exam 4 (final)

Question 1

Psychoanalysis– main idea

Answer 1

Fread
The main idea– unconscious needs, desires, and fears underlie behavior and form personality (and related difficulties)
Therapy– therapists interpretations help to provide insight and eventual relief
Gaining self awarenes

Question 2

psychoanalysis method

Answer 2

Method– talking cure
If they could verbalize their uncinous, they can relieve internal tension
Free association– im going to say a word and you say the first thing that comes to mind
Sometimes they say a topic (example– family) and you talk for 10 minutes about what comes to mind
Eventually maybe the client will say something they weren’t even aware of

Question 3

dream interpretation (freud)

Answer 3

client comes to you with a dream they recently had a therapist will interpret it
Freud argued their were symbols in our dreams that can represent themes in our lives
Not backed up by modern psychology
However therapists will recognize dreams if client wants to talk about it

Question 4

Interpretation of transference– freud

Answer 4

Therapist should not have emotions to clients (not even empathy)
Be as neutral as possible so client will transfer emotions of other people in their life onto the therapist
Be a blank canvas so clients can paint their emotions on you

Question 5

counter transference

Answer 5

therapist transfers feelings in their life onto the client
Treating client like friend or family member

Question 6

psychodynamic approach

Answer 6

more modern approach
Took a lot of freud’s theories and modernized them
Attachment theory– the way you relate to caregivers can create internal foundations to how you relate to people when you are older
Platonically and romantically

Question 7

Behaviorism

Answer 7

emphasis observable behavior and empirical validation
Attempt to make the field more scientific
Too complicated to focus on the internal mind and instead we should try to focus on things that are observable/measurable like behavior

Question 8

behaviorism– main idea

Answer 8

behavior is learned
Phobias– people are not born with them, they are learned through experiences
From this view– it doesn’t always matter if we know how the problem developed, or id there’s insight
Root of the problem does not matter because specific behavior is easiest to modify
Can be critiqued for how it does not validate why clients are the way they are
Sometimes clients have really deep, complex wounds

Question 9

behaviorism when working with children

Answer 9

Behaviorism is almost always the first approach when working with children
Psychoanalysis would be too complicated
Other specialties– health, common mental disorders, and phobias

Question 10

behaviorism– therapist

Answer 10

The therapist is a teacher
Goal– to unlearn old behavior and learn new, more adaptive behavior

Question 11

behaviorism– method

Answer 11

Direct instruction
Exposure
exposing client to the thing they are most afraid of
Example– desensitization, ERP (exposure and response prevention)
One of the scariest forms of therapy because of the intensity, however it works extremely well

Question 12

fear ladder– behaviorism

Answer 12

start at lower level of the ladder (lower anxiety inducing) and work your way up to the thing they fear the most

Question 13

behaviorism– key figures

Answer 13

Pavlov– father of behaviorism
Classical conditioning
Skinner– operant conditioning
Learning from the consequences of your actions
Reinforcement/ punishment
Bandura– social cognitive theory gestalt

Question 14

Gestalt

Answer 14

Main idea– authenticity comes through awareness in the “here and now:
Emphasis on body awareness
How people perceive us and our impact on others

Question 15

Gestalt therapy

Answer 15

therapist observes and provides in the moment feedback to the client
Like a coach
Practice different ways of communicating, showing up, being authentic
Roleplay
Empty chair technique– therapist has client talk to empty chair pretending that they are talking to the person they have conflict with

Question 16

Gestalt and talking cure

Answer 16

Doing is preferable to simply talking
Critical of talking cure– can’t just talk about something and hope it will go away, you have to actually do something about it

Question 17

Humanism

Answer 17

person/client centered therapy
Self actualizations– occurs when an inborn tendency develops if the the environment fosters it
Humanist believe all people are aspiring to become the best version of themselves they can be
Top of Maslow’s hierarchy of needs
Can only reach it if we have all of our other basic needs met
In context of therapy– therapist are trying to help their clients seek self-actualization
Therapy is in an environment that fosters it

Question 18

Positive regard

Answer 18

therapist being warm, loving and accepting unconditionally
Receiving positive regard = “prizing”

Question 19

humanism goal

Answer 19

help clients foster self-actualization
Psychological problems are byproducts of stifled growth towards self actualization
Conditions of worth– idea that in a lot of spaces of our life, we are told that we are only worthy or valuable if we are a certain way
Ex– only good enough if you have a 4.0

Question 20

congruence– humanism

Answer 20

Clients often times feel a gap between their actual self and their ideal self
Amount of distance is what creates our distress
Convergence is the process of trying to bring actual self and ideal self together
Self actualization fosters congruence

Question 21

Empathy– three elements of humanistic psychotherapy

Answer 21

Involves a deep, nonjudgmental understanding of the clients experiences
Client-centered therapy emphasizes empathetic understanding
Empathy can have a positive impact on client
Sympathy feeling for, empathy feeling with

Question 22

unconditional positive regard– three elements of humanistic psychotherapy

Answer 22

Full acceptance of another person “no matter what”
Facilitates higher levels of congruence and self-actualization
Humanistic therapists accept client entirely and unconditional
Recognizing client is doing the best they can with what they have

Question 23

Genuineness– three elements of humanistic psychotherapy

Answer 23

Also called therapist congruence
Helps therapist establish relations that feel “real”
Humanistic therapist accept client entirely and unconditionally
Therapist being a genuine human being with another genuine human being

Question 24

three elements of humanistic psychotherapy

Answer 24

empathy
unconditional positive regard
genuineness
these are attitudes not behaviors

Question 25

CBT key figures

Answer 25

aron beck and albert ellis– first to do clinical work and use model
Normal cotterell and judith beck
Judith beck– aaron beck daughter

Question 26

cognitive behavioral therapy

Answer 26

Most common and research supported type of therapy
CBT– focuses on behavioral change through changing dysfunctional thought processes
Relationship between thoughts and behaviors

Question 27

CBT main idea

Answer 27

Remember the ABC’s– activating events lead to beliefs (thoughts) which lead to consequences (behaviors)
Not the events that lead to depression, but the way we make sense of the things that happen to us is what leads us to depression

Question 28

Diff between automatic thoughts and core beliefs

Answer 28

Automatic thoughts– quick and uncontrollable beliefs that show up immediately after we have experienced an event
Getting a c on an exam and thinking you are unworthy

Core beliefs– central beliefs we have of ourselves regardless of the situation/event
Much deeper

Question 29

Beliefs about goodness– aaron Becks core beliefs

Answer 29

we tend to believe some people are inherently good and others are inherently bad
People without depression typically believe they can make mistakes and still be a good person
People with depression may believe they are inherently bad

Question 30

beliefs about likability– arron Becks core beliefs

Answer 30

belief that you are either inherently likable or unlikable
People with depression have the core belief they are unlikable and undeserving of love or connection

Question 31

beliefs about the world– Aaron Becks core beliefs

Answer 31

world is either unsafe or safe, fair or unfair

Question 32

beliefs about competence

Answer 32

you are inherently competent or incompetent

Question 33

CBT therapy

Answer 33

examining thinking patterns and challenging/disrupting eros and replacing them with thoughts that are rationale, positive, and helpful
Help connect how thoughts are related to behavior
Then help challenge negative thoughts through questions like “what’s another possibility?”

Question 34

ACT

Answer 34

acceptance and commitment therapy
Steven hayes
Creator of ACT
Diagnosed panic disorder
Was in therapy doing CBT which was not working for him
Created a therapy that would help people like him
Third wave therapy”
First and second wave are psychoanalysis and CBT

Question 35

ACT main theory

Answer 35

counterproductive to try to control our emotions
Attempt of trying to control our thoughts and emotions is doing more harm than good
Pain and discomfort is something that we should learn to accept instead of avoid
We can live with a range of emotions and thoughts
“What we resists, persists”
Thoughts are just words and stories we tell ourselves
How does ACT approach the idea about weather the thought is true or not
It doesn’t matter if it is true or not, what matters is if the thought is helpful

Question 36

ACT myths

Answer 36

If i’m not happy, i’m defective
There’s something wrong with you
Hayes argues we are often times not happy and that’s just a natural part of the human experience

I must get rid of uncomfortable feelings
Hayes argus we should learn its okay to have uncomfortable feelings

Question 37

ACT therapy

Answer 37

Acceptance (expansion)
Accept the negative emotions and things that happen to us
Making room for unpleasant feelings and sensations
Mindfulness
thoughts are not necessarily to be attended to, or believed
You can notice your thoughts and then let them go
Nonjudgmental awareness of thoughts, emotions, senses
Full engagement in present activity
“Defusion”– trying to create distance between yourself and your thoughts
Values clarification and committed action

Question 38

DBT (dialectical behavioral therapy

Answer 38

Marsha linhehan– created DBT for people that are not benefiting from CBT who had Borderline PErsonality Disorder (like her)
Developed in the 1970s
Third wave CBT
Originally developed for people with chronic suicidality and BPD
Still the only therapy that has strong empirical support for treating BPD
But it also helpful with other concerns

Question 39

DBT main idea

Answer 39

emotion-regulation difficulties that are the core of serious dysfunction
People with DBT typically engage right into crisis mode
People can learn healthier ways of reacting and relating

Question 40

DBT therapy

Answer 40

emotion regulation skills and for learning new skills
Slow down and not jump to the worst casinario
Distress tolerance– acceptance, self-soothing
Creating space for distress
Includes exposure to feared situations, and skills training in group and individual
Popularized group therapy

Question 41

Dialectics and the reduction of dichotomous thinking

Answer 41

Idea that you can simultaneously be happy and sad
Ex– nostalgia
Making space for the gray area instead of thinking in black and white
“The Power of And”
I can accept myself AND need to change
Someone can be angry at me AND still love me
Also incorporates mindfulness and validation

Question 42

Multicultural therapy

Answer 42

issues that arise for minority groups are relevant for mental illness and should be acknowledged during therapy
These identities are critical in terms are how people experience the world
Important to consider how this impacts mental health and well-being
Clients don’t just into therapy with the value that they are worthless for no reason
Have to consider how society impacts our clients

Question 43

Feminist therapy

Answer 43

mental health can be understood through an individual’s social and cultural identities and the political environment in which they live
These forms of therapy emphasize contextual features
Social conditions, SES, family, peers, historical context, media

Question 44

multicultural and feminist therapy main ideas

Answer 44

Empowerment– seeking to empower our clients
Acknowledging you are not the deficit, maybe the society is the deficit to you

Question 45

Egalitarian relationships

Answer 45

making the relationship between the therapist and client more equal
Who is the expert?
In a year, we see them for less than a percent of their life
We are the expert in therapeutic knowledge and techniques, but they are the experts of their life
Appropriate self-disclosure and mutuality
Therapist seeks to understand, acknowledge, and process identities and cultural values with client

Question 46

Common presenting issues that lend themselves well to a feminist or multicultural approach

Answer 46

Interpersonal violence
Family and career issues
Body image

Question 47

Integrative therapy

Answer 47

Combines 2+ approaches
Vast majority of therapist are integrative in nature, depending on the client and the presenting concern

Common– combining CBT with other therapies like humanistic or psychodynamic
Ex– a client struggling with anxiety around dating
Might use CBT to challenge core beliefs
Might explore psychodynamic interpersonal patterns and attachment styles from childhood

Question 48

integrative therpy– main idea

Answer 48

each client is unique, and can benefit from a unique type of therapy
Emphasized common factors– common things across all of these different approaches regardless of the specific techniques that make therapy work

Question 49

Does the therapist degree predict effectiveness

Answer 49

Not really, no

Question 50

Does age or gender predict effectiveness

Answer 50

Note really, but older adults and women are rated slightly higher
Clients rate therapist depending on identities
Tendency to rate older adults as more effective because they carry more wisdom
Gender bias that women are naturally more empathetic and nurturing

Question 51

Does the therapists experience predict effectiveness

Answer 51

Most studies “not much,” after the initial steep learning curve
Plateau after learning curve (first 2-4 years)
However, most therapists perceive themselves as getting over time and becoming more confident
Confirmation bias– we want to believe that the more educated we are, the more open minded we are
Actually not true
More educated/ experienced you are, the most susceptible you are to confirmation bias

Question 52

Does the therapist personal experience with the clients issue predict effectiveness

Answer 52

Not really, except for when the client perceives it as important to the alliance when it builds trust
Can serve as a mechanism to build a relationship between the client and therapist
For people that don’t have a preference, there is no difference in effectiveness

Question 53

Does the therapist need to share the same characteristics and identities as their clients to be effective

Answer 53

Not really, but with the same exceptions
Some clients view this as important, but majority but don’t have a preference

Question 54

Is there a particularly effective therapist personality

Answer 54

Not that researchers can identify
Neuroticism and agreeableness tend to be common Big 5 personality traits in therapist
Don’t need to be extroverted– no difference in effectiveness

Question 55

Do interpersonal skills matter– ability to initiate and maintain conversation

Answer 55

Yes
The most important thing for a therapist to have
Ability to navigate difficult conversations
Rupture and repair
Awkwardness and tension in session (rupture)
Successful therapist can help repair that rupture

Big 5 that relate to this
Mostly agreeables
Maybe neuroticism– being aware of your emotions as well as the ones being conveyed by others

Question 56

What else– therapist skills

Answer 56

Ability to build rapport, trust, and alliance
Warmth, genuineness
Ability to read and identify emotions of other people (emotional literacy)
Verbal processing skills– ability to process what people are saying and being able to articulate it accurately back to them

Question 57

Super shrinks article
What did the best of the best therapy do?

Answer 57

Amount of effort
Asking for feedback was a big constitute for this
Also have to follow up on feedback

Question 58

super shrinks article– Do ineffective therapist know they ineffective

Answer 58

No
Ineffective therapist rated themselves on par with the most effective therapist
Don’t ask for feedback– dont know they are ineffective if they don’t get clients opinion

Question 59

super shrinks article– Should therapist talk about effectiveness with their clients

Answer 59

Yes
Have to ask clients if you’re doing good to do better for them

Question 60

Best predictors of treatment effectiveness

Answer 60

Severity of symptoms
Biggest factor
Clients with debilitating symptoms will take a lot longer to work with
This question will be on the exam

Extra therapeutic factors
Anything that occurs outside of the therapy room
Includes family, school, and work life, current events, etc

Readiness for change (stage of change)
Being ready and eager for feedback and change
Some clients feel differently

Question 61

Stages of change

Answer 61

“Transtheoretical Model”
Not specific to one approach
Main idea– a client’s readiness to change informs a therapist about what to do
Therapists approach depends on clients preparedness they are to make adjustments in their lives

Question 62

Precontemplation

Answer 62

People just starting a change journey
Hardest stage of change to work with– how do you get someone to change if they don’t realize their is a problem in the first place
Most don’t want to be there– often have to go because of court mandated therapy
Could also be their partner or parents making them go

Question 63

Contemplation

Answer 63

Starting to become aware of the problem
Still conflicted about making a change
See both the benefits and consequences of their issue
Can get stuck in this back and forth mindset for awhile

Question 64

Preparation

Answer 64

People are prepared and committed to making a change
Usually happens gradually
Very important to the stage process- therapist are told to never advise clients to quit cold turkey
Detox process can be very dangerous
Helping clients grieve– scary to make a huge life change even if its positive

Question 65

Action

Answer 65

People are acting on their change and modifying their behaviors
Clients report a strong commitment and self-directed
I am doing this for myself mindset

Question 66

Maintenance

Answer 66

Trying to maintain and solidify changes over time to sustain their new behavior
Big emphasis on avoiding relapse
Preparing for relapse

Question 67

Relapse

Answer 67

Engaging in behaviors you are trying to limit or get rid of
Can occur at any stage of this process
Incredibly common– 40-60% of people do relapse
Important to normalize it, but also have a plan to jump back in

Question 68

Strategies for precontemplation

Answer 68

Build rapport– give as much empathy and grace as possible
Trying to jump in too quickly and have them acknowledge they have a problem won’t help
Raise consciousness about the issue
Make them feel like you are on their side

Question 69

Strategies for contemplation

Answer 69

Explore and validate ambivalence, highlighting the pros and cons of change
Motivational interviewing– asking clients questions that promote change and motivate them to make that change
Start with highlighting the cons of change, but always end with the pros of change
Humans naturally latch on to the things we say last in a sentence
When we end with the good sides of changing (how would your life be better), clients will latch on to that

Question 70

Strategies for preparation

Answer 70

Strengthen commitment
Remind them of the pros of changing and how they are ready
Prepare an action plan

Question 71

Strategies for action and maintenance

Answer 71

Enhance self-efficacy
Validate everything they have been doing
Build supportive relationships– things like AA can be very helpful for some people seeking recovery

Question 72

Strategies for relapse

Answer 72

Important to convey that it is normal for it to happen, but providing resources for when/if it does
Emphasize learning and jumping back in
If they tell you they relapsed–
“Thank you so much for telling, I’m sure that was a scary thing to say”
Remind them it might feel like they are back at square one, but that’s not true– remind them they are not a failure, and now they have tools and skills they didn’t have before they started therapy

Question 73

Other important predictors for treatment effectiveness

Answer 73

Clients expectations of success–hope
Client has specific goals– having SMART goals is very helpful
Active engagement and participation

Question 74

Efficacy studies

Answer 74

experimental, highly controlled research testing types of therapy
Comparing one therapy to another, or comparing therapy to no therapy

Dependent variable– which therapy is more effective
Measure effectiveness through symptom reduction

Question 75

Effectiveness studies

Answer 75

correlation, usually form survey data or naturally-occuring data
Can definitively say the therapy causes people to get better because it is correlational
Shorter, less expensive, easier to gather data

Question 76

What does the research say

Answer 76

Therapist degree is unrelated to their level of effectiveness
Minor expectations– MDs (psychiatrist), couples
Therapeutic orientation (type of therapy) does not matter
people in treatment longer do better than those who are not
most report high client satisfaction

Question 77

The dodo bird effect

Answer 77

Empirical outcomes of therapies shows that competing therapies work about equally well
Common factors across all forms of psychotherapy
“Everyone won so all must have prizes”

Question 78

Therapeutic alliance
common factors

Answer 78

the relationship between the therapist and client
Most crucial factor in therapy
Best predictor of therapy outcomes
Facilitates positive change
Reciprocal– therapist feels more invested when the client genuinely listens to what they have to say

Question 79

other common factors

Answer 79

Hope
Shared goals– therapist has to recognize how ready the client is for change to formulate the right goals
Empathy
Affirmation– therapist affirming and reminding them that they are doing a good job
Genuines
Motivation

Question 80

— is to traditional therapy as — is to contemporary therapy

Answer 80

Gestalt, DBT

Question 81

free association is used by psychotherapist in attempt to help their clients

Answer 81

gain insight into their unsocnsious

Question 82

according to CBT and activating event is followed by —– which are followed by consequences

Answer 82

beliefs

Question 83

for DBT therapist, “dialects” are related to

Answer 83

coexisting contradictions

Question 84

the technique of using a fear hierarchy is most likely to be done by which kind of therapist

Answer 84

behaviorist

start at lower level of fear ladder and keep moving up

Question 85

what is the best way to describe the purpose of cognitive delusion in ACT

Answer 85

to see thoughts for what they are: just thoughts

Question 86

which therapist characteristic is known to have a strong effect on therapeutic effectiveness

Answer 86

strong intrapersonal skills

Question 87

someone who is aware of their problem, but is ambivalent about change is in which stage of change

Answer 87

contemplation

Question 88

which of the following client factors most strongly predicts therapeutic outcomes

Answer 88

the severity of symptoms

Question 89

which of the following best describes the dodo bird verdict

Answer 89

all valid therapies are about equally effective