Clinical must review Flashcards
Communication theory (family and group)
Contributes to family therapy, repetitive patterns of communication and interactions that cause problem behavior (how we interact with schizophrenics)
General Systems Theory (family and group)
inteactions come from rules and have homeostic mechanisms that maintain stability and equailbrium
Double-bind communication (family and group)
- Schizophrenia -person gets 2 messages from family that contradicts and cannot comment
- Symmetrical interactions-equality, similar as the other, 1-upmanship
- Complementary interaction-inequality and behavior one person complements the behavior of the other. dominate and subordinate role
Socratic Dialogue
- Beck client asks questions to
- define problem
- identify thoughts
- evaluate consequences of bad behavior
Collaborative Empieism
Beck therapist and client co investigate accept support reevaluate or reject assumption, intention or belief
Symmetrical Interactions (communications theory)
one upmanship equality elicits similar behavior in someone else
Complementary interactions (f & g) (communications theory)
dominant and subordinate role inequality (polar opposites attract) behavior of one complements behavior of other (messy and neat person attract)
Extended Family Systems (EFS)
Bowen -aka Intergenerational and transgenerational family therapy -goal is differentiation (think of a bow and the D in the bow for differentiation) 2 people try to rope in a 3rd -origination of therapy with schizophrenic families and children -therapist is the coach -family will speak to therapist not each other
Extended Family Systems (EFS) -Differentiation -Intrapersonal -Interpersonal
- Differentiation- both intra and interpersonal
- Intra-personal distinguish between own feelings/thoughts
- Inter-personal differentiation decrease can be emotionally fused with other family members
EFS Emotional Triangle
dyed 3rd family member (mom-dad, kid or mom-kid, dad)q
EFS-Family Projection
Process-project emotional immaturity on to family
EFS- Multigenerational Transmission Process
extension from one generation to the next
EFS therapy
therapist sees client and family at the same time increase family differentiation ask questions to diffuse emotion teach family how to engage and interact support family while being neutral and avoid family emotional process *talk directly to therapist vs each other
Structural Family therapy-Minuchin
goal is to unbalance family structure (alter hierarchal relationships) create boundaries/restructure the family
Structural Family therapy Subsystems Boundaries
- Subsystem-similar units for specific tasks (nursing mom)
- Boundaries-implicit and explicit rules of contact oververly
- diffiused-enmeshed relationship clear boundaries-
- close relationship overly ridged-disengaged relationship
Structural Family Therapy Ridged family Triads
- Stable coalition-one parent/child alliance against other parent
- Unstable coalition-aka-triangulation-each parent demands child side w/them
- Detouring-attack coalition-parent blames child
- Detouring-support-avoid conflict by being overprotective
Structural Family therapy Joining aka therapeutic alliance
- Joining-adopting communication
- Mimesis- adopt style and language
- Maintenance-provide family with support
Structual Family Therapy Family Structure
family map- subsystems and boundaries reframing-name problem behavior unbalancing-hierarchical relationships with family members boundary making-change degree of proximity to members enactment-roleplay problem behavior for a therapist to see
Strategic Family-Haley
- family control &
- power/hierarchies therapist straightforward tells them what to do
Strategic Family Family therapist interactions
- 1) brief stage-observe family
- 2) problem stage- family tells view
- 3) interaction stage- discuss view of problem (family)
- 4)goal setting stage-together family define develop goal
SF Therapy
- straightforward -
- paradoxical techniques-help family see they have control (prescribing, ordeals, restraining)
- prescribing to problem- exaggerated behaviors
- restraining-do does not change too quick (small steps)
- ordeal- unpleasant task family has to do/engaged
Milan Systematic Family Therapy main idea
family games aka dirty games alter family rules (MULAN became warrior) short term
Milan Systemic Family Therapy difference from others
therapeutic team 5 part therapy-pre session, session, intersession, intervention, and post-session w/ 4-6 week gaps to alter behavior (dirty games)
Milan Systemic Family Therapy treatment
- hypothesis-initial interview/phone
- neutrality-therapist interact/accept each fam mem prob
- circular questioning-ask each fam mem same question
- position connotation- symptom maintain fam cohesion
- family rituals-between session alter problems (games)
Milan Systemic Fam Therapy (key to remember)
kid with Milano cookies family games-patterns of communication vs dirty games-communication problematic (need alter)
Narrative Family therapy
-restory -replace problem stories with better ones -person is not the problem, problem is outside of the person
Narrative family therapy story replacement
get to know family separate listen to client “sparkling moment” separate family from problem bring in preferred better narratives
Narrative family therapy techniques
QUESTIONS -externalizing questions, view problems outside self -opening space questions, family identify unique outcome -therapeutic letters-reinforce emerging alternative story -therapeutic certificate end therapy acknowledgment -definitional ceremonies tell others of their change/celebrate
Emotionally Focused Therapy (EFT) Geenburg&Johnson
attachment theory & humanistic experimental -emotions/attachment influence relationship -partner needs usually a health problem -distress-partner interaction and emotion from others
Emotionally Focused Therapy (EFT) Technique
partner needs to EXPRESS & deal w/emotion *expand & restructure emotional experience 1)assessment & de-escation 2) change position& creating bonding events 3) consolidation & intergration
Group therapy model effective & contraindicated
inclusion and exclusion effective-increase motivation, self reflective, disclosure vs contraindicated-people w/suicidal ideation, delusion, pose threat to group, unable to control aggression
Group therapy antisocial behavior
better—>homogenous group worse—>hetergenous group
Group Therapy Characteristics # of people cohesiveness closed open
7 to 10 people >7 limited interaction <10 too hard to involve everyone 2 # people decrease cohesiveness, increase dropout closed-specific # people, sessions, no replace dropout open-replace people, unlimited session, decrease cohesiveness, may benefit from energy of new people
Group Therapy Formative Phases Yalom
Overlapping phases 1) Initial Orientation-hesitant, giving/seeking advice, clarify purpose 2) Conflict-dominance &rebellion, group must “share” therapist 3) Cohesiveness- decrease conflict, open communication, trust, self disclosure
Group Therapy Factors Yalom
effects of group therapy, group cohesiveness instillation of hope
Group therapy Tuckman and Jenson think Pinata
Forming-group ground rules Storming-members confrontational w/each other/leader Norming- growth stage, commitment and trust Performing-group functions effectively Adjourning-get closure and say goodbye 2 members
