Clinical (therapies) Flashcards

1
Q

Describe Interpersonal Psychotherapy (IPT – Klerman and Weissman), model and goals.

A

Medical model, goal of symptom relief and improved interpersonal function.

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2
Q

Three stages of IPT (Klerman and Weissman)

A

Initial – diagnosis and interpersonal context. Assign the sick role (shift blame, view as treatable).
Middle phase – address identified problem
Final phase – issues related to termination and relapse prevention

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3
Q

What are the 4 targets of IPT for depression (initial phase)

A

Interpersonal role disputes,
Interpersonal role transitions
Interpersonal deficits
Grief

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4
Q

Encouragement of affect, role-playing, communication analysis, and decision analysis are common tools in what therapy?

A

Interpersonal Psychotherapy (middle phase)

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5
Q

Describe the goal and types of questions used in solution focused therapy

A
Problem solving (not etiology/nature of problems) 
Miracle question (goal setting) 
Exception questions (times it was not a problem) 
Scaling question (current status)
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6
Q

What is the logic and strategy of the Transtheoretical Model (Prochaska and DiClemente)?

A

Integrates concepts/strategies from multiple approaches, because strategies are most effective when they match the client’s stage

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7
Q

List and describe the stages of change in the transtheoretical model (Prochaska and DiClemente)

A

Precontemplation – no intention to change (denial or hopeless)
Contemplation – plan to change in 6 months, some ambivalence
Preparation – plan to take action within 30 days
Action – Taking action to change behavior
Maintenance – Maintained desired change for 6 months
Termination – Client is confident that change will last (low risk of relapse)

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8
Q

What strategies are used in the Precontemplation stage

(transtheoretical model, Prochaska and DiClemente)

A

Consciousness raising
Dramatic relief (experiencing/expressing emotion)
Environmental Reevaluation

(wake up all dramatic, then look around)

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9
Q

What strategies are used in the Contemplation stage

(transtheoretical model, Prochaska and DiClemente)

A

Self-re evaluation (how they feel about it)
Consciousness raising
Dramatic relief (experiencing/expressing emotion)
Environmental Reevaluation

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10
Q

What strategies are used in the Preparation stage

(transtheoretical model, Prochaska and DiClemente)

A

Self re-evaluation
Self-liberation (hope and commitment)

(Prepare to liberate!)

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11
Q

What strategies are used in the Action stage

(transtheoretical model, Prochaska and DiClemente)

A

Contingency management
Stimulus control
Counterconditioning

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12
Q

What strategies are used in the Maintenance stage

(transtheoretical model, Prochaska and DiClemente)

A

Relapse prevention using:
Contingency management
Stimulus control
Counterconditioning

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13
Q

What three factors affect motivation to change in the transtheoretical model?

A
Decisional Balance (beliefs about pros and cons) 
Self-efficacy 
Temptation (intensity of urge)
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14
Q

What are the primary techniques of motivational interviewing

A

develop Discrepancy, express Empathy, build self Efficacy, roll with Resistence

(DEER)

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15
Q

Decisional Balance

A

Motivation to change in transtheoretical model – beliefs about pros and cons of change.

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16
Q

Change talk

A

MI concept – statements that move the client toward making positive changes in behavior.

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17
Q

CBT is based on the assumption that disturbance is caused by maladaptive what? (3 things)

A

Schemas, automatic thoughts, cognitive distortions

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18
Q

Cognitive Schemas

A

Core beliefs developed through experiences and stress reactivity. They are enduring and produce the content of automatic thoughts. Structure for interpreting the world

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19
Q

Cognitive profiles (in Beck’s cbt)

A

A set of maladaptive schemas associated with a given disorder (eg cognitive triad of depression)

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20
Q

Automatic thoughts - how do they arise and function

A

Statements/images triggered by circumstance and shaped by schemas. Intermediary between event and emotional/behavioral reaction

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21
Q

What type of therapy did Ellis create?

A

Rational Emotive Behavior Therapy

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22
Q

Basic premise of Ellis’s Rational Emotive Behavior Therapy (REBT)

A

Disturbance is based on irrational beliefs, which tend to be absolutist/extreme and take the form of must/should statements. Uses ABCDE model of disturbance and change in therapy.

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23
Q

Explain the ABCDE model in Ellis’s Rational Emotive Behavior Therapy (REBT)

A

Activating event

irrational Belief

Consequence of that belief (emotional/behavioral)

Dispute that belief (therapist’s techniques)

Effect of those techniques – replace belief with more rational one.

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24
Q

Active disputation of irrational beliefs, imagery, systematic desensitization, and skills training are tools of what therapeutic approach?

A

REBT (Rational Emotive)

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25
Q

What therapies did Meichenbaum create?

A

Self-Instructional Training and Stress Inoculation training

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26
Q

Briefly describe Self-Instructional Training (Meichenbaum)

A

Teaching problem solving skills to impulsive children (and other populations). Modelling a task with vocalized instruction fades to verbal then “covert” self-instruction.

Instructions focus on 4 skills: Identifying task, focusing attention to behaviors needed for the task, self-reinforcement, and evaluating performance/correcting errors.

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27
Q

Skills of task identification, focusing attention to required behaviors, self-reinforcement, and evaluating performance are used in what approach?

A

The instructions used in Self-Instructional training (Meichenbaum)

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28
Q

Explain the focus and stages of Stress Inoculation Training

A

Deal better with current/future stress with coping skills.

Phases: initial conceptualization/education (stressful situations are problems to be solved), skill acquisition and consolidation (learn cog/beh coping skills), Application and follow through (use coping skills through role-play then in real life).

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29
Q

What is the main goal of ACT

A

Enhance psychological flexibility. Inflexibility is the rigid dominance of psychological reactions over values

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30
Q

Explain ACT concept of clean pain and dirty pain

A

Clean pain – discomfort that is unavoidable/expected

Dirty pain – Suffering caused by attempts to control/avoid clean pain

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31
Q

What are ACT’s six processes to promote psychological flexibility?

A

Experiential acceptance (of internal experience without attempt to change)

Cognitive defusion – distancing from own thoughts/feelings to view as experience rather than reality

Being Present – mindful attention to present (not past or future)

Self-as-Context – Viewing self as the context in which thoughts/feelings happen

Values-Based Action – using chosen values to guide actions rather than avoidant/compliant/unclear motives

Committed action – ongoing commitment to acting accordingly to own values.

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32
Q

Metaphors, mindfulness strategies, and experiential exercises are strategies used in what modality?

A

ACT

33
Q

Briefly explain mindfulness based cognitive therapy

A

Combines MBSR and CBT, originally for recurrent depression but useful for lots of things. Goal is to enhance self-awareness to de-centre from distress. Includes psychoed, mindfulness, and cbt techniques

34
Q

Attention regulation, emotion regulation, body awareness, and decentring are thought to be the mechanisms of change in what type of therapy?

A

Mindfulness based interventions

35
Q

Id operates according to the ______ principle

A

Pleasure

36
Q

Drives of the Id (Freud)

A

Life (sex) and Death (aggression)

37
Q

According to Freud, the ego develops at what age, and operates according to what principle?

A

6 months. Reality principle (satisfy the id in realistic ways)

38
Q

Relationship between ego and superego toward the id

A

Ego attempts to satisfy the id in realistic ways

Superego attempts to permanently block the id’s instincts due to social norms.

39
Q

According to Freud, what creates stress resulting in use of defense mechanisms?

A

When ego cannot resolve a conflict between the id and superego.

40
Q

What is the main goal of Freudian psychoanalysis

A

To bring conscious awareness to unconscious conflicts and strengthen the ego, so behavior is based more on reality.

41
Q

Free association, dream analysis, resistance, and transference are primary techniques of what approach?

A

Freudian psychoanalysis

42
Q

What are the four steps of Freudian psychoanalysis?

A

Confrontation (recognize behaviors and causes)

Clarification (of those behaviors)

Interpretation (link behavior to unconscious processes)

Catharsis, insight, and working through repressed emotion

43
Q

Personal unconscious (theorist and definition)

A

Jung. Own forgotten/repressed memories

44
Q

Collective unconscious (theorist and definition)

A

Jung. Memories shared by all people, passed through generations. Includes archetypes (universal images/thoughts)

45
Q

How did Jung conceptualize transference?

A

As the projection of elements of personal and collective unconscious.

46
Q

Individuation (Jung)

A

The process, in adulthood, of become a separate ‘whole’ individual

47
Q

What is emphasized in Adler’s individual psychology?

A

Drive for social connection, future goals informing behavior.

48
Q

Style of Life (theorist and explanation)

A

Adler (Individual Psychology). The way a person strives for superiority, this style develops in early childhood.

An unhealthy style is when goals focus on overcompensating for feelings of inferiority and don’t include concern for others.

49
Q

What is the primary goal in Adler’s Individual Psychology?

A

Correct mistaken style of life by overcoming inferiority and strengthening social interest.

50
Q

Early memories, dream analysis, and acting “as-if” are tools of what approach?

A

Adler’s Individual Psychology

51
Q

What is the focus of object relations therapy?

A

Impact of early relationships with caregiver (objects) on future relationships

52
Q

Object Constancy

A

In object relations therapy: development of consistent mental representation of the self and others (objects) across situations (e.g., continuing to love partner while in a fight).

53
Q

According to Mahler, what are the stages of object constancy development (object relations theory)

A

Normal autistic (first weeks, fully self absorbed)

Symbiotic stage (infant is aware of external environment but cant differentiate self from caregiver)

Separation-individuation (around 5 months to 3 years, gradual development of object constancy)

54
Q

According to Mahler (object relations theory) what is the cause of psychiatric issues (eg BPD, narcissism)

A

Problems during separation-individuation phase that cause an ongoing failure of object constancy.

55
Q

Introjects

A

In object relations theory – mental representation of self and others

56
Q

What is the goal/approach of object relations therapist?

A

Use corrective reparenting experience to replace maladaptive introjects with healthy ones, therapy improving current relationships.

57
Q

Empathic acceptance and analysis of resistance/transference is used in what approach?

A

Object Relations

58
Q

Person-centered therapy (aka client centered therapy): basis and theorist

A

Rogers. All people have a drive toward self-actualization (meeting full potential)

59
Q

Incongruence

A

In person-centered therapy (Rogers), occurs when self-concept and experience are inconsistent. People react by distorting or denying their experience, leading to maladjustment.

60
Q

Conditions of worth

A

In person-centered therapy (Rogers), source of incongruence when parents only provide love/acceptance when this child is well behaved.

61
Q

What is the primary goal of Rogers’ person-centered therapy?

A

Help client become a fully functioning person (ie, not defensive, open to experience, engaged in self-actualization)

62
Q

What are the three “facilitative conditions” used in person centered therapy?

A

Empathy, unconditional positive regard, congruence (authenticity/honesty)

63
Q

Explain the role of needs of Gestalt therapy

A

People try to maintain homeostasis, which is disrupted by unfulfilled needs. People seek to get something from environment to fulfill those needs and restore homeostasis.

64
Q

Boundary disturbance (Gestalt therapy)

A

Problems with the boundary between person and environment, causing maladjustment

65
Q

Introjection (Gestalt Therapy)

A

type of boundary disturbance: adopt beliefs of others

66
Q

Projection (in Gestalt therapy)

A

type of boundary disturbance: Projection of undesirable traits of the self to others

67
Q

Retroflection (in Gestalt therapy)

A

type of boundary disturbance: do to self what they’d like to do to others

68
Q

Deflection (in Gestalt therapy)

A

type of boundary disturbance: (avoid contact with environment)

69
Q

Confluence (in Gestalt therapy)

A

type of boundary disturbance: blur distinction between self and others

70
Q

What is thought to be the curative factor in Gestalt therapy?

A

Increased awareness of experience/behavior.

71
Q

Dream role-plays and empty chair technique are primary tools of what approach?

A

Gestalt therapy

72
Q

Explain choice theory, the basis of Glasser’s Reality therapy

A

People have 5 basic needs (love, power, fun, freedom, survival). Success identity or failure identity develop based on how the individual fulfills those needs (responsibly or irresponsibly)

73
Q

What strategies are used by reality therapists? WDEP

A

Help client identify Wants, what are the Doing to increase awareness, Evaluate own behaviors, Plan of action.

74
Q

What is the aim of Seligman’s Positive Psychology?

A

Increase happiness and valued subjective experience.

75
Q

According to Seligman’s PERMA model (positive psychology), what are the 5 essential components of wellbeing?

A

Positive emotions

Engagement (in activities, “flow”)

Relationships

Meaning (cause bigger than self)

Accomplishment

76
Q

Briefly explain Kelly’s Personal Construct Therapy

A

There are different ways of construing events, and the way one does shapes behavior. These construals can be changed to improve functioning.

77
Q

What are Personal Constructs (Kelly’s Personal Construct Therapy)

A

Conscious or unconscious beliefs/predictions about the world

78
Q

How does fixed-role therapy work (within Personal Construct Therapy)

A

Therapist describes a fictional person, client roleplays that person and construes events in different ways