F Flashcards
Who developed person-centered psychotherapy?
Carl Rogers.
What is the central view of human well-being in person-centered psychotherapy?
A radical, nonpathologizing view that sees the client as an agentic whole capable of growth and healing.
What are the phenomenological foundations of Rogers’ theory?
Emphasis on subjective human experience; behavior is understood based on perception, not just stimuli.
What is the main goal of person-centered psychotherapy?
To create conditions in which the client can optimize their psychological functioning.
What is the central question person-centered therapists ask when engaging clients?
How can we engage with clients in ways that recognize and dignify their humanity?
What are the four Rogerian techniques commonly used by U.S. psychotherapists?
Empathy, unconditional positive regard, congruence/genuineness, and reflection of feeling.
What does “shared-decision making” in person-centered therapy signify?
Rejection of the assumption that the therapist knows best — promotes client autonomy.
What is Rogers’ theory of personality?
Humans are experiencing organisms with an innate striving to maintain and enhance their being.
What is the organismic valuing process?
The organism’s internal drive to satisfy its needs and wants, guided by emotions.
What is subception in Rogers’ theory?
The discrimination of experiences without awareness because they threaten the self-concept.
What is self-estrangement/self-alienation?
A discrepancy between actual experience and self-image, often rooted in caregiver judgment and societal expectations.
What are the psychological effects of greater self-estrangement?
Increased psychological disturbance, self-destructive behaviors, and persistent anxiety.
What is the actualizing tendency?
The organism’s basic drive to maintain and enhance itself.
What are Rogers’ six necessary and sufficient conditions for change?
- Two people in psychological contact
- Client is in a state of incongruence
- Therapist is congruent
- Therapist has unconditional positive regard
- Therapist has empathic understanding of the client
- Client perceives the therapist’s empathy and regard
What three conditions are considered the core conditions for change?
Therapist congruence, unconditional positive regard, and empathy.
What does therapist congruence mean?
The therapist is authentic and integrated in the relationship, open to their own internal experience.
How can therapist congruence facilitate change?
- Models authenticity
- Builds trust
- Offers feedback
- Prevents therapist projection
What are the main criticisms of person-centered psychotherapy?
- Ethnocentrism and lack of cultural sensitivity
- Limited evidence for universality of core conditions
- Restrictive nondirectivity
What is a cultural critique of the approach?
It may not account for external constraints and support systems important to clients from diverse backgrounds.
What is metatherapeutic nondirectivity?
A responsive approach that honors the client’s desires for direction, structure, or advice, even within a non-directive framework.
What are some key branches of the person-centered and experiential approach?
- Child-centered play therapy
- Focusing-oriented psychotherapy
- Emotion-focused therapy
- Dialogical/relational approaches
- Creative person-centered approaches
- Pre-therapy
- Integrative person-centered approaches
- Person-centered experiential counseling for depression
How do HEPs compare to CBT in effectiveness?
HEPs are as effective as CBT, especially in relationship issues, self-damaging behaviors, chronic conditions, and psychosis.
What are the outcomes of HEPs?
- Healthier emotional experiencing
- Greater self-acceptance
- Feeling supported in relationships
- Changed view of self and others
What is unique about person-centered psychotherapy training?
Often self-directed, with experiential learning, personal development groups, and peer practice.
What skills are emphasized in training?
Empathy, acceptance, active listening, reflection, and paraphrasing.
What philosophical perspective does person-centered psychotherapy draw from?
Humanism, especially Rousseau’s belief in the innate goodness and growth potential of people.
How does Rogers define “experience”?
Everything going on within the organism at a given moment that is potentially available to awareness.
What happens when a person’s experience doesn’t fit their self-concept?
It becomes subceived — processed outside of awareness, which can create psychological distress.
What are three effects of increased self-estrangement, according to Rogers?
- Less engagement in self-enhancing activities
- Increased self-destructive behaviors
- Ongoing anxiety due to subceived, “unacceptable” feelings near awareness
What is nondirectivity in person-centered therapy?
Clients are encouraged to lead their own healing journey and discover personal pathways to change.
What is the therapist’s role in fostering personality change?
To build a reparative, nonjudgmental relationship free of conditional positive regard.
What type of learning is prioritized in person-centered psychotherapy training?
Experiential learning, including personal development groups and mutual practice as both client and therapist.
What pedagogical approach is often limited in these training programs?
Theoretical or didactic instruction.
How do somatic experiences like muscle tension affect the client’s emotional processing?
The shoulder and back tension signals the emotional blockages that the client has around grief and emotional release.
Why do masculine gender norms pose a challenge in EFT?
These norms, such as avoiding emotional expression, contribute to powerlessness and delay the development of a strong therapeutic alliance.
What “better of two options” conflict does the client face?
The client feels torn between needing emotional connection and needing solitude—balancing intimacy and independence.
How does the client process his childhood separation trauma using role‑play?
The client uses a role‑play where he speaks directly to his mother (as if she is present) about the terror he felt being left alone at age 4.
What happens during the “mother role” in the role‑play?
The client steps into the mother’s shoes and voices her feelings, including guilt and the sacrifices she made in her parenting decisions.
What is the purpose of the “return to self” phase after the role‑play?
The client reflects on compassion for his mother, integrating feelings of guilt, anger, and relief while releasing resentment and trauma.
How is the “close‑your‑eyes” exercise used in EFT?
The therapist guides the client to close their eyes to track the emotional obstacles that get in the way of their happiness and identify emotional incongruence.
What is the goal of the “head versus heart” distinction in the “close‑your‑eyes” exercise?
The client is encouraged to differentiate rationalizing thoughts (head) from emotional experiences (heart) in order to connect with true feelings.
What role do somatic markers play in the intervention?
Muscle tension in the shoulders and back becomes a somatic marker signaling emotional barriers, particularly the suppressed emotional responses of grief or fear.
What is the client’s primary issue in therapy?
The client experiences anxiety and grief, with lingering feelings of existential dread related to childhood losses.
How did the client’s father’s death at age 4 affect him?
His father’s death at age 4 alleviated some of his school-related anxiety, but deep unresolved grief remained, contributing to his panic attacks.
What was the emotional impact of being pushed into kindergarten by his father?
The event caused deep emotional scar tissue, and the client carries fear of abandonment and feelings of unworthiness tied to this memory.
What are the client’s current stressors contributing to his anxiety?
Family conflicts, particularly with his brother, and being a single father to a teenage daughter.
What key role did Dr. Nancy McWilliams take in therapy?
Bearing witness to the client’s emotional truth without intellectualizing and normalizing his feelings through research.
How did Dr. Judith Beck tailor her approach to this client?
By focusing on his anxiety and relapse prevention—adjusting interventions to his personality style rather than a fixed protocol.
According to Dr. Leslie Greenberg, what challenge arises with many male clients?
They often avoid emotions, so it takes longer to build the safety and alliance needed for EFT.
Which childhood event first triggered the client’s panic attacks?
His father pushed him into the classroom on his very first day of kindergarten at age4.
How did the client’s father’s death affect his school‑related anxiety?
After his father died when he was in 4th grade, his fear of attending class subsided.
Name one experiential intervention used to access his separation‑related grief.
A mother‑role play (asking him to speak “as his mother” about what it was like to separate at age4).
What is “productive emotional arousal” in EFT?
A moderate level of emotion in which clients are aware of their feelings and can discuss them coherently.
Why is accessing one’s needs crucial in EFT?
Needs represent the healthy, adaptive force that drives therapeutic change.
What kind of environment must an EFT therapist provide?
A safe space that tolerates and contains intense emotional experiences.
What dialectic must the therapist manage when working with emotion?
Balancing following the client’s lead with gentle guidance—without leading them away from their own experience.
What core principle guides direct emotion regulation in EFT?
Identification of emotions and understanding how they relate to outcomes.
What is a “marker” in EFT?
A signal of a problem in emotional processing where a particular intervention is indicated.
How many “delimited markers” has Greenberg identified?
Twelve.
Give three examples of these delimited markers.
Self‑soothing & self‑compassion; “empty story”; “broken story.”
What’s the “25% arousal rule”?
About 25% of the time, clients need to be optimally aroused—too little or too much emotion both impede therapeutic work.
List two things the EFT therapist should not do.
- Lead too much (clients need space to self‑organize).
- Shame or raise anxiety—instead, validate and contain emotion.
EFT focuses on two main questions in any moment:
- What are you experiencing—your core pain (can be positive or negative)?
- Where are you in the emotional markers (e.g., conflict splits, unresolved bad feelings, problematic reactions)?
Why “follow the core pain experience”?
The client’s vocal/facial cues lead you to their core need—and true healing only happens when that pain is fully felt.
What’s the EFT motto for emotional change?
“The best way to change an emotion is with another emotion.”
What is the “chair‑dialogue” in EFT?
An empty‑chair exercise where clients enact emotion schemes (e.g., dialogue with a significant other) to access and transform core feelings.
What is “systematic unfolding”?
A step‑by‑step intervention that helps clients unpack layers of their emotional experience.
What are the four circularly organized steps in EFT?
- Bonding & Awareness (establish safety & emotional focus)
- Evoking Emotion (activate the felt experience)
- Transforming Emotion (use new, adaptive emotions to reshape old ones)
- Narrative Consolidation (integrate insights into a coherent story)
What makes EFT unique in its approach to emotion? (2 bullets)
- Focuses on the visceral, bodily experience of emotion.
- Teaches direct emotion regulation by identifying emotions and linking them to outcomes.
How is EFT evidence‑based?
It uses reliable measures of emotional change and has been empirically tested.
Which therapeutic models are integrated in EFT?
Client‑centered, Gestalt, humanistic, systemic approaches, and dialectical constructivism.
Why is the therapist’s “presence” so important in EFT?
They must be fully attuned to the client’s felt experience—not taking notes—so they can follow shifts in emotion in real time.
What is the defining stance of Emotion‑Focused Therapy?
An experiential psychotherapy that emphasizes experiencing rather than conceptualizing—“feeling your feelings,” not just talking about them.
Who developed EFT?
Dr. Leslie Greenberg.
EFT is both a “process‑assessment” and a “process‑diagnosis.” What does that mean?
The therapist continually monitors where the client is in emotional processing (markers) and tailors interventions accordingly.
What is one use of the PQS in therapy research?
To identify differences between psychodynamic and cognitive-behavioral therapies.
What recommendation did the authors make regarding prototypes and patient populations?
Modified, more specific prototypes may be needed for particular populations or problems (e.g., PTSD).
How closely did CBT therapists follow their theoretical model?
CBT therapists adhered closely to the cognitive-behavioral model.
What strategies did psychodynamic therapists often include in their sessions?
Both psychodynamic and cognitive-behavioral strategies.
How did the CBT prototype correlate with outcomes in the CBT treatment sample?
Only significantly associated with one outcome measure.
How did the psychodynamic prototype correlate with outcomes in the CBT treatment sample?
Significantly associated with positive outcomes on 4 out of 6 outcome measures.
How did the CBT prototype correlate with outcomes in the psychodynamic treatment sample?
Only significantly associated with one outcome measure.
How did the psychodynamic prototype correlate with outcomes in the psychodynamic treatment sample?
Significantly associated with positive outcomes on 3 out of 6 outcome measures.
What are signs of patient engagement in CBT, according to the prototype?
Bringing up significant issues, feeling helped, commitment, understanding expectations.
Name key CBT techniques from the prototype.
- Giving advice
- encouraging new behaviors
- presenting new perspectives
- fostering independence.
What are key features of the cognitive-behavioral therapy prototype?
Supportive therapist stance, structured/didactic interaction, focus on goals, tasks, beliefs, and current life.
What are the goals and communication style emphasized in psychodynamic therapy?
Clear, coherent communication that helps patients speak freely and achieve new understanding.
Name key psychodynamic therapy techniques from the prototype.
1) Interpreting unconscious material
2) identifying themes
3) linking feelings to the past
4) pointing out defense mechanisms.
What are key aspects of the psychodynamic therapy prototype?
Therapist empathy, neutrality, focus on transference/countertransference, and exploration of past experiences and fantasies.
What are expert prototypes in this study, and how were they created?
They are models of ideal therapy developed by expert panels using the PQS.
What does the data suggest about CBT possibly using psychodynamic strategies?
Psychodynamic techniques may be responsible for promoting change, even within CBT sessions.
Was the ‘cognitive-behavioral technique’ factor significantly associated with successful outcomes?
No, it was not significantly associated with successful outcomes in either therapy type.
What was the correlation between the ‘psychodynamic technique’ factor and successful outcomes?
It was significantly correlated with successful outcomes in both psychodynamic and cognitive-behavioral therapies.
What are the key features of the PQS?
100 items tied to specific actions, behaviors, and statements; reliable, valid, and allows comparison between therapy types.
What is the Psychotherapy Process Q-set (PQS)?
A descriptive, pantheoretical measure of the psychotherapy process used for quantitative analysis.
What common factor is responsible for promoting change in therapy?
The therapeutic/working alliance between patient and therapist.
What does research suggest about the outcomes of different forms of brief therapy?
They tend to have equivalent outcomes despite differences in content.
What are the 8 core mechanisms of change in psychodynamic therapy?
- Insight/self-understanding
- Defense mechanisms
- Quality of object relations
- Relationship rigidity & transference
- Reflective function
- Corrective emotional experience
- Therapeutic alliance
- Real relationship between patient and therapist
What is the role of defense mechanisms in psychodynamic therapy?
Therapy helps reduce immature defenses and promote mature ones, which correlates with symptom improvement
What is insight in psychodynamic therapy?
It’s the “aha” moment when patients gain self-understanding, linked to improved symptoms
What is a corrective emotional experience?
It involves re-experiencing an old conflict with a new, healing outcome within the therapy relationship
How is the therapeutic relationship conceptualized in psychodynamic therapy?
It includes the therapeutic alliance, transference, countertransference, and the real relationship
Name the major schools of psychodynamic theory.
Ego psychology, object relations, self psychology, attachment theory, interpersonal psychology, and relational psychoanalysis
What was Erikson’s major contribution to psychodynamic theory?
He extended development across the life span with psychosocial stages like identity vs. confusion and generativity vs. stagnation
What diagnostic systems have been proposed for psychodynamic therapy?
The Psychodynamic Diagnostic Manual (PDM) and Operationalized Psychodynamic Diagnostics (OPD)
What are the three main phases of psychodynamic treatment?
- Opening (formulation & treatment plan)
- Middle (create a new life narrative)
- Ending (termination, integration, future planning)
What are the six core psychodynamic issues treated with this approach?
- Depression
- obsessionality
- fear of abandonment
- low self-esteem
- panic anxiety
- trauma
What is the psychodynamic explanation for depression?
Internalized anger from early loss and self-criticism; therapy aims to build self-esteem and reduce abandonment fears
How is obsessionality addressed in psychodynamic therapy?
By helping patients tolerate emotions, reduce guilt, and challenge perfectionism and control tendencies
What is the psychodynamic approach to fear of abandonment?
It involves working through attachment issues, integrating object representations, and reducing emotional reactivity
What is the psychodynamic view of low self-esteem/narcissism?
Caused by lack of early selfobject support; therapy helps build realistic self-concept and tolerance for frustration
How is panic conceptualized psychodynamically?
Panic is seen as a defense against unconscious conflict, often related to aggression and fear of separation
How does psychodynamic therapy treat trauma?
Through processing the trauma story, mourning losses, and reconnecting with life, while managing transference/countertransference
What is Freud’s tripartite model of personality?
It divides the psyche into the id (instincts), ego (reality), and superego (morality), forming the foundation of ego psychology .
What is the difference between one-person and two-person psychologies?
- One-person: Therapist as neutral observer (classical psychoanalysis).
- Two-person: Therapist and patient mutually influence each other (relational psychoanalysis) .
How has the understanding of countertransference changed?
Once seen as an obstacle, countertransference is now viewed as a valuable tool to understand the patient’s dynamics and relationship patterns .
What is the core emphasis of object relations theory?
It focuses on how early relationships are internalized and shape current emotional life and interpersonal patterns .
What does empirical research say about the effectiveness of psychodynamic therapy?
Meta-analyses show it is effective, especially for complex, chronic, and personality-related disorders, and benefits increase over time .
What’s the optimistic outlook for CBT’s “descendants”?
They’ll be even more diverse, inclusive, and process‑focused—continuing to thrive as a dynamic family of therapies.
How does the “case conceptualization” work fit into CBT’s future?
It underpins the move to tailor strategies to each client’s unique problem genesis, ensuring interventions match individual profiles.
What are transdiagnostic models, and why are they important for the future?
They target common processes of change (e.g., emotion regulation) across disorders, allowing flexible application to diverse clinical presentations.
How is the conceptual model of CBT expected to evolve?
Toward identifying risk and resilience factors, matching interventions to client needs, and emphasizing transdiagnostic, process‑based care.
Why focus on moderators and mediators in future CBT research?
Understanding which client characteristics predict better or worse outcomes—and why—will allow more precise, individualized intervention matching.
What role do training and credentialing guidelines play in the future of CBT?
They ensure standardized, high‑quality care by defining core competencies and fidelity measures for practitioners.
Why are CBTs considered the “gold standard” in psychotherapy today?
They’re relatively short, evidence‑based, widely adopted in healthcare systems, and have demonstrated strong outcomes, including via web‑based delivery.
What is the philosophical “realist assumption” criticized in early CBT?
That reality exists independent of experience, and psychological health means aligning cognition with reality.
What is the Cognitive Therapy Rating Scale?
A standardized tool to measure CBT therapist competency, used by organizations like the Beck Institute and the Academy of Cognitive and Behavioral Therapies.
What are the two components of treatment integrity in CBT?
- Adherence – following the model as designed
- Competence – knowing when/how to apply or withhold interventions based on case formulation
What relational principle is core to CBT?
Collaborative empiricism – therapist and client jointly test and evaluate beliefs, behaviors, and therapy progress.
What does the therapeutic alliance include in CBT?
A positive, respectful, goal-oriented relationship with an emphasis on scientific hypothesis testing.
What have meta-analyses concluded about CBT efficacy?
CBT is effective across a broad range of disorders, especially for anxiety and depression.
What is the “Improving Access to Psychological Therapies” (IAPT) program?
A UK initiative that successfully expanded access to evidence-based therapies like CBT across the country.
What is process-based CBT?
A model that emphasizes general treatment processes over manualized disorder-based treatments.
What are the 3 universal change principles in CBT (Mennin et al., 2013)?
- Behavioral engagement (vs. avoidance)
- Attentional change (e.g., mindfulness)
- Cognitive change (e.g., reframing, de-fusion)
What is MBCT and what does it target?
Mindfulness-Based Cognitive Therapy, developed to reduce recurrent depression by changing one’s relationship to thoughts.
What is metacognitive therapy?
A therapy that targets thinking about thinking and maladaptive beliefs about cognition, applicable across many disorders.
What is DBT and who developed it?
Dialectical Behavior Therapy, developed by Marsha Linehan for self-injury and borderline personality disorder.
What dialectical themes are emphasized in DBT?
Stability vs. change, confrontation vs. support, reflection vs. action.
What does ACT stand for and what is its basis?
Acceptance and Commitment Therapy, based on Relational Frame Theory (RFT), which views language as the core of how humans create meaning.
What are key therapeutic goals in ACT?
Seeing oneself as an active creator of meaning, identifying values, and committing to value-consistent action.
What terms are used in ACT instead of traditional CBT language?
“Avoidance” becomes experiential avoidance, and “irrational thoughts” become cognitive fusion.
What criticism led to the development of the “third wave” of CBT?
That CBT was too linear, focused only on correcting negative thoughts, and ignored deeper meaning-making and human experience.
What is constructivist psychotherapy?
An early third-wave response that emphasized the unique, idiosyncratic meanings people attach to thoughts through language and self-in-world relationships.
What issues are raised around CBT training and practice?
There’s a strong emphasis on credentialing, training consistency, and fidelity to evidence-based protocols, especially as CBT expands across settings and formats.
How has CBT adapted to modern delivery systems?
CBT is increasingly delivered through internet-based platforms and smartphone apps, enabling wider access and new ways to track and measure therapeutic change.
What in-session process is central to CBT effectiveness?
A collaborative therapeutic relationship, involving Socratic questioning, structured agendas, and active client engagement.
What is the Unified Protocol?
A transdiagnostic CBT model targeting emotion regulation across disorders.
What are the five core elements of the Unified Protocol?
- Mindful awareness
- Cognitive flexibility
- Reducing emotional avoidance
- Tolerating physical sensations
- Exposure to distress
What is Young et al.’s (2003) contribution to CBT?
A framework of 16 early maladaptive schemas for emotional and behavioral dysfunction.
What did Leahy (2015) contribute to CBT?
A focus on emotional schemas that reflect how people interpret and respond to emotions.
What did Beck & Bredemeier (2016) propose about depression?
A unified model that includes genetic, biological, and evolutionary influences on cognitive vulnerability.
How does avoidance maintain dysfunction in CBT?
Avoiding feared situations prevents learning corrective information, reinforcing beliefs and emotional distress.
What is the foundation of the general cognitive model?
Core beliefs or schemas shaped by experience, development, and biology.
What are intermediate beliefs?
Conditional rules (e.g., “If I take a risk, I’ll fail”) that guide behavior.
How do schemas lead to cognitive distortions?
They bias information processing, reinforcing negative beliefs and avoiding disconfirming evidence.
What is cognitive conceptualization?
An individualized model integrating client problems, treatment options, and personal background to guide intervention.
Why is it essential in CBT?
It helps tailor therapy to the specific cognitive patterns and needs of the client.
What milestone increased CBT’s influence in the 1980s?
Publication of DSM-III (1980), which allowed diagnosis-based treatment development.
What was the significance of the APA Division 12 task force?
It created criteria for empirically supported treatments and endorsed CBT models.
What early CBT methods influenced behavior change?
Self-instructional training and problem-solving therapy.
What did Aaron Beck introduce in 1970?
Cognitive therapy (CT), focused on identifying and modifying distorted thoughts.
How did Ellis’s RET (later REBT) differ from CT?
RET used logical disputation; CT emphasized collaborative empiricism and Socratic questioning.
What are the three core principles of CBT?
- Mediational Hypothesis – Cognitions mediate emotions and behaviors.
- Access Hypothesis – Cognitions are accessible and assessable.
- Change Hypothesis – Changing cognition leads to improved functioning.
What are the three waves of CBT?
- Behavior therapy
- Traditional cognitive therapy (RET, CT)
- Third-wave approaches (e.g., mindfulness, ACT)
Who are key figures in the cognitive revolution influencing CBT?
Piaget, Chomsky, Bandura, and others in the 1950s–1960s.
What role did the cognitive revolution play in psychotherapy?
It shifted focus to conscious, accessible cognitions and the social construction of meaning, challenging psychoanalytic and behaviorist models.
