Final Exam Flashcards
Postmodern therapy
Collaborated with family members with self creating independent participants
Shared expertise, not just therapist
Concerned with how a family constructs their reality
Characteristics of social constructionist
Egalitarian
Mutual inquiry
Client is expert in their lives
Assumptions are explored
Focus is cognition not behavior
Beliefs shape action
Culture shapes beliefs
Help clients explore Meanjbgs
Solution focused brief therapy
Focused on change rather than finding it why the family has problems
Skeleton keys
Interventions, that work with a variety of locks (don’t need to know why they door is locked or won’t open just need a key)
In sfbt
De shazer
Observe what works
Read write and burn thoughts
Types of therapeutic questions
1st session change questions
Miracle question
Exception question
Scaling question
1st session formula question
What is happening in your family that would want to continue? Have the explain Good hinges they want more of
Miracle question
What would tj be like if a miracle happens and the problems you have are solved?
Exception questions
When are there times that pieces of this miracle happen just a little? What’s the exceptions?
Scaling questions
Develop solutions based off the exceptions
Assess clients viewpoint and gauge perceptions
SfBT three types of client therapist relationships
Visitor host
Complainer listener
Customer seller
Visitor/host relationship
Client is the visitor who does have a problem and may be there against their will, don’t expect anything
Counselor is the host, sympathize with clients plight, compliment when possible, hosting activities make them comfortable, look for complainants
Complainant/listener
Client is the complainant, can describe the problem or goal, see the solution as external to their control and can overwhelmed with info and complaining
Counselor is he listener, listens and is accepting, accepts the clients world view, gives noticing or observing tasks at the end of session
Customer/seller relationship
Customer is the client, there’s a problem and the client states or understand that he/she is the one who has to do something, are ready to buy and do whatever is possible
Counselor is the seller, agreeing to work on the clients goal or problem, is active and more directive, may give a behavioral task, when helpers responses match client motivation and cooperation are enhanced
Solution oriented brief family therapy figures
O’hanlon and wiener-davis
Narrative family therapy founder
Michael white
Role of narrative therapists
Collaborating partners with clients
Honor the stories
Help clients re-examine the so called truths about themselves, imposed by others and culture
Help clients reconstruct a new narrative
Goals of narrative therapy
For families to create and internalize new stories
Make new assumptions
Open themselves to new views and future possibilities
Rewrite their future story lines
Actively changes or reshapes their lives
Thin descriptions
Problem stories are based on thin descriptions, using labels such as bad, selfish
Lead to thin conclusions, fail to remember times when these labels didn’t occur
Thick descriptions
Help clients talk about their life in rich, retelling of stories of ones history or identity
Not a replacement if stoy with a mother but help them view life as multistorued with options
Deconstruction
The dominance of one meaning or one set of assumptions is an illusion
It’s possible to apply multiple meanings to understand the same event or experience
Help clients examine so called truths
Externalizing
Person isn’t the problem, problem is the problem
Unique outcomes
Search for instances events or thoughts contradicting their dominant problem saturated story, opens doors to explore alternative narratives
Ceremonies
Tell or perform stories of their lives with outside witnesses, witnesses respond to provide thickening
Therapeutic letters
Variety of types, between sessions as summaries, ticked alternative story lines
Gender sensitive family therapy
Regardless of theoretical approach, attempts to overcome confining sex role stereotyping by therapists in any clinical intervention efforts
Impact of multiculturalism on family therapy
Avoid pathological assumptions of ethnic minority families whose behavior is unfamiliar, avoid ethnocentric views
Gender schema
What is considered masculine and feminine is developed early in childhood, this is reinforced and hamper both sexes
The women’s project
Marriane Walters,Betty carter, Peggy Pap, Olga silverstei
1977-recently
Ongoing examination of gender patterns in family relationships as well as patriarchal assumptions underlying classic classic family therapy approaches.
Thru workshops these family therapists offered female informed clinical perspective
The invisible web
Argued that family therapy relies on me dominant gender defined functions
Gender analysis.
Gender sensitive family therapy
Intended to liberate and empower both male and female clients, enabling them to move beyond prescribed roles determined by their biological status to ones in which they can exercise choice
Built upon feminist therapy
Attempts to overcoming confining sex role stereotypes
Therapist is attuned to common gender roles clients absorbed
Help confront sexist messages
Jean baker Miller and Sandra Ben
Cultural sensitive therapy
Recognizes that the whole middle class cultural outlook most therapies operate from (prizing individual choice, self sufficiency, independence)
Issues in family violence
Gender, asymmetrical power and control are used in family violence
Physical and Sexual violence
Using coercion and threats intimidation Emotional abuse Isolation Minimizing, denying, blaming Use children Make privilege Economic abuse
Ethnicity
Unique characteristics of a social grouping sharing national origin and linguistic/cultural traditions
Informed consent
Document outlining risks and benefits of counseling
Session structure, costs, assessment, treatment approach, confidentiality, policy on providing legal testimony, information on insurance/diagnosis
Confidentiality
Protecting a clients privacy
Ensuring that info shared in therapy isn’t shared outside without clients prior consent
Limits on confidentiality
Client signs disclose agreement to talk with attorneys doctors etc
Therapist acts in court appointed capacity
Suicide or homocide
Mandated reporter, child abuse elder abuse
Therapist defendant or insurance billing
Under supervising confidentiality
Must inform you’re an intern and will share with supervisor
Supervisor info make and number
Indicate if you will record
Family and minor confidentiality
You lay out with family who is the client and then talk about their confidentiality
If you don’t come to an agreement, the whole family or couple is the client
Confidentiality with minors
Counselor informs parents and legal guardians about role of counselor and the confidential nature of counseling relationship
Collaborate relationship with parent but trust with client
Safety issues parents should be told, first session decide what will be shared and not shared with both
Advantages of licensure
Establishes minimum standards of service
Holds professionals accountable, protects the public
Increases likelihood that practitioners will be competent (ceu requirements)
Gather practitioners together, maintains commitment to high standards
Professional identity
Managed care
Benefits dependent upon in network vs out of network
Preauthorization often required
Treatment plans may be shared
Progress may be shared
Additional sessions must be approved
Only individual sessions, not family or couples
Generally requires diagnoses from DSM 5
Challeges with insurance
Often want short term problem solving therapy
Return clients to previous level of functioning vs optimum level
Clients must sign release to insurance company
Malpractice
Therapist fails to render services as a competent provider (standard of care generally accepted by other professionals and within the ethical standards of professionals
How to avoid malpractice, informed consent, diagnose correctly, practice within competence, don’t abandon instead refer, no sexual contact, protect clients and others, document)
Components of competent family therapy
Continuing education
Ethical code
Core components of competent family therapy
Admission to treatment
Clinical treatment and diagnosis
Treatment plan and case management
Therapeutic interventions
Legal issues ethics and standards
Research program evaluation
Conceptual skills, perceptual skills,executive skills, evaluative skills, professional skills
