Counselling knowledge and application Flashcards
What are the 3 main skills that comprise active listening
- Empathic responding
- Reflection and summarisation
- Questioning
What is empathic responding
Accurately idnetifying and reflecting back to clients what they might be feeling to allow clients to understand their own emotional reactions more fully as well as feeling understood and validated by the clinician
What is a check out?
Am I hearing you correctly? Is that right?
What is reflection and summarisation
Involves reflecting back content by summarising and clarifying the content of what someone is saying
What is the purpose of relfections and summarisations
To encourage clients to elaborate on their expereinces, make them feel understood and give them the opportunity to correct the psychologist
What is an open question
A question that gives the client to tlka more freely using words like what could how would why
What is a closed question
A question that leads to one word answers
What are some ways of monitoring progress
- Client observation
- Outcome measures
- Assessment of behaviour, thought and emotional changes
What is the therapeutic relationship
The rapport and trust a psychologist builds with their client
What does rogers person centred therapy emphasise
The need to be congruent and geniune, empathic, non-judgemental, unconditional positive reagrd, attention, a collaborative relationship, respect
What are some styles you could adopt in therapy
- Directive
- Non-directive
- Collaborative
What are the advantages of a collaborative appproach
client feels a greater sense of self-efficacy
How can you deal with resistance in therapy
Gently discuss and acknowledge resistance and ambivalence
what are the 3 R’s of therapy
- Resistance
- Ruptures
- Reenactments
What is a rupture in the therapeutic alliance
Misunderstanding or interpersonal conflict between the therapist and client
What is a re-enactment
When a client acts out a problem or interaction in therapy that is occuring in their wider life
What is resistance
Slowing the rate of change in therapy
Why does resistance occur
An indiviual may feel one’s personal freedom is being threatened or they may be amibvalent about being in therapy
What is a case formulation
a conceptualisation of what the client’s core difficulties are, how they developed and how these difficulties are being presented and maintained
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What is the main purpose of CBT
To target irrational or maladaptive cognitive patterns and establish healthy and helpful behavioural patterns
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What happens in cognitive therapy
The client and practitioner collaborate to examine and challenge automatic thoughts, maladaptive assumptions
What are the 3 levels of cognitive distortions
- Automatic thoughts
- Maladaptive assumptions
- Dysfunctional schemas
What takes precednece over insight and understanding in CBT
Reducing symptoms
What type of therapeutic relationship is present in CBT
Collaborative
What is the underlying assumption of CBT
THat cognition influences emotion, behaviour and physical eractions
How does the content of cognition impact emotion and behaviour
By impacting the way we interpet ourselves, others and the world
What is the negative triage in cognitive therapy
A negative view of self, the world and the future
How does the process of cognition impact emotion and behaviour
Cognitive flexibility and being able to switch between processing can be more adaptive. So if you can quickly shift from all or nothing thinking to problem-solving rather than getting stuck in rumination you will feel better and act in a way that is more adaptive
Wha are the 4 general steps of cognitive therapies
- Create a supportive atmosphere
- Use socratic dialogue to draw out beliefs and assumptions and to a more logical conclusion
- Client tests their beliefs and assumptions
- Guide clients to modify thoughts to more adaptive thoughts
What is the event mood thought record
When the client records events along with their moods and thoughts this can then be used to identify automatic thoughts, maladptive assumptions and dysfunctional schemas
How would you challeng catastrophising distortions
Explore what if and worst case scenarios
When do emotions become dysfunctional
When they interfere with adptation and choosing adaptive behaviour
What are some of the cognitive strategies used to regulate emotions
- Labelling emotions
- Distraction from negative aspects of a situation to more neutral positive aspects
- Reappraisal of the meaning of an emotion
- problem solving
What are some maladaptive cognitive strategies to manage emotions
Rumination and thought suppression
What is a behavioural experiment
When a client gathers information which tests the validity of a certain belief or tests a new belief
What are the 5 stages of change
- Pre-contemplation
- Contemplation
- Determination
- Action
- Maintenance
What are some of the techniques of Motivational interviewing
- Giving advice
- Removing barriers
- porviding choice
- Decreasing desirability
- Providing feedback
What are the 3 fundamental components of MI
- Collaboration
- Evocation
- Autonomy
What is evocation
Drawing out fromthe client the motivation to change and helping the client find their own motivation for change
What is autonomy in MI
The client is free to make change or not and are not imposed by the therapist
What are the steps of relapse prevention
- Identify goals
- Identify negative emotions that influence the use of drugs
- Identify relationships in life that enable behaviour
- Problem solve situation that might lead to relapse
What are the 2 approaches of psychoeducation
- Educating the client about their illness
2. Mastering techniques that can be used to manage the condition
What is an advantage of psychoeducation
It enables the client to self-treat outside of therapy and live more independently and adaptively
What format of psychoeducation encourages compliance and a more sustained effort at managing a condition
Family and group formats
What increases the efficacy of psychoeducation
When the clients family is integrated into treatment
What is included in psychoeducation
early symptom detection, adaptive skills like lifestyle regularity
What illness is psychoeducation particularly useful for
psychotic and mood disorders when used with pharmological treatments as well
What therapy is assertiveness training included in
Psychoeducation
What is the basic assumption of behaviour modification
Behaviour is controlled by antecedents and consequences, both appropriate and inappropriate behaviour is learned and changing antecedent and consequences will increase or decrease the associated behaviours
What is a functional analysis
A process of indetifying antecedents and consequences supporting the behaviour to be changed as well as intensity and frequency of the behaviour
What is the ABC method of observation
Identifyin gnad recording antecedents, behaviour and consequences of the behaviour
What are the two main schedules of reinforcment
continuous and intermittent
What is a continuous reinforcer
Somethign that rewards every single production of a target behaviour
What is an intermittent schedul of reinforcment
Reinforcement of a behaviour after a specific number of occurances
When should you use a continuous reinforcer
When a new behaviour is being established
What is the definition of exposure therapy
The modification of a pathological fear structure by providing corrective information incompatible with the fear
What is in vivo exposure
Systematic and gradual confrontation with real life objects and situation
What is imaginal exposure
Vividly imagining the feared situation. The client is instructured to close their eyes and imagine the thoughts feelings and sensations experienced in that situation
What are the 4 main steps of Exposure treatment
- Preparation
- creating of an exposure hierarchy
- initial exposure
- Repeated exposure
What is a SUDS scale
a subjective unit of distress score which ranges from 0 to 100 with 100 meaning creating the greatest level of distress.
What is the SUDS scale used for
It is used to monitor anxiety levels during gradual exposure. Exposure continues until the SUDS scale lowers significantly
When is imaginal exposure most useful
Social anxiety, trauma and OCD
What is interoceptive exposure
When the client deliberately experiences feared phsyical sensations associated with panic like hyperventilating or doing rigurous exercise
How does behaviour activation increase client mood?
By decreasing rumination as the client has a new focus on the various activities tehy will engag ine
What are the 4 steps of behavioural activation
- Monitor current activities
- Develop a list of rewarding activities
- Develop a plan to engage in activities
- Client completes the activity
What is graded task assignment
When the therapist assists the client to break a task into smaller tasks and can be particularly useful when a client is too anxious or depressed to begin engaging in a seemingly complex or demanding task
What is the difference between skils training and psychoeducation
Skills training focuses more on overt behaviour
What are some examples of skills training
Problem solving, anger management, emotional self-regulation, social interactions, stress management, parenting ability, self-care
Is skill straining used in isolation
NO it is deployed as part of a wider therapeutic intervention for example training in mindfulness associated with DBT
What are some of the skills training used in DBT
Mindfulness, interpersonal effectiveness, emotion regulation
What a skills training is used in Anger management
- Relaxation
- Emotional awareness
- Alternative coping strategies
What are some of the skills involved in parent programs
- boundary setting
- Communication
- Emotional self-care
What does radical behaviourism note
The cause of behaviour is found in the environment
What is an alternative cause of behaviour aside from the environment
Internal causes like willpower, desire, drive
What is self-management
A person applies principles of behaviour change to produce a desired behaviour change in themselves
What are common areas for self-management?
Habit changing, living a healthier lifestyle, accomplishing difficult tasks
What should relaxation strategies begin with
A discussion of the benefits and drawback as well as the purpose of the strategy - this should lead to a greater buy in
What is the purpose of relaxation strategies
To provide the client with a rapid reliable and easy to apply means for coping with and moderating anxiety
What does PMR start with
The lower part of the body moving to the upper body
Who is breathing retraining pariticularly useful for
Cliens who hyperventilate when anxious
What is breathing retraining
Clients cup their hands over their mouths and breate into their hands
What are the 3 main characteristics of psychdynamic theory
- Conscious and unconscious drives as determinants of psychological state
- Client practitioner relationship as a key tehrapeutic facotr
- Interpreting patterns of clients expression of emotions and thoughts
What is the role of the therapist in psychodynamic therapy
interpersonal problems
interpret subconscious motivations
How can motivations be detected in psychodynamic therapy
Through defensiveness and reistsance, re-occurence of themes and evasive behaviours
How does Interpersonal Therapy differ from other types of psychodynamic therapy
It focuses more on the client’s psychosocial environment rath than internal expreinces and previous psychosocial environments
How does ITP work
IT alleviates depression by addressing dysfunctional social conditions in the client’s environment and promoting positive interpersonal relations
WHat are teh 3 phases of ITP
- Evaluation of client environment
- Introducing strategies to correct interpersonal problems
- Planning for the end of therapy
What are some of the mechanisms of psychodynamic approach
- Goal setting
- Reality testing
- Confrontation
- Empathic validation
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What are some of the mechanisms of change in IPT
- Enhancing social support
- Decreasing interpersonal stress
- Processing emotions
- Improving interpersonal skills
What is the purpose of family system approaches
To improve marital and couple relationships as well as family dynamics as a part of treating psychological disorders as well as ensuring healthy development in children and adolescents
What are some of the techniques used in family systems interventions
family communication exercises, education about dysfunctional family relationships and how to create a functional family relationship
What is ecological approahces
THis approach extends on family systemsn and looks at a broader array of influences on the developmental course
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What population is the ecological approach specifically useful for
Adolescents
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What is narrative theory
That people organise their reality and self concept into personal narratives and that we can work to heal people through working with these narratives and exploring them
How are questions used in narrative therapy
The therapist uses questions to help generate a new experience through therapy and to help the keep the client as teh central focal point of the therapy process
WHat is the main goal of narrative therapy
Replace maladaptive narratives with preferred aternatives
How can a healthy meaningful narrative be constructed
THrough reinforcing preferred alternatives and externalising problematic stories
Who is narrative particularly useful for an why
Indigenous Australian people because it aligns with the practice of yarning or sharing and handing down information
What is a primary goal of solution focused therapy
set goals, identify strengths to achieve goals
What are some examples of internal and external resources used in solution focused therapy
Internal - reading, exercise, meditation, adjusting expectations, humour and journing
external - supportive people in your environment like partners, family, friends and professional connects, crisis line contacts
