Exam 2 Study Guide Dr.Langston Flashcards
What does EMDR stand for?
Eye Movement Desensitization and Reprocessing
What are the main goals of EMDR therapy? (REMINDER)
Reprocessing of traumatic memories
Eye movements or other bilateral stimulation (BLS)
Memory integration with adaptive networks
Incorporation of past, present, and future
Neurobiological changes (amygdala, hippocampus, prefrontal cortex)
Desensitization to distressing memories
Evidence-based therapy (44+ RCTs and proven efficacy in PTSD with 77-100% remission in 3-6 sessions)
Resolution of PTSD and other disorders
Who helped develop EMDR therapy?
Developed by Dr. Francine Shapiro in the late 1980s.
What are the components of the three-pronged approach in EMDR?
- Earlier life experience
- Present triggers
- Future coping
What does BLS stand for in the context of EMDR?
Bilateral Stimulation
What are the eight phases of EMDR therapy?
- Patient History & Treatment Planning
- Preparation: Establish safety and teach relaxation techniques.
- Assessment: Identify trauma image, NC, PC, VOC, SUD, and body sensations associated to trauma.
- Desensitization: Begin BLS while focusing on traumatic memory.
- Installation: Strengthen PC using BLS.
- Body Scan
- Closure: Ensure patient feels calm before ending session.
- Reevaluation: Reassess progress in next session.
What are differences to look at when deciding between TF-CBT or EMDR?
TF-CBT: Prolonged exposure required, requires direct belief challenging, HW, time intensive, and higher dropout rates
EMDR: Brief exposure through processing, no direct cognitive restructuring, no HW, less time intensive, and lower drop out rates.
What is the MOA of EMDR therapy? (BRAIN)
Bilateral stimulation (BLS) activates both hemispheres.
REM sleep-like processing enhances memory integration.
Amygdala regulation reduces emotional intensity.
Information processing speeds up trauma resolution.(Holding distressing memories while focusing on BLS weakens emotional impact).
Neuroplasticity strengthens adaptive networks.
What are the neurobiological changes associated with EMDR?
- Reduced amygdala activation
- Increased hippocampal volume
- Engagement of the prefrontal cortex
What is the mnemonic that summarizes the therapeutic window in EMDR?
Zero overwhelm – patient must stay within tolerance levels.
Optimally engaged – not too detached, not too hyperaroused.
Navigation – therapist helps patient process distress safely.
Equilibrium – goal is emotional balance and regulation.
What is the goal of the ‘Resilient Zone’ in EMDR?
To maintain emotional balance and regulation; not too hypoaroused or too hyperaroused.
What are stabalization techniques in EMDR? (SAFE)
- Safe Place Exercise
- Affirmations & coping skills
- Focused breathing and mindfulness
- Exercises like the Butterfly Hug
Stabilization is crucial before trauma processing, especially for patients with complex PTSD or dissociation.
What is the significance of the SUD (Subjective Units of Distress) scale in EMDR?
Monitors emotional disturbance on a scale of 0-10. Goal is the reduction of SUD to 0.
What is CBT?
Cognitive Behavioral Therapy. CBT is a structured, evidence-based psychotherapy that helps individuals modify dysfunctional thoughts and behaviors to improve psychological health.
What is the core belief of CBT?
Psychological well-being depends on cognitive adaptation (rational learning from experiences) and functional adaptation
(modifying behaviors to meet life’s demands).
Both thinking (cognitive adaptation) and acting (functional adaptation) work together to help us stay mentally strong and navigate life’s ups and downs.
What mnemonic summarizes the guiding principles of CBT?
Structure (sessions follow a set structure)
Monitoring (patients track thoughts & behaviors through HW/journal)
Active (patients practice skills outside therapy; exposure therapy)
Reality-focused (modifies present-time thoughts)
Targeted (addresses specific issues)
What is the Cognitive Triad in CBT?
- Negative view of self
- Negative view of the world
- Negative view of the future
What is the Thought-Feel-Act loop in CBT?
Thoughts influence feelings, which affect actions.
CBT believes that changing these thoughts leads to improved feelings and adaptive behaviors.
What technique in CBT involves guided questioning to uncover thought patterns?
Socratic Dialogue uses guided questioning to help patients self discover their thought patterns.
Types of questions: Memory, Translation, Interpretation, Application, Analysis, Synthesis, Evaluation.
What is the purpose of the Downward Arrow Technique in CBT?
To uncover core beliefs by repeatedly asking ‘If this is true, then what happens?’
What does the mnemonic ‘DON’T FALL INTO CBT TRAPS’ represent?
- Catastrophizing
- Black-and-white thinking
- Time-tripping
- Tunnel vision
- Reading minds
- All-or-nothing thinking
- Personalization
- Should-statements
Cognitive Distortions.
What is Behavioral Activation (BA) in CBT?
Encourages engagement in enjoyable activities to improve mood.
What is Systematic Desensitization?
Gradual exposure to fearful stimuli combined with relaxation techniques until anxiety reduces.
What is Flooding?
Confronting the worst fear immediately.
What is Schema Therapy (Young)?
Focuses on deep-rooted, maladaptive belief systems from childhood.
What is DBT (Linehan)?
Dialectical (balancing opposites) Behavior Therapy is used for BPD and emotional dysregulation disorders.
What is Motivational Interviewing?
Motivational Interviewing: A collaborative, person-centered communication method aimed at resolving ambivalence and enhancing motivation for change.
What are the guiding principles of MI?
Partnership – Therapist and client work together.
Acceptance – Affirming autonomy and worth.
Compassion – Prioritizing client’s well-being.
Evocation – Drawing out the client’s intrinsic motivation.
What are the theories that influence MI?
Cognitive Dissonance Theory (Festinger, 1957) – Discrepancy between beliefs and behavior drives change.
Self-Perception Theory (Bem, 1967) – Voicing change strengthens commitment.
Reactance Theory (Brehm & Brehm, 1981) – Resistance increases when autonomy is threatened.
What is the history of MI?
Developed by Miller in 1983 from research on addiction treatment. Integrated with TTM because the Stages of Change in TTM align with MI principles.
What are the TTM Stages of Change?
Precontemplation: No awareness/interest in change.
Contemplation: Acknowledging need for change.
Preparation: Planning steps to change.
Action: Implementing change.
Maintenance: Sustaining change.
What are the four phases of MI?
- Engage: Build trust and support
- Focus: Focus on the problem at hand
- Evoke: Draw out their self motivation
- Plan: Develop a change strategy
What does OARS stand for in MI communication skills?
- Open-ended questions
- Affirmations
- Reflections
- Summaries
What are MI techniques to manage resistance?
Rolling with resistance: Avoid arguing; reflect statements instead.
Highlighting discrepancy: Emphasize differences between goals and current behavior.
Scaling Questions: Ask how ready/confident a client is to change (1-10 scale).
Elicit-Provide-Elicit: Ask permission before giving information, provide information, then ask for the client’s thoughts.
What is the key takeaway regarding MI’s effectiveness?
Effectiveness varies depending on adherence and context.
