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EPPP > Clinical Psych > Flashcards

Clinical Psych Flashcards

1
Q

What therapies are included in the psychodynamic psychotherapies category?

A
  1. Freudian psychoanalysis
  2. Jung’s analytical psychology
  3. Adler’s individual psychology
  4. Object-relations approachts
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2
Q

What therapies are included in the humanistic, existential, and other psychotherapies category? (6)

A
  1. person-centered therapies
  2. Gestalt therapy
  3. existential therapies
  4. Reality therapy
  5. Positive psychology
  6. Personal construct therapyt
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3
Q

What is the freudian psychodynamic view of human nature?

A

-deterministic and pessimistic
-psychological problems are due to unconcious unresolved conflicts that arise during childhood

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4
Q

What are the 3 freudian aspects of personality? And how do they compete?

A

Id, ego, superego

-Id: present at birth, operates according to pleasure principle and seeks immediate gratification of its needs using unconscious irrational means
-ego: develops at about 6 mo. old, operates according to the reality principle. seeks to at least partially satisfy the id but does so in realistic ways
-supergo: the last aspect of personality to develop; represents internalization of society’s values and standards and acts as the conscience, attempts to permanently block the ids instincts

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5
Q

What are the freudian defense mechanisms?

A

defense mechanisms are used when the ego cant resolve an issues between the id and supergo. occassional use adaptive but reliance on them prevents one from resolving conflicts causing distress

-repression, denial, reaction formation, projection and sublimation (these operate on an unconscious level)

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6
Q

What is the freudian defense mechanism of repression?

A

repression is the basis of all other defense mechanisms, is involuntary, keeps undesirable thoughts and urges out of concious awreness

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7
Q

What is the freudian defense mechanism of denial?

A

Denial is refusing to acknowledge distressing aspects of reality

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8
Q

What is the freudian defense mechanism of reaction formation?

A

reaction formation invovles defending against an unacceptable impulse by expressing its opposite

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9
Q

what is the freudian defense mechanism of projection?

A

projection is attributing an unacceptable impulse to someone else

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10
Q

What is the freudian defense mechanism of repression?

A

repression is the basis of all other defense mechanisms, is involuntary, keeps undesirable thoughts and urges out of conscious awareness

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11
Q

What is the primary goal of freudian psychoanalysis?

A

to make the unconcious concious and strengthen the ego so that behavior is based on reality more and less on instinctual cravings

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12
Q

What are the primary techniques of freudian psychoanalysis?

A

analysis of the person’s free associations, dreams, resistance and transference through 4 steps:
1. confrontation- helping patients recognize behaviors theyve been aware of and their possible cause
2. clarification- brings cause of the behaviors into sharper details
3. interpretation- explicitly linking conscious behaviors to unconscious processes
4. repeated interpretation leads to catharsis (the experience of repressed emotions) and insight into the connection between unconscious info and current behavior and then working through by which patient accepts new insights into their life

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13
Q

Jung’s analytical psychology

A

Jung accepted some aspects of freudian theory. believed behavior is driven by positive and negative forces, personality continues to develop across lifespan, behavior is affected by the past and future

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14
Q

Describe Jung’s division of the unconscious aspects of the psyche

A

personal unconcious - person’s own forgotten or repressed memories
collective unconscious- memories that are shared by all people and passed on between generations. collective unconscious includes archetypes

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15
Q

What are Jung’s archetypes of the conscious collective?

A

universal thoughts and images that predispose people to act in similar ways in certain situations. expressed in myths and dreams and include:

persona, shadow, hero, anima, animus

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16
Q

What is the primary goal of Jung’s analytical psychotherapy?

A

to bring unconscious material into conciousness to facilitate process of individuation which occurs mainly during second half of life

techniques used include dream interpretation, analysis of transference

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17
Q

How does Adler’s individual psychology differ from Freud’s theory?

A

replaced sexual instincts with innate social interest and desire for connectedness

teleological approach - emphasizes the effects of future goals on current behavior

people are motivated by feelings of inferiority that come up during childhood in response to real or perceived inadequacies, we strive for superiority to overcome these feelings

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18
Q

How does Adler define a healthy style of life?

A

when a person’s goals reflect their concerns for personal achievement as well as the well-being of others

unhealthy lifestyle is if their goals only focus on overcoming sense of inferiority and lack of concern for others

neurosis, psychosis, addiction etc are result of a mistaken style of life

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19
Q

What is the view of object relations theory?

A

View behavior as being motivated by a desire for human relationships and focus on impact of early relationships between child and caregiver (objects) on child’s future relationships

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20
Q

What is object constancy in object relations theory?

A

the development of mental representations of the self and objects that the individual to value an object for reason’s other than its ability to satisfy the individual’s needs

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21
Q

What are the 3 stages of development of object constancy?

A
  1. normal autistic stage- first few weeks of life, infants are self absorbed and unaware of the external environment
  2. normal symbiotic stage- infants become aware of the environment but can’t differentiate self from caregiver
  3. separation-individuation- begins at about 5 mo. continues til 3 yo. consists of 4 substages: differentiation, practicing, rapprochement, beginning of object constancy

narcissism, BPD, etc develop from failure of this process and lack of object constancy

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22
Q

What are the humanistic, existential, and other psychotherapies?

A

humanistic: person-centered, gestalt therapy
existential therapy
others: positive psychology, reality therapy, personal construct therapy

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23
Q

how are humanistic and existential therapies similar and different?

A

similar: both focus on the here and now, phenomenological orientation (prioritize client’s subjective experience over reality)
-reject medical model and use of clinical labels
-concentrate on client’s internal qualities and perspectives rather than symptoms

differences: humanstic emphasize acceptance and growth and help clients function better while existential emphasize freedom and responsiblity and to confront anxieties that arise from one’s awarness of their own existential condition

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24
Q

What is Roger’s person-centered therapy (client-centered therapy) based on? and what is the goal?

A

assumption that people have innate drive toward self-actualization which motivates them to reach full potential

can be an issue when person experiences incongruence between own self-concept and their experience

Goal: to help client become a fully functioning person who is not defensive, open to new experiences, and engaged in process of self-actualization

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25
Q

What techniques are used by person-centered therapy?

A

facilitative (core) conditions: empathy, unconditional positive regard, and congruence (being genuine, authentic, and honest)

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26
Q

What is the theory behind Gestalt therapy?

A

assumes that 1) people are motivated to maintain homeostasis which is interrupted by unfulfilled psychological and physical needs; 2) people are constnatly seeking something from the environment to fulfill these needs and get back to homeostasis.

maladjustment occurs when there is a persitent disturbance that prevents person from fulfilling their needs

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27
Q

What are the boundary disturbances of gestalt therapy?

A

introjection- adopting beliefs, values of others without evaluation or awareness
projection- people attribute undesirable aspects of self to others
retroflection- when people do to themselves what they would like to do to others
deflection- when people avoid contact with the environment
confluence- blurring of distinction between self and others

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28
Q

What techniques are used in gestalt therapy?

A

cure is gaining awareness of one’s current thoughts, feelings and actions

techniques include
dreamwork- role playing dreams that represent disowned parts of their personality
the empty chair technique- person interacts with opposing aspects of their own personality OR resolves unfinished business with another

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29
Q

What is the primary goal of Existential Therapies?

A

emphasize personal responsiblity and choice and belief that each person has to define their own personal existence

Goal: to help patients live authentic life, choosing values and purposes that will define and guide their existence, supporting htem in actions that express these values and purposes

30
Q

How do existenital therapies define psychological disturbances?

A

an inability to resolves conflicts that arise when facing four ultimate concerns of existnece: death, freedom, isolation, and meaningless

31
Q

How do existential therapies define normal (existential) anxiety and neurotic anxiety?

A

normal (existential) anxiety- in proportion to the threat, can be used to motivate positive change
neurotic anxiety- disproportionate, involves repression, keeps people from reaching their potential

32
Q

What techniques are used in existential therapies?

A

Authentic therapist-client relationship is the most important therapeutic tool

use other techniques such as questioning, interpreting, reframing

33
Q

What theory is Reality Therapy based on?

A

Based on choice theory- people have 5 basic innate needs (love and belonging, power, fun, freedom, and survival)

the way a person chooses to fulfill these needs determines if they have a success (fulfilling needs in responsible way that does not infringe on others) or failure (irresponsible, destructive ways) identity

34
Q

What is the primary goal of reality therapy?

A

to replace the client’s failure identity with success identity by helping them assume responsibility for own actions and use more adaptive ways to fulfill needs.

35
Q

What strategies is used by reality therapy?

A

WDEP system:
W- ask client about wants and needs
D- determine what client is currently doing to foster awareness of their behaviors
E- encourage client to evaluate own behaviors
P- help client create plan of action

36
Q

What is the theory of positive psychology?

A

about the valued subjective experiences: well-being, contentment and satisfaction (in the past) and hope and optimism for the future, and flow and happiness in the present

37
Q

Describe the PERMA model of well-being in positive psychology

A

PERMA model describes 5 essential elements of well-being:
P- experiencing Positive emotions
E- Engagement with situations and tasks, characterized by state of flow
R- having Relationships that are positive and meaningful
M- having meaning, dedicated to a cause bigger than the self
A- Accomplishment-Achievement, striving to better the self and achieve goals

38
Q

What is the focus of Personal Construct Therapy?

A

how people perceive, interpret, and anticipate events

changing the way we construe events can alleviate undesirable behaviors/outcomes

39
Q

How are events construed in personal construct therapy?

A

events are construed through personal constructs:
fair/unfair
relevant/irrelevant
friend/enemy
these constructs arise through personal experience and can operate consciously or unconsciously

client/therapist work together to identify and replace maladaptive constructs

40
Q

Focus of Interpersonal Therapy

A

Focuses on interpersonal factors that contribute to client’s current symptoms

based on the medical model, views psych disorders as treatable medical illnesses, primary goal is to relieve symptoms and improve interpersonal functioning

originally created to treat depression but modified for bipolar, eating disorders, and others

41
Q

Describe 3 stages of interpersonal therapy

A
  1. initial stage- therapist determines diagnosis and interpersonal context of symptoms, and identify primary goal for therapy (for depression problem areas are interpersonal role disputes, interpersonal role transitions, interpersonal deficits, and grief). patients take on “sick role” - temporary and treatable
  2. middle phase- strategies are used to address the problem including encouragement of affect, role-playing, communication analysis, decision analysis
    3.final stage- therapist addresses issues related to termination and relapse prevention
42
Q

What is the focus of Solution-focused therapy? and what are techniques used?

A

focuses on solutions to problems rather than the etiology of the problems

takes collaborative approach and uses questions to help clients identify treatment goals, examples:

miracle question-if a miracle happened over night and your problem was solved how would you know it was solved? (used to identify treatment goals)

exception questions- used to identify times when their problems did not exist

scaling questions - help clients to assess current status/progress, on a scale of 1-10 how stressed are you now?

each session is structured, involves askign questions, providing feedback, assigning a task to be done before next session

43
Q

What is the theory of the Trantheoretical Model

A

integrates concept and strategies from multiple approaches - based on assumption that strategies are most effective when they match the persons stage of change

44
Q

What are the 6 stages of change in the transtheoretical model?

A
  1. precontemplation- no intention of taking action to change behaviors in next 6 months, may be in denial, or dont beleive they can change (can benefit from consciousness raising, dramatic relief, environmental reevaluation)
  2. contemplation- plan to make change in the next 6 months but ambivalent about change which can make it difficult to go to the next stage (benefit from self-reevaluation)
  3. preparation- plan to take action in the next month (benefit from self-reevaluation and self-liberation)
  4. action- taking action to make behavior change (benefit from contingency management, stimulus control, counterconditioning)
  5. maintenance- have maintained change for 6 months, primary goal = relapse prevention
  6. termination- confident risk for relapse is low
45
Q

What 3 factors affect motivation to change in the Transtheoretical Model?

A

decisional balance- strengths of persons beliefs about the pros/cons of changing and is most important determinant of change in contemplation stage
self-efficacy- persons confidence in their ability to change and avoid relapse (most important for contemplation to prep to action)
temptation- intensity of urge to engage in the undesirable behavior (strongest in first few stages)

46
Q

What other models does MI combine?

A

aspects of person-centered therapy, transtheoretical model, and bandura’s concept of self-efficacy, and festinger’s cognitive dissonance

47
Q

When is MI most useful?

A

for patients in precontemplation or contemplation stage. beleives interventions are most effective when they meet a client where they are at

48
Q

What are the 4 processes of MI?

A

engaging- establishing a productive client-therapist relationship
focusing- identifying the targets of change
evoking- eliciting the client’s own motivation for change
planning- consolidating patients commitment to change and developing a plan of action

49
Q

What are the 4 communication skills of MI?

A

OARS
open-ended questions, affirmations, reflective listening, summaries

50
Q

What strategies are used in MI?

A

strategies used to evoke the patient’s motivation:
brainstorming, reframing, reviewing past successes, developing discrepancies between behaviors and values/goals, eliciting change talk, reducing sustain talk, recognizing and resolving discord (discord=statements that signal dissonance in therapist-client relationship - “you just don’t understand”

51
Q

What are change talk and sustain talk in MI?

A

change talk: statements that favor change- id probably feel a lot better if i stopped smoking
sustain talk: statements that favor maintaining status quo- i’m just not ready to stop smoking

52
Q

What are brief psychodynamic psychotherapies?

A

various types, time-limited versions of the longer psychodynamic therapies
Various types have the following in common:
-believe change can occur with brief therapy, or that the therapy can begin a change process that will continue after therapy
-therapy should have limited goals agreed upon in initial sessions
-appropriate only for certain types of clients
-therapists adopts an active role early on to establish therapeutic alliance and ensure therapy stays focused on major issues so goals can be accomplished in short time
-emphasize the development of positive transference
-address separation and other concerns related to termination early in the course of treatment

53
Q

Define internal/external locus of control and locus of responsibility

A

internal locus of control- believe they are in control of their own outcomes
external locus of control-have little or no control over their outcomes
internal locus of responsibility- responsible for their own successes and failures
external locus of responsibility- others are responsible for one’s success/failure, may keep one from being able to be successful

54
Q

Define the 4 acculturation strategies

A

integration- one retains their own minority culture and adopts the majority culture
assimilation- one rejects their own minority culture and adopts the majority culture
separation- retains their own minority culture and rejects the majority culture
marginalization- reject their own minority culture and the majority culture

55
Q

Define the two types of paranoia that may prevent a minority client from disclosing personal information to a white therapist

A

functional paranoia- unhealthy, suspicion and distrust, not willing to disclose to a white therapist

healthy cultural paranoia- suspicion and distrust as a normal reaction to the prejudice and discrimination they’ve experienced, only willing to disclose to a white therapist if certain conditions are met

56
Q

Define the 3 types of microaggressions

A

microassaults- explicit rational derogations, intentional, meant to cause harm, “old fashioned” racism
microinsults- verbal and nonverbal messages that are insensitive or demean a person’s racial/ethnic/cultural background
microinvalidations- communications that exclude, negate, or nullify the thoughts, feelings, or experiences of people of color (myth of meritocracy)

57
Q

What is internalized racism or colorism?

A

when a person accepts societies negative beliefs/stereotypes of their own racial group

58
Q

Define etic vs. emic perspectives

A

emic- that cultures are all different and what might work for one won’t necessarily work for all
etic- behaviors are similar across cultures and what works for one person will work for everyone despite their cultural background

59
Q

Define autoplastic vs. alloplastic interventions

A

autoplastic- making changes within the person to help address their problems- learning skills to cope, changing behaviors etc.
alloplastic- changes things in the environment or situation to address the problem

60
Q

Define cultural encapsulation

A

When a person is too caught up in their own culture and beliefs and believe this applies to all people regardless of their backgrounds

61
Q

Define tight vs. loose cultures

A

refers to the strength of a culture’s social norms and tolerance for deviant behavior

CA/OR/WA are considered loose because people are more open to change, more likely to engage in risk-taking or innovative behaviors

States in the south like MI, AL, AR are tight, more likely to conform to social norms, avoid risky behaviors, prefer stability, higher levels of concientiousness

62
Q

Define high vs low context communication

A

high context communication relies on things that are unsaid, the context of the conversation - characteristic of many minority groups, especially common in African Americans

low context- relies on the verbal message, independent of context, more characteristic of white people/mainstream culture

63
Q

Define diagnostic overshadowing

A

originally developed to refer to when therapists would attribute all of a client’s problems to their diagnosis of intellectual disability and overlook other potential causes of their problems. this is now applied when people attribute an individuals problems to being gay without considering other explanations

64
Q

Define minority stress theory

A

People of sexual minorities are at greater risk for mental health problems related to the chronic stress they experience as a result of stigmatization. distinguishes between distal and proximal minority stress processes

distal- external to the person, include verbal harassment, prejudice, discrimination
proximal- occur within the person, includes concealment, fear of rejection, internalized hetereosexism

65
Q

culturally competent guidelines for working with african americans

A

-consider how racism and other environmental factors may contribute to the presenting problem
-extended kinship network likely to include nuclear and extended family and friends, members of church/community
-roles within families often flexible, male-female relationships tend to be egalitarian
-prefer problem-solving and decision-making skills to help them take control of their own life
-use multi-system approach- intervene in numerous systems at multiple levels including individual, family, friends, church/community, social service agencies

66
Q

culturally competent guidelines for working with american indians

A

-consider impact of environmental contributors: discrimination, poverty, acculturation effects
-collateral social system includes family, community, tribe
-cooperating, sharing, generosity are important values, interest of the family and tribe are more important than the individual
-regard wellness as harmony of mind, body, and spirit
-more emphasis on nonverbal than verbal communication, listening more important than talking, direct eye contact a sign of disrespect, firm handshake a sign of aggression
-collaborative therapeutic approach and build trust by demonstrating familiarity and respect for their culture/acknowledge when dont know something
-collaborative problem-solving, client centered approach that avoids highly directive techniques and incorporates values and traditional healers
-network therapy- mobilizing people in their netowrk to help

67
Q

culturally competent guidelines for working with hispanic/latinos

A

-consider their beliefs about the nature of their problems
-more likely to express psychological symptoms as somatic complaints
-consider how religious/spiritual beliefs might inform assessment, dx, tx
-emphasize family welfare over individual welfare
-families are patriarchical, stress machismo
-use formal style in therapy initially and become more personal over time
-likely to prefer CBT, problem-solving therapy, solution-focused therapy, family therapy, group therapy
-cuento- use of olktales to present models of adaptive behavior
dichos- use of proverbs to help express feelings

68
Q

culturally competent guidelines for working with asian americans

A

-differences in acculturation make cause issues within the family
-holistic view of mind and body, express psychological problems as somatic symptoms
-hierarchical and patriarchical, traditional gender roles , emphasize family needs over the individual
-fear of losing face and shame are powerful motivators
-maintain formal style in therapy
-periods of silence and avoidance of eye contact are signs of respect
-prefer cbt, brief structured goal oriented, probelm focused approaches that focus more on the family
-expect therapist to be knowledgeable experts who give advice and suggest specific courses of action while also encouraging client participation

69
Q

culturally competent guidelines for working with LGBTQ

A

LGBTQ men and women more than twice as likely to have mental health problems in their life especially anxiety depression and SUD
-evidence suggests bisexual have the most mental health problems
-sexual minorities utilize mental health services at higher rates than hetero
-affirmative therapy approach
-distinguish maladaptive thoughts from thoughts that are normal response to stigmatization theyve experienced
-sexual identity milestones happen in same order for all generations but at an earlier age for younger generations

70
Q

culturally competent guidelines for working with older adults

A

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