Clinical Psychology Flashcards
What are the two dimensions of worldview (Sue)
Locus of control and Locus of Responsibility
Believe they are in control of their own outcomes and responsible for their success and failures (what kind of LOC and LOR)
Internal locus of control and internal locus of responsibility [IC-IR]
Believe they can determine their out outcomes if given the chance but others are responsible for keeping them from doing so (what kind of LOC and LOR)
Internal locus of control and external locus of responsibility [IC-ER]
Believe they have little/no control over their outcomes and they are not responsible for them (what kind of LOC and LOR)
External locus of control and external locus of responsibility [EC-ER]
Believe they have little control over their outcomes but tend to take responsibility for their failures (what kind of LOC and LOR)
External locus of control and internal locus of responsibility [EC, IR]
What kind of responsibility and locus of control is typical of American culture
Internal control and internal responsibility
According to Sue, clients with this kind of level of responsibility and control can be hard for white therapists with IC-IR
Clients with internal control and external responsibility [IC, ER]
What are the 4 acculturation strategies
Integration
Assimilation
Separation
Marginalization
When you retain your own culture and adopt majority culture
integration
When you reject your own culture and adopt majority culture
assimilation
When you retain your own culture and reject majority culture
Separation
When you reject your own culture and reject majority culture
Marginalization
When a person accepts society’s negative beliefs/stereotypes about their own racial group
Internalized Racism
Discrimination based on skin hue/color, hair texture, eye color, preference for lighter skin (can be a form of internalized racism)
Colorism
Brief or commonplace daily, verbal, behavioral, or environmental indignities and intentional or unintentional
microaggression
3 types of microaggressions
Micro assault
Micro insult
Micro invalidation
Explicit, usually intentional and meant to hurt; “old fashioned racism”
Micro assault (exp: name calling)
Verbal and nonverbal; insensitive or demeaning and pathologizing of culture, communication styles, and assuming race makes them dangerous/deviant
Micro insult (exp: believe Black people are hired because of affirmative action)
Exclude, negate thoughts, feelings or experiential reality of POC; assuming POC are foreigners, color blindness/not acknowledging race or impacts of race
Micro invalidation (exp: assuming Asian student wasn’t born in the US; complimenting them on their English)
This refers to the different perspectives that psychologists can take when working with clients from different cultural backgrounds about cultural interventions
Emic vs. Etic
Emic Perspective
Bx is affected by culture so psychological theories and interventions may not apply the same across cultures
Etic Perspective
Bx is similar across cultures and the same psychological theories and interventions are appropriate for everyone regardless of cultural background
This term explains the inability of some mental health professionals to work effectively with people of different cultural backgrounds; these mental health professionals are insensitive to cultural differences and believe their own cultural assumptions about mental health or normality applies to people from all cultural backgrounds
cultural encapsulation
Psychologist who’s work highlights White Privilege
Peggy McIntosh
These interventions focus on making changes in the client so they can adapt to the environment
Autoplastic interventions; strategies including gaining insight into problems or changing behaviors
These interventions focus on altering the environment/situation to fit client’s needs, desires, attributes
Alloplastic interventions; strategies including removing self from stressful situation (changing jobs)
What are tight cultures and what are some examples
Strong social norms
Decreased tolerance for deviant bxs
Greater conformity
Risk avoidant bxs
Preference for Stability
Lower openness to change
Higher conscientiousness
Exps: Mississippi, Alabama, Arkansas, Pakistan, Malaysia, India
Tight cultures tend to have high population densities, greater vulnerability to natural disasters & disease & scarcity of resources so strong norms and punishments are required for survival
What are loose cultures and what are some examples
Weak social norms
Increased tolerance for deviant bxs
Greater willingness to take risks
Greater openness to change and innovation
Exps: California, Oregon, Washington, Estonia, Hungary, Israel
This communication style relies on group understanding, non-verbal messages, and is characteristic of several minority groups
High context communication style (may be used by many African Americans)
This communication styles relies on the verbal message independent of context
Lox context communication style [characteristic of white (mainstream) cultural]
Diagnostic Overshadowing
tendency to attribute all of a person’s problems to a previous diagnosis or demographic factor without considering something else or overlooking other problems (exp: assuming presenting problem of gay people is due to sexual orientation and not something else)
Minority Stress Theory explains increased risk for mental health problems among which population
Sexual minorities due to chronic stress and stigma; has also been applied to other minority groups
Stress within the person including concealment, fear of rejection, and internalized heterosexism
Proximal stress (close)
What is ascribed status
It’s related to credibility and it’s the position or role assigned to therapists by client’s culture; for example, age and gender can contribute to this in certain cultures
What is achieved status
It’s related to credibility and is based on the therapist’s expertise and experience working with client’s of a particular culture
The fidelity adaptation dilemma is related to what
Evidenced Based Treatments and efforts to make them more culturally relevant. The concern is that doing so may impact standardization; but research has found that cultural adaptations benefit outcomes especially for adults and populations that need the modification (language and acculturation issues) and when adding to a protocol instead of taking away from it
With this population, eye contact may be seen as disrespectful and a firm handshake may be seen as aggressive
American indians
With this population, using a therapy network to provide support and engaging in collaborative problem solving that is client centered and not very directive is preferred
American Indian
These terms refer to male dominance and female submissiveness respectively in Spanish
Machismo and Marianismo
This population may find it effective to use folktales, proverbs, and idioms to present models of adaptive bxs and help express feelings
Hispanic/Latin Americans
For this population, fear of losing face and shame are motivators for bx and may keep them from expressing emotions and discussing personal problems
Asian American
This population may prefer the therapist to maintain a formal style and an expert role
Asian American
True or False, LGBTQ clients may be twice as likely as heterosexual clients to have mental disorders
true
True or False, bisexual clients may be more likely than gay and lesbian clients to have mental disorders
true
Who has higher therapy utilization, gay men or lesbian women
Gay men
Who has higher therapy utilization, bisexual men or bisexual women
they have similar utilization
Social disapproval that leads to discrimination and stigmatizes non-heterosexual identity, relationships, and behaviors
heterosexism
true or false, mental disorders are lower in older adults (besides neurocognitive disorders)
true
What diagnoses are most common among older adults
Anxiety and Depression (but most likely to complain of physical and cognitive sxs rather than sadness)
What is the integration paradox
higher status immigrants (more education and economically successful) are more likely than lower status immigrants to report experiences of discrimination and disrespect and are less likely to have positive attitudes about mainstream culture.
One explanation is that they have increased likelihood of experiencing discrimination because of their social standing. Another explanation is that they are more likely to see bxs as discrimination due to sophisticated cognitive abilities
What is the immigration paradox
For some immigrant groups, new immigrants tend to have better physical and mental health and educational outcomes compared to more established immigrants and non immigrants
This therapy developed by Glasser (1965) is based on choice theory which proposes that the ways a person chooses to fulfill his or her needs determines whether they have a success or failure identity
Reality Therapy
What are the 5 basic innate needs of Reality Therapy
love and belonging
power
fun
freedom
survival
According to Reality Therapy, when a person chooses to fulfill their needs responsibly (in a positive way that don’t infringe on the right of others), they have what kind of identity;
When they do it irresponsibly (negatively in a way that infringes upon the rights of others) they have a what kind of identity?
success identity
failure identity
What is the WDEP system intervention from reality therapy
- Ask clients about their WANTS and needs
- Determine what they are currently DOING to foster awareness of their behaviors
- Encourage the client to EVALUATE their behaviors
- Help the client create a PLAN of action
This therapy focuses on how people construe (perceive, interpret, and anticipate) events. People can change how they do this to alleviate undesirable behaviors and outcomes. What theory does this therapy come from?
Personal Construct Therapy
Humanistic/Existential
This type of therapy is about valued subjective experiences: well-being, contentment, and satisfaction (in the past); hope and optimism (for the future); and flow and happiness (in the present)
Positive Psychology
What is the state in positive psychology where people are so involved in an activity that nothing else seems to matter; they are most likely to experience this when there is a challenge-skill balance
Flow
The distinctive characteristic of this existential/humanistic theory is its emphasis on the scientific method to evaluate its theories, concepts, and interventions
Positive psychology
Yalom, May, and Frnakl helped create what branch of theory and what is the primary goal of this therapy
Existential Therapies ; help clients lead more authentic lives by assisting them in taking charge of their life, helping them choose values and and purposes that define and guide their existence
This group of therapies emphasize personal responsibility and choice and view psychological disturbances as the result of inability to resolve conflicts that arise when facing 4 ultimate concerns
Existential Therapies
What are the ultimate concerns of existence according to existential therapies
death, freedom, isolation, and meaningless
According to existential therapists, what is the difference between normal (existential) anxiety and neurotic anxiety
Existential anxiety (normal) is proportional to an object threat and can be used constructive to identify and confront conditions that elicit it and can motivate positive change
Neurotic anxiety is disproportionate to an objective threat, involves repression, and keeps people from reaching their full potential
This therapy is based on the assumption that people are motivated to maintain a state of homeostasis which is repeatedly disrupted by unfulfilled physical and psychological needs. It also posits that neurosis (maladjustment) occurs when there’s a persistent boundary disturbance between the person and the environment that interferes with the person’s ability to fulfill their needs
Gestalt Therapy
This boundary disturbance (Gestalt Therapy) occurs when people adopt the beliefs, standards, and values of others without evaluation of awareness
introjection
This boundary disturbance (Gestalt Therapy) occurs when people attribute undesirable aspects of themselves to other people
Projection
This occurs when people do to themselves what they’d like to do to others (Gestalt Therapy)
Retroflection
This occurs when people avoid contact with the environment (Gestalt Therapy)
Deflection
This occurs when people blur the distinction between themselves and others (Gestalt Therapy)
Confluences
Dream work and empty chair are techniques used in this therapy to help clients accomplish the ultimate goal of gaining awareness of their current thoughts, feelings, and actions
Gestalt Therapy
The goal of this therapy is to help the client become a “fully functioning person” who is not defensive, is open to new experiences, and is engaged in the process of self-actualization
Person Centered Therapy
What are the similarities between humanistic and existential therapies
Similarities: focus on the here and now, prioritize client’s subjective experiences over reality (phenomenological orientation), reject medical model and use of labels, focus on client’s internal qualities rather than sxs
What are the differences between humanistic and existential therapies
Humanistic therapies emphasize acceptance and growth and help clients become more fully functioning and self-actualizing
Existential therapies emphasize freedom and responsibility and help clients confront anxieties that arise from the awareness of one’s existential condition
What aspects makes Jung’s Analytical Psychology different from Freudian
Jung believed in both positive and negative forces as drives, that personality develops throughout lifespan, behavior is affected by past and future. Also, divided unconscious aspects of the psyche into personal and collective unconscious
In Jungian theory, this is a person’s own forgotten or repressed memories while this consists of memories that are shared by all people and passed down from one generation to the next (universal thoughts and images that predispose people to act in similar ways in certain circumstances)
Personal unconscious ; collective unconscious
What are the archetypes of the collective unconscious
persona, shadow, hero, anima, and animus
They are expressed in myths, symbols, and dreams
This goal of Jungian analytical psychotherapy is the process by which a person becomes a psychological individual that is a separate and indivisible unity or whole
Individuation
This therapy reflects a deterministic and pessimistic view of human nature that views current psychological problems as being due to unconscious conflicts from childhood
Freudian psychoanalysis
According to Freud This was present at birth and it’s life and death instincts are the primary source of psychic energy; operates according to pleasure principle and seeks immediate gratification
Id
According to FreudThis develops at about 6 months of age and operates according to reality principle. seeks to partially gratify instincts in realistic and rational ways
Ego
According to Freud, this is the last aspect of personality to develop and it represents internalization of society’s value and standards and acts as a conscious. Attempts to permanently block id’s instincts
Super ego
This is an immature defense that involves refusing to acknowledge distressing aspects of reality. Includes ignoring, distorting, and rejecting reality
Denial
This defense mechanism is the basis of all other defense mechanisms, is involuntary, and involves keeping undesirable thoughts and urges out of conscious awareness
Repression
This defense mechanism involves defensing against an unacceptable impulse by expressing it’s opposite
Reaction formation
This defense mechanism involves channeling an unacceptable impulse into a socially desirable and often admirable endeavor
Sublimation
What are the 3 steps in the analysis process according to Freudian psychoanalysis
- Confrontation- helping clients recognize bxs they’ve been unaware of
- Clarification- brings cause of bxs into sharper focus
- Interpretation- explicitly linking conscious bxs to unconscious processes
What are the 5 stages of Sue’s Racial/Cultural Identity Development Model (R/CID):
- Conformity
- Dissonance
- Resistance and Immersion
- Introspection
- Integrative Awareness
What are the 5 stages of Cross’s Black Racial Identity Development Model (formerly known as Nigrescence Model)
- Pre-Encounter
- Encounter
- Immersion-Emersion
- Internalization
- Internalization-Commitment
What is racial salience
extent to which a person’s race is a relevant part of his/her self concept at a particular point in time and in a particular situation
What is racial centrality
extent to which a person normatively defines him/herself in terms of race and is affected by the importance of race to the person relative to other identities. This is relatively stable across situations
What is racial regard and it’s two parts
Private regard- refers to the extent to which a person feels positively or negatively toward African Americans and how positively or negatively they feel about being African American
Public regard- extent to which a person feels that others view African Americans positively or negatively
What is racial ideology
refers to a person’s beliefs and opinions about the ways African Americans should live and interact with society.
4 kinds
1. nationalist
2. oppressed minority
3. assimilationist
4. humanist
What are the stages of Trioden’s Model of Homosexual Identity Development
- Sensitization- feeling different from same sex peers
- Identity Confusion- start to feel sexual attraction to same sex and suspect that you are gay which leads to anxiety and denial, avoidance, repair, redefinition, and repair
- Identity Assumption-Begin to accept homesexuality as a way of life. Disclose to select people
- Identity Commitment- internalized and accepted identity and comfortable disclosing to people
According to Jung, _________ involves bringing aspects of the personal and collective unconscious into consciousness
individuation
(integrating the conscious and unconscious aspects of one’s personality in order to develop a unique identity
“collaborative empiricism” is most related to what theory
Beck’s CBT
Helping clients to achieve awareness of his/her thoughts, feelings, and behaviors in the here and now is a primary goal of what therapy
Gestalt
This is a curative factor that enables a person to make better choices, satisfy their needs, and become a unified whole
3 theories contributed to the foundations of family therapy. What are those three systems?
- General systems theory (predicts that all systems consist of interacting components, are governed by same rules, and try to maintain homeostasis)
- Cybernetic theory
(distinguishes between negative and positive feedback loops) - Communications theory
(certain repetitive patterns of communication can cause problems)
What kind of feedback loops, according to cybernetics theory, resist change and help maintain the status quo
negative feedback loops
(positive amplify change and disrupt the status quo)
What type of interaction, according to Bateson’s communication theory reflects equality and can occur when the bx of one person elicits a similar type of bx from the other person. This type of interaction can escalate quickly and become a one upmanship game
Symmetrical or Complementary
Symmetrical
Problems occur in families when interactions are exclusively symmetrical or complementary
These type of interactions reflect inequality. One person may assume a dominant role while the other assumes a subordinate role.
symmetrical or complimentary
Complimentary
Problems occur in families when interactions are exclusively symmetrical or complementary
Multigenerational Transmission Process is described by what theory
Bowen’s Extended Family Systems Theory
(refers to the transmission of emotional immaturity from one generation to the next–extension of the family projection process)
According to Minuchin’s structural family therapy, what is an unstable coalition (also known as triangulation)
Occurs when each parent demands the child side with them
(a stable coalition is when one parents and a child have an inflexible alliance against the other parent)
According to Minuchin’s structural family therapy, what is a detouring attack coalition? What is a detouring support coalition?
Detouring attack: when parents avoid the conflict between them by blaming the child for their problems
Detouring support: when parents avoid their own conflict by overprotecting the child
These directives in Hayley’s strategic family therapy are to help the family realize that they have control over problematic bxs and they include prescribing the sxs, restraining, and ordeals
Paradoxical directives
This is an unpleasant task that a family member is asked to perform whenever they engage in an undesirable bx
ordeal
Blaming, Computing, Distracting, and Placating are 4 dysfunctional communication styles identified by who/what family therapy and what are they
Satir’s conjoint Family Therapy
Placating- agreeing with others due to fear, dependency, etc
Blaming- involves accusing, judging, and bully to avoid responsibility or vulnerability
Computing- taking an overly intellectual and rational approach to avoid being emotionally engaged
Distracting- changing the subject, inappropriate jokes to avoid conflict
These are systematic errors in reasoning that often affect thinking when a stressful situation triggers a dysfunctional schema that in turn affects the content of automatic thoughts
cognitive distortions
This distortion involves drawing negative conclusions without any supporting evidence
arbitrary inference
This distortion involves paying attention to and exaggerating a minor negative detail of a situation while ignoring other aspects of the situation
selective abstraction
This distortion involves concluding that one’s actions caused an external event without evidence for that conclusion
personalization
What are the three phases in Michenbaum’s Stress Inoculation Training
- initial conceptualization/
education phase (clients are provided information about stress and its effects and encouraged to view stressful situations as “problems to be solved) - Skills acquisition and consolidation phase (clients learn a variety of cognitive and behavioral coping skills including relaxation, self instruction, and problem solving)
- Application and follow through phase (clients use newly acquire coping skills, first in imagination and then real life)
This CBT intervention developed by Meichenbaum was initially developed to teach problem solving skills to children with high levels of impulsivity, it has since been applied to other populations and problems
Self-Instructional Training
What are the 5 stages of Meichenbaum’s Self-Instructional Training
- Cognitive modeling stage (children observe, the model verbalizes instructions)
- Overt external guidance stage (children do the same task while model verbalizes instructions)
- Overt self-guidance stage (children do task while verbalizing the instructions)
- Faded overt guidance stage (children do the task while whispering instructions)
- Covert self-instruction stage (children do task and repeat instructions to themselves silently)
According to ACT, what is the difference between clean and dirty pain
clean pain is natural levels of physical and psychological pain that are inevitable and can’t be controlled
dirty pain refers to the emotional suffering that’s caused by attempts to control or resist pain
Experiential acceptance
Cognitive defusion
Being present
Awareness of self as context
Values based action
Committed Action
are the 6 core processes of what?
ACT
This is considered to be an EBT for chronic pain, psychosis, depression, anxiety, and OCD
ACT
metaphors, mindfulness, and experiential exercises are interventions for what theory
ACT
Mindfulness Based Stress Reduction is a group program to help people cope with stress, pain, and illness through teaching awareness of breathing, yoga, sitting and walking meditation. How many sessions is it?
8
This 8 session group program combines Mindfulness Based Stress Reduction and CBT to help clients become self aware and de-center from distressing thoughts, feelings, bodily sensations, and behaviors
Mindfulness Based Cognitive Therapy
What do the letters in Elli’s Rational Emotive Behavior Therapy stand for? This process helps to explain psychological disturbance and the process of change in therapy.
A: activating event
B: client’s irrational belief
C: emotional and behavioral consequence of that belief
D: how therapist disputes client’s irrational belief
E: effect of the therapist techniques, the replacement of the irrational belief with a rational one
Both Cognitive Therapy for Suicide Prevention (CT-SP) and Brief Cognitive Behavioral Therapy (BCBT) for suicide prevention consists of 3 phases, what are they
- emotion regulation
- cognitive flexibility
- relapse prevention
Research has found that for patients with MDD, the extent of improvement in depressive sxs following participation in CBT are positively correlated with increases in the volume of what
anterior cingulate cortex
What are WEIRD cultures
Western, Educated, Industrialized, Rich, and Democratic Cultures
This type of bias in research is the tendency to exaggerate differences between men and women and can reinforce gender stereotypes and justify discriminatory practices
Alpha bias
linked to androcentrism- male centeredness
This type of bias in research is the tendency to ignore or minimize differences between men and women. It can lead to erroneous conclusions
Beta bias
What is the average cost savings attributable to psychological intervention
20%
What racial population has the highest outpatient and inpatient mental health service utilization
Those with 2 or more racial groups
Sexual Minorities (gay/lesbian/bisexual) may use mental health care at higher rates that heterosexual men and women by how much
2-4 x
Racial/Ethnic Therapist and Client matching may reduce termination rates for which population
Asian, Hispanic, and European American
(not African American)
(only associated with improved treatment outcomes for Hispanic Americans)
30% (the highest percentage of variability in psychotherapy outcomes is due to what?
Patient contributions
(followed by therapeutic rx at 12% and treatment method 8%)
Which researcher concluded that therapy was ineffective
Eysenck
Smith, Glass, and Miller did a meta-analysis that compared outcomes of therapy and found that people who received therapy were better off that what percentage of people who didn’t
80%
What did Howard and Colleagues Dosage Model say
50% of people show significant improvement in sxs by 6-8 sessions
75% of people show significant improvement by 26 sessions
85% of people show significant improvement by 52 sessions
What’s the difference between Efficacy Research and Effectiveness Research
Efficacy research , also known as clinical trials maximizes internal validity through random assignment
Effectiveness research maximizes external validity through naturalistic clinical settings
What are the 3 primary benefits of interprofessional collaboration (IPC) and which population seems to benefit most
- improvement of patient care
- Improvement of health outcomes for patients
- Decreased healthcare costs
Older patients with multiple and complex healthcare needs
This kind of prevention, according to Caplan’s model targets people who have already received a diagnosis of a mental or physical disorder and includes relapse prevention and rehabilitation
Tertiary
This kind of prevention, according to Caplan’s model targets specific individuals who have been identified as being at elevated risk for a disorder. The goal is to reduce the prevalence of a mental or physical disorder in a population through early detection and intervention
Secondary
This kind of prevention according to Caplan’s model is aimed at an entire population and the goal is to reduce the occurrence of new cases of a mental or physical disorder
Primary
In Gordon’s model of prevention, selective prevention is aimed at who
individuals who have been identified as being at increased risk of a disorder due to their biological, social, or psychological characteristics
(exp: drug abuse prevention program for adolescents who se parents have a substance use disorder)
In Gordon’s model of prevention, Indicated preventions are for individuals who…
are known to be at high risk because they have early or minimal signs of a disorder.
(exp: a drug abuse program for adolescents who have experimented with drugs)
What are some examples of Transdiagnostic Treatments
CBT-E (for eating disorders, share some core pathology)
These consist of strategies applicable to disorders from different categories:
Unified Protocol for Transdiagnostic Treatment of Emotional Disorders
Emotion Focused Transdiagnostic
Acceptance and Commitment Therapy (ACT)
Parent Child Interaction Therapy (PCIT)
What are some of the benefits of Routine Outcome Monitoring (ROM)
clinically significant improvement and significant reductions in:
client deterioration
premature termination
What are some of the barriers to using Routine Outcome Monitoring (ROM)
client: concerns about confidentiality and time needed to complete them
clinician: lack of training, believe clinical judgment is a better measure, unease about the impact on therapeutic rx, concerns about time to administer, score, and interpret etc, concerns about how it will be used by employers and insurance companies
What are the goals of consultee centered case consultation
improve consultee’s knowledge, skills, confidence, and/or objectivity. Lack of objectivity can be related to theme interference- occurs when a consultee’s biases and unfounded beliefs interfere with their ability to be objective
