Exam 3 Update Flashcards
Therapy with older adults modifications
1. Take more time to review new material
2. Repeat material and skills
3. Allow more time, glasses, bigger print, hearing aids
PHQ-9
1-4………minimal depression
5-9………mild depression
10-14…..moderate depression
15-19….moderate severe depression
20-27…severe depression
How is the PHQ-9 modified for teens
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”
Interpersonal Therapy
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.
Stages of development: Thought Substage lasts from 4-7 years
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
Motivational Interviewing is used with children and adolescents because
Resistance can be managed with less resistance and hostility
Strength-Based Approach with Children
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.
Strength-Based Approach with Children-Using CBT with family systems focuses to address bipolar using a strength-based approach…what’s an example
“Can you tell me about the family?”
Trauma-focused cognitive behavior therapy
Is the best therapy for a child with extensive trauma history (abuse, neglect) with symptoms of poor sleep, nightmares, irritability, minor aggression, and restlessness.
3 main characteristics of ADHD in children…
the DSM-5 criteria
1. Inattentiveness
2. Hyperactivity
3. Impulsivity
Strength-Based Approach with Children
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
Cognitive training focused on enhancing working memory. Behavior therapy and psychosocial treatment are recommended as an adjunct to medication for moderate to severe ADHD
Fusion
Example- seeing a family where parents formed dysfunctional interaction patterns and function as single system
Know the term
Normalizing
Person states “I am weird, I don’t like heights.”
Normalizing reply- “At times many people feel anxious when they are high up.”
Multigenerational Transformation Process
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.”
Transform dysfunctional generation patterns
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.
Triangles and triangulation
Ex- When distressed or feeling intense emotions, they will seek a third person to triangulate.
Undifferentiated Ego Mass
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.
Family Projection Process
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
Bowen’s Theory
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
Enmeshed Family
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)
Codependent Family
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.
Disengaged Family
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.)
Minuchin's factors that lead to family dysfunction
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.
Minuchin's Family Theory Type
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.
Promoting Self-Statements during therapy
Using "I" statements help couples work through their differences in an effective manner and prevents further harm from being done.
Structural Family Approach (Minuchin's)
What is the most important goal of structural family therapy?
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.)
Structural Family Approach (Munichin's)
An example of
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.
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
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.
Know the Terms (Parentification) -
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).
Know the term - (Unbalance)
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.
Stages of Change
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.
Grounding
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)
Mindfulness
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.
Shaping Competence (refers to acknowledging and praising positive behaviors. In a sense, it's a form of positive reinforcement
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.
Reframing
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.
First order change
Making the decision to stop an action.
Attachment styles
1. Insecure attachment
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
Attachment styles
1. Vacillating attachment
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.
Family Therapy Terms
-----Life Review
is a retrospective survey or evaluation, a critical study of a life or a second look at one's life.
Family Therapy Terms
-----Reminiscence
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.
Recovery and Supportive Talk
-----Recovery
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----
Recovery and Supportive Talk
-----Supportive
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.
