Clinical Flashcards
Which therapist trait is related to most successful therapy outcome
empathy
Treatment for chronic pain
hypnotherapy
CBT
Mental disorder most consistently linked with genetic factors
bipolar I (65-80% for mz twins)
Parallel process in supervision
When therapist feels and acts towards supervisor like the patient acts to the therapist (process of supervision is paralleling the process of therapy)
Projective identification
involves both loving and hateful feelings being transferred from the client into the therapist in an unconscious effort to evoke empathy and understanding
Acting out (psychoanalysis)
patient acting out on transference feelings as opposed to talking about transference in session
Factitious disorder
characterized by intentional feigning symptoms or creating a disorder, motivation to be in sick role (not motivated by external gains)
Malingering
feigning or creating symptoms for secondary gain
Key symptoms of schizoaffective disorder
Concurrent schizophrenia symptoms with major mood episode, with delusions/hallucinations also present without mood symptoms
primary prevention
preventing onset of disorder
secondary prevention
early identification and prompt treatment of disorder
tertiary prevention
reducing residual effects or optimizing functioning of patients with chronic condition
Essential features for autism diagnosis
persistent deficits in social communication and interaction, and restricted, repetitive patterns of behavior
According to Howard’s meta-analytic psychotherapy outcome research: __% of patients demonstrate measurable improvement in 6 months; __% by end of 8 sessions
75% of patients demonstrate measurable improvement in 6 months; 50% by end of 8 sessions
Most effective treatment for older adults with paranoia?
Neuroleptics/antipsychotics and managing the environment
Signs of opioid intoxication
pupillary constriction,
drowsiness,
slurred speech
Substances which cause hallucinations during withdrawal
alcohol,
sedatives,
hypnotics, and
anxiolytics
withdrawal can be fatal
Symptoms of amphetamine withdrawal
dysphoria,
fatigue,
unpleasant dreams,
increased appetite,
psychomotor agitation or retardation
Symptoms of opioid withdrawal
flu-like symptoms
Jungian definition of transference
part of the personal or collective unconscious that is projected out
James-Lange theory (of emotions)
emotions result from perceiving bodily reactions or responses (e.g., notice heart pounding, assume you are anxious)
Cannon-Bard theory
emotions and bodily responses occur simultaneously
Schacter’s two-factor theory (of emotion)
emotion results from both internal information and external information
Selye’s general adaptation syndrome
a model or response to severe stress consisting of three stages (alarm, resistance, exhaustion)
Concordance rates for monozygotic and dizygotic twins for schizophrenia
MZ=50%
DZ=10-15%
Concordance rates for monozygotic and dizygotic twins for bipolar disorder
MZ=80%
DZ=20-25%
Sleep changes related to MDD
Decreased REM latency, reduced slow-wave (stage 3-4) sleep, prolonged sleep latency, increased REM density (more rapid eye movements)
Most common type of dyslexia
phonological dyslexia (aka dysphonic, dysphonetic, auditory dyslexia) - inability to sound out words
Symptoms of neurocognitive disorder with Lewey bodies
fluctuating cognition that involves changes in attention and executive functions
recurrent and detailed visual hallucinations
spontaneous features of parkinsonism
Perseverative, stereotyped, or compulsive/ritualistic behavior is a diagnostic criterion for _______neurocognitive disorder.
frontotemporal
Relation between stimulant medication for ADHD and children and SUD later in life
stimulant use does not increase nor decrease risk for SUD
some evidence that stimulant treatment at younger ages and higher dose less likely to develop SUD than those who started stimulants at older ages and lower doses
According to Moffitt, life-course persistent antisocial behavior is due to ______, where as adolescence-limited antisocial behavior is explained by ________.
neuropsychological vulnerabilities and an adverse social environment
a maturity gap
Role of dopamine in schizophrenia: DA _____ in subcortical regions of brain causes ______ symptoms; DA _____ in cortical regions causes _____ symptoms
DA hyperactivity…. positive symptoms (subcortex)
DA hypoactivity… negative symptoms (cortex)
Medication treatment for Tourette’s and other tic disorders (med class, neurotransmitter affected)
anti-psychotics
block dopamine receptors
Peripartum depression rates according to DSM vs other estimates
DSM: 3-6%
others: 10-20%
Psychogenic nonepileptic seizures (PNES) are best detected using which imaging technique?
Video electroencephalography (vEEG)
Trauma-focused CBT used to treat _______
children/adolescents with sexual trauma or other trauma
Creutzfeldt-Jakob disease is categorized in the DSM-5 as a neurocognitive disorder due to prion disease. It’s caused by ________ that has a ____ latency period; deterioration in functioning is _____.
a slow-acting virus
long
rapid
Externalizing the problem is a core strategy of _______ and involves “reframing the problem from an internal deficiency or pathological condition in the individual to an objectified external and unwelcome narrative with a will of its own to dominate their lives”
narrative family therapy
Meichenbaum’s (1977) self-instructional training to help impulsive children control their behaviors while completing certain tasks involves five steps:
cognitive modeling,
overt external guidance,
overt self-guidance,
faded overt self-guidance
covert self-instruction
A primary goal of _______ family therapy is to disrupt destructive family games (“dirty games”) that involve deceit and power struggles and lead to and maintain symptoms.
Milan systemic
Helms’s White racial identity development model distinguishes between six stages (statuses):
(in order)
contact,
disintegration,
reintegration,
pseudo-independence,
immersion-emersion, and
autonomy
3 phases of stress inoculation training (SIT)
conceptualization,
skill acquisition and
rehearsal
Boyd-Franklin developed the _________ family therapy specifically for African American families. It consists of two main axes: Axis I consists of ____, while Axis II consists of ____.
-multisystems model of
-the components of the treatment process (e.g., joining, assessing, restructuring)
-the various levels at which the components can be applied (e.g., individual, family, nonblood kin, friends, church, community)
Nonpharmacological evidence-based treatment for autism
early intensive behavioral intervention (EIBI)
Gender ratio of ADHD in adults
1.6 males : 1 females
Up to __% of school-age children with ADHD continue to meet the diagnostic criteria for the disorder in adolescence, and up to __% continue to do so into adulthood
80%
30%
Neurotransmitters implicated in ADHD
dopamine,
norepinephrine, and
serotonin
Criteria for Tourette’s
1+ vocal tic
multiple motor tics
persisted more than one year
onset before 18
Typical age of onset of tics
4-6 years old
Medication treatment for tic disorders (class)
antipsychotics
3 components of Beck’s cognitive triad
negative beliefs about self, the world, and the future
Self-instructional training (Meichenbaum, 1977) was initially developed to teach ______ skills to ______.
problem-solving
children with high levels of impulsivity
5 stages of Self-Instructional Therapy (Meichenbaum)
Cognitive Modeling
Overt External Guidance
Overt Self-Guidance
Faded Overt Guidance
Covert Self-Instruction
4 skills taught in Self-instructional training
-identifying the nature of the task
-focusing attention on the task and the behaviors needed to complete it
-providing self-reinforcement that sustains appropriate behavior
-evaluating performance and correcting errors
3 phases of stress inoculation training (Meichenbaum)
conceptualization/education
skills acquisition and consolidation
application and follow-through
Six core processes of ACT (hexaflex)
-(Experiential) acceptance
-(Cognitive) defusion
-Being present/Contact with the present moment
-(Awareness of) self-as-context
-Values (-based actions)
-Committed action
Format of mindfulness-based stress reduction (MBSR)
eight-session group program
mindfulness-based stress reduction (MBSR) is used to treat
stress, pain, and illness
MBCT was originally designed to treat ____.
Recurrent Depression
According to Holzel, what 4 mechanisms are responsible for the effectiveness of mindfulness-based interventions?
-attention regulation
-emotion regulation
-body awareness (awareness of one’s internal states)
-decentering (reperceiving; the ability to separate oneself from one’s thoughts and emotions)
Cognitive therapy for suicide prevention (CT-SP) was designed for _____.
Brief cognitive-behavioral therapy for suicide prevention (BCBT) was designed for ____.
Cognitive-behavioral therapy for suicide prevention (CBT-SP) was developed for _____.
-adults who recently attempted suicide
-active-duty members of the military
-adolescents and combines strategies of CBT and dialectical behavior therapy
Three phases of cognitive therapy for suicide prevention (CT-SP) and brief cognitive-behavioral therapy for suicide prevention (BCBT) target ___, ____, and ____.
emotion regulation
cognitive flexibility
relapse prevention
Criteria for Brief Psychotic Disorder
1 of 3 symptoms below present for more than 1 day but less than 1 month
-delusions
-hallucinations
-disorganized speech
-(grossly disorganized or catatonic behavior also possible)
Criteria for schizophreniform disorder
at least 2 of 5 symptoms below (1 must be of first 3 listed) for more than 1 month, but less than 6 months
-delusions
-hallucinations
-disorganized speech
-also: grossly disorganized or catatonic behavior
-negative symptoms
Criteria for schizophrenia
an active phase that lasts for at least one month and includes at least two of five characteristic symptoms, with at least one symptom being
-delusions,
-hallucinations, or
-disorganized speech.
The other two characteristic symptoms are
-grossly disorganized or catatonic behavior
-negative symptoms
There must also be continuous signs of the disorder for at least six months that may include prodromal and/or residual phases in addition to the required active phase. Prodromal and residual phases consist of two or more characteristic symptoms in an attenuated form or negative symptoms only.
Concordance rates of schizophrenia:
Parent
Bio sib
Child of one parent with schizophrenia
Dizygotic twin
Child of two parents with schizophrenia
Monozygotic twin
Parent 6%
Biological sibling 9%
Child of one parent with schizophrenia 13%
Dizygotic (fraternal) twin 17%
Child of two parents with schizophrenia 46%
Monozygotic (identical) twin 48%
Over half of individuals with schizophrenia also meet criteria for ______
Tobacco Use Disorder
Onset of schizophrenia symptoms tends to occur ___ for men and ___ for women
in early-mid twenties for men
late twenties for women
Factors associated with better prognosis for schizophrenia
-female gender
-acute and late symptom onset
-comorbid mood symptoms
-predominantly positive symptoms
-precipitating factors
-family history of mood disorder
-good premorbid adjustment
“Immigrant paradox” of psychological disorders (define, and identify disorders)
newly arrived immigrants have better health outcomes than much more acculturated immigrants (with longer US residence) or even US born natives of the same ethnicity
-schizophrenia, alcohol use disorder
Western vs non-Western differences in schizophrenia
non-Westerners are more likely to experience an acute onset of symptoms, a shorter course, and a higher rate of remission
Psychosocial treatments for schizophrenia
assertive community treatment
cognitive-behavior therapy for psychosis
cognitive remediation for schizophrenia
family psychoeducation
social skills training
supported employment
acceptance and commitment therapy.
Criteria for schizoaffective disorder
concurrent symptoms of schizophrenia and a major depressive or manic episode for most of the duration of the illness, but with the presence of delusions or hallucinations for two or more weeks without mood symptoms.
Criteria for delusional disorder
(a) the person have one or more delusions for a duration of at least one month and (b) the person’s overall functioning has not been markedly impaired except for any direct effects of the delusion.
5 types of delusions
erotomanic
grandiose
persecutory
jealous
somatic
Symptoms of tourettes have been linked to abnormalities in which brain area
basal ganglia
Which brain area is responsible for procedural memories?
cerebellum
Severe damage to the ________ is often fatal because of its role in the regulation of respiration and cardiovascular functioning.
medulla oblongata
Neuroimaging studies have linked ADHD to a:
smaller-than-normal prefrontal cortex.
The most effective intervention for children with childhood-onset fluency disorder is likely to be which of the following?
habit reversal training
Gestalt therapy techniques
Paradoxical change (need for self-acceptance)
“Here” and “now”
Empty chair technique/role plays
Exaggeration technique (ask pt to exaggerate a behavior or emotion)
“I” statements
Locating emotion in the body
Key concepts in Gestalt therapy
Experience influences perception
Context matters
Focus on the present
Working through pain
Self-awareness/experiential exercises
Gestalt therapy: contact boundaries and modifications to contact
contact boundaries limit how fully they experience themselves, others, and the world
modifications to contact interrupt normal developmental processes and person gets stuck into fixed beliefs about themselves, others, and world, limiting their ability to experience contact
Gestalt therapy: polarity continuums to modify contact
(Both extremes cause problems)
Retroflection - Impulsiveness
Deflection - Reception
Desensitization - Sensitivity
Confluence - Withdrawal
Egotism - Spontaneity
Projection - Ownership
Introjection - Rejection
Beck’s model of “suicide mode” is activated by _____ (4 components)
Cognitive
Affective
Motivational
Behavioral
Primary goal of CBT-SP
Deactivate the suicide mode, replace with more adaptive mode that promotes desire to live
Howard’s model for improvement in therapy (3 phases)
remoralization (increased hopefulness)
remediation (of symptoms)
rehabilitation
Helm’s white racial identity development model (6 stages/statuses)
CONTACT - oblivious to racism
DISINTEGRATION - not acknowledging racial oppression while witnessing it; conscious of their whiteness; dissonance between own group and humanism
REINTEGRATION - resolution of dissonance moves in the direction of dominant ideology; a regression; idealization of whiteness and intolerance of minorities
PSEUDO-INDEPENDENCE - painful/insightful event jars person from reintegration; interaction with minority individuals based on how “similar” they are; understanding of privilege tends to be an intellectual exercise
IMMERSION-EMERSION - personal exploration of self as a racial being; increasing willingness to confront one’s own biases and privilege
AUTONOMY - increasing awareness of one’s whiteness, acceptance of one’s role in perpetuating racism, renewed determination to abandon white entitlement; development of a non-racist white identity;
Multisystemic therapy is used to treat _____
families with an adolescent with antisocial tendencies at risk for out-of-home placement; also used for adolescents with serious psychiatric disturbance, substance use, or history of child maltreatment
Multidimensional family therapy is used to treat
families that include a member who is 11 to 21 years old and has a substance use disorder and comorbid internalizing or externalizing symptoms
Family-focused therapy is used to treat
families with a member who has bipolar disorder
It is based on recognition that high levels of criticism, hostility, and emotional overinvolvement (i.e., high expressed emotion) by family members can trigger relapse in the family member with this disorder.
Transference-focused psychotherapy is used to treat _____.
borderline and other personality disorders
highly structured, twice-weekly modified psychodynamic treatment based on Otto F. Kernberg’s object relations model of borderline personality disorder
According to Carl Rogers personality theory, problems are due to ______, which means ____.
Incongruence
discrepancy between a person’s sense of self and their experience (occurs due to conditions of worth)
Research has found that culturally competent interventions for members of racial and ethnic minority groups are more effective for ____ than ____.
Adults
Children & adolescents
Yalom’s five stages of group therapy
Forming/orientation
Storming/transition
Norming/cohesiveness
Working/performing
Adjourning/termination
Three types of microaggressions (Sue)
microinvalidation
microinsult
microassault (closest to “old-fashioned racism”)
Microassault (Sue)
racial derogation characterized primarily by a verbal or nonverbal attack meant to hurt the intended victim through name-calling, avoidant behavior, or purposeful discriminatory actions
Microinsult
communications that convey rudeness and insensitivity and demean a person’s racial heritage or identity. Microinsults represent subtle snubs, frequently unknown to the perpetrator, but clearly convey a hidden insulting message to the recipient of color
Microinvalidation
communications that exclude, negate, or nullify the psychological thoughts, feelings, or experiential reality of a person of color.
4 stages of Adlerian therapy
creating a relationship
assessment
insight
reorientation.
The basic principle of Adlerian theory
humans are social beings and therefore all behavior is socially embedded and has social meaning. Adler emphasized the importance of relationships and being connected to others, including the larger community in which people reside.
What drive did Adler believe was the motivating force behind human behaviors, emotions, and thoughts?
every person has a sense of inferiority. From childhood, people work toward overcoming this inferiority by “striving for superiority.”
Seller et al.’s (1998) multidimensional model of racial identity proposes that there are four dimensions of African American identity _____.
SALIENCE (affected by current situation and centrality of race to that person; self-definition)
CENTRALITY (of race in individual’s self concept; self-definition)
REGARD (a person’s affective and evaluative judgment of their race; has private (how they view blacks) and public (how they believe others view blacks) dimensions; qualitative meaning of being black)
IDEOLOGY (associated with the racial identity; beliefs about the ways that Blacks should act; qualitative meaning of being black)
Sellers 4 identities of racial ideology
NATIONALIST philosophy‚ characterized by a viewpoint that emphasizes the uniqueness of being of African descent;
OPPRESSED MINORITY philosophy‚ characterized by a viewpoint that emphasizes the similarities between African Americans and other oppressed groups;
ASSIMILATION philosophy‚ characterized by a viewpoint that emphasizes the similarities between African Americans and the rest of American society;
HUMANIST philosophy‚ characterized by a viewpoint that emphasizes the commonalties amongst all humans.
the four stages of Troiden’s homosexual identity development model
SENSITIZATION - feeling different from peers, view of self as atypical (before puberty)
IDENTITY CONFUSION - feelings of difference become more associated with sexuality (adolescence; most difficult stage)
IDENTITY ASSUMPTION - less feelings of social and personal isolation; greater integration of self with sexual identity (early adulthood)
COMMITMENT & INTEGRATION - Sexual identity becoming a way of being rather than only a description of one’s sexual behavior.
Practitioners of motivational interviewing use ________ to elicit change talk
evocative questions
three stages of the development of object constancy (Mahler)
normal autistic stage occurs during the first few weeks of life
normal symbiotic stage
separation-individuation stage.
What is narrative therapy? (White & Epston)
a style of therapy that helps people become—and embrace being—an expert in their own lives. In narrative therapy, there is an emphasis on the stories that you develop and carry with you through your life.
Techniques of narrative therapy
PUTTING TOGETHER YOUR NARRATIVE
EXTERNALIZATION (create distance b/w person and their problems)
DECONSTRUCTION (breaking down the story to help clarify the problem)
UNIQUE OUTCOMES (helping pt realize their stories are not concrete and consider alternative stories)
Structural family therapy (Minuchin)
looks at the structure of a family unit and improves the interactions between family members
Techniques in Structural family therapy (Minuchin)
FAMILY MAPPING (each member maps family relationships, family rules, patterns of behavior, and family structure/hierarchies)
JOINING
BOUNDARY-MAKING
ROLE-PLAY
REFRAMING
Types of boundaries explored in structural family therapy (Minuchin)
diffuse (enmeshed)
rigid (disengaged)
clear
Detouring in family relationships
Detouring occurs when parents, rather than directing anger or criticism toward each other, focus the negativity on the child (overprotecting/fragilizing the child or blaming the child) and the parent-child conflict thus serves to distract from the tension in the marital subsystem.
AKA scapegoating
Cross-generational coalitions in family relationships
when one or both parents trying to enlist the support of the child against the other parent
What is the role/outcome of positive vs negative feedback in systems theory?
-Positive feedback amplifies deviation from the status quo and promotes change
-Negative feedback counteracts (attenuates) deviation and maintains the status quo.
Berry’s acculturation model distinguishes between four acculturation strategies (identify strategies; how are they defined?)
based on whether a member of a minority group accepts or rejects his/her own culture and the culture of the dominant (majority) group
INTEGRATION - values both dominant and native culture
ASSIMILATION - values dominant culture; devalues native culture
SEPARATION - devalues dominant culture; values native culture
MARGINALIZATION - devalues both dominant and native cultures
The transtheoretical model (Prochaska and DiClemente) is also known as the ____
stages of change model
Stages of the transtheoretical model
PRECONTEMPLATION - do not intend to take action in foreseeable future (~6 months); unaware that their behavior is problematic
CONTEMPLATION - intending to start behavior change within next 6 months; recognize their behavior is problematic; ambivalence about making change
PREPARATION - aka determination; ready to take action within next 30 days; start taking small steps toward change; believe change will be helpful
ACTION - have recently changed their behavior (within last 6 months) and intend to keep moving forward with change
MAINTENANCE - people have sustained behavior changes for more than 6 months and work to prevent relapse
TERMINATION - people have no desire to return to previous unhealthy behaviors and are sure they will not relapse
Ten processes of behavior change (transtheoretical model)
CONSCIOUSNESS RAISING - Increasing awareness about the healthy behavior.
DRAMATIC RELIEF - Emotional arousal about the health behavior, whether positive or negative arousal.
SELF-REEVALUATION - Self reappraisal to realize the healthy behavior is part of who they want to be.
ENVIRONMENTAL REEVALUATION - Social reappraisal to realize how their unhealthy behavior affects others.
SOCIAL LIBERATION - Environmental opportunities that exist to show society is supportive of the healthy behavior.
SELF-LIBERATION - Commitment to change behavior based on the belief that achievement of the healthy behavior is possible.
HELPING RELATIONSHIPS - Finding supportive relationships that encourage the desired change.
COUNTER-CONDITIONING - Substituting healthy behaviors and thoughts for unhealthy behaviors and thoughts.
REINFORCEMENT MANAGEMENT - Rewarding the positive behavior and reducing the rewards that come from negative behavior.
STIMULUS CONTROL - Re-engineering the environment to have reminders and cues that support and encourage the healthy behavior and remove those that encourage the unhealthy behavior.
Define autoplastic interventions
making changes in the individual so he/she can successfully adapt to the environment
Define alloplastic interventions
altering the environment to fit the needs, desires, or other attributes of the individual
Difference between emic vs etic
-Emic perspective believes that some behaviors are affected by culture and are, therefore, culture-specific.
-Etic perspective believes that all behaviors are essentially unaffected by culture and are, therefore, universal (cross-cultural)
Define reality therapy (Glasser)
-based on choice theory, which views depression, anxiety, and other psychological symptoms as the result of choices a person makes in an attempt to satisfy his/her innate needs
-focuses on realism, responsibility, and right-and-wrong, rather than symptoms of mental disorders
-psychological pain is caused by ineffective attempts to satisfy one’s needs.
Cognitive therapy for suicide prevention (CT-SP) was designed for _____.
adults who recently attempted suicide
Brief cognitive-behavioral therapy for suicide prevention (BCBT) was designed for ____.
active-duty members of the military
Cognitive-behavioral therapy for suicide prevention (CBT-SP) was developed for _____.
adolescents and combines strategies of CBT and dialectical behavior therapy
Define object relations
how experience with another comes to be represented in the mind
Stages in Mahler’s theory on ego development within the context of object relationships (2 precursors, 4 substages)
Precursors to differentiation:
- normal autism (first few weeks of life)
- normal symbiosis (starts in week 3-4)
Separation-Individuation
- differentiation (4-10 months)
- practicing (6/10-18 months)
- rapprochement (15-24 months)
- consolidation of individuality / on the road to object constancy (24-36 months)
Five core elements of psychological well-being in Seligman’s PERMA model
POSITIVE EMOTIONS
ENGAGEMENT
RELATIONSHIPS
MEANING
ACCOMPLISHMENT
Define sublimation
channeling unacceptable impulses into socially desirable (and often admirable) activities.
Define displacement (Freud)
when a person shifts his/her impulses from an unacceptable target to a more acceptable or less threatening target.
Define reaction formation (Freud)
a defense mechanism in which a person unconsciously replaces an unwanted or anxiety-provoking impulse with its opposite, often expressed in an exaggerated or showy way
According to the transtheoretical model, which 3 factors contribute to a person’s motivation to change an undesirable behavior
decisional balance
self-efficacy
temptation.
What are the four problem areas that are targeted by practitioners of interpersonal psychotherapy?
interpersonal role disputes
interpersonal role transitions
interpersonal deficits
grief.
Motivational interviewing incorporates concepts and procedures from which four theories?
Rogers’s person-centered therapy
Prochaska and DiClemente’s transtheoretical model
Bandura’s concept of self-efficacy
Festinger’s notion of cognitive dissonance.
What is the intrapersonal aspect of differentiation according to Bowen?
a person’s ability to distinguish between his or her own feelings and thoughts.
What is the interpersonal aspect of differentiation according to Bowen?
the ability of a person to separate his or her own emotional and intellectual functioning from the functioning of others
What is the purpose of circular questioning in Milan’s systemic family therapy?
asking each family member the same question to identify differences in perceptions about events and relationships and uncover family communication patterns.
What is the primary goal of primary goal of Satir’s conjoint family therapy?
increase congruent communication between family members
What is the goal of Bowen’s extended family systems therapy?
increase the differentiation of each family member.
What is the goal of Minuchin’s structural family therapy?
create clear boundaries between family members.
What is the goal of emotionally focused therapy?
heighten and restructure the emotional experiences of family members.
Styles of family communication according to Satir (4 dysfunctional styles, 1 functional style)
Dysfunctional
-placating (self-effacing pleasers)
-blaming (self-righteous accusers)
-computing (emotionally detached, rigidly intellectual)
-distracting (unfocused, unable to relate)
Functional
-congruent (expressive, responsible, genuine, articulate)
Who is strategic family therapy used to treat?
families with children or adolescents who are dealing with behavioral issues.
What is enactment in strategic family therapy?
family members are asked to talk with each other rather than to the therapist.
What is an ordeal in strategic family therapy?
an unpleasant task that a client is asked to perform whenever he or she engages in the undesirable behavior.
Based on the results of their meta-analysis of 475 psychotherapy outcome studies, Smith, Glass, and Miller (1980) concluded that the average psychotherapy patient is better off than ____% of patients who do not receive psychotherapy.
80%
Four obstacles to providing effective mental health services, according to Caplan:
lack of:
knowledge,
skills,
confidence
objectivity
What is theme interference? (Caplan)
a type of transference in Consultee-centered case consultation that occurs when a past unresolved conflict related to a particular type of client or circumstance is evoked by and interferes with the consultee’s current situation.
Research evaluating the effects of routine outcome monitoring (ROM) suggests that it:
decreases premature termination and client deterioration during therapy.
What is the difference between efficacy and effectiveness clinical research?
Efficacy research is conducted in well-controlled circumstances
Effectiveness research is conducted in naturalistic clinical settings
Which has better internal validity, efficacy or effectiveness clinical research?
efficacy
Which has better external validity, efficacy or effectiveness research?
effectiveness
Norcross and Lambert (2011) concluded that _____ accounts for the greatest amount of variability in psychotherapy outcomes, specifically __% of variance
patient contributions
30%
Transdiagnostic treatments are used to treat ___.
Multiple disorders that are caused and maintained by similar core mechanisms.
Sue suggests that African Americans prefer a therapist who _____. They tend to prefer a _____ approach.
fosters an egalitarian therapist-client relationship.
goal-oriented problem-solving approach
Communication styles according to Hall (context)
-High-context communication relies heavily on group understanding, nonverbal messages, and the context in which the communication occurs and is characteristic of several cultural minority groups.
-Low-context communication relies on the verbal message, is independent of the context, and is characteristic of the White (mainstream) culture.
Who is best known for their work on White privilege and provided a list of examples of privileges that Whites take for granted.
Peggy McIntosh
4 types of worldview according to Sue, and which represents dominant white perspectives?
Based on Internal vs External judgments of loci of control and responsibility
Internal locus of control/internal locus of responsibility (IC-IR) - characteristic of white, mainstream American culture
EC-IR - marginalized individuals with internalized self-hate
EC-ER - “learned helplessness”
IC-ER - pride in one’s racial identity; activism
Stages of Atkinson, Morten, and Sue’s R/CID Model
CONFORMITY - positive towards dominant, negative towards own
DISSONANCE & APPRECIATING - question identity, appreciate own culture & existence of racism, shift from seeing dominant as all good
RESISTANCE & IMMERSION - positive towards own; rejects dominant
INTROSPECTION - questions costs of negativity toward dominant; notes that not all aspects of dominant and own are good or bad
INTEGRATIVE AWARENESS - secure, confident sense of and pride in cultural identity; appreciating all diverse groups; recognize racism as societal illness
What are the five stages of Cross’s original Nigrescence Model?
PRE-ENCOUNTER (+dominant, -blackness; two forms: active, passive)
ENCOUNTER (-dominant, reevaluate relationship between blacks and whites; substages: realization, decision)
IMMERSION (-dominant, +black making use of dominant stereotypes, anger at blacks not black enough)
& EMERSION (+multiple ways of being black; better able to control emotions and behavior when participating in dominant society)
INTERNALIZATION (dissonance between old and new self is resolved; nuanced definition of blackness)
INTERNALIZATION-COMMITMENT
Treatment for bulimia
CBT (most effective), IPT; pharmacotherapy can be helpful, but is not as effective as CBT
Exception questions
times when you didn’t feel this way
Used in solution focused therapy
Circular questions
make overt the overall dynamics and interactive patterns in the system, thereby reframing the problem for all participants without the therapist having to verbally provide a reframe;
identify alternative options, think beyond available facts
Used in Milan family therapy
Scaling questions
On a scale of 0-10….
used in solution focused therapy
Smith, Glass, and Miller’s (1980) meta-analysis of 475 psychotherapy outcome studies effect size
0.85
average patient who received therapy was better off than 80% of people who did not receive therapy
Most effective treatment for OCD
the combination of the tricyclic clomipramine or an SSRI and exposure with response prevention is more effective than either treatment alone.
Risk of tardive dyskinesia when taking an antipsychotic is greater for ___ and ____
Older adults
women
Five types of boundary disturbances, according to Gestalt therapists:
boundary disturbances AKA “resistances”
projection,
retroflection (withholding of emotions, thoughts, and behavior and their redirection back onto the individual; protecting oneself),
confluence (dissolving the contact boundary resulting in lack of differentiation from another,
deflection (turning away from an emotional trigger to prevent full awareness),
introjection (adopting the beliefs of another without evaluation)
Order in which self-conscious emotions emerge
18-24 months: embarrassment, envy/jealousy, empathy
30-36 months: pride, shame, guilt