Counseling and Helping Relationships (4/6) Flashcards
Miscellaneous terms
1
Q
The brain grows and differentiates because of
A
- genetics
- continuous interaction with environment
Since a person’s experiences with different environmental stimuli and events throughout life can promote re-mapping of different regions, so too the experience of therapy can restructure neural networks
2
Q
Triune model of the brain
Surviving Brain
A
the stem and responds to danger and controls automatic functions (flight-fight)
3
Q
Triune model of the brain
Feeling Brain
A
limbic system. emotion center, mediating feelings/thoughts, storing some memory
4
Q
Triune model of the brain
Thinking Brain
A
cortex. executive functions, meaning-making, self-awareness
5
Q
Neuroplasticity
A
brain’s ability to reproduce new neurons and reorganize itself as the individual experiences new situations and experiences (including psychotherapy)
Many counseling approaches result in formation of new neurons and connections. The production of neurotransmitters is promoted
6
Q
Does CBT promote cognitive restructuring in clients with PTSD
A
Yes.
CBT promotes new connections within memory network leading to reduction of symptoms
7
Q
Does EMDR help clients access new, more adaptive info?
A
Yes
8
Q
Biofeedback (neurofeedback)
A
is useful for many client problems including sleep disorders, anxiety attacks, phobias, migraines
attempts to rewire neural networks
9
Q
Cultural neuroscience
A
counselors help generate neurons and networks to assist diverse clients to lead more satisfying and empowered lives
10
Q
Ways to increase production of positive neurotransmitters besides talk therapy:
A
- invovement in integrative therapies like art/music/physical movement/exercise
- relaxation exercises
- balanced nutrition
- yoga
- new/repeated emotional/verbal/interpersonal processes of learning that have become ingrained into brain structures
11
Q
Medication can reduce or control symptoms but
A
there are no biochemical means to change faulty interaction patterns and behaviors that have led to a disorder
12
Q
Council for Accreditation of Counseling and Related Educational Programs (CACREP)
A
standards require curricular experiences for all counselors in training to promote an understanding of theories of learning and personality develop to include current understanding of neurological behavior
13
Q
CACREP definition of neurological behavior
A
relationship among brain anatomy, function, biochemistry, learning, behavior
14
Q
Mindfulness components
A
- focus and attention on one’s current experience including environment, internal sensations, emotions, thoughts
- nonjudgmental, accepting attitude to whatever the client is experiencing externally/internally
15
Q
Mindfulness
A
form of mental discipline with a focus on the here and now
may include:
- deep breathing exercises
- relaxation techniques
- meditation
16
Q
Mindfulness-based cognitive therapy
A
assists client in stopping the self-perpetuating mental habits of ruminating on negative thoughts
- learn to pay attention to thoughts/body sensations in a nonjudgmental way
- accept them and let go of cycles and patterns of responding that are not useful
17
Q
Purpose of mindfulness-based cognitive therapy
A
not to change these thoughts/body sensations as much as change the relationship to them in a reframing sort of way
18
Q
Application of mindfulness counseling practices
A
- depression
- GADs
- stress
- anxiety
mindfulness may not be appropriate for:
- schizophrenia
- bipolar disorder
- PTSD
19
Q
Counseling skills and conditions influencing counseling
Empathic understanding
A
the ability to experience the client’s subjective world including feelings/cognitions
20
Q
Counseling skills and conditions influencing counseling
Congruence
A
AKA genuineness
counselor is authentic and integrated in the counseling session
can also mean an agreement between client’s behavior and their values/beliefs
21
Q
Counseling skills and conditions influencing counseling
Unconditional positive regard
A
AKA acceptance
counselor is caring without condition and is neither evaluative nor judgmental
22
Q
Counseling skills and conditions influencing counseling
Concreteness
A
the extent to which the client and the counselor deal with issues in specific terms rather than in vague generalities
23
Q
Counseling skills and conditions influencing counseling
Immediacy
A
dealing with what is going on in the counseling process at the present time
24
Q
Counseling skills and conditions influencing counseling
Interpretation
A
uncover and suggest meanings and relationships often underlying the apparent expression
25
# Counseling skills and conditions influencing counseling
Self-disclosure
appropriate self-disclosure means that the counselor shares personal affect and experiences relative to the client's issues
26
# Counseling skills and conditions influencing counseling
Attending
several behaviors including listening, engaging in eye contact, and being psychologically present
27
# Counseling skills and conditions influencing counseling
Restatement
repeating what the client has stated with emphasis on the cognitive message
28
# Counseling skills and conditions influencing counseling
Reflection
repeating what the client has stated with emphasis on the affective or feeling portion of the message
29
# Counseling skills and conditions influencing counseling
Paraphrasing
restating the message of the client to show or to gain understanding
30
# Counseling skills and conditions influencing counseling
Summarizing
counselor or client brings together several ideas or feelings usually following a lengthy interchange
31
# Counseling skills and conditions influencing counseling
Silence
may have many meanings:
- quietly thinking
- boredom
- hostility
- waiting for the counselor to lead
- preparing the next thrust
- emotional integration
32
# Counseling skills and conditions influencing counseling
Confrontation
occurs when the counselor identifies and presents discrepancies between a client's verbal and nonverbal behaviors or between counselor's and client's perceptions
33
Clinical Interventions
the treatment plan outlines the counseling interventions
Interventions are influenced by:
- diagnosis
- client characteristics
- counselor therapeutic orientation
34
Evidence-based interventions
should know and apply evidence-based research findings in selecting therapeutic interventions
- particular issues/problems consistent with particular client characteristics may thus be dealt with most effectively
- quality standards of care are the goal and consistent with ethical practices
35
Dual-diagnosis interventions
integrate practices with other mental health specialists including doctors
- ex. co-occurring mental disorders and substance use issues - need additional professional interventions
ensures an appropriate level of care is provided
36
Structuring
defining the nature, limits, goals of the counseling process
- roles of client and counselor may be described
37
Robert Carkhuff
five point scales to measure empathy, genuineness, concreteness, respect
- counselor responses may be viewed as additive, interchangeable, subtractive
38
# Carl Jung - Analytic Psychology
Collective unconscious
determined by evolutionary development of the human species and contains brain patterns for the most intense emotional responses that humans experience
There is also a personal unconscious (similar to Freud's)
39
# Carl Jung
Archetype
operant for collective unconscious
response pattern occurring universally in the human experience and is characterized by an emotional charge to the existential issue of identity, meaning, purpose
- ex. anima, animus (female/male traits)
- androgynous (having both male and female characteristics)
- dark side of the personality relates to animal instincts
- extroversion/introversion (MBTI has roots in Jung)
the self is symbolized as a mandala or a balnce between the personal unconscious and collective unconscious
40
# Carl Jung
Goals of Jungian therapy
- transformation of self including gaining knowledge of self
- recognition
- integration of self
41
# Carl Jung
Therapy is viewed as
a healing process
42
# Carl Jung
Jung introduced
introversion/extraversion concepts
43
# Carl Jung
Which assessment is based on Jung's theory
Myers-Briggs Type Indicator
44
# Alfred Adler - individual psychology
Two important concepts
Birth order, family constellation
45
# Alfred Adler
Techniques of counseling:
- counselor is egalitarian with client - it's a collaborative effort
- neuroses are a failure in learning which results in distorted perceptions
- stress is on client responsibility
- **will to power**: generates feelings of superiority
- **fictional finalism**: behavior is motivated primarily by future opportunities than the past
**Teleological theory** - focused on future
46
# Alfred Adler
Counseling should examine
- family constellations - birth order
- dreams
- early memories
47
# Alfred Adler
Asks the question
What would be different if you were well?
- focuses on counseling process
48
# Alfred Adler
Birth order implications
children in the same family have different psychological environments because of differences in birth order
49
# Alfred Adler
Birth order implications
Oldest child:
- gets much attention
- tends to be dependable, hard-working, achievement oriented
- when another child (intruder) comes, oldest may fear losing love
50
# Alfred Adler
Birth order implications
Second child:
- shares attention
- sees self as if in a race to compete with first child
- often succeeds where older fails
51
# Alfred Adler
Birth order implications
Middle child:
- often feels left out
- may see life as unfair
- "poor me" attitude
- may develop problems
52
# Alfred Adler
Birth order implications
Youngest child:
- baby in family
- pampered
- special role to play
- influenced by all others
- tends to go own way
- often develops in directions no one else thought of
53
# Alfred Adler
Birth order implications
Only child:
- does not learn to share/cooperate
- often deals with adults well
- wants center stage even as adult and if does not get any, may have difficulties
54
# Alfred Adler
Childhood experiences influences ____
our adult interactions and family dynamics
55
# Gordon Allport and Kurt Lewin
Gordon Allport
acknowledged that individuals with their personalities exist within systems
- behavior of an individual must be viewed as fitting any system of interaction including culture, situational context, field theory
56
# Gordon Allport and Kurt Lewin
Kurt Lewin
field theorist
believed behavior is a function of life space which is a function of the person and the environment
- challenged the linear, mechanistic view of behavior
57
# Aaron Beck
Aaron Beck
developed a system of psychotherapy called cognitive therapy
58
# Aaron Beck
Automatic thoughts
similar to the preconscious
59
# Aaron Beck
Internal communication system
in depressed people, this system was negatively focused resulting in low self-esteem, self-blame, negative interpretations of experience
negative cognitive shift
60
# Aaron Beck
Developed this assessment
Beck Depression Inventory
61
# Joseph Wolpe
Theory of reciprocal inhibition
underlying principle states that a person cannot be both anxious and relaxed at the same time
62
# Joseph Wolpe
Systematic desensitization
(based on theory of reciprocal inhibition)
behavioral intervention of counterconditioning
- goal: to reduce anxiety by associating negative stimuli with positive events
- - specifically, negative images are paired with muscle relaxation
63
# Donald Meichenbaum
cognitive behavior modification
shift from self-defeating thoughts to coping ones
64
# Donald Meichenbaum
Stress inoculation
practicing positive or reinforcing self-statements
65
# Behavioral techniques
Token economy
use of tokens (points, rating, etc.) as a reinforcement in a behavioral treatment program
- shaping of behavior can occur through the use of these tokens
- privileges and goods can be purchased with tokens
66
# Behavioral techniques
Paradoxical intention
clients are urged to 'intend' that which they fear or wish to change
- may work with a variety of unwanted behaviors like insomnia, smoking, arguing, etc.
67
# Behavioral techniques
Implosive therapy
induces anxiety around the problem by presenting vivid images or cues (flooding)
- the anxiety is expected to diminish (extinguish) with repeated exposure and in the absence of any threat
68
# Behavioral techniques
Thought stopping
inhibit recurring thought by consciously stopping it whenever it occurs
69
# Johari Window
Looks like...
.......................known to....not known
.......................self...............to self
.......................------------------------
known to.....|..............|..............|
others..........|..............|..............|
.....................---------------------------
not known..|..............|..............|
to others.....|..............|..............|
....................--------------------------
70
# Johari Window
Named after
Joe Luft and Harry Ingham
(Johari is a combination of their first names)
71
# Johari Window
How it works
client brings material in this window to the counseling session; some is known, other info is not
72
# Johari Window
Principles of change may be identified
- a change in one quadrant affects all other quadrants
- it takes energy to hide, deny, or be blind to behavior
- threat increases awareness; mutual trust tends to increase awareness
- the smaller the first quadrant (upper left), the poorer the communication
- there is universal curiosity about the unknown area but customs, social training, fears keep parts unknown
- the goal of counseling is to minimize the lower right quadrant and maximize the upper left
73
# Johari Window
Helps explain
dynamics which occur in group therapy
- in productive groups, the quadrants not known to self and others may decrease in size and self-awareness and feedback from others increase
74
Consultation
voluntary, problem-solving process, initiated or terminated by the consultant or consultee, to help consultees develop attitudes or skills so they can function more effectively with individuals, groups, organizations
- work-related
may be client, consultee, system focused, and goal is to resolve issues that cause human problems and increase competence so future problems may be avoided
- has a preventative function
- not counseling
75
Consultation may be:
**content oriented**: transfer of knowledge or info from the consultant to the consultee
**process oriented**: looking at the process - may use communication theory, attribution, change, motivation theory
76
# Models of consultation
Bergan
behavioral model with 4 stages:
1. problem identification
2. problem analysis
3. plan implementation
4. problem evaluation
Part of the focus of this consultation is on problem behaviors and their antecedents and consequences
- model emphasizes verbal interaction in consultation
77
# Models of consultation
Bandura
social learning model
- dynamic interplay of behaviors, cognitions, enviornment and all three are assessed in problem identification
- many solutions revolve around modeling, rehearsing, changing cognitions
78
# Models of consultation
Schein
- **purchase model**: buying the consultant expert's knowledge or service
- **doctor-patient model**: stresses diagnosis and problem identification
- **process model**: consultee with the consultant in the diagnostic process and identification of interventions
79
# Models of consultation
Caplan
mental health consultation model
- consultation occurs between two professionals and can be centered on the client, the consultee and client, the program, consultee and administration
80
# Models of consultation
Splete
Nine-stage process of consultation
1. pre-contract
2. contract and exploration of relationship
3. contracting
4. problem identification
5. problem analysis
6. feedback and planning
7. implementation of the plan
8. evaluation of the plan
9. conclusion and termination of relationship
81
Animal-assisted counseling
helps clients establish a relationship with an animal that facilitates communication, builds self-confidence, non-judgmental
- these positive interactions can be used to better understand oneself and generalize to others
- dogs/horses are most commonly used although many other animals have been found to be effective
- individuals who are physically/mentally challenged, victims of trauma, socially shy may be good candidates
82
Wilderness therapy
more clinically-oriented
outdoor behavioral mental healthcare approach for troubled adolescents and adults
- purpose: to identify/address emotional, behavioral, psychological problems through an outdoor, often unfamiliar environment
82
Adventure-based counseling
desired for children and younger/older adults as an experiential set of outdoor activities
- may range from camping to hiking to completing 'challenge' courses designed for individuals, pairs, small groups
possible outcomes:
- self-awareness
- self-confidence
- communication skills
- trust
- camaraderie
- diversity sensitivity
- multicultural skills
83
Distance counseling/Telehealth
encompasses webcounseling, e-counseling, telephone counseling
- may be info-giving, be assessment-focused, psychoeducational, deal with personal/therapeutic issues
84
Issues of distance counseling/telehealth
- security of communications
- imposters
- records maintenance
- trust building/transparency
- contacts for clients in case of crisis
85
Trauma/Disaster Counseling
- training is required to work with this population
- possible consequences for counselors working with clients impacted by trauma include: compassion fatigue, secondary traumatic stress, vicarious trauma
- displayed by lack of energy, prefer isolation, be irritable, have sleeping problems, self-medicate, cease self-care activities
86
Compassion fatigue
evidenced by counselors who work with difficult client issues and may result in lack of empathy and interest in the client's concerns
- may occur even when working with clients who have not experienced trauma
87
Secondary traumatic stress
may result because of exposure to graphic material presented by traumatized clients
- may begin experiencing some of the same symptoms as the client
some think vicarious trauma is the same as secondary traumatic stress; others believe vicarious trauma includes change in counselor's worldview, sense of self, beliefs
88
Neurolinguistic programming
Richard Bandler and John Grinder are the original proponents
89
Neurolinguistic programming
communications theory using the five sensory channels
- can be used to establish and maintain rapport and pace the client's verbal cues
- examines the structure of language and how it is used to represent reality
90
Eye Movement Desensitization and Reprocessing (EMDR)
used to facilitate client's accessing of memories of painful and traumatic experiences and reprocessing these experiences through eye movements similar to those found in REM sleep cycles
- has generated considerable positive research
91
Alcohol and Substance Abuse Counseling
substance abuse is often viewed as the number one problem in the US
Personality traits often found in alcoholics and drug users:
- low self-concept
- anxiety
- underachievement
- feeling of social isolation
- sexual dysfunctions
- dependence
- fear of failure
- suicidal impulses
Individual, group, family counseling are valuable components of treatment
- residential programs, often using behavior modification and soical learning theory, may be effective
- treatment of physical addiction is also necessary
92
Questionnaire that is useful in assessing signs of addiction
SASSI (Substance Abuse Subtle Screening Inventory)
93
Twelve Step programs
effective for many with drug or alcohol problems
94
Kinesics
nonlinguistic communication which occurs through body movements such as gestures and facial expressions
95
Proxemics
spatial features of the environment such as positioning of furniture, seating arrangements, etc.
- how we arrange space will have an impact on behavior
- each of us has a personal space
96
Tryptophan is an amino acid that is related to this in the brain
serotonin
when it is removed from diet, memory/anxiety/sleep/mood decrease and aggresssion rises
97
A meta-analysis by Smith, Glass,& Miller (idk what year)
found that psychotherapy has a strong/big effect at .85
(this is often quoted and you should know about this meta-analysis)
## Footnote
small assocation less than .2
medium association is .50 or less
big/strong/large assocation is over .80
98
# Glasser
Reality-Choice Theory
focuses on present behavior. clients create their own personal reality with the behaviors they choose
- behavior is the control of our perceptions
- success identity is the result of being loved/accepted
- does not deal with dreams, the past, traumatic memories
eight steps:
- build a relationship
- focus on present moment behavior
- help client to evaluate current behavior
- develop contract with an action plan
- accept no excuses
- do not use punishment
- refuse to give up on client
psychological needs
- freedom
- belonging
- power
- fun
