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Comp Exam New Flashcards

1
Q

Narrative (Family) (12)

A
  1. No objective reality, we attempt to label people to control things, this is a fiction
  2. We live in a story of our own making; we can shift understanding, change the story
  3. Power of language-control our speech, control the future
  4. present/future focus
  5. Focus on ways society oppresses people- look for lessons we are taught, make them conscious
  6. Most stories start thin “I am bad at math”- thicken it with context
  7. Externalize the problem to de-fuse with it: examples given in class- instead of “he’s sneaky”, we say “when does this sneakiness happen?” “it’s us against the sneakiness”
  8. Look for sparkling events: times the family has been able to avoid/overcome the problem- we want to shine these times up and make them seem more important in order to change the narrative
  9. Engage each member in the story
  10. Bring in external influences- not all our fault we turned out this way- understand the big picture of how dysfunctional patterns are created
  11. Ask how each family member spends their time- focus on talents and strengths.
  12. Write a letter after therapy to each family member detailing their strengths, what you believe is possible for them
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2
Q

9 Steps of EFT ACE RIA ESC

A
  1. Alliance 2.Cycle 3.Emotions. 4. Reframe the problem in terms of the cycle and attachment related emotions. 5. Promote identification with disowned needs and aspects of self; integrate these into relationship interactions. 6. Promote acceptance of the partner’s experience and creating new interaction patterns. 7. Facilitate the direct expression of needs and wants to create emotional engagement. 8. Facilitate the emergence of new solutions to old relationship problems. 9. Consolidate new positions/cycles of attachment behaviors.
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3
Q

EFT Interventions (5)

A

1) Empathic reflection. 2) Validation of client realities & emotional responses. 3) Evocative questions and prompts that call up emotion through open ended questions about stimuli, bodily responses, desires, meanings, or action tendencies. 4) Heightening: Expand and intensifies emotional experience through repeating, re-enacting, focusing, refocusing, and using imagery. 5) Empathic conjecture, interpretation and inferences.

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4
Q

EFT assesses relationship factors: (7)

A

a) Strengths b) Cycle – c) Behaviors d) Perceptions e) Secondary Emotions f) Primary Emotions g) Attachment Needs

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5
Q

EFT Therapy Goals (5) CEDSA

A

Cycle/emotions/de-escalate/safety/attach 1. ID cycle 2. ID attachment emotions 3. Use in session enactments to de-escalate 4. Establish new ways of relating (safer) 5. Form healthy attachments

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6
Q

Contraindications for EFT:

A

ongoing violence, substance abuse, ongoing affairs- no trust

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7
Q

Methods of Assessment (EFT):

A

Dyadic adjustment scale, attachment hx (parents), family environment scale

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8
Q

DV main points- 1. what must we know (2. and how?) and 3. when is couples counseling okay?

A
  1. Assess individually for violence/risk/suicide/affairs- 2. Use written assessment: Partner Violence Scale (has gender bias) 3. Couples counseling okay iff: violence has stopped, violence is only mild, perpetrator takes responsibility for abuse and agrees to nonviolent tx
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9
Q

Safety Planning Steps:

A
  1. Identification that the risk is increasing 2. Identification of specific steps survivor can take once they’ve realized risk is increasing 3. Methods for maintaining safety once survivor leaves
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10
Q

Psychoanalytic Terms (3)

A
  1. behavior determined by unconscious factors/patterns early in life/developmental drives 2. Id- pleasure principle ego- reality principle superego- perfection principle/concience & standards 3. anxiety- reality (danger), neurotic (instincts will get you in trouble), moral (fear of one’s own conscience getting you in trouble)
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11
Q

defense mechanisms (11) RRRFR CIPIDDS

A

rrrfr cipidds 1. repression, 2. regression 3. reaction formation (express opposite of true impulse), 4. rationalization 5. compensation (focus on accomplishments to avoid shortcomings) 6. Introjection (swallowing others’ values), 7. projection 8. identification 9. displacement 10. denial 11. sublimation

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12
Q

Stages of development (Freud)

A

Erikson (see below) vs freud psychosocial (Oral (trust), anal (independence), phallic (sexuality, approval), latency (socialization), genital (sex energy channeled into achievement))

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13
Q

Goal of psychoanalytic:

A

make unconscious conscious and strengthen the ego so behavior is based on reality not instinctual cravings/irrational guilt

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14
Q

Therapist Role (psychoanalytic)/Client experience/What I’m looking for:

A

Blank screen, transference relationship, notice areas of resistance/interpret for client Client experience- free association, dream interpretation, explore past and present My interests: early childhood lessons, messages received; transference relationship (who am I to him, what can I learn from it); countertransference from me; developmental tasks mastered/not and attachment style/wounds

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15
Q

Individual Assessments: Depression Anxiety Trauma Substance Use Suicide Career Couples DV

A

Intake: Intake Assessment, cultural formation interview, adult plan of care, NEO FFI Depression: BDI Anxiety: BAI Trauma: TSI Substance Use: CAGE-AID Suicide- SAFE-T; assess risk/protective factors, intent, plan Career- Strong Inventory (Interest- highly researched), ONET (Values) Couples: Dyadic Adjustment Scale, Attachment hx, Experience in Close Relationships Scale, DV: Partner Violence Scale

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16
Q

Terminology to Describe Assessments

A

Reliability (consistency), Validity (accuracy), Bias (culture, error, instructor), Compare with Z/T scores

17
Q

Depressive Sx (9)

A

Depressed mood (sad, tearful) Loss of interest/pleasure Feelings of worthlessness Suicidal thoughts/ideation/plan/attempt Increased/Decreased appetite/weight Insomnia or hypersomnia Fatigue or loss of energy Diminished ability to think or indecisiveness Psychomotor agitation or retardation

18
Q

MDD PDD R/O

A

MDD- 5+ sx for at least 2 weeks PDD- 2+ sx for 2 years R/O: PMDD (monthly), Substance/Medically induced (Triggers), Bipolar (Manic Ep), DMDD (Temper, Kids, 1yr)

19
Q

Anxiety Sx (6)

A
  1. Restlessness or feeling keyed up or on edge.
  2. Muscle tension.
  3. Being easily fatigued.
  4. . Sleep disturbance (difficulty falling or staying asleep, or restless, unsatisfying sleep).
  5. Difficulty concentrating or mind going blank.
  6. Irritability.
20
Q
  1. Separation D/O
  2. Mutism
  3. Specific Phobia
  4. Social anxiety D/O
  5. Panic D/O
  6. Agoraphobia,
  7. GAD
A
  1. Separation D/O (4 weeks in kids, 6mos in adults),
  2. Mutism (1mo),
  3. Specific Phobia (6mos),
  4. Social anxiety D/O (6mos),
  5. Panic D/O (4 panic sx + 1mo avoidance/fear),
  6. Agoraphobia,
  7. GAD (3+ sx, 6mo)
21
Q

R/O for Anxiety

A

OCD (1hr/day, 6mos), Body Dysmorphic D/O, Hoarding, Substance/Medical

22
Q

PTSD

A

An event 1 or more intrusion symptom 1 or more avoidance symptom 2 or more cognitive and mood symptoms 2 or more arousal and reactivity symptoms Duration of symptoms for longer than a month. Specifiers: Dissociative symptoms, Delayed expression

23
Q

Acute Stress D/O

A

(1-30 days) Intrusion Negative mood Dissociative sx Avoidant sx Arousal sx

24
Q
  1. Oppositional Defiant
  2. Intermittent Explosive
  3. CD
  4. Autism
  5. ADHD
A
  1. ODD (4sx, 6mo, Angry/Argumentative/Vindictive)
  2. Intermittent Explosive (2 outbursts/week, 3mos)
  3. CD (3 criteria in past year) Aggression to people/animals Destruction of property Deceitfulness/Theft Serious rule violation
  4. Autism- social defecits, rigidity of interests/behaviors
  5. ADHD- 6 sx each of inattention & hyperactivity for at least 6 mos
25
Q

Personality D/O

  1. ASPD
  2. BPD
  3. Histrionic
  4. Narcissistic
A
  1. ASPD- 3sx, since age 15
  2. BPD- instability of interpersonal relationships, self-image and affects, and marked impulsivity, beginning by early adulthood and present in a variety of contexts, (5+sx)
  3. Histrionic- attention seeking, 5+ sx (seductive)
  4. Narcissistic- Need to be admired, 5+ sx, lack of empathy
26
Q

Psychotic D/O

  1. Delusional D/O
  2. Brief Psychotic
  3. Schizophreniform
  4. Schizophrenia
  5. Schizoaffective
  6. Cyclothymia R/O
A
  1. Delusional D/O (1 mo)
  2. Brief Psychotic (1 day-1mo, 1+ sx) Delusions. Hallucinations. Disorganized speech (e.g., frequent derailment or incoherence). Grossly disorganized or catatonic behavior.
  3. Schizophreniform (2+sx, 1-6 mo)/
  4. Schizophrenia (6mo+)/
  5. Schizoaffective (6mo+, +mood sx) Delusions. Hallucinations. Disorganized speech (e.g., frequent derailment or incoherence). Grossly disorganized or catatonic behavior. Negative symptoms (i.e., diminished emotional expression or avolition).

R/O: Substance/Medical, OCD, Bipolar Bipolar 1 (manic ep, 3 manic sx, 1wk+)/Bipolar 2 (hypomanic ep, 4 days, less severe impairment, no psychotic sx)

  1. Cyclothymia (1yr kids, 2 yr adults; hypomanic/depressive sx ½ the time, fail to meet criteria for bipolar)
27
Q

Erikson Stages

A

Infancy: Hopes — Trust vs. Mistrust

Toddlerhood: Will – Autonomy vs. Shame and Doubt

Preschool Years: Purpose – Initiative vs. Guilt

Early School Years: Competence – Industry vs. Inferiority

Adolescence: Fidelity – Identity vs. Role Confusion Young

Adulthood: Love – Intimacy vs. Isolation

Middle Adulthood: Care – Generativity vs. Stagnation

Late Adulthood: Ego Integrity vs. Despair

28
Q

Stage Salient Tasks

A

Attachment (0-12mos) Emotion regulation (1-3) Identity/Autonomy Peer Relations Externalizing Behaviors/Internalizing Behaviors

29
Q

Yalom Curative Factors

A

Mike’s Acronym: 4I’s, 2C’s, GUD, A&E 4I’s: Instillation of Hope, Imparting Information, Imitative Behavior, Interpersonal Learning 2C’s: Catharsis, Corrective Recapitulation of the Primary Family Group GUD: Group Cohesion, Universality, Development of Socializing Techniques A&E: Altruism & Existential Factors

30
Q

Couples Ethical Issues (7) MAC RT CV

A

Multiple Relationships Avoiding Harm Confidentiality/Disclosures Clarifying Therapist Role Testimonials Competency Personal Values/Biases

31
Q

Thorough Assessment of DV includes

A

Written/Verbal, Couple/Individual ID severity & Safety, ask about a gun

32
Q

Risk Assessment of DV (4):

A

Dispositional RF (impulsive, hostile) Contextual RF (esp pregnancy, end of relationship) Historical RF Clinical RF (Substance Abuse, BPD, ASPD, NPD)

33
Q

Safety Plan

A

ID Risk is increasing Specific steps to get to safety Ways to stay safe

34
Q

Four Main Duties (DV):

A

Duty to Care- Do no harm, assess, refer, competence Duty to Protect- safety planning Duty to Warn- Tarasoff Duty to Report- child abuse Individual/Couple/Group tx

35
Q

Subpoena

A

Check for Validity Contact Client/Atty

36
Q

Retain Records:

A

10 yrs from termination

37
Q

Tarasoff:

A

Duty to protect and predict only when a.) patient has communicated w/psychotherapist b.) serious threat of physical harm c.) against a reasonable identifiable victim. Communicate to victim and police.

38
Q

DSM Cross-Cutting Measure Domains

A
  1. Depression
  2. Anxiety
  3. Anger
  4. Mania
  5. Somatic Sx
  6. Suicidal Ideation
  7. Psychosis
  8. Sleep
  9. Memory
  10. Repetitive Thoughts & Behaviors
  11. Dissociation

Comp (17 decks)

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