Clinical Psych Flashcards
Parallel Process
Parallel process occurs in clinical supervision when the therapist (supervisee) behaves toward his/her supervisor in ways that mirror how the client is behaving toward the therapist.
Acculturation (Berry)
According to Berry, a person’s level of acculturation can be described in terms of four categories that reflect the person’s adoption of his/her own culture and the culture of the dominant group - i.e., integration, assimilation, separation, or marginalization.
Cultural Encapsulation (Wrenn)
Culturally encapsulated counselors interpret everyone’s reality through their own cultural assumptions and stereotypes and disregard cultural differences and their own cultural biases.
Cybernetics (Positive And Negative Feedback Loops)
Cybernetics is concerned with communication processes and distinguishes between negative and positive feedback loops. A negative feedback loop reduces deviation and helps a system maintain the status quo, while a positive feedback loop amplifies deviation or change and thereby disrupts the system.
Personal Construct Therapy
George Kelly’s personal construct therapy focuses on how the client experiences the world. It assumes that a person’s psychological processes are determined by the way he or she “construes” (perceives, interprets, and predicts) events, with construing involving the use of personal constructs, which are bipolar dimensions of meaning (e.g., happy/sad, competent/incompetent) that begin to develop in infancy and may operate on an unconscious or conscious level. The goal of therapy is to help the client identify and revise or replace maladaptive personal constructs so that the client is better able to “make sense” of his/her experiences.
Cultural Vs. Functional Paranoia (Ridley)
Ridley described nondisclosure by African American therapy clients as being due to two types of paranoia: A client is exhibiting cultural paranoia (which is a healthy reaction to racism) when he/she does not disclose to a white therapist due to a fear of being hurt or misunderstood. A client is exhibiting functional paranoia (which is due to pathology) when he/she is unwilling to disclose to any therapist, regardless of race or ethnicity, as a result of mistrust and suspicion.
Feminist Therapy (Nonsexist Therapy, Self-In-Relation Theory)
Feminist therapy is based on the premise that “the personal is political.” It focuses on empowerment and social change and acknowledges and minimizes the power differential inherent in the client-therapist relationship. Self-in-relation theory applies feminism to object relations theory and proposes that many gender differences can be traced to differences in the early mother-daughter and mother-son relationship. Feminist therapy must be distinguished from nonsexist therapy, which focuses more on the personal causes of behavior and personal change.
Worldview (Sue)
As defined by Sue (1978), a person’s worldview is affected by his/her cultural background and is determined by two factors - locus of control and locus of responsibility. Differences in worldview can affect the therapeutic process. For example, White middle-class therapists typically have an internal locus of control and internal locus of responsibility (IC-IR) and are likely to have problems working with an African American client with an internal locus of control and external locus of responsibility (IC-ER) who may challenge the therapist’s authority and trustworthiness and be reluctant to self-disclose.
Howard and Colleagues (Dose Dependent Effect; Phase Model)
Howard et al. (1996) identified a dose dependent effect of psychotherapy - i.e., about 75% of patients show measurable improvement at 26 sessions and that this number increases to only about 85% at 52 sessions. They also identified a phase model, which predicts that the effects of psychotherapy are related to the number of sessions and distinguishes between three phases: remoralization, remediation, and rehabilitation.
Motivational Interviewing (Oars)
Motivational interviewing was developed specifically for clients who are ambivalent about changing their behavior and combines the transtheoretical (stages of change) model with client-centered therapy and the concept of self-efficacy. The specific techniques of motivational interviewing are open-ended questions, affirmations, reflective listening, and summaries (OARS).
Strategic Family Therapy (Paradoxical Interventions)
Haley’s strategic family therapy focuses on transactional patterns and views symptoms as interpersonal events that serve to control relationships. Therapy focuses on symptom relief (rather than insight); and involves the use of specific strategies, especially paradoxical interventions (e.g., ordeals, prescribing the symptom, reframing) that are designed to alter the behavior of family members by helping them see a symptom in an alternative way or recognize they have control over their behaviors or by using their resistance in a constructive way.
General Systems Theory
General systems theory defines a system as an entity that is maintained by the mutual interactions of its components and assumes that the actions of interacting components are best understood by studying them in their context. Consistent with general systems theory, family therapists view the family as primarily an open system that continuously receives input from and discharges output to the environment and is adaptable to change. The influence of general systems theory on family therapy is evident in the concept of homeostasis, which is the tendency for a family to act in ways that maintain the family’s equilibrium or status quo.
Diagnostic Overshadowing
Diagnostic overshadowing was originally used to describe the tendency of health professionals to attribute all of a person’s psychiatric symptoms to his or her intellectual disabilities. Subsequent research found that diagnostic overshadowing applies to other conditions and diagnoses.
Multisystems Model (Boyd-Franklin)
Boyd-Franklin’s multisystems model is an ecostructural approach for African American families that addresses multiple systems, intervenes at multiple levels, and empowers the family by utilizing its strengths. Systems that may be incorporated into treatment include the extended family and nonblood kin, the church and other community resources, and social service agencies.
Smith, Glass, And Miller (Meta-Analysis/Effect Size)
Smith et al. used meta-analysis to combine the results of the psychotherapy outcome studies and found, contrary to Eysenck, that psychotherapy does have substantial benefits. In one study, they obtained an average effect size of .85, which indicates that the typical therapy client is better off than 80% of individuals who need therapy but are untreated.
Network Therapy
Network therapy has been identified as an effective intervention for American Indian clients and is often used as a treatment for alcohol and drug abuse. It is a multimodal treatment that incorporates family and community members into the treatment process and situates an individual’s problems within the context of his/her family, workplace, community, and other social systems.
Group Therapy (Formative Stages, Cohesiveness, Premature Termination)
According to Yalom, therapy groups typically pass through three formative stages - (1) orientation, participation, search for meaning, and dependency; (2) conflict, dominance, and rebellion; and (3) development of cohesiveness. Yalom describes cohesiveness as the most important curative factor provided by group therapy and the group therapy analog for the therapist-client relationship in individual therapy. He proposes that prescreening of potential group members and post-selection preparation can reduce premature termination from group therapy and enhance therapy outcomes.
Therapist-Client Matching
Research on therapist-client matching in terms of race, ethnicity, or culture has produced inconsistent results. However, matching may reduce premature termination for members of some groups (e.g., Asian and Hispanic/Latino). Some research suggests that other factors (e.g., similarity in values and worldview) are more important than similarity in terms of race, ethnicity, or culture.
Solution-Focused Therapy (Questions)
Solution-focused therapists focus on solutions to problems rather than on the problems themselves. In therapy, the client is viewed as the “expert” while the therapist acts as a consultant/collaborator who poses questions designed to assist the client in recognizing and using his/her strengths and resources to achieve specific goals (e.g., the miracle question, exception questions, scaling questions).
Person-Centered Therapy (Facilitative Conditions)
Rogers’ person-centered therapy is based on the assumptions that people possess an inherent ability for growth and self-actualization and that maladaptive behavior occurs when “incongruence between self and experience” disrupts this natural tendency. The therapist’s role is to provide the client with three facilitative conditions (empathy, genuineness, and unconditional positive regard) that enable the client to return to his/her natural tendency for self-actualization.
Treatment Manuals
Treatment manuals were originally developed to standardize psychotherapeutic treatments so their effects could be empirically evaluated and to provide guidelines for training therapists. They specify the theoretical underpinnings of the treatment along with treatment goals and specific therapeutic guidelines and strategies. A potential limitation of treatment manuals is that they may oversimplify the therapeutic process.
Separation-Individuation (Mahler)
Mahler’s version of object relations theory focuses on the processes by which an infant assumes his/her own physical and psychological identity, and her model of early development involves several phases. The development of object relations occurs during the separation-individuation phase, which begins at four to five months of age. According to Mahler, adult psychopathology can be traced to problems that occurred during separation-individuation.
Eysenck
Eysenck was a British psychologist known for his factor analysis of personality traits, contributions to behavior therapy, and 1952 review of psychotherapy outcome studies in which he found that 72% of untreated neurotic individuals improved without therapy, while 66% of patients receiving eclectic psychotherapy and 44% receiving psychoanalytic psychotherapy showed a substantial decrease in symptoms. Based on these findings, Eysenck concluded that any apparent benefit of therapy is due to spontaneous remission.
Psychiatric Inpatients (Demographic Characteristics)
Research on the utilization rates of mental health services has provided the following information about the demographic characteristics of psychiatric inpatients: (1) For both men and women, admission rates into psychiatric hospitals are lowest among the widowed, intermediate for those who are married or divorced/separated, and highest for the never married. (2) Although Whites represent the largest number of psychiatric inpatients, when population proportions are taken into account, patients from other races are overrepresented. (3) For both men and women, the largest proportion of admissions is in the 25 to 44 age range.
