Essay topics Flashcards
Describe the responsiveness of each of the following groups to group therapy approaches: people identifying as Black/African American, Hispanic or Latinx, and Asian American. What are the implications of these perspectives for the counseling process
Black/African American - Moderate engagement. Positive when it aligns with cultural values of community, shared experiences, and resilience. Focuses on empowerment. Potential mistrust toward mental health systems can be a barrier. Stigma around vulnerability can be a barrier as strength is often emphasized.
Hispanic or Latinx - High engagement when group is familial and warm. Strong collectivist values. Respond well to people that feel like an extension of family. Clients may prefer engaging and warm facilitators, bilingual support is essential
Asian American - Lower initial engagement. Due to mental health stigma and preference for privacy. Shame, dishonor, and judgment prevents them from sharing. Collectivism can be an advantage. They have a preference to practical solution focused methods. Prefer psychoeducational groups over open ended emotion based
Implications - Cultural adaption is key to successful therapy. Trust and relationship building matter (especially due to mistrust in the system). Therapist must be culturally competent. Psychoeducation can help reduce stigma. Group structure and focus can be tailored
Define attachment. How does the process of attachment occur? Discuss factors that are important in facilitating attachment. Describe the effects of secure and insecure attachment for early (preadolescence) and later (adolescent and above) development, emphasizing the potential impact of the quality of attachment on the development of psychopathology.
Attachment is the emotional bond between a child and caregiver that influences cognitive, emotional, and relational development.
Attachment is developed through consistent caregiving interactions, typically in the first year of life. Key processes include: Bonding at birth, consistent caregiving (meeting needs), Separation and reunion experiences(how caregivers respond to a child’s distress), exploration vs proximity seeking.
Several factors influence attachment development: caregiver sensitivity, emotional availability parental mental health. Consistency and stability. Cultural influences
Insecure attachment preadolescence: emotional detachment, clingy, fear of caregivers, prefers independence, struggles with self regulation, seeks reassurance
Insecure attachment adolescence: avoids emotional closeness, difficulty expressing emotions, unstable relationships, vulnerability to disorders
Secure attachment pre: strong self esteem, healthy emotional development, strong peer relationships
Secure attachment adolescence: healthy relationships, emotional resiliency, lower risk for anxiety and depression
Describe the purpose of professional documentation, emphasizing why documentation is so important. Discuss the ethical and legal issues associated with professional documentation
Purpose of documentation:
1. Provides accurate record of history, assessments, treatment plans
2. Enhances treatment effectiveness as they can track interventions, measure progress, and adjust if needed
3. Facilitates communication
4. Legal protection
5. Compliance with Legal standards
6. Billing ans reimbursement
Ethical issues in documentation
1. Confidentiality
2. Informed consent
3. Accuracy and Honesty
4. Timeliness
5. Cultural sensitivity
Legal Issues
1. HIPAA
2. Mandatory reporting
3. Subpoenas and court orders
4. Retention policites
5. Electronic record keeping
The use of diagnostic statistical manuals offers both strengths and weaknesses for the assessment and treatment of clients. Discuss three strengths and three weaknesses, including suggestions to overcoming the weaknesses
Strengths
1. Standardization of Diagnosis
2. Facilitates research and evidence based practice
3. Supports insurance and reimbursement and treatment access
Weaknesses
1. Over pathologizing normal behavior
2. Cultural bias
3. Limited focus on individual differences
Discuss the three main parental discipline styles (Authoritative, Authoritarian, and Permissive) described by Diana Baumrind. What factors affect which parenting style is seen in a family, and what are the possible consequences of each style on the child and family?
Factors influencing parenting styles
1. Cultural influences
2. Parental upbringing
3. Social economic status
4. Child temperament
5. Parental stress and mental health
Eric Johnson, an 8-year-old, African American boy, is a client of yours who is experiencing significant behavior problems in school. You want to refer him to a school psychologist to assess his cognitive functioning because you are concerned that he may have a learning disability. Ms. Johnson is concerned because she has heard that “those tests” are biased against minority students. What can you tell her to facilitate her support of the testing?
- Acknowledge her concerns
- Explain the purpose of the assessment
- Address potential bias concerns
- Highlight the benefits of accurate identification
- Emphasize collaboration and family involvement
- Offer alternatives if necessary
Compare and contrast 1st, 2nd, and 3rd generation behavior therapies. Provide examples of therapies from each generation.
1st generation
1. Based on classical and operant conditioning
2. Key features are behavioral principles and emphasis on learning
3.Effective for observable problems but often neglects internal processes
4. Overly simplistic
EX: systematic desensitization, token economy
2nd
1. Integration of cognitive principles and thought patterns
2. Key features are cognitive restructuring and self-regulation
3. Holistic approach, more flexible and adaptable
4. Can overlook deeper emotional issues
EX: CBT REBT
3rd
1. Emphasizing acceptance, mindfulness, and psychological flexibility
2. Emphasizes contextual factors
3. Holistic and flexible
EX: ACT and DBT
Even though using diagnostic labels for psychological disorders is extremely common, discuss three ethical factors one ought to consider in the use of diagnostic labels. What are some ways in which diagnoses can also be useful?
Ethical factors
1. Stigmatization and social consequences
2. Overpathologizing and medicalization of normal behavior
3. Identify formation through diagnosis
Usefulness
1. Facilitates communication among professionals
2. Helps guide treatment planning
3. Access to resources and accommodations
What are the developmental functions of peer groups in children and adolescents?
- Social skills development
- Identity formation and self-concept
- Emotional support and belonging
- Social norms and conformity
- Development of autonomy and independence
- Moral and ethical development
- Risk taking and exploration
- Cognitive and academic development
- Cultural and social learning
Distinguish between the components of personality and the components of personality disorder. Additionally, why is psychotherapy so often ineffective in treating personality disorders?
Components of personality
1. Traits
2. Self concept
3. Behavioral patterns
4. Emotional regulation
Personality disorder
1. Enduring maladaptive traits
2. Distorted thinking patterns
3. Difficulty in relationships
4. Impairment in functioning
Why is psychotherapy often ineffective for personality disorders
1. Long standing ingrained patterns
2. Limited insight and awareness
3. Therapeutic relationship challenges
4. Emotional dysregulation
5. Resistence to change
6. Cooccuring mental health issues
7. Lack of structures treatment approaches
You are counseling/assessing Darrell, a 13-year-old boy who is depressed and falling behind at school. You learn that he is struggling with issues related to his sexual orientation. He recognizes that he has sexual feelings towards other men and is confused and anxious about this. You are the first person to whom he has mentioned this. Describe the process of coming out and how you might best help him navigate this process.
The process of coming out refers to recognizing, accepting, and sharing one’s sexual orientation or gender identity with others. For Darrell, a 13-year-old experiencing confusion and anxiety about his attraction to men, this process can be emotionally challenging. As a counselor, it is important to provide a safe, affirming, and supportive space to help him navigate this experience.
- Understanding the coming out process
- Create a safe and affirming space
- Address anxiety and emotional well being
- Help him explore supportive resources
- Guide him through disclosure
- Address family and cultural concerns
- Empower self acceptance
The Jones family is referred for treatment because their 9-year-old daughter has been acting out at school. During the intake, you learn that Mr. Jones, who has been the primary breadwinner, has been unemployed for the past 8 months. Ms. Jones works out of the home, but her income just barely covers rent, food, and gas. What are the effects unemployment that you are likely to see in this family?
Unemployment can have significant emotional, financial, and relational impacts on families, especially when it has persisted for several months, as in the case of Mr. Jones. In the scenario you described, there are likely to be a range of psychological and practical consequences for both the Jones family as a whole and for individual family members. These effects may manifest in behavioral, emotional, and interpersonal ways. Here are some of the potential impacts you might expect to see
- Increased family stress and tension
- Emotional and behavioral effects on daughter (increased anxiety, acting out from unresolved emotions), distracted at school, feelings of insecurity)
- Social and relational effects – withdrawal, shame
- Possible impacts on parenting (reduced parent attention and supervison)
- Increased risk of psychopathology
Describe ways in which religion and psychology are compatible and then discuss the view that psychology and religion are disconnected. In what ways is religiosity positively correlated with mental health? In what situations might religiosity be associated with poor mental health?
Compatible
1. Shared Focus on Well-being and Mental Health
2. Spirituality as a Source of Strength
3. Psychology and Religious Coping Mechanisms
Disconnect
1. Different Methods and Goals
2. The Focus on Evidence-Based Practices
3. Potential Conflicts with Therapeutic Approaches
Positive correlations
1. Increased coping and resilience
2. Social support and community
3. Healthy lifestyle choices
4. Reduction in stress and anxiety
Negative correlations
1. Religious struggles and guilt
2. Shame or fear
3. Psychological inflexibility
4. Exclusion or discrimination
R. is a professional in your field who espouses a strong individualistic perspective. What kind of difficulties are they likely to face when dealing with clients with a different cultural outlook? What can they do to enhance their effectiveness with a broader range of clients?
Difficulties
1.Misunderstanding the role of the group
2.Lack of sensitivity to cultural norms
3.Challenges in building trust and rapport
4.Possible conflicts in therapy goals and treatment
Enhance
1. Cultivate cultural awareness
2. Adopt a flexible culturally responsive approach
3. Build rapport with patience and respect
4. Explore client’s values
Pick two of the stages/statuses identified in the R/CID (formerly MID) and describe the characteristics of someone who is at that level of racial identity development. What are the implications of these two identity statuses for this individual working with (1) a professional of their own race and (2) a professional who is White.
- Conformity Stage
Characteristics: Individuals at this stage have internalized the values and beliefs of the dominant (often White) culture. They may devalue their own racial or cultural background, believing that the dominant culture’s standards are superior. There is often a preference for White professionals, institutions, and ways of thinking, along with negative stereotypes about their own racial group. They may experience low racial self-esteem and seek validation from the dominant culture.
Implications for Counseling:
With a Professional of Their Own Race:
oThe client may view the professional as less competent due to internalized bias against their own racial group. They may resist discussions about racism or cultural identity. The professional may need to gently challenge internalized negative beliefs while fostering a positive racial identity
With a White Professional:
oThe client may feel more comfortable and validate the therapist’s perspective, potentially seeing them as more competent. The therapist may inadvertently reinforce internalized racism if they are unaware of the client’s racial identity struggles. A White professional can help by encouraging critical self-reflection and validating the client’s cultural background.
- Immersion-Emersion Stage
Characteristics: Individuals at this stage have rejected the dominant White culture and embraced their own racial or cultural identity with intensity. They often experience anger and resentment toward White individuals and institutions. There is a strong sense of racial pride, sometimes leading to an idealization of one’s racial group while rejecting diversity within it. The person may be highly invested in learning about racial oppression and activism.
Implications for Counseling:
With a Professional of Their Own Race:
o If the therapist shares a similar racial identity, the client may feel a strong sense of connection and trust. If the therapist does not match the client’s level of racial identity exploration, there may be tension or frustration. The therapist should validate the client’s feelings while helping them navigate anger and integrate a more balanced perspective.
With a White Professional:
oThe client may feel distrustful or resistant, seeing the therapist as a representative of the oppressive system. Therapy may focus on building trust, acknowledging systemic racism, and validating the client’s racial experiences. A White therapist should practice cultural humility, avoid defensiveness, and focus on active listening
Define the 4 D’s associated with abnormal behavior and their relationship to the DSM and diagnosis. Provide a clinical example of abnormal behavior consistent with each
- Deviance
Definition: Deviance refers to behaviors, thoughts, or emotions that are considered statistically unusual or outside the cultural norms for a given society. These behaviors deviate from what is commonly expected or accepted.
DSM and Diagnosis: Deviant behavior is considered in the diagnosis of certain mental health disorders, though it is not always sufficient on its own.
Clinical Example: A person engaging in compulsive hoarding (keeping excessive amounts of items like newspapers, clothes, or trash) to the extent that their home becomes unlivable. - Distress
Definition: Distress involves emotional suffering or discomfort experienced by the individual or those around them.
DSM and Diagnosis: The DSM includes distress as a significant factor in diagnosing mental disorders.
Clinical Example:
A person with major depressive disorder feels overwhelming sadness, loss of interest in daily activities, and significant emotional pain. These feelings of distress interfere with their ability to function in life and are indicative of the disorder. - Dysfunction
Definition: Dysfunction refers to impaired functioning in various areas of life, such as work, social relationships, or daily living. It is a disruption of the normal ability to perform essential tasks or engage with others effectively.
DSM and Diagnosis: Dysfunction is a key diagnostic criterion in many mental health conditions. The DSM requires evidence of functional impairment for most diagnoses (e.g., in work, school, or social environments).
Clinical Example: A person with social anxiety disorder may experience severe difficulty engaging in everyday interactions, such as avoiding work meetings, fearing public speaking, and withdrawing from social events. The dysfunction impairs their professional and personal relationships. - Danger
Definition: Danger refers to behaviors that may pose a risk of harm to the individual or others. This may include self-harm, suicidal behaviors, or actions that threaten the safety and well-being of others.
DSM and Diagnosis: Danger is a critical factor in emergency situations and risk assessments. While danger itself is not always part of every diagnosis, behaviors that threaten safety are often considered in the evaluation process.
Clinical Example: A person with borderline personality disorder may engage in self-harming behaviors, such as cutting, as a way to cope with emotional pain. In more extreme cases, this could include suicidal ideation or attempts.
What are the strengths and weaknesses of punishment? How does this particularly relate to the use of punishment as a primary means of changing behavior?
Strengths
Immediate behavior reduction
Established clear boundaries
Increased awareness of consequences
Weaknesses
Emotional and psychological harm
Does not teach alternative behaviors
Potential reinforcement of negative behaviors – attention
Creates a negative relationship
While punishment can reduce problematic behaviors, it is generally not recommended as the primary means of behavior change, especially in therapy. Here’s why:
1. Behavior Change Without Understanding
- Over-reliance on Punishment: Relying solely on punishment can lead to behavioral suppression, where the person may not exhibit the undesired behavior, but the root causes or emotional triggers of that behavior remain unaddressed
- Ineffectiveness Over Time: Punishment alone may lose effectiveness over time, particularly if it’s not applied consistently or if the person becomes desensitized to it. Without a system of positive reinforcement to encourage alternative behaviors.
Key components of a consent to treat form
Key Components of a Consent to Treatment Form and Why They Are Important:
1. Description of Services: Outlines the nature and scope of therapy so that clients understand what to expect from treatment. This helps avoid misunderstandings and ensures clients are fully informed.
2. Voluntary Participation: Affirms that the client can terminate treatment at any time, emphasizing the autonomy of the client and ensuring they feel comfortable with their treatment choices.
3. Confidentiality: Clearly explains the limits of confidentiality, which is critical for establishing trust between the therapist and client. It is important for clients to understand that certain exceptions to confidentiality exist, such as in cases of harm to self or others.
4. Risks and Benefits: Outlines the potential discomforts and challenges of therapy, as well as the benefits. Clients need to be aware of both aspects to make informed decisions about proceeding with therapy.
5. Fees and Payment: Discusses the financial aspect of treatment, ensuring transparency and preventing confusion or financial strain. Clients need to understand what their financial obligations are from the outset.
6. Treatment Alternatives: Reminds clients that other treatment options are available, which helps clients feel more empowered and informed about their choices.
7. Emergency Procedures: Provides clients with critical resources in the event of an emergency, showing the therapist’s commitment to their safety even outside of therapy hours.
By providing this information, the therapist helps clients make informed decisions, establishes clear expectations for the therapeutic process, and protects both the therapist and client in the event of legal or ethical issues. It also promotes a positive and trusting therapeutic relationship
Discuss the major racial identities and help-seeking attitudes you may encounter with people identifying as Black/African American, Hispanic or Latinx, and Asian American. What are the implications of each of these for the counseling process?
African American
Racial identity = systemic racism, community, religion
Help seeking attitudes = stigma about mental health, sign of weakness, distrust in the system, preference to African American counselors
Hispanic/Latin x
Racial identity = range of ethnicities, immigration statuses, emphasis on family, acculturation
Help seeking attitudes = stigmatized to be familial, spiritual, etc. high reliance on support systems, language barriers and immigration status prevents help seeking
Asian American
Racial identity = unique traditions, collectivist, academic values, family honor, emotional restraint
Help seeking attitudes = help seeking seen as dishonorable or shameful, preference to problem solving/ goal oriented approaches
Discuss similarities and differences between Freud’s, Erikson’s and Piaget’s developmental theories.
Similarities Across Freud, Erikson, and Piaget
Stage-Based Development – All three theorists propose that development occurs in distinct stages, with each stage building upon the previous one.
Sequential Progression – Each theory suggests that individuals must progress through stages in a fixed order.
Influence of Early Experiences – Freud and Erikson emphasize the significance of early childhood experiences, while Piaget highlights the importance of early cognitive development.
Universal Development – All three suggest that development follows a predictable sequence, though the focus of their stages differs (psychosexual, psychosocial, or cognitive).
Internal and External Influences – Freud and Erikson emphasize the role of both internal drives and external social factors, while Piaget focuses primarily on internal cognitive processes.
Describe the association between mental disorders and violence. Include a discussion of how mental disorders may or may not be a risk factor for violence (as perpetrator or victim) and what other factors may supersede or interact with mental disorders in predicting violence.
Mental Disorders as a risk factor
1. Psychotic disorders (Schizophrenia) -Individuals experiencing paranoia, delusions, or command hallucinations may exhibit violent behavior, but this is relatively rare - higher risk if untreated
2. Mania (in bipolar disorder) can lead to impulsive or aggressive behaviors
3. Personality Disorders - Antisocial Personality Disorder (APD) is one of the strongest predictors of violent behavior due to traits like impulsivity, lack of remorse, and disregard for others. Borderline Personality Disorder (BPD) may involve self-directed aggression more than outward violence
4. Substance use - probably the strongest indicator
Several non-psychiatric factors play a more significant role in violence than mental illness itself: substance use, history of violence, environment and social factors, personality traits and impulsivity, situational stressors
People with mental illnesses are more likely to be victims of violence than perpetrators. Studies suggest that individuals with severe mental illnesses are 2-10 times more likely to be victims of violence compared to the general population. Factors contributing to this include homelessness, substance abuse, poverty, and social isolation.
Distinguish between the sympathetic and the parasympathetic divisions of the autonomic nervous system. For each division, provide an example of a situation in which the division would become active. Describe the effects on several bodily processes of the activity of each division.
The sympathetic nervous system helps the body respond to stressors by increasing alertness and energy output, while the parasympathetic nervous system restores calm and supports routine bodily functions. Both systems work together to maintain balance in the body, activating in response to different situations.
Describe the processes of classical and operant conditioning. How do these processes apply to the development and maintenance of anxiety or fear-based behaviors? What are the implications of these processes for treatment?
Mowrer’s Two-Factor Theory of Fear and Avoidance Learning provides insight into how anxiety disorders develop and persist. It explains conditions such as phobias, PTSD, OCD, and social anxiety disorder by combining classical conditioning (fear acquisition) and operant conditioning (fear maintenance through avoidance)
Mowrer proposed that fear and avoidance behaviors are learned through two processes:
- Classical Conditioning (Fear Acquisition)
o A neutral stimulus (NS) becomes associated with a frightening event (unconditioned stimulus, US).
o Example: A person gets bitten by a dog (US), leading to pain and fear (unconditioned response, UR). The dog (NS) becomes a conditioned stimulus (CS), causing fear (conditioned response, CR) whenever the person sees a dog.
2.Operant Conditioning (Fear Maintenance)
o Avoidance of the feared stimulus is negatively reinforced because it reduces anxiety.
o Example: The person avoids dogs, which lowers their fear temporarily. This reinforces avoidance behavior, making the fear persist.
Since classical and operant conditioning play a major role in anxiety disorders, treatments often involve breaking these associations through evidence-based interventions.
1. Exposure Therapy (Classical Conditioning) - Gradual exposure to feared stimuli (e.g., riding an elevator in small steps). Extinction of fear responses by preventing avoidance.
Systematic desensitization – pairing feared stimuli with relaxation techniques.
- Cognitive-Behavioral Therapy (Operant Conditioning) - Identifying and modifying avoidance behaviors that reinforce anxiety. Reinforcing positive coping strategies instead of avoidance.
Challenging irrational beliefs that maintain fear responses
