Clinical (therapies) Flashcards
Describe Interpersonal Psychotherapy (IPT – Klerman and Weissman), model and goals.
Medical model, goal of symptom relief and improved interpersonal function.
Three stages of IPT (Klerman and Weissman)
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
What are the 4 targets of IPT for depression (initial phase)
Interpersonal role disputes,
Interpersonal role transitions
Interpersonal deficits
Grief
Encouragement of affect, role-playing, communication analysis, and decision analysis are common tools in what therapy?
Interpersonal Psychotherapy (middle phase)
Describe the goal and types of questions used in solution focused therapy
Problem solving (not etiology/nature of problems) Miracle question (goal setting) Exception questions (times it was not a problem) Scaling question (current status)
What is the logic and strategy of the Transtheoretical Model (Prochaska and DiClemente)?
Integrates concepts/strategies from multiple approaches, because strategies are most effective when they match the client’s stage
List and describe the stages of change in the transtheoretical model (Prochaska and DiClemente)
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)
What strategies are used in the Precontemplation stage
(transtheoretical model, Prochaska and DiClemente)
Consciousness raising
Dramatic relief (experiencing/expressing emotion)
Environmental Reevaluation
(wake up all dramatic, then look around)
What strategies are used in the Contemplation stage
(transtheoretical model, Prochaska and DiClemente)
Self-re evaluation (how they feel about it)
Consciousness raising
Dramatic relief (experiencing/expressing emotion)
Environmental Reevaluation
What strategies are used in the Preparation stage
(transtheoretical model, Prochaska and DiClemente)
Self re-evaluation
Self-liberation (hope and commitment)
(Prepare to liberate!)
What strategies are used in the Action stage
(transtheoretical model, Prochaska and DiClemente)
Contingency management
Stimulus control
Counterconditioning
What strategies are used in the Maintenance stage
(transtheoretical model, Prochaska and DiClemente)
Relapse prevention using:
Contingency management
Stimulus control
Counterconditioning
What three factors affect motivation to change in the transtheoretical model?
Decisional Balance (beliefs about pros and cons) Self-efficacy Temptation (intensity of urge)
What are the primary techniques of motivational interviewing
develop Discrepancy, express Empathy, build self Efficacy, roll with Resistence
(DEER)
Decisional Balance
Motivation to change in transtheoretical model – beliefs about pros and cons of change.
Change talk
MI concept – statements that move the client toward making positive changes in behavior.
CBT is based on the assumption that disturbance is caused by maladaptive what? (3 things)
Schemas, automatic thoughts, cognitive distortions
Cognitive Schemas
Core beliefs developed through experiences and stress reactivity. They are enduring and produce the content of automatic thoughts. Structure for interpreting the world
Cognitive profiles (in Beck’s cbt)
A set of maladaptive schemas associated with a given disorder (eg cognitive triad of depression)
Automatic thoughts - how do they arise and function
Statements/images triggered by circumstance and shaped by schemas. Intermediary between event and emotional/behavioral reaction
What type of therapy did Ellis create?
Rational Emotive Behavior Therapy
Basic premise of Ellis’s Rational Emotive Behavior Therapy (REBT)
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.
Explain the ABCDE model in Ellis’s Rational Emotive Behavior Therapy (REBT)
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.
Active disputation of irrational beliefs, imagery, systematic desensitization, and skills training are tools of what therapeutic approach?
REBT (Rational Emotive)
What therapies did Meichenbaum create?
Self-Instructional Training and Stress Inoculation training
Briefly describe Self-Instructional Training (Meichenbaum)
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.
Skills of task identification, focusing attention to required behaviors, self-reinforcement, and evaluating performance are used in what approach?
The instructions used in Self-Instructional training (Meichenbaum)
Explain the focus and stages of Stress Inoculation Training
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).
What is the main goal of ACT
Enhance psychological flexibility. Inflexibility is the rigid dominance of psychological reactions over values
Explain ACT concept of clean pain and dirty pain
Clean pain – discomfort that is unavoidable/expected
Dirty pain – Suffering caused by attempts to control/avoid clean pain
What are ACT’s six processes to promote psychological flexibility?
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.
Metaphors, mindfulness strategies, and experiential exercises are strategies used in what modality?
ACT
Briefly explain mindfulness based cognitive therapy
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
Attention regulation, emotion regulation, body awareness, and decentring are thought to be the mechanisms of change in what type of therapy?
Mindfulness based interventions
Id operates according to the ______ principle
Pleasure
Drives of the Id (Freud)
Life (sex) and Death (aggression)
According to Freud, the ego develops at what age, and operates according to what principle?
6 months. Reality principle (satisfy the id in realistic ways)
Relationship between ego and superego toward the id
Ego attempts to satisfy the id in realistic ways
Superego attempts to permanently block the id’s instincts due to social norms.
According to Freud, what creates stress resulting in use of defense mechanisms?
When ego cannot resolve a conflict between the id and superego.
What is the main goal of Freudian psychoanalysis
To bring conscious awareness to unconscious conflicts and strengthen the ego, so behavior is based more on reality.
Free association, dream analysis, resistance, and transference are primary techniques of what approach?
Freudian psychoanalysis
What are the four steps of Freudian psychoanalysis?
Confrontation (recognize behaviors and causes)
Clarification (of those behaviors)
Interpretation (link behavior to unconscious processes)
Catharsis, insight, and working through repressed emotion
Personal unconscious (theorist and definition)
Jung. Own forgotten/repressed memories
Collective unconscious (theorist and definition)
Jung. Memories shared by all people, passed through generations. Includes archetypes (universal images/thoughts)
How did Jung conceptualize transference?
As the projection of elements of personal and collective unconscious.
Individuation (Jung)
The process, in adulthood, of become a separate ‘whole’ individual
What is emphasized in Adler’s individual psychology?
Drive for social connection, future goals informing behavior.
Style of Life (theorist and explanation)
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.
What is the primary goal in Adler’s Individual Psychology?
Correct mistaken style of life by overcoming inferiority and strengthening social interest.
Early memories, dream analysis, and acting “as-if” are tools of what approach?
Adler’s Individual Psychology
What is the focus of object relations therapy?
Impact of early relationships with caregiver (objects) on future relationships
Object Constancy
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).
According to Mahler, what are the stages of object constancy development (object relations theory)
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)
According to Mahler (object relations theory) what is the cause of psychiatric issues (eg BPD, narcissism)
Problems during separation-individuation phase that cause an ongoing failure of object constancy.
Introjects
In object relations theory – mental representation of self and others
What is the goal/approach of object relations therapist?
Use corrective reparenting experience to replace maladaptive introjects with healthy ones, therapy improving current relationships.
Empathic acceptance and analysis of resistance/transference is used in what approach?
Object Relations
Person-centered therapy (aka client centered therapy): basis and theorist
Rogers. All people have a drive toward self-actualization (meeting full potential)
Incongruence
In person-centered therapy (Rogers), occurs when self-concept and experience are inconsistent. People react by distorting or denying their experience, leading to maladjustment.
Conditions of worth
In person-centered therapy (Rogers), source of incongruence when parents only provide love/acceptance when this child is well behaved.
What is the primary goal of Rogers’ person-centered therapy?
Help client become a fully functioning person (ie, not defensive, open to experience, engaged in self-actualization)
What are the three “facilitative conditions” used in person centered therapy?
Empathy, unconditional positive regard, congruence (authenticity/honesty)
Explain the role of needs of Gestalt therapy
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.
Boundary disturbance (Gestalt therapy)
Problems with the boundary between person and environment, causing maladjustment
Introjection (Gestalt Therapy)
type of boundary disturbance: adopt beliefs of others
Projection (in Gestalt therapy)
type of boundary disturbance: Projection of undesirable traits of the self to others
Retroflection (in Gestalt therapy)
type of boundary disturbance: do to self what they’d like to do to others
Deflection (in Gestalt therapy)
type of boundary disturbance: (avoid contact with environment)
Confluence (in Gestalt therapy)
type of boundary disturbance: blur distinction between self and others
What is thought to be the curative factor in Gestalt therapy?
Increased awareness of experience/behavior.
Dream role-plays and empty chair technique are primary tools of what approach?
Gestalt therapy
Explain choice theory, the basis of Glasser’s Reality therapy
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)
What strategies are used by reality therapists? WDEP
Help client identify Wants, what are the Doing to increase awareness, Evaluate own behaviors, Plan of action.
What is the aim of Seligman’s Positive Psychology?
Increase happiness and valued subjective experience.
According to Seligman’s PERMA model (positive psychology), what are the 5 essential components of wellbeing?
Positive emotions
Engagement (in activities, “flow”)
Relationships
Meaning (cause bigger than self)
Accomplishment
Briefly explain Kelly’s Personal Construct Therapy
There are different ways of construing events, and the way one does shapes behavior. These construals can be changed to improve functioning.
What are Personal Constructs (Kelly’s Personal Construct Therapy)
Conscious or unconscious beliefs/predictions about the world
How does fixed-role therapy work (within Personal Construct Therapy)
Therapist describes a fictional person, client roleplays that person and construes events in different ways
