends to greater productivity
- work adjustment is the match between expectations of employee and of the employer
Coefficient of nondetermination
- subtract the coeffient of determination from 100
- formula for coefficeitn of determination = coefficent squared.
Urie Bronfenbrenner
- codeveloper of national head start program
- proposed an ecological systems theory
- not a stage theory
- stresses microsystem, mesosystem, exosystem, macrosystem
EQ
- emotional intelligence
- includes empathy, impulse control, motivation, ability to love
- Associated with Daniel Goleman
- EQ > IQ
What is related to serotonin?
- Tryptophan - an amino acid
- when tryptophan is removed from the diet, memory, anxiety, sleep, and mood worsen and aggression increases
Neurocounseling research indicates
- The left hemisphere is dominant in most people
Parametric designs
- use interval and ratio data
- used when distribution is normal
- random sampling has been utilized
- nonparametric designs rely on nominal and ordinal data
IS PATH WARM
- assessing suicidality
I: ideation
S: substance abuse
P: purposelessness
A: anxiety
T: trapped
H: hopelessness
W: withdrawal
A: anger
R: recklessness
M: mood changes
Child-centered play therapy (CCPT)
- created by Virginia Mae Axline
- An associate of Carl Rogers
- does not direct the child’s topics of conversation or behavior
- process should not be rushed
Nathan Azrin
- studied with BF Skinner
- Job club groups
- based on behaviorism and somewhat on positive reinforcement
- not intended for career exploration
- individual already had an idea of type of job they wanted
Fetal origins hypothesis
- in utero malnutrition could lead to
– adult heart disease
– some emotional disorders
– type 2 diabetes
Order of four processes in MI
- engaging
- focusing
- evoking
- planning
In MI, change comes from
- the client and not an outside source
- client must overcome ambivalence toward change
- spiral
Yalom and death
- Yalom believes we are all hardwired to have anxiety about death
- believes life can be richer when keeping death in mind
- when it crosses over to terror and immobilizes our life, it is not healthy
Yalom’s four existential concerns
- death
- meaninglessness
- isolation
- freedom
Regarding patients with cancer
- As of Jan 1, 2015, there is official recognition that a diagnosis of cancer will affect a patient’s mental health
- should be screened for psychosocial stress at time of cancer diagnosis
Effect size
- helps us analyze the magnitude of the differences when looking at correlations, tests of significance, or meta-analysis
Fundamental attribution error
- occurs when a person attempts to look at somebody else’s negative behavior, failure, etc. and come up with an explanation
- the problem is attributed to the person instead of the situation
- However, most people attribute their own negative outcomes in life as situational/external, but assess others as dispositional/ internal
Self-serving bias
- a positive event occurred because of the self
- a negative event occurred because of the situation, not the self
Marsha M. Linehan
- created DBT
- DBT is used often with suicidality and personality disorders
DBT four modes
- skills training
- phone counseling
- therapist consultation team
- individual treatment
Telelogical approach
- focus on the client’s goal to do something in the future
- future focused