Exam Two Flashcards
characteristics of master therapists
- voracious learners who draw heavily on accumulated experience
- aware their emotional health impacts their work
- emotionally receptive, valuing cognitive complexity and ambiguity
- possess strong relationship skills
- mentally healthy, mature, and attend to their own well being
- believe in the working alliance
characteristics of the therapeutic alliance
CARL ROGERS
- the emotional bonds that develop between P and C
- the shared understanding of what is to be done (tasks) and what is to be achieved (goals).
What the research says about the relationship between therapeutic alliance and therapy outcomes
overall effect size for the alliance on therapy outcomes is small to moderate, but the effect size varies considerably depending on a number of variables, including how the alliance is measured
CBT and MCT
- both emphasize theneed to tailor interventions to the unique needs and strengths of theindividual; MCT particularly emphasizes cultural influences thatcontribute to this uniqueness.
- both emphasize empowerment:CBT via an educational approach that teaches specific skills thatclients can take with them; MCT through its attention to culturalidentity as a source of strength.
- CBT focuses on consciousprocesses that can be easily articulated and assessed—an approachthat is well suited to people who speak English as a secondlanguage or who do not share the same cultural assumptions thatunderlie the European American concept of the unconscious.
- CBT integrates assessment throughout therapy, an action thatcommunicates respect for clients’ viewpoints regarding theirprogress; such demonstrations of respect are considered a core partof culturally responsive practice
- bothCBT and MCT call attention to naturally occurring strengths andsupports that can be used to facilitate change.
- CBT’s behavioral roots emphasize the influence of environment on be-havior, which fits well with MCT’s emphasis on cultural influ-ences.
central hypothesis on misdiagnosis
clinician’s misinterpretation of cultural mistrust as clinical paranoia leads to the misdiagnosis of schizophrenia
internet therapy
These results highlight the importance ofincluding motivational components in treatments and providingmultiple methods in which clients can seek to engage in treatmentsto suit various communication and interactive preferences.
-Similarly, comparative research trials have found that Internettherapy clients reported experiencing greater ease self-disclosing,deeper and smoother exchanges and equal or greater workingalliances with online therapists that were more positive as comparedto face-to-face therapy clients
REBT
rational emotive behavior therapy - change irrational thoughts
Neimeyer
externalizing language to separate joanne from her symptoms. empty chair (gestalt techniques)
SUPER EGO vs EGO vs ID
Super ego (societal) ; Ego (reality) ; ID (pleasure)
transference
unconsciously brings a maladaptive pattern of relating into the therapy
countertransference
therapists own issues get elicited during treatment
object relations theory
less id, more ego. self and separation/individuation.
therapy techniques: engaged therapist, encourage trust/support, “reparenting” and ego support
psychodynamic therapy efficacy reseasrch
archaic (outdated), elitist, unsubstantiated
self actualization
achieving one’s full potential and independence
phrenomenology
study of one’s own conscious, direct experience
humanistic therapy techniques
empathy, unconditional + regard, congruent feelings/actions matched, reflection
gestalt
problem etiology- whole is > sum of its parts
gestalt therapy
aims at enhancing clients’ self awareness in order to free them to grow in their own consciously guided ways
Techniques & goal: Role playing, focus on here & now, nonverbal behaviors, “empty chair”, games/defense, body sensations. Goal is to stop blaming and denying.
behavior therapists
rely on techniques designed to identify maladaptive behavior & change it. “Centrality of learning.”
operant conditioning
occurs when certain behaviors are strengthened or weakened by the rewards or punishments that follow those behaviors.
classical conditioning
occurs when a neutral stimulus (such as a musical tone) comes just before another stimulus (such as a pin-prick) that automatically triggers a reflexive response (such as a startle reaction).
Functional analysis/assessment
SORC - stimulus, organism, response, and consequence
PRT
involves tensing & then releasing various groups of muscles while focusing on the sensations of relaxation that follow.
system desensitatization
anxiety-related stimuli with relaxation. Reciprocal inhibition. Pair fear stimulus with relaxation.
Components: progressive relaxation, anxiety hierarchy, fear thermometer, pairing (relaxation & item), gradual progression.
reciprocal inhibition
can’t be anxious and relax at the same time. new response is learned based on cc paradigm.
aversion therapy
unpleasant stimuli with high probability undesired behavior.
exposure therapy
entail direct exposure to frightening stimuli, but the idea here is not to prevent anxiety. Fear will extinguish by breaking escape that reinforce it. Prolonged intense exposure, blocking compulsive behaviors used to escape.
response prevention
Accompanied with exposure. Clients are not allowed to perform the rituals they normally use to reduce anxiety.
VR exposure therapy
clients can be exposed to carefully monitored levels of almost any stimulus situation. ( Adv: feasibility, control Disadv: realism , expensive )
operant conditioning based learning
SKINNER. “Consequence shapes subsequent behaviors” Reinforcer- increases behavior // Punishment- reduces behavior. Example from class- little girl Lisa crying tantrum reduced by ignoring it. Juice-reinforcer
contingency management
1 Shaping
2 Time-out
3 Response Cost
cognitive therapists
view faulty reasoning as the main cause of many disorders, designed to change how clients think about events and about themselves. Errors in thinking cause psychological distress.
collaborative empiricism
working with patient to examine assumptions/schema
socratic dialogue
a style of discourse in which the therapist pursues a line of questioning until the client’s fundamental beliefs and assumptions are laid bare and open to analysis.
guided discovery
works with client to test out hypothesis. Develop behavioral experiments
cognitive restructuring
earn to identify and dispute maladaptive behaviors
Techniques:
De-catastrophizing (what if X happened? Then what?)
Reattribution (alternative explanations systematically examined)
Redefining (help the patient see things differently)
Decentering (used with social anxiety to shift the focus)
albert ellis
he believed the root of the problem = crooked magical and unrealistic thinking. founder of REBT.
REBT
1) give up perfectionism
2) teaching to differentiate b/w desires and “musts”
3) change habit & cognition
4) minimize grandiosity
goals: teach removal of self destructive thoughts and teach acceptance of fallibility
ABC model
Activating event > Belief > Emotional consequence.
aaron beck
focus on intervention = defective thinking
cognitive triad
negative views of self, future, and the world.
2 core beliefs: Lovability & competence.
waves of CBT
1st wave: behavioral (observable)
2nd wave: CBT - observable/cognition
3rd Wave CBT: behavioral therapies w/ overlapping conceptual and technical foundations
Not get rid of negative thoughts/feelings. Instead change the impacts of the thoughts by creating other contexts/ control behavior for them.
group therapy
a small, carefully selected group of individuals who meet regularly with a therapist. Purpose is to assist each individual on emotional growth & emotional problem solving.
therapeutic factors of GT
sharing information, instill hope, altruism, universality, group cohesiveness, and interpersonal learning
conjoint therapy
when a therapist sees both members of the couple at the same time.
identified client
the client whos family begins with a focus on them who has noticeable problems.
community psych
collaboration w/ nonprofessionals, community empowerment, education, social reform/advocacy
social system change
community psychologists emphasize indirect services that have no particular target client but are expected to achieve benefits because of the social changes they produce radiate to intended target groups.
promoting a psychological sense of community
Paraprofessionals: encouraging nonprofessionals
Use of Activism: social activism is the use of power to accomplish social reform. (may be economic, political or coercive power).
Use of Research as a Form of Intervention: dissemination research.
Revolutions of mental health
1st- Englightenment
2nd- Sig Freud Talking Cure
MH’s 3rd revolution: Community psych - social and community interventions
Prevention is an outgrowth of community psychology with a focus on preventing problems before they occur or trying to reduce any exacerbation of problems once they are evident.
factors contributing to its emergence of 3rd revolution
lack of professionals, changing concepts of MH, dissatisfaction with psychotherapy and dissatisfaction.
3 different preventions
PRIMARY = counteract harmful circumstances before it produces illness. (ex. Changing curriculum
involves avoiding the development of disorders by either modifying environments or strengthening individuals so that they are not susceptible to those disorders in the first place)
SECONDARY = early detection and screening
TERTIARY = reduces negative after effects and duration
bibliotherapy
Bibliotherapy reading books on how to deal with psychological problems, a large component to self-help movement. Although, no single resource summarizes all controlled outcome studies of popular self-help books and online resources, there is a growing body of research literature that suggests that bibliotherapy and online resource can be effective for problems such as mild depression, anxiety, eating disorders, gambling and mild alcohol abuse.
psychotherapy integration
is the process of combining elements of various clinical psychology theories in a systematic manner
ethnic matching findings
most effective = reducing early termination
language match more important
worldview likely more important (cultural mistrust and ethnic identification)
MCC for assessment/intervention
SACK = skills (use “a and b” therapeutically; awareness (personal knowledge); cultural humility (other focused, openness, lack of arrogance; knowledge (human diversity)
barriers to service utilization
- language
- verbal production
- revelation
- trust
- individual change
- individuation (become own self assumption)
- time
- historical context
- dichotomy- mental and physical
therapists awareness- ADDRESSING
Age Developmental Disability Religion Ethnicity Ses Sexual orientation Indigenous heritage National Origin Gender
Community psych vs traditional psych
Focus = ENVIRONMENTAL (vs intrapsychic) Interventions = SYSTEMS (vs persons) PREVENTION (vs treatment) enhance COMPETENCE vs reduce distress EXISTING STRENGTHS SEEKING vs waiting COLLABORATION with nonprofessionals Community EMPOWERMENT public EDUCATION SOCIAL REFORM/ADVOCACY
Emotion Focused Couples therapy EFT
humanistic (validates); problem: negative interaction cycles that prevent safe/emotional connection. goals: guide partners to be emotionally responsive to one another and clarify attachment/emotional needs
behavioral approach couples therapy
problem = low reinforcement and high punishment goal = help couples learn new ways to change contingencies in a relationship (increase + reinforcements)
maladapted communication probz in couples
- coercive exchanges
- withdrawal
- retaliatory exchanges
- cross complaining
- summarizing self syndrome
cognitive errors in couples
- Tunnel vision
- assumed intent
- magnification
- global labeling
- good-bad dichotomy
- letting it out fallacy
Dialectical based therapy DBT
radical acceptance, distracting activities, relaxation, coping thoughts, zen, focus on in the moment; ACCEPTANCE AND CHANGE (balancing them)
CBT key concepts/ techniques
DRRD (decatastfrophizing; reattribution; redefining; decentering)
3 musts
i must do well; you must treat me well; the world must be easy
psychodynamic therapies are…
archaic, elitist, unsubstantiated
