Clinical Psychology Flashcards
etic
“universal” all ppl from different cultures are the same
emic
emic stands for “empathy”; culture-specific therapy
Allostatic
adapt to the environment by changing the environment
autoplastic
adapt to the environment by “self change”; changing your responses/behavior
Helm’s Racial Identity Model (stages)
Contact
Disintegration
Reintegration
Pseudo-independence
Immersion-Emersion:
Autonomy:
Contact Phase
“color-blind”; unaware of racial differences
First stage of Helm’s Racial Identity model
Disintegration stage
greater awareness of inequality; leads to a sense of dissonance and moral conflict
Second stage of HRIM
Reintegration stage
Resolve moral conflict by believing that whites are better
3rd stage in HRIM
Pseudo-independence
**Triggered by an event
dissatisfied with racist views but still judge minorities by white standards
4th stage in HRIM
Immersion-Emersion
explore what it means to be white; how they can be proud of being white without being racist
5th stage in HRIM
Autonomy
HRIM
internalize non-racist white identity;
understand the strengths and weaknesses of white culture
6th stage in HRIM
Conversion V on MMPI
scale 1 (hypochondriasis) and scale 3 (hysteria) high;
scale 2 (depression) low
Passive Aggressive V on MMPI
Scale 4 (psychopathic deviate/antisocial) and scale 6 high (paranoia);
scale 5 low (masculine/feminine)
Psychotic V or “paranoid valley” on MMPI
Scale 6 (paranoia) and 8 (schizophrenia ) high;
scale 7 (psychosthenia–irrational fears; obsessive compulsive anxiety) low
defensive profile
F scale lower than scores on L and K scale
Types of cognitions
Beck’s CBT
schemas
automatic thoughts
cognitive distortions
Schemas definition
Becks Cognitive Behavior Therapy
core beleifs that determine how something is perceived or conceptualized
Maladaptive schemas
create inaccurate interpretations and conclusions
Adaptive schemas
Efficient information processing and realistic evaluation
Automatic thoughts based on maladatpive schemas…
Beck’s Cognitive Behavior Therapy
lead to dsyfunctional emotional and behavioral responses
Negative triad
Beck’s Cognitive Behavior Therapy
negative thoughts about
oneself
the world
the future
Cognitive distortions
Arbitrary Inference
Selective abstraction
Overgeneralization
Personalization
Dichotomous thinking
Arbitrary Inference
Cognitive distortions; Beck CBT
No evidence but drawing conclusions
Selective abstraction
Cognitive distortions; Beck CBT
focus on negative details and ignore other info
Overgeneralization
Cognitive distortions; Beck CBT
drawing a conclusion to one event;
generalizing to all events
Dichotomous thinking
Cognitive distortion; Beck CBT
categorizing to the extreme
Personalization
Cognitive distortion; Beck CBT
external events are your fault
Behavioral Techniques
Beck’s Cognitive Behavioral Therapy
Activity Scheduling
Behavioral Rehearsal
Exposure to feared stimuli
Beck’s Cognitive Techniques
- reattribution
- redefining the problem
- thought recording
- Socratic questioning
Reattribution
Beck’s CBT cog. techniques
finding alternative causes to events
Redefining
Beck’s CBT techqnies
restating a problem in terms of client’s ability to resolve it
Thought recording
Beck’s CBT techniques
maintaining a record of automatic thoughts, antecedents and consequences
Socratic questioning
Beck’s CBT techniques
testing validity of thoughts and feelings using inductive reasoning
Bowenian key word
Differentiation
Minuchin key word
restructuring Boundaries
Milan key word
Games
Four major family therapy orientations
- Extended Family Systems/Muti-generational (Bowenian)
- Structural (i.e., Minuchin)
- Strategic (i.e., Haley)
- Systemic (i.e., Milan)
Systemic Family Systems creator
Milan
Strategic Family Systems creator
Hayley
Structural Family Systems creator
Minuchin
Extended family Systems creator
(Bowenian)
Family Therapy theoretical influences
systems theory–interdependent subsystems with autonomy
cybernetics–feedback loops
negative feedback
maintains the status quo
postive feedback
produces instability in the system
equifinality
different processes have the same outcome
equipotentiality/multifinality
one process can have several different outcomes
Levels of Communication
report level (content; explicit behavior)
command level (nonverbal)
Double-bind communication
report level does not equal command level
Extended Family Systems theory
i.e., (Bowenian); Multigenerational family therapy
emotional processes are transmitted from one generation to the next
Extended Family Systems (Bowenian) primary goal
i.e., Multigenerational family therapy
help family members become more differentiated while remaining connected
Extended Family Systems (Bowenian) techniques
i.e., Multigenerational family therapy
genograms
process questions
relationship experiments
genogram
Bowenian techniques
visual representation of 3 generations
provides info on structures, life events, and rel. dynamics
Process Questions
Bowenian techniques
used to help family members see how they contribute to the problem and how others perceive specific situations
(i.e. “how do you react when your husband criticizes you?”
Process Questions are answered directly to the _________
family member VS. therapist?
Why?
Therapist
Minimizes emotional reaction
Relationship Experiments
Bowenian techniques
homework assignments to help practice relating to to members in more differentiated way
(i.e., discuss an unresolved conflict rather than focus on child’s behavior)
Bowenian Therapists _______ involvement with family members
maximize VS. minimize
Minimize
NO JOINING
How are emotional processes transmitted to the next generation in a Bowenian system?
Differentiation
Triangles
Nuclear family emotional system
Family projection process
Multigenerational transmission process
Emotional Cutoff
Sibling position
societal regression
Differentiation of Self
Bowenian concept
- High differentiation = seperate identity + connected to family
- Low differentiation = emotional fused
Triangles
Bowenian concept
- 2 person system becomes unstable –> conflict
- Bring in a third person to restore stability
(e.g., become overly involved in child to avoid facing unresolved conflict between them)
Nuclear family emotional system
Bowenian concept
Methods nuclear family uses to deal with stress + anxiety
Family projection process
Bowenian concept
projecting parental problems onto the child
results in symptomatic behavior in the child
Multigeneration transmission process
Bowenian concept
transmission of differentiation patterns from one generation to the next
“low levels of differentiation begets low levels of differentiation”
Emotional Cutoff
Bowenian concept
Family member distance themselves (physically or emotionally) to deal with conflict in the system
indicates low levels of differentiation (i.e., Andre)
Sibling position
Bowenian concept
birth order contributes to child’s personality and role in family’s emotional life
Societal Regression
Bowenian concept
impact of societal stress on society and family
What are “Family Structures”
Structural Therapy theoretical constructs
repetitive patterns of interactions between family members
forming subsystems w/i family system
Theoretical terms found in Structural Therapy
Structural/Minuchin Therapy
- “Family Structure”
- “Boundaries”
- Rigid Family Triads
Structural Therapy goal?
Minuchin Therapy
Restructure family and their boundaries so they are better able to respond to stress
Action over insight
What are the three dysfunctional coalitions in Rigid Family Triads?
Structural Therapy theoretical constructs
dysfunctional coalitions
- Triangulation–each parent demands a child take a side; pulled in both directions
- Detouring–parents reinforce deviant behavior to take away from spousal problems
- Stable coalition–2 members gang up against other members
What is the definition of boundaries in structural therapy?
Structural Therapy theoretical constructs
implicit rules that determine contact
Describe the types of boundaries in Structural Therapy
Structural Therapy theoretical constructs
implicit rules that determine contact
- clear–balanced separateness and connectedness
- rigid–disengagement between family members
- diffuse–enmeshment and excessive dependence
What are the three stages that the Structural Family therapist goes through?
Minuchin
Joining
Formulation
Restructuring (goal)
What techniques occur in the joining stage?
Minuchin/Structural Therapy Technique
build rapport
mimesis (mimick emotional state and demeanor)
tracking (using content of what family communicates)
In the Formulation stage the therapist identifies dysfunctional repetitive patterns through…
Minuchin/Structural Therapy Technique
- observing family interactions
- making family map of family structure
What is Restructuring?
Minuchin/Structural Therapy Technique
A technique that alters repetitive interactions
What techniues are involved in Restructuring?
Minuchin/Structural Therapy Technique
enactment
reframing
boundary marking
unbalancing
Unbalancing
Restructuring Technique
Taking the side of a “scapegoated” family member to alter how members act toward that person
Boundary Marking
Restrucuring Technique
Strengthening diffuse boundaries OR loosening rigid boundaries
Reframing
Restrucuring Technique
Describe undesirable behavior in a positive way; highlight advantages and disadvantages
Enactment
Restrucuring Technique
Role play dysfunctional behavior
Minuchin Therapists only focus on the…
Present
(won’t include intergeneration or family history)
Strategic Family Therapy theory
(Haley)
communications are focused on power (ability to control relationship with others)
Power is determined by hiearchies
Strategic Family Therapy techniques
- direct and indirect directives
- reframing
direct and indirect directives
- direct directives are orders the family will agree to follow
- indirect directives involve asking the family to do a behavior they will resist and so changing behavior in a desired way (e.g., prescribing the symptom)
Name three strategic family therapy techniques
direct (agree to follow)
indirect directives (manipulate)
reframing (giving problem behaviors alternative meaning)
Paradoxical interventions
Ask family to do something they will resist to change behavior in desired way (e.x., prescribing the symptom)
How do strategic therapists develop the course and outcome of treatment?
Use the first session to and go through the stages:
- social stage
- problem stage
- interaction stage
4 goal setting stage
- task setting stage
Social Stage
First session of Strategic Family therapy
- social stage–speak to each member and observe interactions
* Use the first session to and go through the stages:*
Problem stage
First session of Strategic Family therapy
- Ask each family member about presenting problem
* Use the first session to and go through the stages:*
Interaction Stage
First session of Strategic Family therapy
- Ask each family member to discuss the presenting problem
* Use the first session to and go through the stages:*
Goal setting stage
First session of Strategic Family therapy
- everyone agrees on therapy goals
* Use the first session to and go through the stages:*
Task setting stage
First session of Strategic Family therapy
- directives to complete at home
* Use the first session to and go through the stages:*
Systemic Family Therapy theory
Milan
Problems with family members revolve around games that maintian homeostasis and serve a purpose
What are Games in systemic family therapy?
Milan
Repetitive behavioral interactions that serve a purpose
Milan Systemic Family Therapy goals
Change rules of the game
Therapy provided by a team
Milan techniques
hypothesizing
neutrality
circular questioning
positive connotations
paradoxical prescriptions
family rituals
Hypothesizing
Systemic (Milan) techniques
hypothesizing–question asking; revise hypothesis based on answers
Neutrality
Systemic (Milan) techniques
accept perceptions of all family members
Circular Questioning
Systemic (Milan) techniques
ask each family member their perceptions of the event
they gain new info; recog. similiarites and differences in perceptions
Positive Connotation
Systemic (Milan) techniques
Reframing a problematic behavior as beneficial or good
(note someone’s good intentions)
Paradoxical Prescriptions
Systemic (Milan) techniques
Engage in problematic behavior to understand the behavior is in their control
Family Rituals
Systemic (Milan) techniques
Tasks designed to change family games (changing who disciplines child)
Stuart interpersonal operant therapy
increase # of pos. reciprocal interactions using contingency contracts
Structural family therapy the therapist does what with the family system?
“Joins” the family system
How can a structural family therapist join the system?
Mimesis–adopt a family’s communication and affective style
dose-effect model of psychotherapy
50% of people show improvement with 6-8 sessions
75% by 26th session
85% a little over a year
Model of effectiveness of pyschotherapy
(3 phases)
Remoralization
Remediation
Rehabilitation
Remoralization
Phase of effectiveness in psychotherapy
decrease in feelings of hopelessness
occurs during first few sessions
Remediation
Phase Model of Psychotherapy Effectiveness
Symptom Relief
requires up to 16 additional sessions
Rehabilitation
Phase model effectiveness of psychotherapy
gradual improvement in longstanding maladaptive behavioral patterns
Verbs for each family therapist
Bowenian coaches
Minuchin joins
Haley directs
Milan plays games on a team
Displacement
Uncomfortable impulse is expressed on a safe target (usually the therapist)
accuse therapist of being distracted because spouse is distracted
Projection
attributing personal thoughts and beleifs to someone else
You feel angry so you feel your therapist is angry
Sublimation
Transformation of unwanted impulses or acts into something socially acceptable
Undoing
Releives anxiety about a behavior by attempting to make up for it in other areas
What sets REBT apart from other CBT methods?
ABC-DE
Disputation of irrational beleifs
acitively confront and challenge irrational beleifs
Topographical Model
conscious
preconscious
unconscious
Psychodynamic assumptions
current psychological problems can be traced back to early experiences and are due to unconscious experiences
Structural Theory
of psychoanalysis
ID
EGO
SUPEREGO
ID
unconscious biological instincts (sexual, aggressive)
How do we gain information about the id?
Deduced from dreams, slips of the tounge, and free association
Personality is derived from
Psychoanalysis
interactions between the id, the ego, and the superego
Ego
wants to gratify ID in socially acceptable ways
secondary process thinking = logical and rational
primary process thinking
unconscious, impulsive and irrational
Ex. ID
Secondary process thinking
logical and rational
Ex. Ego
Pleausure principle
Associated with the ID
seeks immediate gratification of it’s ego
Reality principle
attempts to gratify instincts in ways compatible with requirements of reality
Ex. Ego
Superego
Conscience
evolves from internalized parental prohibitions, standards, values
Describe the relationship between the EGO and ID
Ego attempts to gratify the ID’s instincts in realistic and socially acceptable ways
Describe the relationship between the SUPEREGO and ID
Superego permanently blocks the ID from socially unacceptable instincts
According to psychoanalysis, conflicts are caused by conflicting….
demands between the ID, the Superego, and reality
What arises when the ego is unable to reconcile conflict between the id and superego?
Defense Mechanisms
Defense mechanisms
definition
unconsciously distort or deny reality
Defense Mechanisms
examples
Denial, Displacement, Projection
Reaction formation, Repression, Rationalization
Regression
Sublimation
Displacement
(defense mechanism: Freudian)
unacceptable impulse expressed toward a safe target
Projection
defense mechanism: Freudian
transferring your own unacceptable feelings onto someone else
Goal of psychoanalysis
Procedures of Psychoanalysis: Freudian
- bring unconscious unresoved conflicts into consciousness
- strengthen the ego so behavior is less instinctual and more on reality
Targets of Analysis
Psychoanalysis: Freudian
free association
resistance
dreams
transference
Procedures of Psychoanalysis
Confrontation
Clarification
Interpretation
Working Through
Confrontation
Procedures of Psychoanalysis: Freudian
help clients view their behavior in new ways
*giving an interpretation*
Clarification
Procedures of Psychoanalysis: Freudian
bring behavior into sharper focus
challenge–I noticed you are late when we talk about tough topics
Interpretation
Procedures of Psychoanalysis: Freudian
explicit linking of client’s conscious behavior to unconscious processes
repeated interpretations lead to catharsis
Working through
Procedures of Psychoanalysis: Freudian
testing, accepting, and assimilating new insights
Other psychodynamic therapies
Jung’s Analytical Psychology
Adler’s Individual Psychology
Neo-Freudians
Ego Analysts
Object-Relations Theory
Jung’s Analytical Psychology keyword (3)
Collective unconscious, archetypes, individuation
Adler’s Individual Psychology keyword
Style of Life
Neo-Freudians keyword (3)
moving toward, against, away
proto,para,syntaxic
character styles
Ego-analyast keyword
ego-defensive functions
Object relations keyword
object constancy
Jung vs. Freud
- Rejected sexual energy as primary motivator
- More positive view of human nature
- Believed behavior impacted by past events and future goals and aspirations
Structure of Psyche
(Jung Analytical Psychology)
Conscious
Personal Unconscious
Collective Unconscious
Conscious
(Jungian Analytical Psychology)
Ego that contians all thoughts and feelings we are aware of