Counseling families, diagnosis, neurocounseling, and advanced concepts Flashcards

Question

What is experimental conjoint family therapy and who is it associated with?

Answer 1

**Conjoint Family therapy** is a type of therapy that implies two or more family members are in therapy at the same time and was created by **Virginia Satir**. She felt that a major goal of therapy was to improve communication between family members. According to Satir, four basic patterns prevented good communication under stress. Satir also used family sculpting to help visualize family dynamics.

Answer 2

Virginia Satir was a social worker who began seeing families in private practice in 1951. She felt that the family could be healed via love, while **Minuchin,** the father of structural family therapy, felt that family therapy was a science requiring therapeutic interventions well beyond warmth. Satir and Minuchin clashed.

Answer 3

According to Satir, four basic patterns prevented good communication under stress. She called these **defensive postures** or **stress positions.** * **placating** - you try to please everyone out of a fear of rejection. This style causes the person to sacrifice his own needs as a way of dealing with stress. The placater is a people pleaser. * **blaming -** basically says “it's your fault I'm the way I am” and might sacrifice others to feel good about himself or point fingers to avoid dealing with his own issues * **being overly reasonable -** likely to engage in the defense mechanism of intellectualization. This person is described as “functioning like a computer” to keep his or her emotions in check. This person is emotionally detached. Could also be called the **responsible analyzer** * **being irrelevant -** Will distract the family from the problem by constantly talking about irrelevant topics

Answer 4

He was the biologist who popularized the notion of the connectedness of all living things or the so-called **systems theory model.** The analogy is that the family is more than merely the separate persons but rather a system with rules and patterns that connect members, etc. **Murray Bowen** based his family therapy on systems theory.

Answer 5

Carl Whitaker, sometimes called the dean of experiential family therapy, was fond of saying that experience not education is what changes families. He said that experience goes beyond consciousness and that the best way to access the unconscious is symbolically. Whitaker's theory is also referred to as **experiential symbolic family therapy.** Whitaker could be described as **atheoretical.** He asserted that theory is often used as an excuse to keep therapists emotionally distance from the family. Whitaker promoted “craziness” and creativity of family members.

Answer 6

His posture would be to join the family and experience it as if he were a family member. Whitaker was a psychiatrist by training and he intentionally minimized the importance of theory, noting that therapeutic interaction is more of an art. Whitaker also believed that a **co-therapist** is helpful.

Answer 7

Whitaker would sometimes use “psychotherapy of the absurd” types of activities in his work. For example, he might ask a couple who was having a power struggle to actually have a tug of war in order to see who really had control.

Answer 8

Maultsby is a psychiatrist who is noted for creating **rational behavior therapy (RBT)** that is similar to Ellis's REBT except it also has a written self-analysis.

Answer 9

Premack, a behaviorist, suggests that a family member must complete an unpleasant task (known as a **low-probability behavior or LPB)** before he or she would be allowed to engage in a pleasant task known as a **high-probability behavior or HPB.** This is known as **Premack's principle.** So, for example, the therapist might say to one of the family members, “you must complete your sociology essay before you can use the family car and go out with your friends”. Note that behavioristic family and marriage therapists also generally rely on the same theorists as individual behaviorist therapists.

Answer 10

In Latin, **quid pro quo** means “one thing for another” or “something for something”. This is a technique that makes use of a behavioral contingency contract in order to get one person in the family to do something as long as the other member agrees to do something comparable. So for example, if the therapist suggested that since the child likes to play golf, every time he cuts the grass the father would take the kid to play golf – and has them sign a contract agreeing to the policy. Note that **quid pro quo** can also refer to an ethical violation (or even legal violation), particularly in the context of sexual harassment – I.e. “I'll supervise you as long as you sleep with me” is quid pro quo.

Answer 11

Behvariorists consider time-outs to be a form of **extinction**. In this instance, the child is removed from an environment so that they do not receive reinforcement for dysfunctional behavior.

Answer 12

The concept of reciprocity in a marriage assets that in most cases, people will reinforce each other at about the same level over time (I.e. each will participate in the tasks of the marriage and household equally, each will appreciate and support the other equally, etc). When this doesn't happen, it typically results in marital discord.

Answer 13

Joseph Wolpe's systematic desensitization pairs feared mental imagery with relaxation to eliminate the fear. This could be used in a case when, for example, a couple is having sexual problems based in anxiety.

Answer 14

This is a behaviorist technique created by psychiatrist **Robert Liberman** and social worker **Richard Stuart. Thought stopping** is intended to…stop thoughts. A man who was fantasizing about his neighbor's wife, for example, would be taught to yell “Stop!” in his mind as loudly as possible each time he had a sexual thought about his neighbor.

Answer 15

This is research that occurred in the past (ex post facto) and the researcher did not have control over the independent variable. A t-test COULD be used to explore whether there differences between two groups. **However, note that** **a t-test would not be used in a correlation study.**

Answer 16

Family sculpting, popularized by Virginia Satir, is an experiential/expressive technique in which a family member places other family members in positions that symbolize their relationships with other members of the family. Finally, the member places him or herself. This helps the therapist understand family dynamics that may have been missing from a mere discussion of family issues.

Answer 17

Nathan Ackerman. Ackerman, an analytically trained child psychiatrist, recommended studying the family vs. just the child being brought in as the identified patient. Some experts consider this the true beginning of the family therapy movement. Because he was analytically trained, Ackerman, unlike many family therapists, was concerned with the internal feelings and thoughts of each individual – as well as the dynamics between them. Prior to Ackerman, it was considered inappropriate to include family members in analytic treatment.

Answer 18

In this context, **object** means a significant other with whom a child wishes to bond. This is the notion that an individual (or an individual's ego) attempts to establish a relationship with an object (often a person or part of the body) to satisfy needs. When this doesn't happen, anxiety occurs.

Answer 19

In a psychoanalytic family therapy, the term **introjects** really means that the client unconsciously internalizes the positive and negative characteristic of their objects into themselves. Eventually these introjects (taking in personality attributes of others that become part of your own self-image) determine how the person will relate to others

Answer 20

Splitting occurs when the client sees an object (another person) as either all good or all bad. Splitting allows one to keep anxiety in check by making objects predictable. This tendency begins in childhood, usually by categorizing one's mother as all good or all bad. It could be expressed in therapy as seeing the therapist as all good or all bad. Removing dysfunctional introjects from childhood is curative.

Answer 21

* **First-order change** can be described as changes hat are superficial – behavioral changes occur but the organization or structure of the system do not change. First-order change often ameliorates symptoms but the changes are often temporary * **second-order change** is when the actual family structure changes in a way that altered and undesireable pattern of behavior. Second order change is more desirable than first order change.

Answer 22

A **greek chorus** refers to a consultant or supervisory team that observes a session from behind a one-way mirror and sends messages to the therapist or the family. This so-called treatment team approach is very popular with strategic therapists. The counselor may accept or reject notions put forth via the Greek chorus.

Answer 23

This was previously labeled dysthymia but was updated in the DSM-5 to refer to a low-level chronic depression that occurs for more days than not, for two years or more.

Answer 24

James Framo and Robin Skynner are both famous psychoanalytic family therapists. * **Framo** believes that important objects (usually parents) often fuel “love-hate” feelings in kids. The more pathological the early life experiences are the more that person as an adult will make all relationships fit the internal “love-hate” scenario from childhood * **Skynner** is a British psychoanalyst who feels that kids who had poor role models as children possess **protective systems**. This means that such individuals harbor unrealistic expectations of people in current relationships carried over from childhood.

Answer 25

Cloe Madanes and Jay Haley are associated with the strategic family therapy, also known as the **MRI approach**. In this paradigm, the therapist gives directives or prescriptions, often paradoxical. **Reframing** and **relableing** problems is comon in this modality. This approach warns us that d**ouble-bind communication** could cause serious psychopathology. More focused on techniques for change than theoretical constructs. Less concerned with changing family structure or hierchy than focusing on the faulty cycles of interaction that are set into motion by misguided attempts to solve problems. Lots of focus on **circular causality, feedback loops, homeostasis** and **cybernetics.**

Answer 26

* Strategic therapy is pragmatic and often focuses on abating symptoms - it is very action-oriented and solution/symptom focused * Haley believed in giving clients directives (I.e. “if. your daughter threatens suicide this week, I want the entire family to stay home and nobody leaves for the day”) * Used paradoxical concepts like: * **double-bind concept** (a paradoxical directive - saying both to do and not do something) * **prescribing the symptom -** I,e. telling a smoker to go smoke a bunch * **restraining -** warning the family or individual about the negative consequences of change * **positioning -** when a helper accepts the client's predicament and exaggerates it * **relabeling -** also called **redefining** and **reframing** - this is when you redefine a situation in positive context to make the situation or behavior seem acceptable to the client. The situation is described in a positive light to evoke a different emotional response. * Believed that a malfunctioning hierarchy is evident in most dysfunctional families – I.e. the **perverse triangle** (when two members are different hierarchical levels team up against a 3rd member) * Assets that a symptom controls a situation when everything else has failed. Symptoms are sometimes viewed as a metaphor for a difficulty being expressed by another family member * Also sometimes known as the **MRI model** or the **communication model**

Answer 27

This is a no-win situation characterized by contradictory messages such as “never smoke again” (in example, this is told using hypnosis) and “smoke as much as you want”. It constitutes a paradox in the sense that the person is told he or she can engage in a behavior that they wish to abide. Although it is used therapeutically, Gregory Bateson believed that when parents repeatedly double-bind children it could result in schizophrenia. This is considered both a **paradoxical intervention** and a **directive.** One of the reasons why this works is because when a person follows a paradoxical directive, the symptoms are under therapeutic control - I.e. the client could say, “you hypnotized me and I smoked 5 cigarettes after the session” and the therapist would say, “of course you didm I told you to smoke as many as you could”. Essentially, the helper prescribes what the client or family would probably do anyway and tells them to exaggerate it. This is known as **prescribing the symptom**

Answer 28

Haley believed the person with the power in the family has the authority to make rules and enforce them. and he believed that you enhance the power of a family member within the context of therapy by speaking to him or her first during the initial session of therapy.

Answer 29

* Cloe Madanes believes in the concept that symptoms serve a function - I.e. a child sees her mom is depressed so throws a glass cup on the floor, which brings her mother out of the depressed state and makes her angry and powerful * This is also an example of **incongruous hierarchy.** In normal family hierarchy, the mother controls the daughter but in this case, since the daughter is in control, the hierarchy is incongruous. * She believed that one of the keys to family functioning is to help children find more direct ways to help their parents so that their symptoms (I.e. throwing a cup) no longer serve a viable purpose * Advocated somewhat paradoxical pretend techniques

Answer 30

Madanes used a pretending technique in which the family enacts a make-believe scenario of the problem (I.e. a child who has panic attacks pretends to have one during the session and the parents pretend to help him). Most experts maintain that the pretend technique is more gentle and less confrontational than traditional paradoxical interventions.

Answer 31

In restraining, the therapist may warn the family or individual about the negative consequences of change. The counselor might tell the family to take it very slow or expect a relapse. Restraining helps overcome resistance by suggesting that it might be best if the family does not change!

Answer 32

Positioning occurs when a helper accepts the client's predicament and then exaggerates the situation. Positioning paints an even more negative picture of the situation for the client than **restraining** (warning the family or individual about the negative consequences of change). The strategic interventions of restraining, positioning, prescribing the symptom, and relabeling are all examples of paradoxical interventions since they defy common sense.

Answer 33

This is associated with Albert Ellis's REBT. In REBT the primary goal is to dispute and change the client's cognitions. In behavioral dispute, the client tries to behave in a way that is markedly different from his normal, though undesirable, pattern.

Answer 34

This is when a counselor imposes goals from his or her own culture on people from another culture. This is a no-go in counseling.

Answer 35

* Fewer African American people are getting married * African American people are less likely to be concerned about gender roles (I.e. both men and women cook meals, work outside the home, etc)

Answer 36

Bowen's family therapy, Minuchin's structural therapy, or Haley's strategic therapy. Several studies indicate that African American families are less likely to seek professional treatment because they often rely on the extended family and the church for support and guidance. When family counseling is utilized, problem-focused, brief, or multigenerational approaches seem to fare best.

Answer 37

Solution-focused/problem-focused modalities.

Answer 38

* Asian Americans might be mentally healthier than the general population (8.6% had mental health symptoms compared to 17.9% for the population at large) * Those with a DSM diagnosis were less likely to seek treatment (34.1% for Asian Americans vs. 41.1% for the general population)

Answer 39

* They have a higher unemployment rate than the national average and often live in poverty. They earn high school diplomas and college degrees less than the national average. * Latnix people often expect mental health treatment to mimic treatment they receive from their medical doctors, so short-term behavioral family therapy or structural approaches work well

Answer 40

Cohesion refers to the level of emotional bonding between family members, as well as the family's level of enmeshment or disengagement.

Answer 41

The **circumplex family model,** created by Olson, Sprenkle, and Russell, suggests that family functioning can be described in two dimensions: * **cohesion -** the family's level of emotional bonding between family members * **adaptability** - the family's balance between stability and change or, in other words, between morphostatis and morphogenesis) They believed that the key factor is that the family should have balance in both cohesion and adaptability.

Answer 42

* They are a very diverse group, belonging to over 550 state-recognized tribes * extended family and the tribe are very important * A high percentage of children are placed in foster care homes, residential facilities, and non-Native adoption homes * Have significant issues with both alcoholism andsuidiced. Suicide is the leading cause of death among Native Americans/Alaska Natives between 10-34 and alcohol is involved in 69% of the suicides for all age brackets in this cultural groups. The high rates of suicide and alcoholism create issues with suicide bereavement, fetal alcoholism, and cirrhosis of the liver

Answer 43

* One of the primary goals of intergenerational family therapy is **differentiation** - that one can separate one's intellect from one's emotional self * Believed in the phenomenon of **triangulation -** When a dyad having problems puts a third person in the middle to try to reduce stress on the dyad * Used **genograms** as a therapy tool – believed they must go back at least 3 generations. * Is concerned with the **nuclear family emotional system** (family's emotional system is influenced by previous generations)

Answer 44

Bowen's concept of intergenerational family therapy asserts the phenomenon of **triangulation:** That when a dyad is under stress, a third person is recruited to help stabilize the difficulty between the original dyad. This could even be a child placed in the middle of the conflict. This rarely helps the situation and typically makes the situation between the original pair worse.

Answer 45

Bowen understood **differentiation** as ability to be in emotional contact with others yet still autonomous in one’s own emotional functioning. **Fusion**, the opposite of **differentiation**, occurs when individual choices are set aside in service of achieving harmony in the system. A person who does not possess differentiation does not have a clear sense of the self and others.

Answer 46

This is concept that although the current family in therapy has an emotional system, this emotional system is influenced by previous generations, whether they are alive or dead. Bowen originally referred to the nuclear family emotional process as an “undifferentiated family ego mass” since families with difficulties display a high degree of fusion.

Answer 47

* Salvador Minuchin is the founder of action-oriented structural family therapy. This approach posits that an individual's behavior can be interrupted by analyzing family interaction. A change in the family's patterns of communication and interaction must occur to create a healthy family. * Used **joining** and **mimesis** (copying the family's style) to help the family accept him as a helper * Uses **enactment** to allow the family to see an instant replay of what transpires in the family * Like **strategic therapy (Haley),** uses **relabeling** and **reframing** * Believed health requires clear **boundaries (**the physical and psychological entities that separate individuals and subsystems from others in the family) that should be firm yet flexible

Answer 48

This is a brief-therapy technique in which the therapist asks “suppose one night there was a miracle and this problem was solved. How would. you know? what would be different?"

Answer 49

The therapist meets, greets, and attempts to bond with the family. The therapist will use language similar to that of the family and **mimesis** which means that he or she will mimic communication patterns. Joining occurs during the initial session to boost the family's confidence in the treatment process and reduce resistance. In subsequent sessions, the therapist will challenge the dysfunctional communication patterns and the structure of the family.

Answer 50

This is a strategy that allows the counselor to see an instant replay of what genuinely transpires in a family (I.e. “okay, I want you to play like you are at home and act out precisely what transpires when the subject of your daughter's boyfriend is mentioned”).

Answer 51

Minuchin – and the structural therapists - understand boundaries as the physical and psychological entities that separate individuals and their subsystems from others in the family. When structural therapists attempt to help the family create healthy boundaries, this is known as **changing boundaries** or the **boundary marking** technique. In this technique, the family seating is often altered and family members are placed at a different distance from each other. Types of boundaries: * **clear boundaries** are considered healthy and refer to boundaries that are firm yet flexible. When boundaries are clear, persons in the family are supported and nurtured BUT each has the freedom to be his or her own person (I.e. to **individuate**) * **rigid boundaries** are characterized by individuals or subsystems being **disengaged**. When people are disengaged (I.e. a wife and husband in which the wife brings up a problem and the husband says “your on your own, I have my own problems”), they will often seek support outside the family system. * **diffuse boundaries** often manifest with the “I devote my life to my children mentality” (I.e. a mom who wants to accompany her 20 year old daughter on a date). He believes that if the spousal subsystem becomes obsessed with parenting, the child will be afraid to experiment and could mature slowly. This child will have trouble making friends outside of the home. And then, when such individuals get married, they rely far too much on their family of origin and may not feel comfortable when they are alone.

Answer 52

* Bowen * Andrew Salter

Answer 53

Boszormenyi-Nagy is a Hungarian analytically-trained psychiatrist who discusses the importance of give-and-take fairness or **relational ethics** in a family. According to the notion of **relational ethics,** a healthy family can negotiate imbalances and preserve a senes of fairness and accountability. He also introduced the term **family legacy** which refers to expectations handed down from generation to generation. He is also known for his **family ledger** technique. The ledger is a multigenerational balance sheet or accounting system that outlines who gave what to whom and who owes what to whom.

Answer 54

**Murray Bowen** is the primary systematic family therapist and he believed individuals are inseparable from their network of relationships. He believed in an intergenerational concept of therapy and change. **Strategic family therapy (Cloe Madanes and Jay Haley)** is another form of systemaic family therapy. They examine family processes and functions, such as communication or problem-solving patterns, by evaluating family behavior outside the therapy session. Therapeutic techniques may include reframing or redefining a problem scenario or using paradoxical interventions to create the desired change. Strategic family therapists believe change can occur rapidly, without intensive analysis of the source of the problem. **Structural family therapy**, designed by **Salvador Minuchin**, looks at family relationships, behaviors, and patterns as they are exhibited within the therapy session in order to evaluate the structure of the family. Employing activities such as role play in session, therapists also examine subsystems within the family structure, such as parental or sibling subsystems.

Answer 55

Disengagement is often defined as an isolated lack of connectedness between family members – I.e. a family member who is emotionally distant.

Answer 56

The **perverse triangle** is a situation when two members who are at different levels of the family hierarchy (usually a parent and a child) team up against another family member. The alliance between the parent and the child might be overt or covert. In any event, the alliance against the other parent undermines his or her power and authority.

Answer 57

Adler opened over 30 child guidance clinics in Vienna in the 1920s that were later eliminated by the Nazis in 1934. These clinics would often perform **open forum therapy** in which Adler worked with the family as well as the open forum audience.

Answer 58

* Solution-oriented therapy focuses primarily on the future and puts little or no emphasis on understanding the problem * the therapist's verbalizations center on the future and the therapist co-formulates a plan of action with the client or family, though there may be more than one appropriate course of action * Noteable solution-oriented therapy theorists/practitioners include **William O'Hanlon, Insoo Kim Berg, Steve de Shazer,** and **Michelle Weiner Davis**

Answer 59

Narrative therapy highlights stories in counseling and is in a new category of treatment known as **postmodernism** or **constructivism** * Clients come up with a story about their lives and they can reauthor these stories in therapy – reality is invented or constructed, it is not objective * Associated with the work of **Michael White,** his wife **Cheryl White,** and **David Epston** who believe that every country and culture espouses a **social narrative**. Social narratives dictate what a family ought to be like * In narrative therapy, the therapist asks questions or uses language to externalize the problem (separate the problem from the person). The therapist teams up with the family to take on the “enemy” (the problem). Thus, a therapist working with a family w/an abusive spouse might say to the abuser, “I know you want to put an end to this violence. Tell me about a time when you stopped a violent episode that keeps you from being the loving husband you want to be”

Answer 60

**Constructivism** or **social constructivism** asserts that a client constructs or invents the way he or she perceives the word. **Narrative therapy** fits into the category of constructivism. The theory stresses that therapy should be less hierarchical - the helper does not treat the client. Instead, the client and therapist have a conversation to work together in a collaborative way. Constructivism is not really a unified therapy based on a single individual theorists but is associated with people like Tom Anderson and the Whites and Epston, etc.

Answer 61

* Anderson's **postmodern** method uses a one-way mirror and a reflecting team * He discovered his technique when he asked a family if they'd like to hear what the team was saying about them. The family said “yes". * The family and the family therapist listen as the **reflecting team** discuss the case and then the therapist processes the family's reaction to the team's observations. * A number of schools of family therapy have now incorporated this technique.

Answer 62

* **Postmodernism assumes that there are no fixed truths in the world, only people's individual perceptions of what constitutes reality or the truth.**

Answer 63

* Feminist counselors often note that a psychological difficulty can be located in the environment or the political system rather than in the person. (I.e. a woman who is depressed because her partner beats her). (also called **gender-fair counseling)** * Feminist therapies are said to be gender-free in the sense that differences between men and women are seen to be the result of socialization * Like the postmodernists, feminist therapists attempt to have an egalitarian relationship w/the client, including avoiding clinical jargon and having a person-centered slant * Often use **bibliotherapy,** appropriate **therapist disclosure,** and **assertiveness training.** * This modality tends to dispute sex-role stereotypes and strive for equality * Feminist therapists are not in agreement whether a man can be a feminist therapist * Often work with male batterers – and ironically, the women's counseling movement has also helped illuminate special issues in counseling men, masculinity, and men's psychology

Answer 64

* Society and parents are more tolerant of girls who adopt masculine behaviors than boys who adopt feminine behaviors * In childhood, girls are often reinforced for showing emotions while boys are not-- instead they are reinforced for physical pursuits and not showing affective/emotional expression * Men are therefore less likely to seek out counseling services and may only do so when experiencing a crisis. * When men do engage in counseling services, their competitiveness can help them work hard to succeed

Answer 65

* They are androcentric (use male views to analyze personality) * They are gender centric (assume that there are two separate psychological developmental patterns - one for men and one for women) * They emphasize hereosexisim and debate same-sex relationships

Answer 66

The term **skeleton keys** refers to a standard or stock intervention that will work for numerous problems.

Answer 67

* Is an **ecosystem approach** – believes that larger systems (I.e. schools, church, health care system, etc) often impact client and family functioning and thus must be taken into account. * Created by Steve de Shazer * Uses techniques like: * **skeleton keys -** standard or stock intervention that will work for numerous problems * **compliment -** therapist hands the client or clients a sheet of paper w/a compliment on it * **past successes -** the therapist may compliment past successes without specifically relating them to current obstacles * Sometimes uses a treatment team behind a one-way mirror but it is not rerquired * often relies on paradox

Answer 68

* The cognitive situation could go against cultural messages * Albert Ellis views dependency as unhealthy and some cultures see interdependence as a positive attribute

Answer 69

**Integrative psychotherapy** is the practice of integrating more than one therapeutic theory - which already seems to happen quite a bit in practice and is becoming increasingly popular and many therapists are eclectic. Two theories about why integrative counseling works: * One idea is that theories of counseling are helpful because they have elements that are common to all approaches. This is called a **common factor approach**. * the idea that regardless of the paradigm there are **common stages of change**

Answer 70

In the **within-subjects design,** each subject acts as his or own control. So for example, if a group of clients were each given a depression inventory, then were given 2 sessions of BST therapy and then given the same depression therapy. Scores were then compared using a *t*-test. This is a less popular approach than the **between groups** design which relies on separate people in the control and experimental groups.

Answer 71

**Pre-experimental design** is when a single group is used in research or when two groups that are not equivalent are used. One type of pre-experimental design is the one-group only posttest design, depicted by **XO.** (The group only receives treatment (X) and a score (O))

Answer 72

Experimental designs are often diagrammed and often use the following abbreviations: * **O -** observation, measurement or score of the dependent variable in the experiment * **X -** treatment (independent variable) * **E -** experimental group * **C -** control group * **R -** random sampling * **NR -** no random sampling of groups. So, for example, you could describe an experiment in which a NR (not randomly sampled) group of clients (E) was given a depression inventory (O), then given two sessions of BST therapy (X), then given another inventory (O) as: * Group: E (experimental group) * Subject assignment: NR (no randomized sampling of the group) * Pretest: O (since a score was accrued * Treatment: X (two sessions of brief-solution oriented therapy * Posttest: O (since another score was accused

Answer 73

A **time-series design** is quasi-experimental design that does not have random chosen control and experimental groups but rather relies on multiple observations of the dependent variable (I.e. the thing you are measuring) before and after the treatment occurs. So this would look something like: O1, O2, O3, X, O4, O5, O6

Answer 74

The **Solomon four-group** is considered a true experimental design because each group is chosen via a random sample. In this design, there are four groups and one control group receives a preset and one experimental group receives a pretest, while the other control group and the other experimental group do not receive a pretest. This design helps weed out the impact of a pretest.

Answer 75

Gottman is best known for creating a paradigm to predict which marriages would likely end in divorce. He postulates 6 predictors of divorce: 1. Te marriage got off to a harsh “start up” 2. The relationship is characterized via negativity which includes criticism, contempt, defensiveness, and stonewalling 3. There is flooding in the sense that the negativity comes on suddenly and is overwhelming 4. body language changes, such as a pulse rate of 110-165 5. Attempts to repair the marriage fail 6. a lack of fond memories from early days of the relationship Detractors are quick to point out that Gottman did not rely on true experiments to come up with his theories.

Answer 76

**Dr. Ellen Langer** is known for demonstrating that physical biomarkers of older adults can be reversed if they are placed in an environment from the past and told to act like they are living in the past. When Langer placed 70-80 year old men in an environment commensurate with the one they had lived in 20 years ago and told them to act like it was 20 years earlier, their biomarkers of aging actually went backwards - people even thought they looked younger at the end of this research! Her book, *Counter Clockwise*, has become a classic in the mindfulness movement.

Answer 77

**Propinquity** is another word for the “**mere exposure effect**”, indicating that the more you are around a person, the greater the liklikehood you will become attracted to them. Emerging research suggests this is even true, though to a lesser degree, for virtual relationships.

Answer 78

The **constructivist** and **cognitive** approaches. Career experts wonder if traditional theories are applicable now since the majority of theories were based on research using white middle-class males which is hardly representative of the work market today.

Answer 79

* The **TWA career counseling model** was created by **Rene V Dawis** and **Lloyd Lofquist.** * TWA stands for **Theory of Work Adjustment** * The theory posits that the person must fit the job – I.e. there must be a high correspondence or congruence between the individual and the work. It also says that the work must meet the needs of the person. Essentially, the relationship works both ways. this is called the **PEC** or **Person environment correspondence** * Higher work satisfaction generally results in greater productivity and that work adjustment is basically the match between the expectations of the employee and the expectations of the place he or she is working * Tests are routinely used to assess one's work personality, abilities and needs * One criticism is that the theory doesn't take into account that both the individual and the work environment change over time. *

Answer 80

Increasing. When the economy goes into a recession, young adults can't afford to live on their own and live with parents. And as people live longer, older people are incapable of caring for themselves. Note that the number of single adults are also increasing.

Answer 81

You square the correlation coefficient. So if the correlation coefficient is .70, your coefficient of determination (aka **variance**) would be 49%

Answer 82

You would subtract the coefficient of determination from 100. So if you have a coefficient of determination (aka **true common variance)** of 36%, your coefficient of non determination would be 64%.

Answer 83

Krumboltz's theory of career development built on the **social learning behvarioristic theory** of **Albert Bandura.** (this is also often referred to as a **cognitive theory** because it emphasizes believes that clients have about themselves as well as the world of work). Krumboltz insists that learning, not interests, guides people into a certain occupation. and changes of interest (hence jobs) occur due to learning. This theory notes that career decisions are influenced by: * genetic endowment and special abilities (I.e. a certain physique) * environmental conditions and events (I.e. a government policy or earthquake) * instrumental learning (I.e positive reinforcement for solving math problems) and/or association learning (I.e. a client wants to go to med school because everyone loves her uncle who's a doctor)

Answer 84

When Krumbholtz refers to **self-observation generalizations,** he really means that in career counseling, your primary concern is the manner in which people view themselves and their ability to perform in an occupation. He also felt **worldview generalizations,** generalizations regarding a given occupation and how successful the client would be in the occupation, are important.

Answer 85

**SCCT** stands for **Social Cognitive Career Theory,** which asserts that self-efficacy beliefs can influence one's career decisions. A woman, for example, may have excellent math skills but might not consider the field because she believes women aren't as good at math as men. **Self-efficacy** is essentially the question of “can I really do this and what will happen if I try to do this?”

Answer 86

* **Linear** approaches are **noninteractive** (like reading a book, hearing a speech, watching a video, etc) – the client has some control over the process. * **Nonlinear** approaches are **interactive** (like visiting a business, interviewing a worker, computer-based guidance system). Interactive approaches are often more expensive and reduce the influence or control the client has over the process.

Answer 87

Bonfenbrenner is credited with creating the theory of human ecology. Note that this is a developmental theory that is **NOT a stage theory.** Before Bronfenbrenner, people from different fields studied their fields but not how they all interacted together. His theory stresses the way the following systems work together: * **microsystem** - any immediate or close relationships or organizations the child interacts with * **mesosystem -** the way Microsystems work together, like family and school * **exosystem** - the school, church, neighborhood, parents' places of employment - places the child interacts with but not as often * **macrosystem -** the largest and most remote system including culture, wars, federal government, customs

Answer 88

On an IQ test, the standard deviation is 15. So someone in the 84th percentile, would be about one standard deviation above the mean (100) so would have an IQ of about 115.

Answer 89

The z-score is the same as standard deviation. So someone who scored two standard deviations below the mean would have a z-score of -2.

Answer 90

**VRT** or **Virtual reality therapy** is a type of high-tech therapy the is useful for phobias. Clients are hooked to a computer by wearing a VR headset and the computer simulates a real-life situation that stimulates the phobia. The client experiencing the virtual environment generally has the same physiological symptoms as he would in the actual situation. Initial research on VRT shows it was as effective as exposure to the actual stimuli.

Answer 91

* IQ score of 70 or below on an **individually administered IQ test** * Onset of the condition prior to age 18 * Client's ability to adapt to normal life in school, work, or family is also impaired Note that training can raise IQ scores.

Answer 92

Daniel Goleman would assert that EQ is more important than IQ. **EQ** would encompass traits like empathy, impulse control, motivation, and the ability to love. Goleman wrote a book saying that EQ, not IQ, determines success.

Answer 93

An interval scale MUST operate based on time (I.e. if a slot machine paid out every 20 minutes, it would be fixed interval). In actuality, a slot machine is a variable ratio scale – it pays out after a certain number of turns but that number carries.

Answer 94

Behavior therapies based on classical conditioning are commonly used to treat phobias but are also utilized for clients with OCD. One of the most popular forms of behavior therapy based on classical conditioning, **Wolpe's systematic desensitization,** is based on Pavlov's classical conditioning and is an excellent for phobic clients in both individual and group therapy.

Answer 95

In psychometrics, the **Barnum Effect** (which can also be called the **Forer Effect)** refers to the fact that clients will often accept a general psychological test report, horoscope, or palm reading and believe that it applies specifically to them.

Answer 96

Neuroscience has shown that cognitive therapy can raise serotonin in the brain, just like antidepressants.

Answer 97

This is the process of generating new neurons. Learning, such as counseling, chess, solitaire, etc, all generate neurons in older adults.

Answer 98

Research shows that when tryptophan is removed from the diet, memory, anxiety, sleep, and mood all go south and aggression rises.

Answer 99

The left hemisphere is dominant in over 95% of the population. Damage to the left hemisphere often results in issues with the right side of the body.

Answer 100

In order to diagnose a **somatic system disorder (SSD),** the client must have a physical exam for the diagnosis to be valid - and that exam must show no physiological basis or medical condition to explain his reaction. The key factor is that emotional factors can cause somatic complaints and health concerns.

Answer 101

* **situationally bound panic attacks** (also known as **cued panic attacks) -** panic attacks that have a cue or an environmental trigger * **uncured** or **unexpected panic attacks -** panic attacks that seemingly occur out of nowhere and no internal or external trigger can be identified. Women experience panic attacks more frequently than men.

Answer 102

In any **dissociative disorder**, the client attempts to avoid stress by dissociating from the situation. In the case of **dissociative identity disorder (DID)** the client has often been sexually abused as a child. counseling can be useful in integrating the personality into a single entity.

Answer 103

**RS** in this case mean “religious and spiritual”.

Answer 104

**Binge eating disorder (BED)** is the most common type of eating disorder. Clients with BED often eat alone and eat very rapidly, often to the point of pain even if they are not hungry.

Answer 105

**Intersexuality** describes an individual with male and female sexual characteristics and possibly male and female internal or external sex organs.

Answer 106

Parametric statistics are used when the distribution is normal and random sampling has been utilized (parametric curves = bell curve). Note that parametric designs use interval and ratio data while nonparametric designs use nominal and ordinal data.

Answer 107

Yes, but unauthorized staff should not be allowed to listen to or retrieve messages. Some other ethical notes about phone usage: * never tell a caller whether or not a client is receiving services * anyone you say to a client over the phone could end up in court * be careful about leaving personal messages for clients on their answering machines * When using a cell phone, remember the call could be monitored by a third party * Same precautions apply to text

Answer 108

* **progress notes** are mandated by law. Also referred to as **clinical notes.** Progress notes are behavioral and focus on what the client does and says. Progress notes could include something about informed consent, assessment procedures or tests used, the client's DSM diagnosis, symptoms, the type of counseling interventions used, the goals of counseling, progress, ROI issues, dates of sessions, and termination dates * **Process notes** are also sometimes called **psychotherapy notes** are not generally shared with clients or made available to them. Process notes are kept separate, are not required by law, and are intended just for the counselor who created them.

Answer 109

No – and it is also unethical. Research has shown that conversion or reparative therapy intended to change someone's sexual attraction not only doesn't work but can actually harm clients.

Answer 110

A therapist must have a transfer plan in the case in which a counselor becomes disabled, dies, or moves to another state. The transfer plan should be set up to protect the welfare of the client as well as his or her files. If the therapist is incapacitated, leaves the practice, or dies, the clients will have access to their records as well as their files. All counselors should include a transfer plan in their informed consent document given to the client at the beginning of treatment, listing the new contact person and custodian of the records, with complete contact info. **The new contact person should contact each client when he receives the record.** Note that it is also preferable to use a **mental health professional** as this new contact person.

Answer 111

According to ACA ethical guidelines, a counselor could refrain from making a diagnosis if it is in the best interest of the client. That said, a decision to refrain from making a diagnosis is ideally made in collaboration with the client - though the counselor has final say.

Answer 112

The ACA says a counselor can decide not to diagnose a client if it may harm the client or others. You could handle this by: * meeting w/supervisor and executive director to figure out how to get funding for the ct w/o a diagnosis * advocate for the client by explaining the situation to the insurance company and teach the client to advocate for herself by having her inform her insurance company that a diagnosis might not be in her best interest * Show supervisor, ED, insurance company, etc the actual ACA code of ethics – counselors are responsible to educating insurance companies, agencies, managed care firms, etc

Answer 113

**ABA (applied behavior analysis)** is basically the new terminology for behavior modification. An ABA counselor might do things like VR reinforcement, FR reinforcement (fixed ratio), and thinning.

Answer 114

**ABA (applied behavior analysis)** is basically the new terminology for behavior modification. An ABA counselor might do things like VR reinforcement, FR reinforcement (fixed ratio), and thinning.

Answer 115

These are terms associated with **EMDR. EM =** eye movement and **REM** = rapid eye movement. EMDR attempts to produced REM/EM during the course of the sessions.

Answer 116

**IS PATH WARM** is a pneumonic device created by the American Association of Suicidology to help people assess the risk of suicide. It stands for: * **I -** ideation * **S -** substance abuse * **P -** purposelessness * **A -** anxiety * **T -** trapped * **H -** hopelessness * **W =** withdrawal * **A =** anger * **R =** recklessness * **M -** mood changes

Answer 117

**Child-centered play therapy (CCPT)** was created by Virginia Mae Axline, an associate of Carl Rogers who penned *Dibs in Search of Self.* CCPT advocates that a therapist should be friendly, warm, and accept the child as he or she is. CCPT does not direct the child's topics of conversation or behavior and recognizes that the process should not be rushed since the child leads and the therapist follows. This approach is also often called **non directive child play therapy** since it has a lot in common with the non directive Rogerian approach.

Answer 118

A children's career counseling group might help the kids have a sense of belonging, share feelings and ideas, and engage in desirable peer interaction.

Answer 119

Yes. Career groups allow members to see that others can also be struggling with similar issues related to work, vocation and career - and that other members of the group are in similar situations. Also, research has shown that group career counseling is more effective than non counselor interventions.

Answer 120

* The group (or workshop) should be structured - structured groups work better than unstructured groups * Group career counseling is more effective than non counselor interventions * special career counseling groups for specific populations work quite well (I.e. displaced homemakers, etc) Group career counseling can be used in any country and is much more cost-effective than individual career counseling.

Answer 121

The main purpose of a career group is to provide information to participants and to help participants explored vocations and enhance their decision-making skills.

Answer 122

Krumbholtz believed that career decision issues are crucial in terms of one's happiness.

Answer 123

* Other clients in the group can help you to rev up your motivation * you get to help other clients and they get to help you * participants can role-play situations like how to answer questions during a job interview

Answer 124

He champions the idea of securing a network of people who can help you with your job search. Bolles is not particularly interested in the existing career counseling theories and is generally a major fan of networking.

Answer 125

**Azrin's job groups are behaviorist** in nature (Azrin studied with BF Skinner). His groups were NOT intended for career exploration – the individual had to have a good idea he wanted to get. Instead, the group was action-oriented and urged the members to forge forward in their job hunting goals (I.e. calling possible job sites, setting up interviews, etc). These groups did provide support but also helped participants build skills and provided networking.

Answer 126

DBT, created by psychologist Martha Linehan, stands for dialectical behavior therapy and is a popular intervention for working with suicidal individuals, clients who are self-abusing, and those with addiction issues. DBT relies on 4 modes: 1. skills training 2. phone counseling 3. therapist consultation team 4. individual treatment When DBT is adapted to a setting where all 4 modes can't be used, it is called **DBT-informed** or **abbreviated DBT-informed practices** (I.e. if a counselor could only do a skills group but not the other stuff). The entire 4-mode treatment is called **standard DBT.**

Answer 127

You could use activities like a game.

Answer 128

**Donald Super's Career rainbow** helps group members answer th question “where have you been in life and where are you going?” The group might examine the clients' roles in life as a child, student, citizen, homemaker/parent, worker, citizen, etc. Super's lines of questioning also open the door to discuss career crises like layoffs.

Answer 129

The concept of plasticity drives home the point that every trait within a given individual can be altered through the course of the lifespan. Change is ongoing and not random.

Answer 130

**Differential sensitivity** refers to the idea that some people are more vulnerable than others to a particular experience due to genetic differences. This arises in many things, including prescription drugs and impact, side effect, etc

Answer 131

You should begin by getting the support of the staff, administration, and clients. Since the agency has nonprofit status, you would also want to get support from the board of directors .

Answer 132

**Program evaluation (PE)** helps agencies, organizations, and centers make wiser decisions. PE takes place in a natural rather than a laboratory or controlled setting and helps programs answer questions posed via staff. Program evaluations help the program and are generally not intended to gear towards hypotheses or theories. Instead, an adept program evaluation answers questions including: * Is this program actually necessary? * If so, which clients should receive the services from the program and for what duration of time? * What are the outcomes of the program? In the majority of cases, stakeholders such as the staff, the board, clients, and administrators pose the questions and conduct the research. Also, best practices are to use existing data whenever possible to keep costs down.

Answer 133

A **cost-benefit analysis (CBA)** answers the question, “was the money wisely spent or does the counseling center need a new program”. Counselors often find it difficult to talk about CBA because it deals with the issues of whether or not it is worth the price to assist people.

Answer 134

The ACA has taken the position that **fee splitting** could be a problem because you might be apt to refer the clients to staff who are paying a greater fee. to the agency rather than assigning clients based on a rotational basis or the competency o the clinicians on staff. **Making referrals based on financial outcomes is not ethical.** However, the owner of a practice could charge each helper a set amount for office use.

Answer 135

**OARS core skills** are part of **Motivational interviewing (MI)** created mainly by **William Miller and Stephen Rollnick.** Motivational interviewing is particularly popular in use for addictions. Motivational Interviewing is considered to be a more goal-oriented offshoot of Rogerian counseling and is a brief form of therapy often implemented in 5 sessions or less. **OARS** stands for: * **O**pen questions (I.e. how is your gambling addiction impacting your life?) * **A**ffirmations (any positive factors the counselor sees in the client's life like awards, achievements, successes, etc) * **R**eflection * **S**ummaries

Answer 136

1. **Engaging** - first creating a relationship with the client. In MI the counselor is intended to be a partner vs. the expert. 2. **Focusing -** this means that the conversation should be limited to the patterns of behavior the client wishes to change 3. **Evoking -** stresses the client should use his or her own motivation to make change 4. **planning -** the act of creating a smart measurable plan that works The MI change must come from the client and not an outside source. The client must overcome his ambivalence towards change (I.e. I guess I could give up smoking but then I might gain weight). Aggressive confrontation, advice giving, and persuasion are not part of the MI process - and thus MI should not be confused with traditional brief therapy.

Answer 137

Yalom believes that most therapists are afraid of their own mortality and avoid the topic of death. He is convinced that we are all hardwired to have anxiety about death. Nevertheless when it crosses over to terror and immobilizes our life it is not healthy. He believes life can be richer by keeping death in mind. He uses the example that cancer patients faced with death would sometimes comment that they were sort they waited so long to learn how to live

Answer 138

The **effect size (es)** is a correlation/association between variables x and y. Basically, it shows how big the difference between two groups is (vs. just the results of an experiment which tell if there is a difference at all) * A small association is .2 or less * A medium association is .5 or less * a large/strong/big association is .8 or higher In a true experiment that is statistically significant and rejects the null hypothesis, you must still provide an ES statistic because it is important to find out how large/strong the effect is. So if the ES was 3.15, the difference between the means of the two groups is very high so there is a VERY large effect. Essentially, the **ES helps us analyze the magnitude of the differences when looking at correlations, tests of significance, or even a meta analysis.**

Answer 139

This study revealed that psychotherapy had a strong effect, checking in at an .85 ES.

Answer 140

Yes. It is a sirodered and is listed with substance-related and addictive disorders.

Answer 141

Online. Cyberbullying is more common and can take place via unwanted text messages or internet posts with negative or hurtful information. Some research, however, reveals that sibling bullying is a more common variety of school bullying.

Answer 142

Wildnerness therapy, a subset of adventure-based therapy, relies on trained staff and well-established theories of psychology, counseling, and change. It is NOT bootcamp therapy. Effective wilderness therapy settings use little or no source, confrontation, or point level systems. Some programs send young adults home after the program but others use aftercare centers or treatment-oriented boarding schools.

Answer 143

**Accidental reinforcement** can occur regardless of the behavior. BF Skinner found this when he reinforced pigeons with food for no special reason and found that whatever the pigeon was doing at the time (I.e. pecking, spinning, etc) they tended to repeat in an attempt to cause the food to come. **Contingent reinforcement** is what happens most of the time we use reinforcement: it is dependent on a given behavior. I.e. your dog knows that you give a treat (a reinforcer) when she comes to the door after you call her.

Answer 144

* Men commit suicide more than women * women suffer from depression more than men * Alcoholism occurs more in men than in women * Autism occurs more in men than in women

Answer 145

**Attribution theories** assign a cause, explanation, or reason for a behavior or outcome of an event. When the cause or outcome is generated by the person, it is a **dispositional** or **internal attribution** (I.e. Melissa flunked the exam because she didn't study). When the cause is attributed to factors outside the individuals, this is **situational** or **external attribution** (I.e. Melissa flunked the exam because the department created a test so hard no one could pass it).

Answer 146

A **fundamental attribution error** (also called a **fundamental attribution bias**) occurs when a person attempts to look at someone else's negative behavior, failure, or undesirable event and come up with an explanation. The tendency is to put more stock in dispositional explanations (personality, judgement, etc) than situational ones – essentially, the problem is attributed to the person. Most people, however, attribute their own negative outcomes to situational/external things but see other peoples' negative outcomes as dispositional/internal. This is known as the **self-serving bias.**

Answer 147

The **self serving bias** is when people attribute their own negative outcomes to situational/external things but see other peoples' negative outcomes as dispositional/internal. This is known as the **self-serving bias.** Note, however, that someone who is depressed will typically do the opposite and will blame internal factors for failure. Ironically, research shows that depressed people often have a more accurate view of reality.

Answer 148

A **thought record** would likely be a part of **CBT treatment.** CBT, now considered the dominant force in psychotherapy, often uses thought records to help clients see how their thoughts are impacting their lives. The thought record is merely a chart depicting an activating event, the actual thought, the emotional consequence and/or behavior, and an alternative thought or perspective. On rare occasions, the log will also include the new emotional response based on the alternative thought

Answer 149

* **First** **wave** treatments were based on operant and classical conditioning such as the work of BF Skinner and Ivan Pavlov * **Second wave** interventions focused heavily on cognitions depicted by the work of Albert Ellis or Aaron T. Beck * **Third wave** or **contemporary CBT** incorporates DBT, motivational interviewing, and Acceptance and Commitment Therapy (ACT)

Answer 150

The downward arrow technique is highly recommended to ferret out what the client is truly upset about and make the client aware of the issue. The therapist keeps asking the client for the next logical conclusion (I.e. if a client is upset he forgot to buy his wife a birthday gift, would ask, “what's the worst thing that could happen”, then would ask again, and again until getting to the real issue known as the **core belief** of "she might be so upset she divorces me). It's like the nightmare question.

Answer 151

**Classical conditioning** is based on paired learning whereas **operant conditioning** is predicated on rewards or punishment.

Counseling families, diagnosis, neurocounseling, and advanced concepts Flashcards

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