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Clinical Psych Flashcards

1
Q

Assumptions of Psychodynamic therapies

A
  1. behavior is motivated by unconscious processes
  2. emphasis on early development
  3. universal principles explain personality devel
  4. increasing insight into unconscious processes
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2
Q

Freud’s Theory of Personality

A

based on 2 theories

  1. structural theory-personality has 3 structures-id, ego, superego
  2. developmental theory-emphasizes the sexual drives of the id and personality is formed in childhood and is the result of 5 psychosexual stages of development
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3
Q

id, ego, superego

A

id

  • source of all psychic energy
  • present at birth
  • pleasure principle

ego

  • at 6 months in response to id’s inability to gratify all needs
  • operates on reality principle

superego

  • between 4-5 yo.
  • internalization of society’s values and standards as conveyed by parents via rewards and punishments
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4
Q

characteristics of defense mechanisms

A
  1. operate on an unconscious level

2. serve to deny or distort reality

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5
Q

types of defense mechanisms

A
  • repression-underlies all other defense mechanisms; id’s drives and needs are excluded
  • reaction formation-expressing the opposite (hate mother but lavish with praise)
  • projection-threat is attributed to another person or source
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6
Q

psychodynamic therapy goal and techniques

A
  • bring unconscious into conscious

- analysis-free associations, dreams, resistances, and transferences

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7
Q

Difference between Adler and Freud

A
  • Adler-teleological approach: behavior is motivated by future goals rather than past events
  • less emphasis on sexual forces
  • more attention on societal factors
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8
Q

Key concepts of Adlerian theory

A

Inferiority
-result of real or perceived weaknesses

Striving for superiority-inherent tendency

Style of life

  • how someone compensates for inferiority and achieves superiority), and social interest
  • healthy style vs. mistaken style
  • affected by early experiences with family and is established by 4-5 y.o.
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9
Q

Adler’s view of maladaptive behavior

A

-disorders represent a mistaken style of life

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10
Q

Adlerian Therapy goals and techniques

A
  • help client identify and understand his/her style of life and consequences
  • use a life style investigation
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11
Q

Jung’s Analytical Psychotherapy-theory

A

Personality is the consequence of conscious and unconscious factors

  • conscious is directed toward external world & governed by the ego
  • unconscious-made up of personal unconscious and collective unconscious
  • personality results from striving to unite different parts of the personality (public mask, the shadow, and animia & animus (feminine & masculine traits)
  • personality consists of extraversion and introversion
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12
Q

Jung’s collective unconscious

A
  • latent memory traces that have been passed down from generations
  • contains archetypes-primordial images that cause people to experience and understand certain phemonena
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13
Q

Jung contrast to Freud

A

development continues throughout the lifespan and most interested in growth after mid 30’s

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14
Q

Individuation

A
  • Jung

- integration of conscious and unscious

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15
Q

Jung’s view of maladaptive behavior

A

symptoms are unconscious messages to the individual that something is awry

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16
Q

Jung Therapy goals and techniques

A
  • goal is to bridge gap b/t uncon & con
  • rely on interpretation, dreams, transference, countertransference
  • more focus on here and now
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17
Q

Object Relations

A

Klein, Fairbairn, Mahler, & Kernberg
-consider object seeking (relationships with others) to be a basic inborn drive and emphasize a childs early relationships with objects

Most concerned with issues related to attachment, safety, and security

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18
Q

Object Relations view of maladaptive behavior

A
  • Maladaptive behavior results from abnormalities in early object relations
  • In infancy there is a natural tendency to split mental representations of “good” and “bad”
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19
Q

Object Relations therapy goals and techniques

A

-provide support, acceptance, and conditions to restore the client’s ability to relate to others
focus on splitting, projective identification

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20
Q

Key Concepts of Humanistic psychotherapies

A
  • to understand a person you must understand their subjective experience
  • focus on current behaviors
  • belief in inherent potential for self-determination and self actualization
  • therapy is an authentic, collabor, and egal relationship
  • rejection of dx and assessment
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21
Q

Person Centered therapy-personality theory

A

Rogers
-the organized self-composed of perceptions of “I” and as “I” relates to the world

-belief that each person can become self-actualized

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22
Q

Person-centered view of maladaptive beh

A
  • result of incongruence between self and experience

- a person may attempt to resolve incongruence through perceptual distortion or denial

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23
Q

Person-centered goals and techniques

A
  • help achieve congruence

- techniques: unconditional pos regard, genuineness, accurate empathic understanding

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24
Q

Gestalt Therapy-overall premise

A

Founded by Perls
-each person is capable of assuming personal responsibility for thoughts, feelings, beha, actions

  • incorporates psychoananlysis, phenomenology, and extentialism
  • Gestalt-reflect current needs
  • people tend to seek closure
  • behavior represents a whole that is a sum of parts
  • behavior can only be understood in context
  • a person experiences the world in accord with the principle of figure/ground
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25
Q

Gestalt Personality theory

A

personality is composed of the self and self-image

  • self: creative aspect of personality that promotes inherent tendency for self-actualization
  • self-image: hinders growth and self-actualization by imposing external standards
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26
Q

Gestalt view of maladaptive behavior

A

boundary disturbances:

  1. Introjection: when someone accepts concepts, facts, and standards from the envir without understanding or fully assimilating
  2. projection: disowing aspects of the self by assigning them to others
  3. retroflection: doing to oneself what one wants to do to others
  4. confluence: absence of a boundary between self and envir
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27
Q

Gestalt therapy goals and techniques

A
  • focus on awareness of thoughts, feelings, and behaviors in the here and now
  • use of imagery, empty chair
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28
Q

Existential Therapy

A
  • emphasis on personal choice and responsibility for developing a meaningful life
  • maladapt beh-results from inability to cope authentically with concerns of existence (death, freedom, maninglessness)
  • goal-help clients live in a more committed, self-aware, authentic, and meaningful way
  • paradoxical intention is used
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29
Q

Reality Therapy

A

Glasser

  • based on choice theory-ppl are responsible for choice (I choose to be depressed)
  • motivation comes from survival, love, power, freedom, and fun
  • success vs. failure identity
  • rejects medical model and biology-focus is on current behaviors and beliefs to develop more realistic plan of action
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30
Q

Personal Construct Therapy

A

kelly

  • focuses on how the client experiences the world-people chose ways to experience the world
  • psychological processes develop from the way you perceive, interpret, and predict events by using personal constructs (dimensions of meaning-happy/sad) and operate on conscious and uncon levels
  • help client to replace maladapt constructs
  • use the repertory grid (people who have various roles)-ways person is similar and different
  • fix role therapy-client “try on” different ways of being
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31
Q

Interpersonal Theory

A
  • brief therapy

- probs in social roles and interpersonal relationships and -prob attachment styles

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32
Q

Interpersonal Therapy goals

A

improve functioning in 4 prob areas

  1. unresolved grief
  2. interpersonal role disputes
  3. role transitions
  4. interpersonal deficits
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33
Q

Solution Focused Therapy

A

focuses on problems rather than problems

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34
Q

role of therapist in solution focused therapy

A

to act as the collaborator/consultant who poses different types of questions (miracle question, exception question, scaling question)

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35
Q

Transtheoretical Model

A

-focuses on factors that facilitate behavior change

identifies decisional balance, self efficacy, and temptation as mediating variables

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36
Q

Stages of change

A
  • Precontemplation-low insight; no change necessary
  • Contemplation-aware of need to change; wants action soon
  • Preparation-plans to take action
  • Action-takes steps to change
  • Maintenance
  • Termination
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37
Q

Motivational Interviewing

A

stresses empathy, reflective listening, and responding to client resistance in non confrontational way
focus is to develop discrepancies

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38
Q

double-bind commuication

A
  • developed by Ackerman
  • contradictory injunctions
  • recipient of injunctions is not allowed to comment
  • repetition of certain types of family interactions influence development of schizo
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39
Q

Communication/Interaction Therapy

A 
-focuses on impact of communication in the family
symmetrical communication (equality)
-complementary (one is more dominant)
-Therapy uses direct and paradoxical strategies
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40
Q

Extended Family System Therapy

A

Bowen

  • focus on differentiation-person’s ability to separate intellectual and emotional functioning
  • emotional triangle
  • family projection process
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41
Q 
Bowenian Therapy (Extended Family System Therapy)
Therapy techniques
A
  • includes 2 family members and the therapist completes the triangle
  • use a genogram to depict relationships between family
  • partners are encouraged to talk to the therapist instead of each other
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42
Q

Structural Family Therapy

A

Minuchin
family hierarchies
family subsystems
boundaries

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43
Q

Structural Family Therapy techniques

A
  • Therapist will join the family in a position of leadership and try to blend
  • evaluate family structure
  • restructure the therapy
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44
Q

Strategic Family Therapy

A 
Haley & Erickson
role of communication is emphasized 
Social Stage-therapist observes
Problem stage
Interaction stage
Goal setting
Therapists are active and use a variety of techniques-paradoxical interventions
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45
Q

Milan Systemic Family Therapy

A

Effective for children with anorexia
based on the fact in a family system there are circular patterns of action and reaction
Goal-help members see their choices
Use of therapeutic team

46
Q

Behavioral Family Therapy

A

based on operant conditioning, social learning, social exchange theory
-goal is to alter environmental factors (consequences and antecedents)

47
Q

Object Relations Family Therapy

A

projective identification

recognize and address multiple transferences

48
Q

First stage of group therapy

A

Orientation, Hesitant Participation, Search for Meaning, Dependency

49
Q

Second Stage of Group therapy

A

Conflict, dominance, rebellion

50
Q

Third stage of group therapy

A

development of cohesiveness

51
Q

Acupuncture (useful for)

A

reducing low back pain, migranes, and dental pain

managing chemotherapy-induced nausea and vomiting

52
Q

Primary Prevention

A
  • getting before it starts

- focused on reducing incidence of new cases by developing a program (prenatal nutrition programs, meals on wheels)

53
Q

Secondary Prevention

A
  • tries to detect early and intervene
  • attempts to reduce prevalence by reducing duration through early detection and intervention
  • screening tests
54
Q

Tertiary prevention

A
  • aim to reduce duration and consequence of mental and physical disorders
  • rehabilitation programs
  • halfway houses
55
Q

Health Belief Model (health is promoted by what factors)

A
  1. person’s readiness to take action
  2. eval of costs and benefits
  3. internal and external cues to action
56
Q

client centered consultation

A

work with consultee (teacher) to develop a plan for them to work better with the client (student)

57
Q

consultee centered consultation

A

enhance skills of consultee performance in delivering services

58
Q

Program centered administrative consultation

A

work with administrators to resolve an issue

59
Q

Conslutee centered administrative consultation

A

help consultee’s improve functioning to better fulfill job responsibilities

60
Q

Eysenck’s conclusions about psychotherapy

A

effects are “small or nonexistant”

methodology was disputed

61
Q

Smith, Glass, & Miller (1980) meta analysis results

A

the average therapy client is better off than 80% of those who needed therapy but were untreated

62
Q

Howard and colleagues (1996) results on treatment length and outcome

A

75% show measurable improvement at 26 sessions
85% at 52 sessions
called dose-dependent effect

63
Q

utilization of mental health and ethnic minorities

A
  • whites receive more services
  • Af Am receive more services via emergency room & inpatient setting
  • Asian Am are underrepresented in both inpatient and outpatient
64
Q

drop out rates and ethnicity

A

50% of those from minority groups drop out after first session compared to 30% of whites

65
Q

therapist and client matching and effect on drop out

A

good for Asian, Hispanic (improved outcomes for hispanic only), & White

66
Q

diagnostic overshadowing

A

when a clinician attributes beh, emo, and social problem to an individuals mental retardation

67
Q

alloplastic vs. autoplastic interventions

A

alloplastic-change a person’s environment

autoplastic-focus on individual changes

68
Q

sources of work related probs for therpsits

A
  1. suicidal statements
  2. lack of success
  3. issues related to confidentiality
69
Q

gender and hospitalization rates

A

-prevalence of mental illness is higher for women
being admitted to to hospitals is higher for men
-explanation-men are more likely to exhibit acting out beh

70
Q

demographic characteristics of psychiatric inpatients

A
  • more likely for never married
  • minority status (when pop proportions are taken into account)
  • age 25-44
  • schizophrenia
71
Q

When working with African Am clients it is impt to consider the following

A
  1. worldview emphasizes interconnectedness
  2. family and extended kinship (biological and extended)
  3. roles in the family are flexible and egalitarian
  4. health cultural parania

*directive and goal oriented approach while promoting egalitarianism

72
Q

Working with Native American and Aliskan Natives it is impt to consider the following

A
  1. spiritual and holistic orientation to life
  2. emphasis on extended family and tribe
  3. time is perceived in personal and seasonal rhythms
  4. sense of cooperation and generosity
  5. listening more impt than talking
  • avoid direct confrontation
  • network therapy-incorporates all elements of community
73
Q

When working with Asian Americans it is impt to consider the following

A
  1. be aware of acculturation status & attitudes toward mental illness
  2. emphasis on family
  3. hierarchial family structure & traditional gender roles
  4. interdependence and mutual loyalty
  5. restraint of strong emotions

*goal oriented and directive (CBT)

74
Q

When working with Hispanic/Latino it is impt to consider the following

A
  1. family welfare
  2. interdependence is healthy
  3. discussing intimate personal details can be challenging
  4. use of concrete, tangible approach
  5. they may attribute control of life events to luck
    * parent child bond is stronger than other bonds
75
Q

gender differences in coming out process

A
  • adol males have an earlier onset of same-sex attraction, self-labeling, first same sex contact
  • age of first disclosure is not different for males and females
76
Q

Acculturation

A

-degree to which a member of a diverse group accepts and adheres to the majority culture

77
Q

4 categories of Acculturation

A

Marginalization-does not identify with either
Separation-withdraws from dominant accepts own
Assimilation-accepts majority withdraws from own
Integration-integrates both

78
Q

worldview is impacted by which 2 factors

A

person’s locus of control and locus of responsibility

79
Q

cultural encapsulation definition

A

define other’s reality based on their own
disregard cultural differences
ignore evidence that challenges beliefs

80
Q

Emic vs Etic

A

Emic-good-cultural specific theories

Etic-view others from diff cultures the same

81
Q

high context communication vs. low context communication

A

high context: relies more on nonverbal cues; helps unify culture; slow to change
low context: relies on the verbal message; less unifying; more likely to change

*High context is characteristic of many cultures

82
Q

cultural vs. functional paranoia

A

cultural: healthy reaction to racism
functional: unhealthy and can result in illness-unwillingness to disclose due to mistrust

83
Q

sexual stigma

A

shared knowledge of society’s negative regard for nonheterosexual practices

84
Q

Heterosexism

A

systems that promote antipathy, hostility, and violence agaisnt LGB individuals

85
Q

sexual prejudice

A

negative attitudes due to sexual orientation

86
Q

Racial/Cultural Id Deve Model

(Atkinson, et al)-5 stages

A
  1. Conformity- positive attitude toward domin culture
  2. Dissonance-confusion & conflict over people in same and different groups
  3. Resistance & Immersion-reject domin society
  4. Introspection-uncertainty about beliefs from prev stage
  5. Integrative Awareness-fulfillment with cultural id and desire to eliminate oppression
87
Q

Black Racial ID Model

Cross

A
  1. Pre-encounter-adopt mainstream society
  2. Encounter-greater awareness and interest in developing a Black identity
  3. Immersion-Emersion-idealizes black culture and rage against whites; intense emotions subside but reject all aspects of white
  4. Internalization-adopt an identity
88
Q

Withe Racial Id Development Model

A
  1. Contact-individual has little awareness of racism
  2. Disintegration status-increasing awareness of race and racism leads to confusion & emotional conflict (over identify with minority grps)
  3. Reintegration-idealizing white society
  4. Pseudo Independence-questioning views and acknowledging role Whites have in racism
  5. Immersion-Emersion-explores Whiteness; confronts biases, understands White privileged
  6. Autonomy-nonracist white identity and actively seeking out interactions with other groups `
89
Q

Gay/Lesbian ID development Model

A
  1. Sensitization-feeling different
  2. Self-recognition-identity confusion
  3. Identity Assumption-becomes more certain of homosexuality
  4. Commitment-identity integration
90
Q

two factors in the trantheoretical model that are the primary predictors of transition from one stage to the next

A

perceived self-efficacy

decisional balance

91
Q

when parents avoid the tension between them by blaming or overprotecting the child

A

Minuchin (family theray)

Detouring

92
Q

A nonsexist practitioner

A

uses non-biased techniques designed to promote personal growth

93
Q

Meta-analysis revealed that ____ had the largest effect size for therapy outcomes of children and adolescents

A

female adolescents

94
Q

Sullivan’s interpersonal approach identified ____ as the primary cause of psychopathology

A

excessive anxiety

95
Q

Sullivan believed human behavior is motivated by

A

Need for satisfaction

Need for security

96
Q

From a psychoanalytic perspective, a phobia is

A

an externalization of a forbidden impulse

97
Q

An initial first step to multicultural therapy

A

is to assess for the following:

  • stage of racial/ethnic development
  • degree of acculturation
  • world view
98
Q

An American Indian group may place greater emphasis on the family and tribe (associated term)

A

consensual collateral

99
Q

When working with an African American with healthy cultural paranoia an Anglo therapist would

A

help the client increase awareness of feelings of suspiciousness, frustration, and antipathy

100
Q

According to Sue & Zane, the most impt factor in culturally sensitive therapy is

A

using techniques that establish credibility

101
Q

existential therapist is most likely to described existential anxiety as

A

a potential stimulus for growth

102
Q

instructing a client to maintain and/or exaggerate a target symptom

A

prescribing

103
Q

They believed in 3 major life tasks - friendship, occupation, and love

A

Adler

104
Q

In Extended family systems therapy (Bowenian), if a family member exhibits a high degree of fusion, but one member is more differentiated, the likely approach would be

A

work with the most differentiated family member

he assumed that working with the most differentiated member would have positive effects on other family members

105
Q

Minuchin’s structural family therapy approach is best described as

A

manipulative, unyielding, and crisis provoking

focuses on marking boundaries, escalating stress, utilizing symptoms, and manipulating mood

for example, he may imitte a dysfunctional beahvior in an exaggerated way

106
Q

Primary advantage of manualized therapy

A

it standardizes treatment delivery so that, in research, txt effects can be more clearly ascertained

107
Q

As defined by Carl Jung, individuation refers to

A

integrating parts of the self to create a unique identity

108
Q

According to Mahler’s object relations, separation-individuation begins when

A

4-5 months

109
Q

according to traditional psychoanalysis, transference is

A

a form of resistance

110
Q

when conducting marital therapy what is the difference in approach if there is instrumental vs. expressive violence present

A

expressive-not as severe or abusive-can conduct conjoint therapy

instrumental-see separately

111
Q

CBT is more effective with older adults when…

A

it is conducted in a slower manner/pace at higher levels of abstraction (focus on schemas and relationship scripts)

112
Q

In a study by Sue et al. (1991) and outcomes of an outpatient program, they found what differences regarding ethnicity

A

Hispanic Am had best outcomes followed by Anglos, Asian Am, and Af Am

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