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Clinical Flashcards

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0
Q

What are the criteria for acute stress disorder?

A

Symptoms occur within 1month of stressor

Sx resolve by 1 month….last 2 days to 1month

At least 3 dissociative sx

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1
Q

What are the defining criteria of childhood onset obsessive compulsive disorder?

A

Compulsions start 1 to 2 years before the obsessions.
Washing, checking, ordering rituals
High comorbidity rate..tic d/o, depression, ADHD
Family loading for OCD
High frequency of hoarding ob/comp

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2
Q

What is the diagnostic criteria for conversion disorder?

A

1 sx or deficit in motor or sensory fx such as paralysis, seizure, blind
May be due to primary gain, decrease anxiety or keep it ucs, or to secondary gain, avoid st, get support

Often conflict or stressful even shortly before onset. No physical cause.
Tx–hypnosis, narcosis, dramatic placebo

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3
Q

What are the dx criteria for somatization disorder?

A 
Multiple physical sx
Before age 30
At least 4 pain sx
2 GI sx, 1 sexual sx, 
1 pseudo neurological  sx

Also called briquets syndrome

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4
Q

How is malingering different than factitious disorder?

A

Malingering is not a mental disorder. It is a deliberate production of symptoms motivated by external incentives (miss work, $). It is under the pts control.

Factitious..behaviors can be deliberate but not necessarily controlled.

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5
Q

What are the types of focal seizures and how do they differ?

A

Partial (focal) seizure–uncontrollable twitching, part of body jerks and can increase.

Complex partial seizure (psychomotor or temporal lobe seizures) impaired consciousness. Stare blankly. Drunk acting.

Simple partial seizures-(Jacksonian)
One side of the body uncontrollable. No problem w consciousness. Tonic clinic may follow.

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6
Q

What are the types of bilateral seizures?

A

No local onset

General tonic clonic (grand mal)
Convulsions, ucs, rigidity. May go 1 hr. deep sleep when done

Generalized absence of seizures (petit mal)– very brief loss of cs, few or no other sx, no deep sleep

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7
Q

What are the differences between tension and migraine headaches? Include info on treatment.

A

Tension headaches–pain both sides, tight band around the head
Use EMG biofeedback to decrease tension or relaxation training

Migraine- pain on one side, nausea and GI sx, aura before
Caused by dilation and spasms of blood vessels.
Tx- thermal hand warming and biofeedback. Relaxation training and biofeedback equally effective. Often combine them and it is more effective then either alone and better than self monitoring.

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8
Q

What is Selye’s theory of general adaptation syndrome to stress?

A

ARE

Alarm–pituitary adrenal system mobilizes sympathetic nervous system

Resistance–defenses stabilized , sx disappear , energy depleted

Exhaustion–depleted

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9
Q

Flooding is used to treat what disorders?

A

Exposure to feared stimuli with response prevention is effective with agoraphobia, specific phobias, obsessive compulsive do, and PTSD.

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10
Q

What is systematic desensitization and who does it treat?

A

Gradual exposure to feared stimuli with relaxation strategies is highly effective with specific phobias.

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11
Q

Erickson’s stages of development

A 
Year 1. Trust vs mistrust (oral). 
Year 2 autonomy vs shame/doubt (anal)
3 to 6. Initiative vs guilt (phallic)
6 to 12 industry vs inferiority...competence occurs
Corresponds to freuds latency phase.

12 to 18 yrs identity vs role confusion

18 to 35 yrs Early adulthood.. intimacy vs isolation..capacity to form intimate relationships

35 to 60. Middle adulthood…generativity vs stagnation…capacity to care and give to next generation.

60 plus . Late adulthood…Integrity vs despair..wisdom occurs

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12
Q

How do ericksons stages correspond to freuds?

A

Oral
Anal….1 to 3. Autonomy v shame/
Doubt
Phallic. 3 to 6. Initiative v guilt
Latency 6 to 12. Industry v inferiority
Genital 12 to 18. Identity v role
confusion

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13
Q

What is rehms self control theory?

A

It is a theory of depression which integrates cognitive and behavioral models. Depression is viewed as a result if negative self evaluations, lack of self reinforcement, and high rates of self punishment.

Tx– self monitoring, self evaluating, self control skills, modify dysfx thoughts and behaviors

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14
Q

What problem use aversive conditioning?

  1. PTSD
  2. Sexual dysfx
  3. Delusional do
  4. Smoking
A
  1. Smoking.

Aversive used for addictive behaviors. Aversive stimulus (shock) Repeatedly paired with conditioned stimulus (smoking). Hoped ucr of pain will become cr, replacing pleasure.

Problems with aversive conditioning..hi relapse rate, lack of generalization, and ethical concerns.

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15
Q

Night terrors remit:

  1. Early childhood
  2. Middle childhood
  3. Adolescence
  4. Adulthood
A
  1. Occur 3 to 12 years. Peak age is 3.5 years.

1 to 6 percent have it.

Equally affected

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16
Q

What is the treatment of choice for a specific phobia?

A

Flooding

Then in vivo modeling…gradual interactions with feared object. Exposed and observes coping.

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17
Q

Howard found in his meta analysis of outcome by the end if 6 months of treatment what percent of pts are improved?

  1. 25
  2. 50
  3. 75
  4. 90
A
  1. 75 percent by 6 mo

50 percent after 8 sessions

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18
Q

What predicts adjustment following a traumatic event?

A

Family history of mental illness, social support, and manner of processing stressful stimuli.

Debriefing has not shown to prevent PTSD and factors such as permit if fx, or training of debriefer have not been shown to matter.

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19
Q

Which theorist believed maladaptive behavior results from ppls attempts to make up for perceived or real disabilities as children?

  1. Freud
  2. Adler
  3. Horney
  4. Jung
A

Adler…inferiority complex. Children experience a sense if inadequacy based on real and perceived limitations. To overcome and achieve mastery, they develop. Lifestyle that is either adaptive or maladaptive. Adler examines the lifestyle..mistaken goals and faulty assumptions are discovered and ideally modified to be more constructive. Individual psychology.

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21
Q

What is an early indicator of therapy outcome?

A

Therapeutic alliance.

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22
Q

What are the steps in psychoanalysis?

A

Confrontation
Clarification
Interpretation
Working through

Proven sequence

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23
Q

From psychoanalytic pt of view, anxiety occurs when:
A. Defense mechanisms have not properly modulated intrapsychic excitation.
B. person has difficulty coping
C. Experiences emotions that have previously been repressed
D. Facing difficult life transition.

A

A

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24
Q

What psychodynamic theorist is linked to introversion/extroversion?

Which is linked to STEP etc?

A
  1. Jung

2. Adler

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25
Q

How did Jung describe the ucs?

A

Analytic therapy. Ucs made cs
He divided the ucs into two.

Personal/individual ucs..contains repressed material.

Collective ucs…archetypes; transpersonal (for all peeps)

Trait theorist…intro/extroversion
4 archetypes: self, shadow, anima, animus

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26
Q

What is associated with Adler?

A 
Individual therapy
Inferiority complexes as kids motivate us to power, superiority
Masculine protest
Style of life...tx replaced broken style
STEP...used with parents, schools etc...
Rejected id concept
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27
Q

Who are the neofreudians and what were their theories?

A

Focus on society and culture
Less emphasis on drives

Horney..parent behaviors cause anxiety. Move to, away, against. Healthy integrate all

Sullivan. Relationship importance through the Lifespan. Cognitive sequentially occurs…
Prototaxic
Parataxic
Syntaxic

Fromm..societal structures and dynamics. 5 character styles.
Productive only one realize true nature.

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28
Q

Describe the sequential cognitive modes Sullivan put forth. Which is the cause of neurotic behavior?

A

Prototaxic…b4 language symbols
Discrete momentary states. First months of life. Schizophrenic experience.
Parataxic…private, autistic symbols w causal connections w events not related..serve developing self and reduce anxiety.
Distortion here cause neurotic behavior
Syntaxic..symbols w shared meaning, logical.. End yr 1. Underlies language acquisition.

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29
Q

Who are the ego analysts and what separates their theory?

A

Anna Freud, rappaport, Hartman

Ego defensive fx..resolution of conflict
Ego autonomous fx..adaptive no conflict fx like learning, memory, speech

Healthy behavior cs
Pathology..ego loses autonomy id

More emphasis present, less transference, re parent , build adaptive fx

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30
Q

Who are the object relation theorists and what is important to them?

A

Mahler, winnocott, Klein, kohit, kernberg, fiarbairn

Object introject, self or other,

3 rd yr…psychological birth of the infant.
Splitting

Kohut..self psych. Narcissism and grandiose self

Tx —re parenting facilitates reintegration of the ego.

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31
Q

What is associated with existential tx?

A

Normal vs neurotic anxiety. Neurotic often loss of responsibility.
Help learn to tolerate anxiety.

Logo tx–frankl…search for meaning of life…motivated to find meaning, freedom to find it, meaning under all circumstances

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32
Q

What do all humanistic tx have in common?

A

Present focus…here and now
Ppl can make own decisions (not ucs, environ)
All potential for growth
Subjective view of ct more important than objective. To understand ct
Downplay assessment, dx…

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33
Q

What is associated with client centered tx?

A

Incongruence
Self actualization in born potential. Maladjustment difference between real and ideal self. Thwart actualization when experiences aren’t in line. Then feel anxious which lead to incongruent behavior.

3 conditions
Unconditional positive regard
Empathy
Congruence/genuineness

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34
Q

What is important to gestalt therapy?

A

Full awareness of self, environment, self-environment
Self (promotes growth) vs self image (imposes external stds impairs growth).

Perls

Interjection..take in wo awareness
Retroflection…sub self for environment..underlies isolation
Deflection..avoid contact/awareness by polite…
Confluence..permeable boundary; self merged with others.
Isolation…importance of other lost
Pathology..outside awareness
Tx..directed awareness, I statement, empty chair, transference is fantasy

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35
Q

What is associated with reality therapy?

A

Glasser…choice theory
Personal responsibility
5 needs survival, love, power, freedom, fun

Success identity replaces failure identity. Take responsibility.
Do not interfere with others to satisfy own needs.
Role play, humor, confront, plans, and WDEP …questioning
techniques.
Wants, direction, evaluate, plan
Apply schools..schools without failure..
Work w ct on what they want, may dc basic needs, must be something they can control. Make plan to satisfy ones needs. Must commit to meeting goal. No rewards, punishment,… Just job take responsibility.

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40
Q

Guided imagery is mostly used in:

  1. Interpersonal tx
  2. Psychoanalytic tx
  3. Cognitive behavior tx
  4. Client ctr tx
A

3

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41
Q

Describe transactional analysis.
Who?
2 notions based on.

A

Berne
Based on: functional ego states to our personality
Internal models converse in transactions in ourselves and in relationships.
Goal..alter maladaptive life positions and scripts and integrate 3 ego states

3 ego states..child, adult, parent
Strokes pos or neg recognition
Script..life plan (unhealthy is malad)
4 life positions (I’m ok, u r ok (healthy one all kids start with)
Transactions..communication exchange..complimentary (appropriate response)
Crossed (inappropriate response)
Ulterior (dual message causes confusion)…basis of games

42
Q

Describe the tenants of self in relation theory.

A

To better understand experience/development of women.
Depends on how connect.
Growth thru empathetic connection and internalization of that.
Pathology..lack connection so increase them. Most important is mother daughter connection.
Mutuality..reciprocity

43
Q

Define the cognitive behavioral theory of stress inoculation training.
Who?
What treat?
3 steps?

A

Michenbaum
Tx…aggressive or impulsive behavior
Self instruction/self talk
Steps..cognitive prep…educate faulty cognitions and how they prevent adaptive coping
..skill acquisition… rehearsal and practice new thinking
…practice…apply to real or imagined situations

44
Q

Who is treated with hypnosis?

A 
Dissociative do
Fugue states
Conversion
PTSD
Phobic
GAD
Habits
Contraindicated for:
Psychotic
Paranoid
OCD 
Severely depressed and manic hard to hypnotize
45
Q

What is associated with beck?

A

Cognitive therapy..think determines how feel and behave.
Tx..collaborative investigation; testable ho

Cause and maintain pathology:
Automatic thoughts
Schemas (core beliefs; can be activated by similar conditions )
Cognitive distortions. (Reasoning errors)…links other two

46
Q

Define necks cognitive distortions:

  1. Arbitrary inference
  2. Selective abstraction
  3. Over generalization
  4. Magnification/minimization
  5. Personalization
  6. Dichotomous thinking
A
  1. Draw conclusion wo evidence or contrary evidence
  2. Focus on out if context detail and disregard other info
  3. Overgeneralization..draw conclusion based on 1 incident
  4. More or less significant than is
  5. External events to self wo cause
  6. Extreme thinking
47
Q

What is the evidence re:pts and cognitive tx?

A

Depressed..more distorted automatic thoughts/errors
Remember more negative info re self
Cognitive triad present..neg thoughts of self, other, world

Depressed and anxious..demoralized, self involved, reduced problem solving.

Differ...
Depressed..hopeless, low esteem, failure
Absolute thoughts/negative themes
Anxious..themes of danger/harm
Questioning thoughts re future
48
Q

What techniques does beck use to help monitor thoughts, recognize connection between feeling, thought, behavior, examine evidence, substitute reality interpretations and identify/alter belief system?

A 
Cognitive techniques:
Elicit automatic thoughts (? and log)
Decatastrophizing..what if
Re attribution...alternative causes
Redefining...restate w cts control highlighted and made concrete
Behavioral:
Homework (monitor,..)
Activity scheduling..w ratings
Graded task assignments..sm steps
Hypothesis testing
Behavioral rehearsal/ role play
Diversion techniques..work out, social..
49
Q

Rational emotive therapy is associated with who? What?

A 
Ellis
ABC theory..
       A...events
       B..beliefs
       C..consequences
Add D..rationality and learn musts
        E..behavior change w diff beliefs

Must-urbation..root to irrational beliefs

Tx…aware beliefs, dispute, show musts contribute
Confrontation, contracts, desensitization, response prevention , education

50
Q

What are the differences between beck/cognitive tx and Ellis/RET?

A

Beck..thoughts dysfx but don’t have to be irrational
Test out beliefs

Ellis..thoughts irrational
More behavioral
Directly challenge beliefs

51
Q

What are the self control techniques?

A

Most effective at the beginning of response chain!

Self monitoring..minor and st effects alone; better in conjunction

Stimulus control…modify s r relationship or make new one.
Narrowing..restrict target behavior
To limited set of stimuli
Cue strengthening
Competing responses (target to eliminate)

52
Q

What are the three factors involved in hypnosis?

A

Absorption
Dissociation
Suggestibility

Memory retrieval helps symptom
Improvement but often distorted and pt may be reluctant to admit .

Generally effective..level of ability to be hypnotized is predictive of response to tx
Most effective with goal to build a sense of control over emotions/ behaviors

53
Q

What is EMG biofeedback and what is it used for?

A

Measures degree of relaxation or tension in muscles

Used for tension headaches (as effective as relaxation)
Chronic pain
Muscle stiffness
Incontinence
Urinary urgency, frequency
Stress

Thermal biofeedback is for migraines and found more effective than relaxation.
Also used for fecal incontinence
Raynauds disease

EEG biofeedback used for:
Depression
Epilepsy
Stroke recovery
Head injury 
ADHD
54
Q

What assumption is paradoxical intention based on?

A

That a person avoids a certain behavior because of anticipatory anxiety the behavior arouses.
Prescribe sx sets up condition of incompatability which eliminates the anxiety. Neutralizes fear.

Tx ....insomnia (may be better than behavioral techniques; mixed re compared to relaxation and stimulus control)
Elimination do
Depression
Procrastination
Anxiety

Get cts cooperation is essential

55
Q

What is the purpose of motivational interviewing?

A

Resolve ambivalence
Build commitment
Reach decision to change

Assumption that ambivalence is main obstacle, change comes from w in ct, ct must resolve, and respected by tx

56
Q

Describe narrative therapy.

Describe schematic therapy

A

Stories of ppls lives and differences that can be made thru telling and retelling or re authoring .

Problem is the problem
Not the person

Schema tx treats chronic characterlogical aspects by looking at themes..early maladaptive schemas. Limited re parenting become empowered to give up maladaptive behaviors. Use with mindful meditation for spiritual..

57
Q

Discuss psychodrama and the 3 components.

A

Group tx

Warm up (theme), action (dramatized), Sharing

Tx... Trauma
Substance abuse
Depression
Anxiety
Grief loss 
Multicultural issues
Decrease stigma
58
Q

What is another name for morita therapy?

A 
Psychology of action
Tx anxiety and neurosis
Feelings uncontrollable
Take action not alleviate for wanted state.  Accept fluctuations.
Reframe, take responsibility
Psychology of reflection...naikan tx
Ask 3 ?
What have I received from?
What given to?
What troubles caused?
59
Q

Who is the father of American psychology?

A

James…first lab at Harvard.

Sad because we cry

(Vs cannon bard…feel emotion and then have physiological response, like sweating)

60
Q

What is covert modeling?

A

Behavioral technique where increase desirable behavior by imagining others performing behaviors with positive outcomes. Imagine specific positive consequences.

(Vs covert sensitization, aversive conditioning, which frequency of undesirable behavior is lessened by mentally associating it w unpleasant images.

61
Q

What is collaborative empiricism and who used it?

A

Beck thought of the ct and therapist as equal partners. Peers
Capable of objectively analyzing own issues and arriving at own conclusions.
Guided discovery…ask questions in Socratic fashion; develop and test ho.

62
Q 
Covert sensitization is a            Technique used to decrease undesirable behavior by using negative imagery.
A.  Behavior tx
B.  cognitive tx
C.  Gestalt tx
D.  RET
A

A

63
Q

What are the properties of the family system?

What is a closed system?

A

Closed system is resistant to change because or if id boundaries which leads the family to disorder and disorganization.

Wholeness..all interrelated. Change In one part impacts others.
Non summativity..whole greater sum
Equifinality..patterns important. Different causes lead to same end result.
Equipotentiality..one cause can lead to different results.
Homeostasis..tendency to restore status quo. Depends on feedback type.
Negative feedback..try correct deviations
Positive feedback..encourage or create deviations. Stay at home mom gets job which requires all to change roles.

64
Q

Discuss communications therapy. Define meta communication, symmetrical , and complementary communications.

A

Meta…report level..intend to say
Command level..implicit non verbal and is the meta communication.

Symmetrical..communicators equal

Complementary..inequality..one dominant and one subordinate. Give and take. Parent/child.

65
Q

How does Bowen family tx view therapist triangulation?

What is multigenerational transmission process?

What is undifferentiated family ego mass?

A

More cognitive, insight oriented

Therapist often casts self in this role as the neutral third member. This helps the two in tx reduce the level of fusion and reach higher differentiation.

Escalation of family dysfunction thru several generations when lack of differentiation is passed down. Explains severe pathology like schizophrenia

Undifferentiated family ego mass …causes family members not to differentiate.
Multigenerational transmission process…lack of diffentiation is passed down.
Often just works w husband and wife or just most differentiated person.
Create therapeutic triangle

66
Q

What are some techniques of structural family therapy?

A

Minuchin
Here and now. Current. Action before understanding.
Directive and action oriented.

Joining to understand the family. second restructure family structure. mapping, enactment, boundary making, reframing, restructuring are strategies.

These are used when parents include children to deflect problems, such as in triangulation (both demand child side w them), detouring (reinforce deviant behavior in child), join stable coalition with child against other.

67
Q

Describe strategic family tx

A

Haley..sx ways to control family members
Tx is power struggle. Tx tries to disrupt patterns of symptomatic behavior. Tx has a plan.
Effect change ASAP. Current focus.
Id major prob and factors maintain it. Look patterns.
Strategies…paradoxical approaches…directives (prescribe the sx), reframing (relabel), circular questioning (help view prob diff), restraining (discourage family from changing)
Goal…reduce current sx not underlying cause.
Tend to be brief and directive.

68
Q

Describe operant interpersonal therapy.

A

Marital tx based on operant and social exchange theory.
Frequency and range of reciprocal positive reinforcements exchanged is difference of un/successful marriage.
Tx…Reciprocal reinforcement quid pro quo. Caring days, trade 3 things, 18 positive behaviors can do

Object relations family tx..insight, transference , interpret kids play..

69
Q

Who are the pioneers if group therapy?

A

Moreno created the movement. Developed association, journal
Adler, burrow
Today yalom..theory and practice of grp therapy.

70
Q

What factors are important when forming a group?

A

Similar developmental level (kids no more than 2 yr. diff)
Intelligence similar (experts say most important).
Size..7 to 10 best

Yalom said motivation most important and the over riding factor for composition is cohesiveness. 3 stages…reluctant to open up, look to leader. 2 nd stage…conflicts develop and find positions. 3rd increase cohesiveness.

71
Q

What are the 11 mechanisms of change related to group outcome or therapeutic outcome?

A 
Instillation of hope
Universality 
Impart information
Altruism
Recapitulate family of origin
Socialization
Imitation
Interpersonal learning
Cohesiveness
Catharsis
Existential factors

Yalom said interpersonal learning, catharsis and cohesiveness most important.
(Hi fx grp…interpersonal, universality,
Lo fx..hope)
Recent studies..cohesiveness most associated w improvement and success
Also related to success..early confrontation, later positive alliance, later affective confrontation w fewer leader interventions in later sessions

Per screening and post selection. Prep reduces premature termination and enhances outcome.

Indiv and grp good for narcissistic and borderline pts

72
Q

What are the goals of crisis intervention?

A

Immediate symptom reduction
Strengthen coping mechanisms
Prevention further probs
Restore to previous level of fx

Tx usually active, supportive

73
Q

What are the stages of crisis intervention?

A

Formulation..id crisis and rx
Implementation..premorbid fx, goals
Termination

74
Q

How does crisis intervention differ from brief tx?

A

Crisis..focus usually trauma w immediate but temporary first aid
Sx often normal rx trauma
Restore to previous fx
Very short less 8 sessions

Brief 
More focused, briefer than tx
Analytical roots/insight
Sx..pathological; try relieve acute sx
Try prevent future sx
Can go 20-25 sessions
75
Q

What is suction focused therapy?

A 
Brief tx focused on solutions (vs problems or causes).
Less 6 sessions
Cts have resources 
Tx only intervenes as necessary 
Goals shift to solutions

Use miracle question (visualize prob not existing and effect), exception question (when problem didnt exist), scaling questions (rate worst to best it’s been), narrative stories

Good w juvenile offenders, substance abuse tx and at risk kids in school setting ESP externalizing kids

76
Q

What is the difference between psychotherapy integration and eclecticism?

A

Eclectic …pick interventions based on what works wo thinking of theory

Integration..attends to theory and technique

Integration has been applied to:
Common factors present in all tx

Assimilation integration..use one theory but willing to use other techniques from other approaches.

Theoretical integration..integrate diff theories and make a grand unified theory

77
Q

What is elective psychotherapy and describe

A

Specific tx for specific conditions and therapist, therapist-ct relationship and intx variables more important than specific techniques.

Lazarus multimodal tx. Basic id
7 areas addressed for effective tx.
Behavior, affect, sensations, imagery, cognitions, interpersonal relationships, drugs/exercise/nutrition …
Psychoeducational..probs due to lack of info

Prescriptive eclectic tx…open system, ct focused
Adjust tx, etc to ct based on empirically supported guidelines
3 parts…synergy of ax and awareness; complementary nature of systems; identify empirical markers to pick tx

78
Q

Prochaska and diclemente have the transtheoretical or stages of change model. What are the 6 stages of change?

A

Transtheoretical…from 18 major theories. Originally developed for tx of cig smoking, addiction. 6 stages. At ea decisional balance..weigh pros and cons if adopting a new behavior.

Precontemplation..denial, reisist

Contemplation..ambivalent, start to recognize; plans to change 6 mo

Preparation..intent for ax next 30 days

Action…changing

Maintenance..for 6 mo plus and working to prevent relapse

6th usually not stated cause rare get 100 percent self efficacy.

79
Q

What are the somatic therapies?

3

A

Drug tx

ECT..non responders to depression tx and dangerously suicidal

Psychosurgery…severe depression, anxiety, and obsessional do

80
Q

Therapy outcome research. Use meta analysis…effect sizes obtained from all the studies. In general what is found about tx vs placebo?

A

Placebo does have an effect when compared to ppl getting no tx.
Considerable effect of therapy over placebo.
Exception…addiction not as established.

All types of tx effective. (No one better than the others..).

Cognitive and behavioral slightly better for certain problems…phobia, childhood aggression, depression

Percentage improve after therapy is 75 percent.!!!!!!!!!!
Negatively accelerated improvement. Improvement to 26 sessions and improvement levels off and not significant after that.

Outcome effected by:
Therapist variable…competence…contributes more to improvement than tx modality.
Tx pt similarity related to positive outcome.
Ct variables..better predictors of tx outcome.
No correlation w age, sex, economics or degree of disturbance w outcome.
Motivation, ego strength, iq, anxiety about the problem impact outcome. Not anxiety per se. Sx ego dystonic then increases motivation.

Ethnic matching…no main effect by itself. Similarity interacts with other variables…like trust of other cultures, therapist sensitivity to cultural variables or lacks cultural identity of her own..could effect outcome.

Manual guided tx not necessarily better.
Tx for kids and adults just as good, still more research needed. Girls may respond better than boys, teen girls best of all. Best for behavioral interventions.

81
Q

What are the 3 phases of psychotherapy effectiveness?

Progressive 3 stage sequence of change

Found relationship between number of tx sessions and tx outcomes.

A

Remoralization..first few sessions
Improve feelings of hopelessness
Subjective well being

Remediation. Between 5th and 15 session. Sx reduction.

Rehabilitation..gradual improvement in various aspects of fx

Different tx goals, interventions, outcome measures may be appropriate for different stages.

82
Q

What is the most stressful type of client behavior for a therapist?

What is the most stressful aspect of their job?

What is the most frequently encountered ethical dilemma.

A

Suicidal statements.

Lack of therapeutic success

Confidentiality is the most frequent ethical dilemma.

83
Q

Who is considered the founder of humanistic therapy?

A

Maslow

Goal eliminate blocks to self actualization.

84
Q

What is associate with michenbaum?

A

Self talk

Stress inoculation
Taught about assumptions
Taught new skills
Practice

85
Q

Biofeedback Is based on what? Who introduced it?

A

Miller

Based on operant conditioning.

86
Q 
What disorders have about equal prevalence?
A.  Depression
B.  autism
C. OCD
D. Bipolar 
E.  schizophrenia 
F.  ADHD
A 
A.  2x women
B.  4 to 6x males
C.  Equal. However, age of onset is significantly different for male and female.  Males onset between 6 and 15.  Female is between 20 and 29 yrs.  childhood OCD more common in males.  Lifetime prevalence 2.5 percent.
D.  Equal
E. equal
F.  6 to 9x
87
Q 
Michenbaum is associated with
Automatic thoughts
Irrational beliefs
Positive self statements
Positive and negative reinforcement
A

C. He uses self instruction w ADHD and impulsive kids. Type of cognitive behavioral tx w modeling and graduated practice w some ret.

A. Beck
B. Ellis
D, skinner and thorndike

88
Q 
Neofreudians;
A.  Underlying ucs conflicts
B.  ego defensive and conflict free fx
C.  Social intx
D.  Beliefs
A

C. Social and cultural factors

B is ego analysis

89
Q 
Therapist ingredient contributes most to successful therapy outcome is:
Experience 
Personal therapy
Empathy
Gender
A

3

Experience doesn’t have much bearing on outcome.

90
Q 
Hyper vigilance is a symptom of:
Reactive attachment, disinhibited type
Reactive attachment, inhibited type
Separation anxiety do
Childhood disintegrative do
A
  1. Disinhibited type …indiscriminate sociability

Inhibited type child is inhibited, hypervigilent or highly ambivalent

91
Q 
While lecturing a speaker has panic attacks on 3 occasions within 1
Month.  Dx:
Panic do w agoraphobia 
Panic do wout agoraphobia
Social phobia
Specific phobia
A

Social. Panic attacks while public speaking.

When focus of panic attacks is soley exposure to certain situations, the dx is a specific phobia,

92
Q 
Who would want to tip a waiter after each course?
Skinner
Watson
Ellis 
Bandura
A

Skinner

Watson is with cc

93
Q

Which is most likely to reduce subsequent hospitalizations of schizophrenics?
Remove pt from family and put in structured setting
Employment for pt
Improve communication w in family
Ongoing support for family members

A

C. Refers to expressed emotion and impact on mental illness. Hi levels result in greater levels of relapse. Critical, hostile, emotionally over involved communication w parents. Family support by itself doesn’t reduce relapse rate. Employment is a good predictor of outcome yet not reduce hospitalizations.

94
Q 
Which is an expansion of maslows work?
ERG theory
Two factor theory
Acquired needs theory
VIE theory
A
  1. Motivators and hygiene factors

Erg also is based on it but is a modification and not expansion. Has 3 needs not arranged hierarchically. Includes frustration regression and says satisfying a need can make it stronger.

Acquired needs is mcclellands and regards the TAT. Has needs for achievement, affiliation and power.

VIE behave based on perceived expectancy of success and rewards.

95
Q

Key elements of self instructional therapy are:
Graded practice, coping statements, reinforcement
Coping, skill development, self reinforcement
Problem solving, graded practice, cognitive restructuring
Repetition, graded practice, cognitive restructuring

A

D. Meichenbaum.
Combo graded practice and RET and involves repeated practice of a targeted task

Therapist models task/verbalizes steps and ends w ct doing task while thinking it through

Form of cognitive restructuring
Helps ct learn to think about how to perform a task rather than problem solving

Coping, skill development used in meichenbaums stress inoculation training.

psychology (16 decks)

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