Clinical Therapies Flashcards
Freud- stages of psychoanalysis
CCIW
Clarification
Confrontation
Integration
Working through
Adler
Teological
Inferiority feelings
Striving for superiority
Styles of life
Therapy is lifestyle investigation, encouragement
Systematic Training and Effective Parenting/Teaching - use natural and logical consequences
Concerned with birth order
Jung (birth- mid 30s)
Conscious governed by ego
Unconscious = personal + collective
Archetypes (anima/mus, self, shadow, persona)
Individuation- integration of conscious and unconscious
Tx - dreamwork, here and now, healthy aspects of person
Object Relations
Relationships are inborn drive
Maladaptive behavior comes from problems during separation-individuation and splitting self and others into good and bad
Tx - bring maladaptive relationships to consciousness
Supportive and accepting therapy
Mahler (Object Relations)
1 mon- infantile autism
2-3 mon - symbiotic - mom and me are the same
4-5 mon - separation individuation begins
Differentiation (5-1 mons)
Practicing/hatching (10-16 mons)
Reproachment - tentative move out (16-24 m)
Object constancy-separate from mom 24-36m
Anna Freud (Neo Freudian)
Acting out during play
Strong bond with kids
Klein - Objects Relations
Free associations in play
Splitting or all or none thinking/black and white thinking
Splitting mom into bad or good
Troiden -LGBT Identity development
Stage 1 - sensitization - pre puberty; Tomboy; gender differences
Stage 2- Self-recognition/Identity Confusion= sexual arousal at puberty leads to guilt, turmoil and anxiety
Stage 3 -Identity Assumption- know they are gay and may hide it or accept it
Stage 4- Commitment, identity pride, coming out
Humanistic
Phenomenological
Current behaviors
Inherent potential for self actualization and self determination
Constructivist- focus on making meaning and not on accuracy or rationality
Roger’s Person Centered Therapy
Maladaptive due to incongruence between self and experience
People alleviate I congruence with denial and distortions
Unconditional positive regard (nonjudgmental )
Genuineness (congruence)
Empathy (see world as client)
No transference, diagnosis or directive sss
Gestalt therapies
Maladaptive behavior is a growth disorder without homeostasis due to disturbance between self and environment
Self image reduces self actualization
Boundary disturbances
Tx -unified whole, here and now, past only when it impacts what functionality, no transference
Gestalt techniques
Empty chair
Top Dog
Dreamwork
Existential therapy
Emphasis on redo all choice for developing a meaningful life
Maladaptive behaviors comes from not being able to deal with ultimate concerns (death)
Existential anxiety leads to growth
Neurotic anxiety comes from avoidance of existential anxiety
Reality Therapy (Glasser)
People are responsible for the choices they make-prisoners/JJ
Innate needs= survival, power, love, freedom,fun
Success vs failure identity
Maladaptive behaviors are a choice
Tx- no medical model, current thoughts and behaviors, value judgments
George Kelly’s personal Constructivist therapy
People choose the way they deal with the world
People construe based on personal constructs, with bipolar dimensions
Maladaptive behavior is inadequate personal constructs
Therapy is focused on “co-experimentation”
Interpersonal Therapy (IPT)
Brief, originally used for depression
Maladaptive behavior comes from grief, social and relational problems that trace back to childhood
Focused on symptom reduction - meds, EBT
Stages of tx 1) diagnosis 2) interpersonal problems 3) progress and termination
Communication, modeling, role playing
Solutions focused therapy
You get more of what you talk about
No focus on problems
Miracle, exceptional and scaling questions
Gestalt boundary disturbances
Introjection- swallowing ideas whole
Projection- leads to paranoia
Retroflection- doing to yourself what you want to do to others
Confluence - no boundaries between self and other - leads to guilt and resentment
Transtheoretical model - 6 stages
Pre-contem- consciousness raising, dramatic relief, re-evaluation
Mediating vars- Decisional balance, self efficacy, temptation
Tx enhances intrinsic motivation Open questions Affirmations Reflective listening Summary reflections
Kohler
Insight learning with chimps and bananas
Ellis
Rational Emotive Behavioral Therapy - ABC-DE
Activating event
Beliefs
Consequential emotions & behaviors
Dispute beliefs
E- new effect
Michenbaum
Cognitive behavioral modification
Self instructional training (5 steps)
- Adult models
- Child imitates
- Child imitates out loud
- Child imitates whispers
- Child imitates thinking
Protocol analysis - verbalize steps to problem solve
Stress inoculation- PTSD tx (Gradual exposure) 1. Education/ cognitive preparation 2. Acquisition of coping skills 3. Application of skills (in vivo, imaginable)
Rehm’s Self Control Model of Depression
Depression caused by
-Self-monitoring -selective attention to neg events and immediate consequences
-Self-evaluation -perfectionistic, critical
Self-reinforcement - low self reward and high self punishment
Marlatt & Gordon
Addition is an overlearned habit
Freud processes and personality traits
Primary process- dreams, hallucinations (id)
Secondary process - think, speak (ego)
Schizoid- intellectualize Narcissists- rationalize bullshit Paranoid - projections Borderline- regress Histrionic- dissociating Dependent - introjection Antisocial - acting out
Hartman
Believes that ego codevelops with the id
Ego defenses vs ego autonomous (learn, think, do)
Kohut (Neo Freudian)
Self Psychology
Primary narcissism - focus on self as baby to get needs met
Idealizing
Mirroring
Twinship
Rx empathetic attunement
Sullivan
Prototaxic mode- series of sensory experiences and nothing is related
Parataxic mode- temporal sequences of causality (one thing caused by another)
-transference is a parataxic distortion
IPT comes from Sullivan’s interpersonal deficits
Biofeedback
Decreases sympathetic overarousal
Operant conditioning
Thermal -increase temperature
—>migraine (cold hands); Reynaurd’s disease (cold hands and feet)
EMG (muscles)—> tension headaches, TMJ, back pain
EEG (brain waves) —> ADHD, seizures
GSR (skin response, sweat)—> anxiety
Feminist therapies
Promote independence and autonomy
Sexism cause of problems
Egalitarian relationship- self disclosing
Models for client
Advocates for socio-political change
OCEAN (5 factors)
Openness Conscientiousness Extraversion Agreeableness Neuroticism
General systems theory
Open systems receive input and discharge output to environment
Tries to maintain homeostasis
Problem with homeostasis is that if one family member changes the disturbance will appear somewhere else
Cyber kinetics
Describes family communications process
Neg feedback loop- halts change
Pos feedback loop- promotes change
Communications/interaction family therapy
Communication has a report (informational) and command (nonverbal) function
Symmetrical communication- equity but results in “one up-manship”
Complementary communication - unequal but maximizes differences between communicators
Malad. Beh- symptoms are causes and effect of dysfunctional communication patterns
Treatment: confronting communication patterns, prescribing symptoms, reframing
Extended Family Systems (Bowen)
Differentiation - ability to separate intellectual and emotional functioning
“emotional triangles”
Maladaptive beh. Multigenerational transmission of low differentiation
Treatment:
Joining
Genogram of family relationships
Go to family of origin to resolve issues
Structural family therapy (Minuchin)
Boundary problems
Hi boundaries —> too diffuse
Lo boundaries —> enmeshed
Boundary problems
Detouring- overprotecting or blaming child to distract from marital problems
Stable coalition- parent and kid pairing up
Triangulation - child put in middle
Malad beh results from boundary issues and inflexible structure
Treatment:
Joining (mimesis and blending)
Evaluate the structure to change it
Restructure via enacting and reframing
Behavioral Family Therapy
Maladaptive behavior maintained from antecedents and consequences
Treatment: Focused on observational data Use reinforcement Communications and problem- solving skills Use CBT approaches
Objects Relations Therapy
Intrapsychic conflicts in family of origin
Projective identification - provoked a person to behave your projections
Treatment:
Interpret transferences and resistances
Resolve attachments to family introject
Strategic Family Therapy (Haley)
Informed by communications, structural and Milton Erickson (hypnosis)
Malad. Beh caused by controlling communication patterns
Treatment: Alter hierarchies and generational boundaries 1. Social stage 2. Problem stage 3. Interaction
Paradoxical intervention - alter behavior in order to see a symptom in a new way
Systemic Therapy (Milan)
Circular patterns of action and reaction
Maladaptive beh caused by patterns being so fixed that people cant make new choices
Treatment: Increase choices Use therapeutic teams One way mirror Hypothesizing Neutrality Paradox Circular questioning
Feminist Objects Relations
Men and women’s division of labor
Mother-son/mother-daughter relationships
Girls—> define self in relation to others
Boys—> define self in separation
Complementary Alternative Medicine (CAM)
Hypnosis—>alternations in memory, cognition, perception
Acupuncture- endorphins, flow of qi, relieves pain and chemotherapy side effects
Reflexology - restores energy flow and promotes relaxation
Health Belief Model
Health impacted by
Perceived susceptibility to illness and consequences
Evaluation of cost benefits
Internal and external cues to action
Caplan’s Mental Health Consultation
Client centered case- help therapist with patient problems
Consultee-centered - help consulted with their problems (theme interference can block progress, type of transference)
Consultee-centered administrative - improve professional functioning of staff
Program-centered administrative - help admin with program
Howard Er al
Dose dependent response to treatment
26 sessions - 75% do better
52- 85% improved
Stages
Remoralization (hopefulness)
Remediation (symptoms improved)
Rehabilitation (live evaluation improved)
