Exam 3 Update

Question 1

Therapy with older adults modifications

Answer 1

1. Take more time to review new material
2. Repeat material and skills
3. Allow more time, glasses, bigger print, hearing aids

Question 2

PHQ-9

Answer 2

1-4………minimal depression
5-9………mild depression
10-14…..moderate depression
15-19….moderate severe depression
20-27…severe depression

Question 3

How is the PHQ-9 modified for teens

Answer 3

Need 5 or more positive symptoms (positive is defined by a 2 or 3 in questions 1-8 and by a 1,2, or 3 in question 9. The functional impairment questions (How difficult…) needs to be rated least as “somewhat difficult”

Question 4

Interpersonal Therapy

Answer 4

Is a good choice for adults who present with grief, loss, interpersonal conflicts, and role transitions.
Helpful for patients who are mild to moderately depressed.

Question 5

Stages of development: Thought Substage lasts from 4-7 years

Answer 5

Is marked by greater dependence on intuitive thinking rather than just perception. At this stage, children ask many questions as they attempt to understand the world around them using immature reasoning

Question 6

Motivational Interviewing is used with children and adolescents because

Answer 6

Resistance can be managed with less resistance and hostility

Question 7

Strength-Based Approach with Children

Answer 7

This approach is best during the first meeting
An example is to praise youth for their efforts to maintain control of some aspect of life.

Question 8

Strength-Based Approach with Children-Using CBT with family systems focuses to address bipolar using a strength-based approach…what’s an example

Answer 8

“Can you tell me about the family?”

Question 9

Trauma-focused cognitive behavior therapy

Answer 9

Is the best therapy for a child with extensive trauma history (abuse, neglect) with symptoms of poor sleep, nightmares, irritability, minor aggression, and restlessness.

Question 10

3 main characteristics of ADHD in children…
the DSM-5 criteria

Answer 10

1. Inattentiveness
2. Hyperactivity
3. Impulsivity

Question 11

Strength-Based Approach with Children

Question 12

For youth taking stimulants for ADHD and still having poor attention in school, the best behavioral, cognitive, or psychoeducational intervention to augment the medication is

Answer 12

Cognitive training focused on enhancing working memory. Behavior therapy and psychosocial treatment are recommended as an adjunct to medication for moderate to severe ADHD

Question 13

Fusion

Answer 13

Example- seeing a family where parents formed dysfunctional interaction patterns and function as single system

Question 14

Know the term
Normalizing

Answer 14

Person states “I am weird, I don’t like heights.”
Normalizing reply- “At times many people feel anxious when they are high up.”

Question 15

Multigenerational Transformation Process

Answer 15

This process entails the way family emotional processes are transferred and maintained over the generations. “She’s just like your cousin Jenny, she was divorced 4 times.”

Question 16

Transform dysfunctional generation patterns

Answer 16

Ex.-an adult woman in a family dyad is the therapist’s client and the therapist states that the “women in the family tend to over function and marry partners who are irresponsible or under function.” —the psychotherapy technique is to transform dysfunctional generation patterns.

Question 17

Triangles and triangulation

Answer 17

Ex- When distressed or feeling intense emotions, they will seek a third person to triangulate.

Question 18

Undifferentiated Ego Mass

Answer 18

Ex-a family you are seeing for family therapy, several members appear stuck together with low levels of differentiation, one member says they could never make it without the others.

Question 19

Family Projection Process

Answer 19

Ex-You are seeing a family and think that the only child is serving as an emotional extension of the parents. You suspect that the child is fused and triangulated to the parents, this is called family projection process

Question 20

Bowen’s Theory

Answer 20

Bowen’s family system theory is a theory of human behavior that views the family as an emotional unit and uses systems thinking to describe the units complex interactions. It is the nature of a family that its members are intensely connected emotionally.
The theory considers family members’ interdependence. A change in one person’s behavior affects the other members of the family

Question 21

Enmeshed Family

Answer 21

Parents are excessively involved in children’s minor conflicts and do not allow the children the opportunity to solve their own problems. Parents consumed with youngest child’s bad grade she brought home the week before (overall has good grades but had one bad grade)

Question 22

Codependent Family

Answer 22

Ex--If a parent sees that something painful is happening in their child's life, they will try to gain control by getting overly involved.

Question 23

Disengaged Family

Answer 23

A family whose members are mutually withdrawn from each other psychologically and emotionally. EX- Families that share little to nothing, typically overly rigid families, are described as detached. (little to no communication and no flexibility in the family patterns to accommodate effective support and guidance.)

Question 24

Minuchin's factors that lead to family dysfunction

Answer 24

Symptoms arise from structural imbalances in the family system (The family composition may change due to the birth of a child, the inclusion of a relative, or the addition of a foster child. *If the family does not change or modify its interactions and transactions to include the new family member, stress resulting from the situation may cause family dysfunction.

Question 25

Minuchin's Family Theory Type

Answer 25

Techniques are "present"-oriented, focusing on current problems and addressing them
--The Structural Family Therapy Model - often seen as a way to treat the individual by treating the underlying cause of their troubling behavior.

Question 26

Promoting Self-Statements during therapy

Answer 26

Using "I" statements help couples work through their differences in an effective manner and prevents further harm from being done.

Question 27

Structural Family Approach (Minuchin's)
What is the most important goal of structural family therapy?

Answer 27

Is to create an effective family structure with functional subsystems and clear boundaries. A strong parental hierarchy is stressed with parents having the necessary power and control. (The best therapy goal is to create an effective family structure.)

Question 28

Structural Family Approach (Munichin's)
An example of

Answer 28

Would be if you were with a lesbian couple who have two children (a pre-teen and a teen). The children are pushing the parent's limits and emotional boundaries.

Question 29

Boundary Making can help with enmeshed family members such as a parent who is over-involved with a child. A boundary may be introduced or reinforced to strengthen or change the distance between relationships

Answer 29

An example of unbalancing is "to change the hierarchical relationship of the members of a subsystem. If an enmeshed father and daughter sit next to each other and frequently exchange looks and laughter while ignoring the mother. The therapist asks the mother and father to change seats so the mother is next to the daughter and the father and daughter have more distance.

Question 30

Know the Terms (Parentification) -

Answer 30

is when people rely on their children to give to them.
For ex - a teenage boy whose dad is irresponsible and neglectful, so the youth has to make adult decisions. (According to structural family therapy, this is an example of parentification).

Question 31

Know the term - (Unbalance)

Answer 31

For example, during a family therapy session, two school-aged children refuse to pay attention to their parent's requests, children are asked to leave the room while you as a therapist help to strengthen the weak parent subsystem.

Question 32

Stages of Change

Answer 32

A teenage boy is vaping. He is willing to quit and has a multistep plan to quit. He is in the "preparation" stage of change.

Question 33

Grounding

Answer 33

Is a self-soothing skill to use when you are having a bad day or dealing with a lot of stress, overwhelming feelings, and/or intense anxiety. Grounding is a technique that helps keep you in the present and helps reorient you to the here and now and to reality. (Identifies object around you)

Question 34

Mindfulness

Answer 34

Therapy builds upon the principles of cognitive therapy by using techniques such as mindfulness meditation to teach people to consciously pay attention to their thoughts and feelings (dual awareness) without placing any judgments upon them. Helpful to patients developing dual awareness. Meditation, yoga, body scan.

Question 35

Shaping Competence (refers to acknowledging and praising positive behaviors. In a sense, it's a form of positive reinforcement

Answer 35

Ex - therapist is seeing a family for therapy when children are out of the room and assists parents in developing a plan for an issue. The children return to the room and the mother informs the children of the parent's joint decision. The therapist states that was great. You were able to work together and provide a joint decision to your child.

Question 36

Reframing

Answer 36

An example is if a youth is identified as "difficult" by their parents. After listening to them argue, you as the therapist state, is this what happens when the 3 of you try to communicate with each other? ---- you suggest looking at it as a systems (whole team) problem rather than as an individual problem of the daughter.

Question 37

First order change

Answer 37

Making the decision to stop an action.

Question 38

Attachment styles
1. Insecure attachment

Answer 38

Diminished ability to express their needs and feelings and discount their needs for attachment. They adopt safe distance and solve problems by themselves without understanding the effect they have on their partners

Question 39

Attachment styles
1. Vacillating attachment

Answer 39

People who have been traumatized frequently fluctuate between attachment and hostility and are usually reactive, they will teeter-totter between pushing their partners away and wanting them to come back.

Question 40

Family Therapy Terms
-----Life Review

Answer 40

is a retrospective survey or evaluation, a critical study of a life or a second look at one's life.

Question 41

Family Therapy Terms
-----Reminiscence

Answer 41

Means sharing one's life experiences, memories, and stories from the past. This therapy uses all senses, sight, touch, taste, smell, and sound. To help individuals with dementia remember events, people, and places from their past. As part of the therapy, care partners may use objects in various activities to help individuals with recalling memories.

Question 42

Recovery and Supportive Talk
-----Recovery

Answer 42

Is a process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential.
(Dimensions of recovery include health, home, and purpose. ----know dual awareness techniques-here and now, present moment, mindfulness----

Question 43

Recovery and Supportive Talk
-----Supportive

Answer 43

Supportive self-talk is helpful with PTSD, flashbacks, and bad memories. Therapists can assist in teaching patients to know that they are safe currently, the memory was then, this is now. Take a deep breath, exhale long and slow.