Final Flashcards
Define Cultural Competence
Clinician is INFORMED and ADAPTABLE to the issues involved in multicultural ASSESSMENTS
Main ethical issues in assessment (boundary violations) (5)
- Potential cultural bias of the instrument or the clinician
- Theoretical orientation of the clinician (assumptions, perceptions)
- Underemphasis on the external situation (overemphasis on personality traits)
- Insufficient validation (of some of the assessments and procedures)
- Inaccurate data or premature evaluation (inaccurately diagnosing or ignoring information)
Why is the therapeutic alliance so crucial? (trust/rapport)
Collaborative, aligned goals and approach to treatment.
More buy-in (esp by those who were referred or in an in-patient program)
Structured vs Unstructured Interviews
- Reliable vs subjective results
- Uniform vs tailored
- Searching for specific answer vs influenced by interviewer
- Cannot deviate, longer, more frustrating vs harder to quantify, sensitive/enjoyable
Presenting problems: What does a clinician want to know? (9)
- Symptoms
- Behaviors
- Situational, ongoing, or unrelated?
- Combo of situational + ongoing disorder?
- Duration
- Cog function?
- SI or Psychotic?
- Coping?
- DSM
4 Major Types of Therapies
- Behavioral (learning, assessment. ex: exposure)
- Cognitive/CBT (thoughts -> feelings/behaviors,
RET (core beliefs)
Becks (biased processing = distortions and errors) - Humanistic-Existential (Freedom and responsibility over life and behaviors)
Client-centered: CT already has the answer
Motivational interviewing: change talk, substance use
Gestalt Therapy: body, empty chair - Psychodynamic: (Insight, memories, dreams)
Behavioral Therapy Treatments (5)
EAMSrT
- Exposure Therapy
- Aversion Therapy – punishment (Antabuse, electric shock)
- Modeling – new skills by imitating
- Systematic Reinforcement – increase desired behaviors (eliminate the reinforcers)
- Token Economies – stickers
Paraphilic Disorders (8) (FTPVEFSM)
- Fetishistic: non-living objects / non-genital body
- Transvestic: cross-dressing
- Pedophilic: kids (-13)
- Voyeuristic: watching (most common)
- Exhibitionist: self-exposure
- Frotteuristic: rubbing up against someone
- Sadism: humiliating others
- Masochism: being humiliated
4 Dimensions of Psychopathy
(IALA)
- Interpersonal (charm, lying, manipulative)
- Affective (no guilt or empathy)
- Lifestyle (bored, parasitic, no long-term goals)
- Antisocial (behavior probs)
4 Causal Factors of Psychopathy
- Genetic
- Fear responses (learned or not)
- Emotional defects
- Early parental loss, rejection, or inconsistency
Treating BPD
Psychosocial Treatments:
- Establish sense of self
- DBT in group
Biological Treatments:
- Mood stabilizers
- Antidepressants (SSRIs)
Beliefs associated with specific PDs
- Paranoid: I cannot trust people.
- Schizoid: Relationships are messy, undesirable.
- Schizotypal: It’s better to be isolated from others.
- Histrionic: People are there to serve or admire me.
- Narcissistic: Since I am special, I deserve special rules.
- Antisocial: I am entitled to break rules.
- Borderline: I deserve to be punished.
- Avoidant: If people know the “real” me, they will reject me.
- Dependent: I need people to survive, be happy.
- Obsessive-Compulsive: People should do better, try harder.
3 Clusters of PD
- Cluster A — 3: Odd/Eccentric
- Cluster B — 4: Dramatic/Emotional (Histrionic, NPD, BPD, Antisocial)
- Cluster C — 3: Anxious/Fearful (Avoidant, Dependent, Obsessive-Compulsive)
What are the 10 PDs? PSSHNABADOc
Paranoid
Schizoid
Schizotypal
Histrionic
Narcissistic
Antisocial
BPD
Avoidant
Dependent
Obsessive Compulsive
Psychopharm (4 categories)
- Psychotic Disorders
Antipsychotic Drugs (Neurotropics) - Depression
SSRI — selective serotonin…
SNRI — selective norepinephrine reuptake
MAOI
Sometimes antipsychotic - Antianxiety Drugs
Benzodiazepines - Bipolar
Lithium
Mood stabilizers
Carbamazepine
…antipsychotics