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Clinical Psychology Flashcards

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1
Q

What are the two qualities of all defense mechanisms?

A
  1. They operate on an unconscious level

2. They servce to deny or distort reality

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2
Q

Repression

A

When the id’s drives and needs are excluded from conscious awareness by maintaining them in the unconscious.

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3
Q

What is the Freudian view of psychopathology

A

It stems from an unconscious, unresolved conflict that occurred during childhood

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4
Q

What is the Freudian view of phobias

A

They are the displacement of anxiety onto an object or event that is symbolic of the object or event involved in the unresolved conflict.

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5
Q

What is the Frudian view of depression

A

It is due to object loss coupled with anger toward the object turned inward.

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6
Q

What is the Freudian view of mania

A

It represents a defense against libidinal or aggressive urges that threaten to overwhelm the ego.

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7
Q

What are the goals of Fruedian psychotherapy?

A

To reduce or eliminate pathological symptoms by brinding the unconscious into conscious awareness and by integrating previously repressed material into the personality.

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8
Q

Teleological approach

A

Adler; behavior is motivated by future goals more than it is determined by past events

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9
Q

Four key concepts of Adler’s individual psychology

A

Inferiority feelings, striving for superiority, style of life, social interest

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10
Q

Style of life

A

The specific ways a person chooses to compensate for inferiority and achieve superiority. Unifies the various aspects of the personality.

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11
Q

What distinguishes a healthy and unhealthy style of life (Adler)

A

Social interest. Healthy is marked by optimism, confidence, and concern about welfare of others. Mistake. Is marked by self-centered ness, competitiveness, and striving for personal power.

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12
Q

When is style of life determined

A

By age 4-5

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13
Q

Lifestyle investigation

A

Adlerian therapy technique

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14
Q

Main parts of awareness (Jung)

A

Conscious, personal unconscious, collective unconscious

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15
Q

Archetypes

A

Primordial images that cause people to experience and understand certain phenomena in a universal way

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16
Q

Five archetypes (Jung)

A

Self, persona (public mask), shadow (dark side), anima (feminine), animus (masculine)

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17
Q

Two attitudes (Jung)

A

Extroversion and introversion

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18
Q

Four basic psychological functions (Jung)

A

Thinking, feeling, sensing, intuiting

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19
Q

Individuation (Jung)

A

Integration of conscious and unconscious that leads to the development of a unique identity

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20
Q

When did development happen (Jung)

A

Throughout life

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21
Q

Jungian meaning of dreams

A

Represent an unconscious message to the individual that is revealed in symbolic form

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22
Q

Jung–optimist or pessimist?

A

Optimistic view of human nature and emphasis on healthy aspects I personality.

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23
Q

Jung–past or present

A

Emphasis on present. Info from past only sought when it will help the client understand the present.

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24
Q

Separation-Individuation (Mahler)

A

Begins at 4-5 mos of age, ends around 3. Child develops a permanent sense of self and is able to perceive others as both separate and related. Includes differentiation, practicing, reapproachment, object constancy

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25
Q

Object relations view of maladaptive behavior.

A

Problems in separation-Individuation. Inadequate resolution of natural tendency for infants to split into good and bad categories.

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26
Q

Object relations therapy goals

A

Bring maladaptive relationship dynamics into consciousness and replace them with more adaptive ones.

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27
Q

What is the view of humanistic therapies toward assessment and diagnosis?

A

Humanistic therapies reject traditional assessment techniques and diagnostic labels.

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28
Q

Do humanistic therapies focus on past or present?

A

Present

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29
Q

What are important qualities of the therapeutic relationship in humanistic therapies?

A

authentic, collaborative, and egalitarian

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30
Q

What do humanists believe you must understand to understand a person?

A

The person’s subjective experience

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31
Q

What are examples of humanistic therapies?

A

Person-centered therapy, Gestalt therapy, existential therapy, reality therapy

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32
Q

What are constructivist therapies?

A

Incorporate some humanistic principles; emphasis on the client’s perceived reality, which is viewed as being individually and/or socially constructed to some extent

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33
Q

What is another name for person-centered therapy?

A

Rogerian therapy or client-centered therapy

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34
Q

What is thought of as a major source of motivation in Rogerian therapy?

A

an innate “self-actualizing tendency” that guides people toward positive, healthy growth

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35
Q

What has to happen for a person to become self-actualized (Rogers)?

A

The self must remain unified, organized, and whole

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36
Q

How does the self become disorganized (Rogers)?

A

As the result of incongruence between self and experience, such as when the individual experiences conditions of worth.

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37
Q

What is the main goal of Rogerian therapy?

A

To help the client achieve congruence between self and experience so that he/she can become a more fully-functioning, self-actualizing person.

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38
Q

What are the three “facilitative conditions” in Rogerian therapy?

A

Unconditional positive regard, genuineness, accurate empathic understanding

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39
Q

Is person-centered therapy generally more directive or non-directive?

A

Non-directive

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40
Q

Who founded Gestalt therapy?

A

Fritz Perls

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41
Q

What is the main premise of Gestalt therapy?

A

A person is capable of assuming personal responsibility for his/her own thoughts, feelings, and actions and living as an integrated “whole”

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42
Q

What are the five main concepts of Gestalt therapy?

A
  1. People tend to seek closure
  2. A person’s “gestalts” reflect his/her current needs
  3. A person’s behavior represents a whole that is greater than the sum of its parts
  4. Behavior can only be fully understood in context
  5. A person experiences the world in accord with the principle of figure/ground
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43
Q

According to Perls, what are the two parts of the personality?

A

Self and self-image

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44
Q

Self (Perls)

A

The creative aspect of the personality that promotes the individual’s inherent tendency for self-actualization, or the ability to live as a fully integrated person

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45
Q

Self-image (Perls)

A

The “darker side” of the personality that hinders growth and self-actualization by imposing external standards

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46
Q

What is the cause of maladaptive (neurotic) behavior, according to Perls?

A

“coundary distrubances” between the self and the external environment that interfere with the person’s ability to satifsy his needs and maintain a state of homeostasis

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47
Q

Introjection (Perls)

A

Boundary disturbance in which a person psychologically swallows whole concepts without understanding/fully integrating them; association with extreme compliance

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48
Q

Projection (Perls)

A

Bourndary disturbance in which a person disowns aspects of self by assigning them to other people; associated with paranoia

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49
Q

Retroflection (Perls)

A

Boundary disturbance in which a person does to oneself what one wants to do to others; e.g., turning anger at others inward

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50
Q

Confluence (Perls)

A

Boundary disturbance in which there is an absence of boundary between the self and the environment; causes intolderance of any difference between self and other and often underlies feelings of guilt and resentment

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51
Q

What is the major goal of Gestalt therapy?

A

To help the client become a unified whole by integrating the various aspects of self

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52
Q

What are the main techniques in Gestalt therapy?

A

Help client recognize difference between “transference fantasy” and reality; “Awareness” (full understanding of one’s thoughts, feelings, and actions in the here-and-how) is the primary curative factor

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53
Q

What do elements of a dream represent for Gestaltians

A

different parts of the self (including parts that have not been fully accepted and integrated)

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54
Q

What are the main commonalities of the existential therapies?

A

Emphasis on personal choice/responsibility for developing a meaningful life; assume that people are in a constant state of evolving and becoming

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55
Q

What causes maladaptive behavior in the view of existential therapists?

A

an inability to cope authentically with the ultimate concerns of existence (e.g., death, freedom, existential isolation, meaninglessness)

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56
Q

What is the primary goal of existential therapy?

A

To help clients live in more committed, self-aware, authentic, and meaningful ways. To help clients recognize their freedom to choose their own destinies and accept responsibility for changing their own lives.

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57
Q

What is reality therapy?

A

William Glasser; based on choice theory, which assumes that people are responsible for the choices they make and focuses on how people make choices that affect hr course of their lives.

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58
Q

What are the five innate needs in reality therapy?

A

Survival, love and belonging (most important), power, freedom, fun

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59
Q

What are the two types of identities in reality theory?

A

Success identity (fulfilling needs in a responsible way) and failure identity (inability to satisfy needs or satisfying needs in irresponsible ways)

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60
Q

What is the view of maladaptive behavior in reality therapy?

A

Mental illness is the result of the individual’s choices.

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61
Q

What are the main goals of reality therapy?

A

Help clients identify responsible and effective ways to satisfy their needs and thereby develop a success identity.

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62
Q

How does reality therapy feel about the medical model?

A

It rejects it

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63
Q

Reality therapy–past or present focus?

A

Focuses on current behaviors and beliefs

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64
Q

Reality therapy–views on transference?

A

Transference is detrimental to the therapy process

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65
Q

Reality therapy–stress unconscious or conscious?

A

Stresses conscious processes.

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66
Q

Reality therapy and value judgements

A

Emphasizes value judgments, especially the client’s ability to judge what is right and wrong in his/her daily life

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67
Q

Personal Construct Therapy

A

George Kelly; focuses on how the client experiences the world and assumes that people choose the ways that they deal with the world and that there are always alternative ways for doing so

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68
Q

What are personal constructs?

A

Bipolar dimensions of meaning (happy/sad, competent/incompetent, friendly/unfriendly) that begin to develop in infancy and may operate on a conscious or unconscious level. They are unique to an individual and are constantly being tested and revised.

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69
Q

Personal construct therapy, view of maladaptive behavior

A

Maladaptive behavior is the result of inadequate personal constructs (e.g., not having a construct for an encountered situation or relying on old constructs despite invalidating evidence)

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70
Q

Personal construct therapy and the medical model

A

Rejects the medical model

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71
Q

Therapy goals in personal construct therapy

A

Help the client identify and revise or replace maladaptive personal constructs in order to better make sense of experiences

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72
Q

Personal construct therapy therapeutic relationship

A

Therapist and client as mutual experts and “co-experimenters”

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73
Q

Personal construct therapy techniques

A

“fixed role therapy” in which client plays out alternative personal constructs; repertory grid in which client identifies similarities and differences in those with whom they have close relationships; self-characterization sketch in which client describes himself from the perspective of a person with whom he has a close relationship

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74
Q

What are the main three theoretical influences on interpersonal therapy?

A
  1. Adolph Meyer’s psychobiological approach, 2. Sullivan’s interpersonal theory, 3. Bowlby’s attachment theory
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75
Q

What does IPT view as the cause of maladaptive behavior?

A

problems in social roles and interpersonal relationships that are traceable to a lack of strong attachments early in life

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76
Q

What are the primary goals of IPT?

A

symptoms reduction and improved interpersonal functioning

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77
Q

How is symptom reduction approved in IPT?

A

Education about the disorder, instillation of hope, pharmacotherapy when necessary

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78
Q

What are the four main primary problems areas in social functioning targeted in IPT?

A
  1. Unresolved grief, 2. Interpersonal role disputes, 3. Role transitions, 4. Interpersonal deficits
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79
Q

What are the three stages of IPT?

A
  1. Assessment of symptoms and interpersonal context, 2. Use of strategies (e.g., affect encouragement, role playing, communication analysis) to address social problem areas, 3. Review progress and discuss termination and relapse prevention
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80
Q

What is the view of maladaptive behavior in solution-focused therapy?

A

Understanding the etiology of the problem is irrelevant, and therapy should focus on solutions.

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81
Q

What is the main idea of the transtheoretical model?

A

Change entails progress through a series of stages. Analysis of empirically-supported techniques across theoretical orientations.

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82
Q

Six stages of change in transtheoretical model

A

Precontemplation, contemplation, preparation, action, maintenance, termination

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83
Q

What is the primary goal of motivational interviewing?

A

To enhance the client’s intrinsic motivation to alter his/her behavior by helping the client examine and resolve his/her ambivalence about changing.

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84
Q

What are four motivational interviewing strategies?

A
  1. Express empathy, 2. Develop discrepancies between current behavior and personal goals/values, 3. Roll with resistance, 4. Support self-efficacy
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85
Q

What does OARS stand for in motivational interviewing?

A

Open-ended questions; affirmations; reflective listening; summaries

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86
Q

Ludwig von Bertalanffy

A

Biologist who first described general systems theory.

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87
Q

General systems theory

A

A system is 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 context.

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88
Q

Open system

A

Continuously receives input from and discharges output to the environment and is more adaptable to change than a closed system.

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89
Q

Homeostasis (family therapy)

A

The tendency for a family to act in ways that maintain the family’s equilibrium or status quo. If problems of one family member improve, the disturbance in likely to reappear elsewhere in the family.

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90
Q

Cybernetics

A

Mathematical theory about feedback loops that has been applied to family therapy.

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91
Q

Negative Feedback Loop

A

Reduces deviation and helps a system maintain the status quo

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92
Q

Positive Feedback Loop

A

Amplified deviation or change and thereby disrupts the system. In therapy, promotes appropriate change in a dysfunctional family system.

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93
Q

Who are some early contributors to family therapy theory?

A

Nathan Ackerman, Gregory Bateson, Murray Bowen

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94
Q

“Grandfather of family therapy”

A

Nathan Ackerman

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95
Q

Double-bind communication

A

Communication that involves conflicting negative injunctions, with one being expressed verbally and the other being expressed verbally. Bowen hypothesized that these communications across generations led to development of schizophrenia in a family member.

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96
Q

What are the main assumptions of communication/interaction family therapy?

A

All behavior is communication; Communication has a report function (content/informational) and a command function (nonverbal statement about relationship); communication patterns are either symmetrical or complementary

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97
Q

Symmetrical communications

A

Reflect equality between communicators but may escalate into a competitive “one-upsmanship” game in which each participant tries to outdo the other

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98
Q

Complementary communications

A

Reflect inequality and maximize differences between communicators. Common pattern is for one participant to assume the dominant role while the other is submissive.

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99
Q

Communication/interaction family therapy–view of maladaptive behavior

A

Circular model of causality that regards a symptom as both a cause and effect of dysfunctional communication patterns, which include blaming and criticizing, mindreading, and overgeneralizing.

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100
Q

Therapy goals/techniques in communication/interaction family therapy

A

Primary goal is to alter the interactional patterns that are maintaining the presenting symptoms, by using both direct techniques and paradoxical strategies

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101
Q

Extended family systems therapy

A

Extends general systems theory beyond the nuclear family, and describes the functioning of the extended family and its members

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102
Q

Differentiation of self (Bowen)

A

Refers to a person’s ability to separate his or her intellectual and emotional functioning

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103
Q

Emotional triangle (Bowen)

A

When a two-person system experiences instability or stress, a third person may be recruited into the system to increase stability and reduce tension.

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104
Q

Family projection process (Bowen)

A

Process by which parental conflicts and emotional immaturity are transmitted to children, which causes a child to have a lower level of differentiation that his or her parents.

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105
Q

Bowen–view of maladaptive behavior

A

Behavioral disorders are the result of a multigenerational transmission process in which progressively lower levels of differentiation are transmitted from one generation to the next.

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106
Q

Bowen (extended family systems therapy) goals

A

Increase differentiation of all family members.

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107
Q

Extended family systems (Bowen) techniques

A

Therapist serves role of an “active expert” who helps family members achieve greater differentiation. Use of genograms.

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108
Q

Salvador Minuchin

A

Creator of structural family therapy

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109
Q

Structural family therapy

A

Focuses on implicit family structures and the boundaries between family members

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110
Q

Boundaries (Minuchin)

A

“Barriers” or rules that determine the amount of contact that is allowed between family members. Overly rigid boundaries lead to disengaged family members; diffuse boundaries lead to enmeshed family members.

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111
Q

Three types of rigid triads

A

Detouring, Stable Coalition, Triangulation

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112
Q

Detouring (Minuchin)

A

Parents focus on the child either by overprotecting or blaming (scapegoating) the child for the family’s problems

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113
Q

Stable coalition (Minuchin)

A

Occurs when a parent and child for a cross-generational coalition and consistently “gang up” against the other parent

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114
Q

Triangulation (Minuchin)

A

aka unstable coalition; occurs when each parent demands that the child side with him/her against the other parent

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115
Q

Minuchin/structural family therapy view of maladaptive behavior

A

Family dysfunction viewed as a result of on inflexible family structure that prohibits the family from adapting to maturational and situational stressors in a healthy way.

116
Q

Minuchin/structural family therapy goals

A

Restructuring the family is the primary long-term goal. Therapy may also address symptom relief and other short-term goals using behavioral techniques.

117
Q

Three major therapy techniques in structural (Minuchin) family therapy

A

Joining, evaluation the family structure, restructuring the family

118
Q

Joining (Minuchin)

A

“joining” the family in a position of ledership by tracking and adopting the family’s affective and communication style (mimesis)

119
Q

Family (structural) map

A

Helps clarify and map family interaction patterns

120
Q

Enactment

A

Structural family therapy technique in which family is asked to role-play their relationship patterns

121
Q

Reframing (Structural family therapy)

A

Relabeling behaviors so that they can be viewed in more positive ways

122
Q

Strategic family therapy–stages of session

A
  1. Social stage (observe and encourage involvement), 2. Problem stage (gathers information), 3. Interaction stage (discuss problems) 4. Goal-setting (agree on contract that defines the goals of treatment)
123
Q

Strategic family therapist–active or passive?

A

active, take-charge role

124
Q

Directives (strategic family therapy)

A

assignments to be performed outside of therapy, issued by the therapist

125
Q

Paradoxical intervention (structural family therapy)

A

intervention that alters 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

126
Q

Types of paradoxical interventions

A

ordeals, restraining, positioning, reframing, prescribing the symptom

127
Q

Ordeals

A

unpleasant tasks that the client must perform every time a symptom occurs

128
Q

Restraining

A

encouraging the family not to change

129
Q

Positioning

A

Exaggerating the severity of a symptom

130
Q

Reframing

A

Relabeling a symptom to give it a more positive meaning

131
Q

Prescribing the symptom

A

instructing a family member to deliberately engage in the symptom

132
Q

Milan Systemic Family Therapy–view of maladaptive behavior

A

there are circular patterns of action and reaction in a family system; maladaptive behavior results when a family’s patterns become so fixed that family members are no longer able to act creatively or make new choices about their lives

133
Q

Goal of Milan Systemic Family Therapy

A

“Help family members see their choices and to assist them in exercising their prerogative of choosing”

134
Q

Techniques in Milan Systemic Family Therapy

A

Use of a therapeutic team, hypothesizing, neutrality, paradox, circular questions

135
Q

Milan–hypothesizing

A

deriving and testing hypotheses about the family system

136
Q

Milan-neutrality

A

therapist remains an ally of the entire family rather than becoming recruited into family coalitions or alliances

137
Q

Milan-paradox

A

use paradoxical strategies to provide family members with information that will help them derive solutions to their own problems

138
Q

Milan-circular questions

A

questions asked of each family member to help them recognize differences and similarities in their perceptions

139
Q

Therapeutic techniques in behavioral family therapies

A
  1. Focus on observable behaviors, 2. Ongoing assessment of behaviors, 3. Emphasis on changing behaviors based on contingent reinforcement, 4. Focus on improving communication and problem solving skills
140
Q

Object relations family therapy view of maladaptive behavior

A

Result of both intrapsychic and interpersonal factors; Major source of dysfunction is projective identification

141
Q

Projective identification

A

Occurs when a family member projects old introjects onto another family member and then reacts to that person as through he or she actually has the projected characteristics or provokes the person to act in ways consistent with those characteristics.

142
Q

Object relations family therapy primary goals

A

to resolve each family member’s attachment to family introjects; insight is considered essential to change; recognizes multiple transferences

143
Q

Mara Selvini-Palazzoli

A

developed Milan systemic family therapy

144
Q

Group therapy stages (Yalom)

A
  1. Orientation, Hesitant Participation, Search for Meaning, Dependency, 2. Conflict, Dominance, Rebellion, 3. Development of Cohesiveness
145
Q

Characteristics of group therapy stage 1 (Yalom)

A

attempts to determine structure and meaning, restricted/rational communication style, speaking directly to leader, advice seeking/giving, search for similarities among group members

146
Q

Characteristics of group therapy stage 2 (Yalom)

A

group members attempt to establish preferred amount of power and a social pecking order emerges; hostility toward one another and the therapist

147
Q

Characteristics of group therapy stage 3 (Yalom)

A

unity, imtimacy, and closeness become chief concerns; trust/self-disclosure increase; attendance improves and concern is shown for absent members

148
Q

Yalom’s view of cohesiveness

A

it is critical in group therapy, the group equivalent of the therapeutic relationship

149
Q

Yalom–three roles of group therapist

A

Creation/maintenance of group; Culture building; Activation and Illumination of the Here-and-Now

150
Q

Activation and Illumination of the Here and Now (Group Therapy)

A
  1. Here is your behavior, 2. Here is how if makes others feel, 3. Here is how it influences what others think of you, 4. Here is how it affects your opinion of yourself
151
Q

Yalom’s view of group/individual therapy together

A

Unnecessary and not beneficial unless needed for a specific crisis or to protect against early termination from group

152
Q

What percent of group members drop out during the first 12-20 sessions?

A

10-35%

153
Q

What makes a good candidate for group therapy?

A

Problems related to interpersonal issues, motivated to change, positive view of group therapy, psychologically and verbally sophisticated, prefers to get involved in therapy slowly, finds peer support and feedback beneficial

154
Q

What makes a bad candidate for group therapy?

A

incompatibility with group norms for acceptable behaviors, inability to tolerate the group setting, certain symptoms or diagnoses (e.g., severe depression and withdrawal, paranoia, acute psychosis, brain damage, sociopathy

155
Q

Main elements of feminist family therapy

A

emphasis on power differentials between men and women and interpretation of events within an oppressive social context

156
Q

What is feminist therapy’s view of maladaptive behavior

A
  1. Problems related to nature of traditional feminine roles; 2. Symptoms are “survival tactics” or ways of exercising personal power, 3. Arbitrary labels that sociality has assigned to certain behaviors in order to exert control
157
Q

Goals of feminist therapy

A

Empowerment; identifying and altering the oppressive forces in society that have affected their clients’ lives

158
Q

Techniques of feminist therapy

A
  1. Striving for an egalitarian relationship; 2. Avoiding labels, 3. Avoiding revictimization, 4. Involvement in social actions
159
Q

Feminist therapy view of self-disclosure

A

Appropriate self-disclosure is necessary to have a more egalitarian relationship with the client

160
Q

Feminist therapy and assessment/diagnosis

A

not used; avoid traditional labels describing feelings and behaviors

161
Q

Difference between feminist and nonsexist therapy

A

Nonsexist therapy focuses more on individual factors and personal behavior; feminist therapists prioritize the role of sociopolitical factors

162
Q

Self-in-relation theory

A

extends traditional object relations theory by proposing that many gender differences can be traced to differences in the mother-daughter and mother-son relationship

163
Q

Hypnosis is effective for treating:

A

acute stress disorder and other anxiety disorders; obesity; insomnia; chronic pain

164
Q

Hypnosis and repressed memories: accuracy

A

may produce more pseudo memories than actual memories

165
Q

Hypnosis and repressed memories: confidence

A

hypnosis may exaggerate confidence in memories, especially inaccurate memories

166
Q

Hypnosis and repressed memories: usefulness

A

recovered memories (even if historically inaccurate) often reflect issues and experiences relevant to treatment and can produce symptom improvement

167
Q

Acupuncture effectiveness

A

evidence for effectiveness in reducing certain types of pain in for managing chemotherapy-induced nausea and vomiting

168
Q

Acupuncture mechanism of action

A

release of endorphins, modification of blood flow

169
Q

Reflexology

A

effectiveness has not been demonstrated

170
Q

Yalom–how to reduce premature termination

A

prescreening, post-selection preparation for clarifying misconceptions/unrealistic expectations

171
Q

Health Belief Model

A

Health behaviors are influenced by 1. person’s readiness to take a particular action (including perceived susceptibility and severity) 2. person’s evaluation of costs/benefits of action, 3. internal and external “cues to action” that triggers response

172
Q

Gerard Caplan

A

Distinguished between four types of consultation: client-centered case consultation, consultee-centered case consultation, program-centered administrative consultation, consultee-centered administrative consultation

173
Q

theme interference

A

when a past unresolved conflict related to a particular type of client or circumstance is evoked by and interferes with the consulter’s current situation

174
Q

parallel process

A

occurs when a therapist (supervisee) replicates problems and symptoms with the supervisor that are being manifested by the therapist’s client

175
Q

Eysenck (1952)

A

Summarized results of 24 therapy outcome studies between 1920 and 1950 and found “small or nonexistent” effects

176
Q

Smith, Glass, and Miller (1980)

A

Used meta-analysis to combine results of 425 outcome studies published between 1941 and 1976–found a mean effect size of .85

177
Q

Is one type of therapy generally more effective than others?

A

Meta analyses have said no

178
Q

What types of disorders is CBT better for?

A

Panic, phobias, compulsions

179
Q

Howard et al. (1996)

A

relationship between treatment length and outcome “levels off” at about 26 sessions

180
Q

Howard et al.’ s phase model of therapy

A
  1. Remoralization, 2. Remediation 3. Rehabilitation
181
Q

Howard-remoralization

A

client’s feelings of hopelessness and desperation respond quickly to therapy; remoralization usually accomplished during the first few sessions

182
Q

Howard-remediation

A

focus on the symptoms that brought the client to therapy; symptomatic relief usually requires about 16 sessions

183
Q

Howard-rehabilitation

A

focus on unlearning troublesome, maladaptive, habitual behaviors and establishing new ways of dealing with various aspects of life; number of sessions depends on goals and problems

184
Q

Sue at el (1991) effectiveness of therapy in different ethnic groups

A

Best outcomes in oder: 1. Hispanics, 2. Anglo, 3. Asian, 4. African American

185
Q

African-Americans and therapy services

A

fewer AA than whites receive mental health services, but AA individuals receive a disproportionate share of mental health services in emergency room or psychiatric inpatient settings

186
Q

Asian Americans and therapy services

A

under-represented in both outpatient and inpatient settings

187
Q

African Americans and psych disorders

A

AA less likely to receive treatment for depression, but more likely to receive treatment for illicit drug use

188
Q

premature termination and race

A

members of minority groups more likely to terminate therapy prematurely than whites

189
Q

Sue and Sue (2003) therapy dropout

A

50% of minorities drop out after first session, compared to 30% of whites

190
Q

Sue et al (1991) droupout rates in CMH settings

A
  1. African Americans, 2. White Americans/Hispanics, 3. Asians
191
Q

therapist-client matching

A

Sue and Sue (1991) founds ethnic matching deducted premature termination rates for Asian, Hispanic, and White americans but not African Americans; Maramba and Hall (2000) concluded that ethnic matching has a small but nonsignificant effect on number of sessions attended

192
Q

Most common mental health problems in older adults

A
  1. anxiety, 2. severe cognitive impairment, 3. depression
193
Q

Older adults–more or less heterogeneous than other groups?

A

more heterogeneous than other groups

194
Q

Older adults and response to therapy

A

generally respond as well as other populations, but more slowly

195
Q

Gatz (1998) meta analysis of therapy in older adults–dementia

A
  1. Behavioral and environmental interventions “well-established” for behavior problems associated with dementia, 2. Memory and cognitive retraining “probably efficacious” for dementia
196
Q

Gatz (1998) meta analysis–depression

A

cognitive, behavioral, and brief psychodynamic interventions all “probably efficacious”

197
Q

Rate of relationship victimization (physical assault)

A

20.4% for women, 7% for men

198
Q

Risk factors for spouse/partner abuse in women

A

younger, heterosexual, American Indian/Alaskan Native, incomes < 10,000/year

199
Q

best predictor of cessation of battering

A

income

200
Q

Goals of interventions for battered women

A

emphasize self-determination, safety, increasing self-esteem, empowerment, control

201
Q

Expressive abuse

A

abuse that is primarily the expression of emotion, is mutual or reciprocal, and is followed by remorse; joint treatment in indicated

202
Q

Instrumental abuse

A

abuse that is committed without provocation to achieve a goal, is unilateral, and is not followed by remorse; joint treatment is contraindicated

203
Q

Factors that predict staying in an abuse relationship

A
  1. emotional attachment to the batterer, 2. desire to “save” relationship, 3. have been in relationship for extended period of time, 4. economic dependence, 5. belief that the batterer will change, 6. fear of retaliation against self or children
204
Q

Diagnostic overshadowing

A

tendency for health professionals to attribute all behavioral, social, and emotional problems to intellectual disability in individuals with this diagnosis

205
Q

Alloplastic intervention

A

goals is to make changes in the environments so that it better accommodates the individual

206
Q

Autoplastic intervention

A

goals is to change the individual so that she/he is able to function more effectively within his/her environment

207
Q

Leading causes of therapist distress

A
  1. suicidal statements, 2. lab of therapeutic distress, 3. issues related to confidentiality
208
Q

Gender and mental illness

A

rates of mental illness higher in females than males, but rate of hospitalization higher in males than females

209
Q

Demographic characteristics of psychiatric inpatients-marital status-

A

admission rates loses among widowed, intermediate for married and divorced/separated, and highest among single

210
Q

Demographic characteristics of psychiatric inpatients-race

A

whites represent largest number, but patients from other races are over-represented

211
Q

Demographic characteristics of psychiatric inpatients-age

A

largest proportion of admission in 25-44 age range

212
Q

Demographic characteristics of psychiatric inpatients-diagnosis

A

schizophrenia most common in 18-44 age range; organic disorder (then affective disorder) most common in 65+ age range

213
Q

Rate of whites in mental health

A

represent 70% of both inpatient and outpatient admissions

214
Q

Boyd-Franklin’s multisystems model

A

model for therapy with African American clients; addresses multiple systems, intervenes at multiple levels, and empowers the family by utilizing its strengths

215
Q

LaFromboise et al. (1990) network therapy

A

incorporates family and community members into the treatment process and sees problems within context; recommended for native american clients

216
Q

somatic complaints more likely to be expressed by

A

Hispanics and Asians

217
Q

LGBT mental health

A

higher risk for depression, anxiety, substance use, and suicidality; evidence indicates thesis due to prejudice/discrimination, not sexual orientation

218
Q

sexual identity in LGB males versus females

A

males had earlier onset of attraction, labeling, and same-set encounter than females; similar ages of coming out

219
Q

Sue and Sue (2003) three parts of cultural competence

A

Awareness, Knowledge, Skills

220
Q

Cultural Awareness

A

awareness of own assumptions, values, and beliefs

221
Q

cultural knowledge

A

attempts to understand the world views of culturally diverse clients

222
Q

cultural skills

A

use of therapeutic interventions that are appropriate for culturally different clients

223
Q

Credibility (Sue and Zane 1987)

A

the client’s perception that the therapist is an expert and trustworthy

224
Q

Giving (Sue and Zane 1987)

A

client’s perception that he/she has received something from therapy

225
Q

Three aspects of indigenous healing

A
  1. rely on community/family networks, 2. integrate religious/spiritual practices, 3. conducted by traditional healer/respected community member
226
Q

Berry et al. (1987) for categories of acculturation

A
  1. Integration (high new culture, high old culture), 2. Assimilation (high new culture, low old culture), 3. Separation (low new culture, high old culture), 4. Marginalization (low new culture, low old culture)
227
Q

Sue 1978-worldview

A

how a person perceives his/her relationship with the world; determined by locus of control and locus of responsibility

228
Q

Cultural encapsulation (Wrenn 1985)

A
  1. define reality according to own cultural assumptions/stereotypes, 2. disregard cultural differences, 3. ignore evidence that does not conform to beliefs, 4. disregard own cultural biases
229
Q

Emic orientation

A

culture-specific theories, concepts, and research strategies; attempt to see things through the eyes of the members of that culture

230
Q

Etic orientation

A

phenomena that reflect a universal (culture-general) orientation; involves viewing people from different cultures as essentially the same

231
Q

High-context communication

A

grounded in the situation, depends on group understanding, relies heavily on nonverbal cues, helps unify a culture, slow to change

232
Q

Low-context communication

A

relies primarily on the explicit, verbal part of a message

233
Q

Internalized oppression

A

system beating, system blaming, avoidance of whites, denial of significance of race

234
Q

Conceptual incarceration

A

adopting a white worldview and lifestyle

235
Q

split-self syndrome

A

polarizing oneself into “good” and “bad” components, with the bad components representing one’s African American identity

236
Q

Playing it cool

A

concealing anger or other unacceptable feeling by acting composed and calm

237
Q

Uncle Tom Syndrome

A

adopting a passive or “happy-go-lucky” demeanor

238
Q

Cultural paranoia

A

a healthy reaction to racism, when a client does not disclose to a white therapist due to fear of being hurt of misunderstood

239
Q

Functional paranoia

A

unwillingness to disclose to any therapist, regardless of race or ethnicity, due to general mistrust and suspicion

240
Q

Intercultural Nonparanoiac Discloser

A

Low functional paranoia, Low Cultural Paranoia; willing to self-disclose to and anglo or AA therapist

241
Q

Functional Paranoiac

A

High functional paranoia, Low cultural paranoia; nondisclosure to all therapists, due primarily to pathology

242
Q

Health Cultural Paranoiac

A

Low functional paranoia, high cultural paranoia; self-disclose only to AA therapist, due to past experiences with racism or the white therapist’s attitudes or beliefs

243
Q

Confluent Paranoiac

A

High functional paranoia, high cultural paranoia; non disclosing to all therapists due to combination of pathology and the effects of racism

244
Q

sexual stigma

A

the shared knowledge of society’s negative regard for any nonheterosexual behavior, identity, relationship, or community

245
Q

Heterosexism

A

cultural ideologies that promote and perpetuate violence against homosexuals

246
Q

Sexual prejudice

A

negative attitudes based on sexual orientation

247
Q

Atkinson, Morten, and Sue 1993-Racial/Cultural Identity Development Model

A
  1. Conformity, 2. Dissonance, 3. Resistance and Immersion, 4. Introspection, 5. Integrative Awareness
248
Q

Cultural Awareness

A

awareness of own assumptions, values, and beliefs

249
Q

cultural knowledge

A

attempts to understand the world views of culturally diverse clients

250
Q

cultural skills

A

use of therapeutic interventions that are appropriate for culturally different clients

251
Q

Credibility (Sue and Zane 1987)

A

the client’s perception that the therapist is an expert and trustworthy

252
Q

Giving (Sue and Zane 1987)

A

client’s perception that he/she has received something from therapy

253
Q

Three aspects of indigenous healing

A
  1. rely on community/family networks, 2. integrate religious/spiritual practices, 3. conducted by traditional healer/respected community member
254
Q

Berry et al. (1987) for categories of acculturation

A
  1. Integration (high new culture, high old culture), 2. Assimilation (high new culture, low old culture), 3. Separation (low new culture, high old culture), 4. Marginalization (low new culture, low old culture)
255
Q

Sue 1978-worldview

A

how a person perceives his/her relationship with the world; determined by locus of control and locus of responsibility

256
Q

Cultural encapsulation (Wrenn 1985)

A
  1. define reality according to own cultural assumptions/stereotypes, 2. disregard cultural differences, 3. ignore evidence that does not conform to beliefs, 4. disregard own cultural biases
257
Q

Emic orientation

A

culture-specific theories, concepts, and research strategies; attempt to see things through the eyes of the members of that culture

258
Q

Etic orientation

A

phenomena that reflect a universal (culture-general) orientation; involves viewing people from different cultures as essentially the same

259
Q

High-context communication

A

grounded in the situation, depends on group understanding, relies heavily on nonverbal cues, helps unify a culture, slow to change

260
Q

Low-context communication

A

relies primarily on the explicit, verbal part of a message

261
Q

Internalized oppression

A

system beating, system blaming, avoidance of whites, denial of significance of race

262
Q

Conceptual incarceration

A

adopting a white worldview and lifestyle

263
Q

split-self syndrome

A

polarizing oneself into “good” and “bad” components, with the bad components representing one’s African American identity

264
Q

Playing it cool

A

concealing anger or other unacceptable feeling by acting composed and calm

265
Q

Uncle Tom Syndrome

A

adopting a passive or “happy-go-lucky” demeanor

266
Q

Cultural paranoia

A

a healthy reaction to racism, when a client does not disclose to a white therapist due to fear of being hurt of misunderstood

267
Q

Functional paranoia

A

unwillingness to disclose to any therapist, regardless of race or ethnicity, due to general mistrust and suspicion

268
Q

Intercultural Nonparanoiac Discloser

A

Low functional paranoia, Low Cultural Paranoia; willing to self-disclose to and anglo or AA therapist

269
Q

Functional Paranoiac

A

High functional paranoia, Low cultural paranoia; nondisclosure to all therapists, due primarily to pathology

270
Q

Health Cultural Paranoiac

A

Low functional paranoia, high cultural paranoia; self-disclose only to AA therapist, due to past experiences with racism or the white therapist’s attitudes or beliefs

271
Q

Confluent Paranoiac

A

High functional paranoia, high cultural paranoia; non disclosing to all therapists due to combination of pathology and the effects of racism

272
Q

sexual stigma

A

the shared knowledge of society’s negative regard for any nonheterosexual behavior, identity, relationship, or community

273
Q

Heterosexism

A

cultural ideologies that promote and perpetuate violence against homosexuals

274
Q

Sexual prejudice

A

negative attitudes based on sexual orientation

275
Q

Conformity (ID Dev.)

A

Preference for dominant culture, depreciating attitudes toward one’s own culture

276
Q

Dissonance (ID Dev.)

A

confusion and conflict over the contradictory appreciating and depreciating attitudes one has toward the self and toward others of the same and different groups

277
Q

Resistance and Immersion (ID Dev.)

A

actively reject the dominant society and have appreciating attitudes toward self and members of own group

278
Q

Introspection (ID Dev)

A

uncertainty about rigidity of beliefs; conflicts between loyalty/responsibility toward own group and feelings of personal autonomy

279
Q

Integrative Awareness (ID Dev)

A

sense of self-fulfillment with regard to cultural identity and strong desire to eliminate all forms of oppression; multicultural perspective

280
Q

Black Racial (Nigresence) Identity Development Model

A

Pre-Encounter (race/racial identity have low salience); Encounter (interest in developing a black identity); Immersion-Emersion (idealizes blacks/black culture, rejection of white culture); Internalization (high race salience, have adopted a pro-black, non-racist (Afrocentric) or biculturalist orientation)

281
Q

White Racial Identity Development Model

A

Contact Status (obliviousness and denial); Disintegration status (suppression of information and ambivalence); Reintegration (selective perception and negative out-group distortion); Pseudo-independent status (selective perception and reshaping reality); Immersion-Emersion status (hyper vigilance and reshaping); Autonomy (flexibility and complexity)

282
Q

Parallel interaction

A

occurs when the therapist and client have similar levels of racial/cultural identity

283
Q

Progressive interaction

A

therapist racial identity if more advanced than client’s

284
Q

Regressive interaction

A

client’s racial identity is more advanced that therapist’s

285
Q

Crossed interaction

A

statuses of client and therapist represent opposite attitudes toward race

286
Q

Troiden’s Homosexual Identity development model

A
  1. Sensitization; Feeling different (middle childhood), 2. Self-Recognition/Identity Confusion (onset of puberty, recognition of homosexual attraction); 3. Identity assumption (becomes more certain of homosexual identity); 4. Commitment/Identity Integration (adopted a homosexual way of life and publicly disclosed homosexuality)

Clinical Psychology (4 decks)

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