Exam 2: Feminist theory, Behavioral therapy, CBT Flashcards
feminist theory of counseling
integrative model of psychotherapy practice informed by feminist political philosophies and analysis ⇒ range of political, ideological, etc. movement
components of feminist counseling (2 main + 5)
- The person is political
- Egalitarian therapeutic relationship
- Emerged from grassroots movements ⇒ no single founder for this
- Grounded in multicultural feminist scholarship
- Attention on power dynamic in and outside therapy
- aims to find equality ⇒ therapist and client toward strategies
- Cultural and identity analysis of the client and the therapist
sex definition
the classification of people as male or female based on some biological characteristics
intersex definition
an individual whose combination of chromosomes, hormones, internal and external sex organs, etc. differs from the two traditionally prescribed patterns of male or female (1-2% population)
- Sex is not grounded in biological reality based on our bodies ⇒ range of biological characteristics
gender
socially constructed roles, behaviors, attitudes, and attributes
cisgender and transgender
Cisgender: a person whose gender aligns with their sex assigned at birth
- Assigned male at birth assumption = boy/man
- Assigned female at birth assumption = girl/woman
Transgender: a person who identifies as a gender other than their sex assigned at birth
sexism
system of attitudes, beliefs, and behaviors that devalue women and femininity while privileging men and masculinity ⇒ often discrimination on the basis of sex and gender
- It is a system and operates across all levels of society ⇒ individual, institution, interpersonal, ideological, etc. ⇒ harmful to all people including men
hysteria
first psychiatric disorder believed to arise only in women
- Anxiety, tremors, conversions, madness, etc.
- Has lead to skewed diagnosis for women ⇒ women have been stigmatized in psychology
- Relates to how gender norms have shaped what makes a person healthy or well
- Any deviations from expected norms were considered signs of mental illness ⇒ still happens
where was hysteria believed to come from?
caused by the uterus being contaminated ⇒ i.e could only affect women
- adherence to gender norms
how were institutionalized women analyzed/treated? (2)
- Pathologization of emotions and behaviors were not matching gender norms
- Psychopathology reinforces gender norms and/or sexually inappropriate behavior from men (sexual assault)
historical background of feminist therapy from 60s
consciousness raising groups ⇒ struggles with marginalization
- Not originally designed for therapy but became therapeutic
consciousness according to feminist theory
a marginalized persons awareness that their mistreatment is not because of their personal failings but occurs because they are a member of an oppressed and disenfranchised group(s)
historical background of feminist therapy from 70s
- Aspects of consciousness groups started being infused into traditional modes of therapy
- American Psychological Association (APA) begins to incorporate feminism
- First created a task force which lead to funding of the division of psychology for women
- Women of color were fundamental for this
historical background of feminist therapy from 80s
- Individual feminist therapy became common
- Exclusion of women of color/minority women ⇒ only incorporated white women
- Movement away from androcentric theories - Androcentricity fails to account for the perspective of women
androcentric theories
male centered theories of development and psychology
historical background of feminist therapy from 90s
- Re-focusing on diversity and multiple identities ⇒ calling for addressing broader diversity issues
- Gender and sex are not dichotomous
- No longer only focused on cisgender women ⇒ oppressions in general
modern feminist therapy (and 2 elements)
emphasize importance of diversity, social activism, and attention to interdependence of personal and social identities
1. person is political
2. egalitarian therapeutic relationship
the person is political definition
people’s experience is intrinsically linked to systems of oppression
egalitarian therapeutic relationship definition
focused on relationship between the role of the client and the therapist ⇒ the client is experienced, trustworthy, etc. about their own experiences
how do problems develop in feminist therapy? (2)
- problems develop within interpersonal, social, and economic contexts
- Origin of problems is often outside the individual ⇒ patriarchy, obsession
- Internalization of oppression and or socially prescribed rules of behaviors
distress/dysfunction vs psychopathology
- Feminist therapist avoid diagnosing as much as possible - problems arise when coping strategies are no longer working in the current context
- View symptoms as signs of resistance to experience of oppression and attempts to solve the problems of powerlessness
how does change occur in feminist therapy?
(empowerment)
- Helps clients develop a range of coping skills and behaviors that are freely chosen
- a powerful client knows what they think and thinks critically about their own thoughts about themselves and others ⇒ able to be effective in their lives and relationships with others
- Understand the choices available to them and make decisions that align with their values
- The therapist helps them understand how power functions in their lives ⇒ pathology lies in a cultural social context as well
empowerment definition
assisting clients in recognizing, claiming, and using their personal power to free themselves from the limitations of socialization processes ⇒ gender roles
techniques of feminist therapy? (4)
technically integrative from other theories
1. identify and label social location aka gender role analysis
2. political analysis
3. focus on the clients strengths
4. self disclosure
gender role analysis
- Placing clients concerns in broader context ⇒ allows them to analyze their place in locations
- Helps the client make their choice about what they want to do and how they feel
political analysis
- Direct discussion of how political forces contribute to the clients distress and how someone or even the client might take part in changing the political structures
- Contributes to empowerment because the client sees how they can use their agency to improve society
self disclosure
the therapist uses this appropriately to help contribute to the egalitarian relationship
therapeutic relationship in feminist therapy (3)
- Egalitarian in nature
- Decisions with the client not for the client
- Collaborative; client as expert
- Recognized as individuals that bring their own expertise and knowledge to the relationship - Encouraging
- Therapists encourage clients to free themselves from roles that have been hindering
- Self disclosure - Safe, transparent ⇒ allows for power sharing
roles of the therapist in feminist therapy (3)
- Recognize and address inherent power imbalance
- Educate the client about how power works in relationships
- Take responsibility for maintaining boundaries
- Give the power to the client whenever possible - Earn the clients trust
- Be accessible
strengths of feminist theory (5)
- Acknowledges and normalizes the impact of social forces on mental health and ability to make positive change
- Client as co-expert
- Orientation to social justice
- Multicultural considerations
- therapist always seeks to learn more
weaknesses of feminist therapy (3)
- Difficulty to measure improvement compared to traditional therapies (Lack of empirical research)
- The F-word ⇒ feminism has itself been stigmatized as a word itself; clients may have a reaction about the approach you take
- Can be culturally biased => therapist must be careful not to impose their cultural values on a client
Behavioral therapy components (2)
- insight oriented
- action oriented
insight orientated behavioral therapy (3)
- Emphasis: self awareness and understanding
- Primary medium: verbal interventions
- More attention to the therapeutic relationship and to process, interpretation, and insight
action oriented behavioral therapy (3)
- Emphasis: relief of symptoms (result)
- Primary medium: action with verbal processing
- More attention to objective, scientific behavioral interventions, and outcome measures
underlying principles of behavioral therapy (4)
- behavior is the product of learning
- It can be unlearned and relearned
- clients can change without insight into underlying dynamics and the origins of a psychological problem
- Knowing there is a problem and knowing how to change it are different
behaviorism
the theory that psychology can be objectively studied through observable action
operant conditioning
subject learns behavior by associating it with consequences
- Voluntary behaviors are learned or conditioned through consequences
- Rewards and consequences make up the difference between behaviors
- Some studies shown that punishment can be associated with psychological impacts ⇒ controversy about how to use the principles
when you have positive stimulus and reinforcement what do you get?
add pleasant stimulus to increase/maintain behavior
when you have positive stimulus and punishment what do you get?
add aversive to stimulus to decrease behavior
when you have a negative stimulus and reinforcement what do you get?
Remove aversive stimulus to increase/maintain behavior
when you have a negative stimulus and a punishment what do you get?
Remove pleasant stimulus to decrease behavior
classical conditioning
subjects learn to associate two unrelated stimuli with each other
- Specific responses are learned or conditioned by pairing a specific stimulus with a response
how do problems develop in behavioral therapy? (4)
- maladaptive behaviors are learned through learning processes => Operant conditioning, classical conditioning, being shown the models of the way things work, imitation
- a person does not have skills in their repertoire to handle situations
- Maladaptive behaviors are maintained by one’s environment (contingencies) and oneself
- Contingencies
contingency definition
the pattern of rewards and punishments we receive from our environment
starting points of behavioral therapy (2)
- functional assessment
- ABC model
functional assessment
attempting to determine the contingencies (patterns of reward and or punishment) maintaining problematic behavior
- What function does this behavior serve and how is it useful?
ABC model
Antecedent ⇒ behavior ⇒ consequence
how does change occur in behavioral therapy? (4)
- Identify factors that influence behavior and find out what can be done about the problematic behaviors => the focus is on what to do about it
- Eliminating problematic or maladaptive behaviors
- Learning more effective behaviors
- Encouraging clients to take an active role in the therapeutic process
techniques and application of behavioral therapy (3)
- relaxation training
- skills training
- contingency contracts (token economy)
relaxation training
method for coping with stress and becomes a habitual pattern to increase parasympathetic nervous system ⇒ decreasing sympathetic nervousness
- Progressive muscle relaxation training
- Has been applied to variety of problems from chronic pain to panic disorder
skills training
learning a different repertoire of behaviors so that one can choose
- Helps clients develop/achieve skills in a specific realm ⇒ assertiveness, study skills, social skills, etc.
- May involve direct instruction and coaching, modeling, role playing, assessment, homework assignments
contingency contracts
established with the client for behavior change
- operant conditioning assumptions
- Works well for children or people with severe mental illness due to lack of understanding in context
exposure therapies in behavioral therapies (2)
- flooding
- systematic desensitization
flooding
prolonged and intensive exposure to stimuli that evoke high levels of anxiety, without the opportunity to avoid them
systematic desensitization
brief and graduated exposure to an actual fear situations
- In-vivo desensitization ⇒ something real
- Imaginal desensitization
- Common problems addressed include phobias and panic disorder
what’s the role of the behavioral therapist? (5)
- Consultant, problem solver, educator
- Directive and active (assigns homework)
- Model desirable behavior
- Assessment focused
- Contemporary behavior therapy promotes collaborative through non-egalitarian relationship (Therapist is expert in techniques and client brings knowledge about self and own goals)
role of the client in behavioral therapy (4)
- Active role
- High degree of responsibility and ownership for the counseling work
- Set agenda, come with goals, develop and complete homework assignments
- Must be motivated to change
strengths of behavioral therapy (3)
- Helps clients translate unclear goals into concrete plans of action
- Wide variety of specific techniques
- Strong empirical support for exposure therapies
limitations of behavioral therapy (4)
- Little focus on emotional aspect of clients lives
- Deemphasizes client therapist relationship
- Tends to focus on symptoms rather than underlying causes
- Some clients may find the directive approach imposing
what are the 2 theoretical approaches to cognitive behavioral therapy (CBT)?
- cognitive theory
- behavioral theory
- most used and most widely studied psychotherapy
- The situation and resulting thoughts and emotions will cause client symptoms
what is the cognitive model?
central focus is thinking about our mood and emotional processing as well as physiological responses and behaviors
1. situation or event
2. automatic thought
3. reaction => emotional, physiological, behavioral
extra components of the cognitive model (3)
- the situation need not always be an external event in one’s environment
- Memories, thoughts, and emotions may promote automatic thoughts - thought need not always be represented verbally in people’s minds
- They may show up as images - the automatic thoughts that people experience are not random
- The thoughts come from a source such as past experiences or deeper thoughts
rational emotive behavioral therapy (REBT) (3)
- Albert ellis
- Irrationality of thoughts
- Therapist is highly directive, persuasive, and confrontive
cognitive therapy (CT) (3)
- Aaron beck
- Automatic, problematic thoughts
- Therapist and client collaborate to investigate the client’s thoughts
→ Aaron beck used words that are less strong and pathologically linked=> Recommended therapist to be more collaborative
how do problems develop in CBT? (2)
- psychological problems are based on inaccurate or unhelpful ways of thinking
- Cognitive distortions
- Inaccurate thoughts are not consistent or based on reality
- Unhelpful thoughts can be somewhat accurate but it is not helpful to have them - psychological problems are based (partly) on learnt patterns of unhelpful behaviors
- The problematic thoughts contribute to problematic behaviors a lot
- Problematic thinking contributes to psychological distress
cognitive distortions
systematic errors in thinking
hierarchy of thoughts (3)
- automatic thoughts
- intermediate beliefs
- core beliefs (scheme)
automatic thoughts
thoughts or images that come up automatically or instantaneously in response to events
- occur so quickly they are not recognized by the client
- Impact of the thoughts on emotional and behavioral reaction can go unnoticed
- Some evaluation or judgment on our current situation
intermediate beliefs
anything between automatic thoughts and core beliefs ⇒ rules, attitudes, assumptions
core beliefs (schema)
one’s core belief system about people, events, and the environment
cognitive distortions (9)
- arbitrary inference
- selective abstraction
- overgeneralization
- magnification
-minimization - personalization
- apologized thinking
- mind reading
- fortune telling
arbitrary inference
draw conclusions with no supporting evidence
selective abstraction
selecting attending to negative cues, neglecting the positive or more neutral ones
overgeneralization
taking a localized or specific negative event and applying it globally
magnification
over emphasizing the importance or magnitude of an event
- Overlaps with overgeneralization
minimization
under emphasizing the importance or magnitude of an event
personalization
attributing external events to oneself without evidence supporting a causal connection
all or nothing/polarized thinking
manifests as an inability or unwillingness to see shades of gray
- Black and white thinking
2 components of jumping to conclusions
- mind reading
- fortune telling
mind reading
filling in the gaps of your knowledge by assuming what someone else’s thoughts are
fortune telling
the tendency to make conclusions and predictions based on little to no evidence and hold them as truth
why do people use cognitive distortions?
people try to use these to decrease stress but it is not helpful in the long run because life changes so often
how does change occur in CBT? (3)
- cognitive restructuring
- Start from automatic thoughts because they are easier to identify as they come up in response to situations
- The ultimate goals is to change core beliefs
cognitive restructuring
identifying and changing thoughts that contribute to presenting problems
socratic dialogue
a series of questions designed to help the client uncover the assumptions and evidence that underpin their thoughts
- Helps the client take a more objective perspective
cognitive techniques in CBT (4)
- socratic dialogue
- thought challenging
- downward arrow technique
- dysfunctional thought record
thought challenging
help the clients challenge their maladaptive thinking patterns ⇒ identify what the thoughts are
downward arrow technique
help get the root of your negative thoughts and unhealthy beliefs about yourself
- Ultimate goal is to challenge core beliefs
dysfunctional thought record
a self monitoring method used to assess clients thoughts, feelings, and behaviors of therapy
behavioral techniques in CBT (2)
- hypothesis testing
- homework
hypothesis testing
testing the validity of one’s thoughts and beliefs
homework in CBT
specific activities to be done between therapy sessions
- Thought record, worry time
roles the therapist in CBT (2)
- Active, collaborative
- Structures therapy to focus on identified goals
roles of the client in CBT
- Must be motivated to change
- High degree of responsibility and ownership for counseling/change process
strengths of CBT (5)
- Discourages dependence on counselor
- Teaches new methods for clients to continue after therapy ends
- Concrete and clear ⇒ accessible to most
- Brief and cost effective
- Great deal of research support ⇒ easy to test because of concrete structure
weaknesses of CBT (5)
- Cannot be used effectively with individuals who have severe mental problems or severe cognitive limitations
- Primarily emphasis os on thoughts, emotions are secondary
- Difficult to implement when clients are not motivated
- Danger to impose therapist own philosophy on clients
- Cultural considerations
