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NURS 661 > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

Examples of Expressive Therapy

A

Rituals, Language arts, Visual arts, Drama, dance

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2
Q

What is expressive therapy?

A

Offers support and introspection by looking at negative thoughts and sad mood

Uses arts to look a difficult emotions

Counter conditioning is where the patient perceives safety, nurturing, and acceptance in the session –> fear diminishes

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3
Q

What is supportive therapy

A

Based on the patient’s psychodynamics, strengthen the defenses

More like talk therapy –> not as structured as expressive psychotherapy

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4
Q

Goals of treatment for supportive therapy

A

Strengthen the defense mechanisms that the patient already has

Promote problem-solving

restore adaptive functioning

Provide symptom relief

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5
Q

What is the diathesis-stress model

A

Genetic vulnerability + Nurture as our BDNF forms = how we’ll react to stress

Explains why some people can handle more amounts of stress and others cannot

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6
Q

HPA axis and stress

A

Stress occurs –> hypothalamus goes into overdrive –> produces cortisol

endocrine/nervous/immune systems = stress response

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7
Q

EMDR
- what does it stand for
- what model does it follow

A

Eye Movement Desensitization and Reprocessing

Adaptive information processing model

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8
Q

Psychodynamic therapy change agent

A

classical - insight

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9
Q

psychoanalytic therapy

A

aims to restructure defenses

based on freud

how the unconscious mind influences

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10
Q

Who would use group therapy

A

difficult with anger

lonely, loss, really shy, depression, social anxiety, addictions

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11
Q

Supportive therapy goals

A

therapeutic alliance to help patient

aims to strengthen defenses, promote problem solving

improve self-esteem to cope with life stressors

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12
Q

Who would use supportive therapy

A

learning how to live alone (widow),

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13
Q

Who would use Trauma Focused Cognitive Behavioral Therapy

A

people dealing with the negative effects of trauma

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14
Q

Who would use psychoanalytic therapy

A

abusive relationship - can’t remember that time period

someone who is experiencing repression - ie can’t remember parts of their childhood

repressed memories
nightmares

because it looks at how the unconscious mind can influence us

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15
Q

What are the contraindications of EMDR

A

strabismus and other eye disorders

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16
Q

Which defense mechanism improves empathy, insight, immune function, attention, and emotional regulation?

A

mindfulness

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17
Q

What is reframing

A

Developing a new conceptual or emotional outlook relation to situations experienced, and putting it into another frame which follows the facts or evidence equally well, changing its whole definition. Restarting

Looking at something from a different angle

ie. Looking at a problem as a challenge rather than a defeat

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18
Q

What is the Adaptive Information processing model (AIP)

A

Humans have an inherent information processing system that usually processes experiences to a physiological adaptive state in which information can be taken in and learning can occur. Memory is stored in a way that allows for connection with other adaptive memory networks

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19
Q

What disorders use EMDR?

A

Schizophrenia and bipolar disorder

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20
Q

Function of acetylcholine

and where the tracts are

A

Decrease levels is associated with memory and cognitive impairments. An increase is associated with Alzheimer’s disease

present in cholinergic track - extending from the limbic structure to the cortex

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21
Q

Function of cortisol

-and r/t PTSD

A

Stress hormone, inhibits inflammatory

PTSD - chronically lower cortisol

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22
Q

Function of dopamine

A

responsible for motor action and the reward system. Too much may change mood, increase motor behavior, and disturb frontal lobe functioning, resulting in depression, memory impairment, and apathy. Too little-parkinson’s/EPS symptoms; Too much-hallucinations

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23
Q

Function of Gaba

A

Calming neurotransmitter;
- too much-sedation
- too little: anxiety

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24
Q

Glutamate

A

Excitatory neurotransmitter involved in memory. Can cause problems with ACH if dysfunctional. Too much agitate neurons and can be toxic

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25
Q

What is the defense mechanism? Ex: Anger and hostility are transformed into pain and somatic complaints

A

Hypochondria

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26
Q

What is the defense mechanism? Ex: Identification with the aggressor through which the person becomes aggressive to gain control

Unconscious adoption of other people’s thoughts and or traits

A

introjection

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27
Q

What is the defense mechanism? Avoiding, no social engagement

A

isolation

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28
Q

What is the defense mechanism? Ex: a child begins wetting the bed after a sibling is born

A

Regression

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29
Q

What is the defense mechanism? Ex: Instead of feeling sad, a person gets drunk

A

Acting out

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30
Q

What is the defense mechanism? Ex: The child cannot remember her anger or hitting her mother

A

Repression

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31
Q

What is the bilateral and unilateral approach of EMDR

A

Bilateral –> activation of both sides of brain –> use bilateral stimulation of sight and touch (tappers)

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32
Q

Neuroplasticity

A

brains ability to adapt

chronic stress decreases neuroplasticity

having good self coping skills helps the brain process change and adapt

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33
Q

Serotonin

A

helps calm you down and makes you happy

main NT in depression –> Rx SSRI

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34
Q

What type of assessment question is this? How many drinks did you have? Do you smoke? Are you anxious or depressed?

A

Closed-ended questions

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35
Q

What type of assessment question is this? You must have been so hurt by that. That is very frustrating. It is hard to lose someone you love.

A

Empathetic statement

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36
Q

What type of assessment question is this? Tell me about your family situation. Try to describe how you felt when…. Share with me what you think a good outcome would be

A

Gentle command

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37
Q

What type of assessment question is this? How have you been sleeping? How is school going?

A

Qualitative questions

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38
Q

What type of assessment question is this? Can you describe the depressive symptoms? Can you tell me anything more about that?

A

Swing questions

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39
Q

The following is an example of which type of interpersonal style: “I try to change other people too much”

A

Domineering

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40
Q

The following is an example of which type of interpersonal style: “It’s hard for me to stay out of other people’s business”

A

Intrusive

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41
Q

The following is an example of which type of interpersonal style: “I put other people’s needs before my own”

A

Overly nuturing

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42
Q

The following is an example of which type of interpersonal style: “I fight with other people too much”

A

Vindictive

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43
Q

What is the change agent of classical psychodynmic therapy?

A

Insight

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44
Q

What is relational psychodynamic therapy

A

better understand how your mind, body, and interpersonal life

Therapeutic alliance

relieve your emotional pain a

discover how your unconscious mind creates problems for you

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45
Q

What is the change agent for relational psychodynamic therapy

A

mindfulness

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46
Q

Which type of therapy would be recommended for people who suffer from grief, substance abuse, and addiction?

A

group

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47
Q

Which therapy for patients with mature defenses

A

psychoanalytic therapy

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48
Q

Which therapy for someone with trust issues or primitive defenses

A

supportive therapy

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49
Q

Which therapy for PTSD

A

trauma focused CBT

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50
Q

Which defense mechanism involves behaving in such a way, that subtle interpersonal pressure is placed on the therapist to take on dimensions of an experience or unconsciously identify with aspects of the patient?

A person projects qualities of themselves that are not acceptable onto another individual and that person internalizes those qualities

ie. Sam is feeling self-conscious because he gained weight but can’t accept it so he convinces himself that Mike has actually gained weight.

A

projective identification

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51
Q

Which defense mechanism is the following example: A young aggressive and impulsive man pursues a career as a boxing coach?

Socially unacceptable qualities are transformed into something socially acceptable.

A

Sublimation

52
Q

Which defense mechanism refers to the patient’s thoughts, feelings, and behaviors that are associated with early important relationships with caretakers and significant others that are felt toward the therapist?

A

transference

53
Q

What are atypical patient responses to EMDR?

A

increased anxiety, dizziness, lightheadedness, fatigue, numbing, and nightmares

54
Q

What part of the brain is affected by EMDR?

A

Hippocampus gets bigger and increased inhibition of the amygdala

55
Q

Affirming statement

A

This must be difficult for you

56
Q

EMDR procedures

A

8 steps:
1. Hx taking
—- s/s, life constraints, screening

  1. client preparation
    —- establish therapeutic alliance, educate about EMDR, practice safe space
  2. assessing the memory target
    —- patient identifies, assigns value
  3. processing the memory target
    —- Desensitization - bilat stimuli
  4. Installation
    —- Install PC
  5. Body Scan
    —- note tension and sensation in body
  6. Closure
    —- keep log, educate about distrubances
  7. Evaluating treatment results
57
Q

What is OARS associate with?
What does OARS stand for?

A
  • motivational interviewing

O: Open-ended questions
A: Affirmation
R: Reflection
S: Summarizing

58
Q

OARS: Engagement

A

getting to know patient, estabilsihing trust

59
Q

OARS: Evoking

A

Eliciting motivation for a specific change

60
Q

OARS: Focusing

A

Guiding interaction to identify a direction of change

61
Q

OARS: Planning

A

Planning a specific change strategy

62
Q

What is cognitive restructuring?

A
  • Strategy used to help retrain the thinking
  • May be helpful to use a thought diary
  • Start the “stinking thinking”
  • Change those negative into positive thoughts
63
Q

Social Skills Training

A
  • Helpful to introduce self and help people make eye contact and feel comfortable
  • Identify socially acceptable boundaries
64
Q

What diagnosis is social skills training beneficial

A
  • Beneficial for patients with Autism, schizophrenia

—– Have so much going on in their minds that they aren’t paying attention to social cues or social skills

65
Q

Shame attacking exercises

A

When people are afraid of doing something in public –> give them exercise to do in public and hopefully help them to realize its not as bad as they think

66
Q

Eating disorders - key risk factors

A

OCD traits

low self esteem
distorted body image
adolescents
females

67
Q

OCD - describe

A
  • Feel like they have to depend on themselves to see that things get done
  • Run a very tight, strict, regimen in the home
  • Overboard on rules, systems, and orders
68
Q

Defense mechanism: no it’s not true, I don’t’ hate you, I just love you so so much

A young boy bullies a girl because he likes her

A

Reaction formation

69
Q

Defense mechanism: I am not selfish. You are the one that always betrays me,

run into someone you don’t like – but are nice to them

A

Projection

70
Q

reflects feelings that the therapist has toward the patient and is similar in some respects to transference

A

countertransference

71
Q

What style: Its hard for me to be assertive with another person

A

Non-assertive

72
Q

Interpersonal therapy
- adolescents

A

Reduced sessions for adolescents (12 sessions)
– helps them recognize feelings, improve communication, enhance socialization

 Also minimal use of the “sick role”
 Addition of parents to treatment
 Highly effective for depression

73
Q

Interpersonal therapy
- goals
- example

A

 Assess the problem – identify problem and the area of interpersonal relationships that it is effecting
 Active treatment – delineation of specific goals for the identified problem area, create new relational patterns, discuss events between session as they relate to the identified problem area
 Termination – finishing treatment, grieve loss of therapist and discuss relapse prevention

Example = patients that struggle with addiction is to stop the addiction/stop using drugs

74
Q

Psychodynamic Therapy: general

A
  • self-awareness and the influence of the past on present behavior
  • emotions not just behavior
  • communication and relationship with others
75
Q

Psychodynamic therapy motivation: classic and relational

A

classic - drives; sex and agression

relational - emotional communication and affect regulation

76
Q

CAGE

A

USE: identify alcohol abuse/dependence

QUESTIONS:
* Have you ever tried to Cut down on your drinking?
* Have people ever Annoyed you by criticizing your drinking?
* Have you ever felt bad or Guilty about your drinking?
* Have you ever had a drink first thing in the morning as an Eye-opener, to steady your nerves or get rid of a hangover?

77
Q

What is Socratic dialogue?

A

Mutual discovery in which the therapist asks a series of questions to help the patient discover the issue themselves

78
Q

What are the steps of cognitive restructuring?

A
  1. Tune in - self-monitoring
  2. Question Assumptions
  3. Gather evidence: keep the thought diary
  4. Perform Cost-benefit analysis
  5. Generate alternatives - stop them and change them to positive words
79
Q

Attunement

A

recognizes other’s emotions and is able to read social cues

80
Q

Egocentrism

A

inability to differentiate b/w self and others. “All about me” (especially in teens and kids)

81
Q

Minimizing

A

Downplaying the significance of an event or emotion; common strategy in dealing with feelings of guilt

82
Q

Erikson’s: Infant

A

Infant (-18 mo)
– Trust vs Mistrust
– Psychosis, addictions, depression

83
Q

Erickson’s: Early Childhood (18mo - 3 yo)

A

– Autonomy vs Self dought

– Paranoia, obsessions, compulsions, impulsivity

84
Q

Late childhood (3-6)

A

– Initiative vs. guilt

– Conversion disorder, phobias, psychosomatic disorder

85
Q

Erickson’s: School age (6-12)

A

– Industry vs inferiority
– Inertia, creative inhibition

86
Q

Adolescent (12-20)

A

– Identity vs role confusion

– Delinquency, gender-related identity disorders, borderline psychotic episodes

87
Q

Young adult (20-30)

A

– Intimacy vs isolation
– Schizoid personality

88
Q

Adulthood (30-65)

A

– Generativity vs stagnation

– Midlife crisis, premature invalidism

89
Q

Older adult (65 - death)

A

– Ego integrity vs despair

– Extreme alienation, despair

90
Q

Gestalt Therapy
- Goal

A

– Goal: assist the patient in returning to natural state of organismic self-regulation

91
Q

Gestalt Therapy
- Cycle of retroflection

A

Turning back onto self what is meant for someone else. Instead of engaging with the environment and directing energy outward, energy is redirected inward.

Examples: biting one’s lip, self-harm, symptoms of depression and psychophysiological disorder

92
Q

Contraindications of EMDR

A

Strabismus, seizures… And possibly nightmares??

93
Q

Signs that EMDR is working

A

Better emotional regulation, positive self-belief, increased self-esteem, and getting better sleep

94
Q

Steps of cognitive restructuring

A

Situation, feeling, and evaluate thought

And decision

95
Q

What therapy for borderline personality

A

DBT or psychoanalytic/psychodynamic

96
Q

What is interpersonal therapy focused on

A

Relationships

Bad breakup and end up with depression

97
Q

What therapy for panic disorder

A

Psychodynamic

98
Q

What therapy for MDD

A

CBT

99
Q

Freud’s stages: Birth - 1 yr

A

Oral stage

main interaction through mouth

  • rooting reflex, sucking reflex, tasting,eating
  • establish trust
100
Q

Freud’s stages: 1 - 3 yr

A

Anal stage

controlling bladder and bowel movements

  • potty training
  • learn independance
101
Q

Freud’s stages: 3 - 6 yr

A

Phallic stage

primary focus is genitals

  • discover differences between males and females
  • boys begin to view their fathers as rivals for mom’s affection
  • Oedipus complex
102
Q

Oedipus complex

A

unconscious sexual desire for the parent of the opposite sex and wish to exclude the parent of the same sex

103
Q

Freud’s stages: 6 - puberty

A

Latent stage

sexual feelings are inactive

  • super ego continues to develop while Id is suppressed
  • develop social skills, values, and relationships with peers and adults outside of family
104
Q

Freud’s stages: puberty - death

A

Genital stage

  • maturing sexual interest
  • interest in the welfare of others
105
Q

Amygdala

A

mediates: fear, anger, and rage

hypersensitive = irritability, anger, hypervigilance, exaggerated startle response in PTSD

106
Q

Cohesion

A

sense of belonging, solidarity, and attractiveness

107
Q

Egocentrism

A

tendency of young children to think that everyone sees things in the same way as the child

108
Q

Hippocampus

A

midbrain

  • memory
  • inhibition of amygdala
  • allows coherent narrative about personal history (what happened when and where so explicit memory can weave an autobiography.)
109
Q

Hypothalamus

A

-regulates BP, body temp, sleep, appetite, glucose lvls and ANS

110
Q

Cognitive distortion: emotional reasoning

A

Because I feel inadequate I am inadequtate

111
Q

Cognitive distortion: personalization

A

That comment must have been directed towards me

112
Q

Cognitive distortion: Global labeling

A

everything I do turns out wrong

113
Q

Cognitive distortion: Catastrophizing

A

If I go to the party it will be a disaster

114
Q

Cognitive distortion: Overgeneralization

A

Everything always goes wrong for me.

115
Q

Cognitive distortion: Control Fallacies

A

If I’m not in complete control all the time, I will go out of control

116
Q

Cognitive distortion: Objectifying the subjective

A

I have to be funny to be liked. It is a fact.

117
Q

Cognitive distortion: Selective abstraction

A

All of the good men are taken or are gay.

118
Q

Cognitive distortion: Fallacy of worrying

A

If I worry about it enough, it will be resolved.

119
Q

Cognitive distortion: Ostritch technique

A

If I ignore it, maybe it will go away.

120
Q

Overdeterminism

A

Refers to the idea that a problem most often has many different causes.

The patient may not be able to provide a full description of these contributions and most likely is unaware of the multiple reasons for the current symptom

121
Q

Resilience

A

ability to cope

122
Q

Thalamus

A

above brainstem

  • relay station for top-down bottom-up neural networks that connect the cortex to the limbic system
  • PTSD: decreased thalamic activity
  • Dysregulation can result in significant memory issues

—- may lead to flashbacks, nightmares, avoidance, dissociation

123
Q

Retroflection

A

doing to oneself what one wanted to have done to oneself by others

124
Q

Why use motivational interviewing?

A

Help individuals resolve
ambivalence and plan for change

It can be used alone to increase motivation for engaging in
psychotherapy or in combination with other forms of therapy when resistance is encountered.

125
Q

Narcissistic Personality Disorder
- what is it
- what therapy

A
  • Consider themselves special &
    expect special treatment; sense
    of entitlement is striking; handle
    criticism poorly; want own way;
    frequently ambitious to achieve
    fortune & fame; relationships
    are tenuous

psychoanalytic
DBT

lithium

antidepressants

126
Q

OCD
- what is it
- what therapy

A

Preoccupied with rules,
regulations, orderliness,
neatness, details & achievement
of perfection

CBT, Group

Clonazepam; Clomipramine;
fluoxetine 60-80mg;
Nefazodone

127
Q
A

NURS 661 (5 decks)

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