Final Study Guide Flashcards
What percent of children live in conditions of poverty?
15% (16 million)
What percent of children living in poverty are under 6 years old?
25%
What percent of children living in poverty are living in extreme poverty (homelessness)?
5%
What percent of children living in poverty are African American?
47%
What percent of children living in poverty are Hispanic?
36%
What percent of children living in poverty are single female-headed families?
55%
How many children are estimated to die from poverty’s effects?
15,000
U.S. infant mortality rate from poverty is higher than how many other nations?
19
How many reports of child abuse and neglect are there each year for families who fall below the poverty line?
4 million
What percent of children living in poverty are diagnosed with a mental disorder?
11%
Why is play therapy important for children living in homelessness?
Allows children to process and address their concerns; a means for children to express, communicate, and make sense of their experiences
How many people are homeless at some time during the year in Georgia?
75,000
How many homeless children are there in Georgia?
More than 58,000
Where does Georgia rank in the nation for child homelessness?
2nd worst
Where does Georgia rank in the nation for states with the highest number of unsheltered people?
6th
Approximately how many homeless veterans are there in Georgia?
2,766
What is the poorest city in the U.S. for children?
Atlanta
What percent of all children in Atlanta living in poverty live in families with annual incomes of less than $15,000 a year?
48%
How many people in metro Atlanta experience homelessness on any given night?
More than 10,000
What percent of the more than 10,000 people experiencing homelessness on any given night are women and children?
More than 40%
What type of relationship exists between socioeconomic states and mental illness?
Strongly negative
What accounts for more than half of community differences in psychiatric hospitalization rates?
Higher unemployment, poverty, and lack of housing affordability in poorer communities
Which is more likely to precede the other: poverty or mental illness?
Poverty is more likely to precede mental illness
What is the prevalence of serious mental illness among those with the lowest family income level?
16.3%
What is the prevalence of serious mental illness among persons with Medicaid coverage?
20.7%
What is the prevalence of serious mental illness among persons who are unemployed or had “other” employment status?
14.2% and 15.5%
Why are men reluctant to ask for help and only do so as a last resort and when confronted by serious problems?
Men’s adherence to traditional masculine norms
Where is there a huge gap in the literature when it comes to gender and mental health services?
Female
Why did the WWII Allies establish the World Bank?
To finance the rebuilding of war-torn Europe
How must our approaches to help relate to poverty since it goes beyond the material dimension?
Approaches to help must go beyond the material as well
What is the goal helping addressing poverty?
See people restored - understanding that they have worth, value, and dignity, with abilities and capacity that can affect change in the world around them
How can we reach the goal of seeing people restored?
Relational processes
What is the ability to maintain an interpersonal stance that is other-oriented (or open to the other) in relation to aspects of cultural identity that are most important to the person”?
Cultural humility
Compassion’s truest measure lies not in our service of those on the margins, but in what?
Our willingness to see ourselves in kinship with them
When working with and hanging out with folks who carry more burden than they can bear, what keeps you from your task and keeps you from truly seeing whoever’s sitting in front of you?
Focusing only on fixing problems
What is one of the major causes of death and disability worldwide?
Interpersonal violence (IPV)
Which clients experience much higher rates of interpersonal violence?
Rehab clients
What is key for encouraging safety promotion among women with disabilities?
Promoting women’s recognition of abuse and fostering conditions and processes that support women’s responses to abuse
What are some supports for women with disabilities?
Providing accessible and empowering abuse safety information and resources, as well as backup personal assistance
Which group fo people experience rates of interpersonal violence much higher than the general population?
Those with intellectual and developmental disabilities
What encompasses, but is not limited to, a continuum of acts that range from slaps to homicide?
Physical abuse
What is a continuum from forcible rape to nonphysical forms of pressure that compel individuals to engage in sex against their will?
Sexual assault
What includes degradation, humiliation, intimidation, and threats to harm?
Psychological abuse
What is repeated harassing or threatening behaviors that an individual engages in?
Stalking
What is restricting access to resources?
Economic abuse
What is the lifetime prevalence of relationship physical assault in women and men?
Women - 22.1%; men - 7.4%
What is the annual prevalence of relationship physical assault in women and men?
Women - 11-12% (married or cohabiting); men - 12% (married or cohabiting)
How do rates of aggression appear across genders?
More equal
How do rates of ongoing abuse, control, and serious injury appear across genders?
Directed at women more often than men
What is noticeably wrong with Georgia’s definition of rape?
Only mentions females
What is the lifetime prevalence of relationship rape?
Women - 7.7%; men - 0.3%
What will people who have experienced trauma do to try to make the situation understandable?
They will blame themselves
They will develop negative cognitions
They will self-medicate
What is the lifetime prevalence of stalking?
Women - 4.8%; men - 0.6%
What is the lifetime exposure rate of rape, physical assault, or stalking by an intimate partner at least once?
Women - 25.5%; men - 7.9%
What is the lifetime exposure rate of physical, sexual, or psychological abuse?
Women - 29%; men - 22%
What is the prevalence of rape among college women?
1 in 4/1 in 5
What percent of completed and attempted college rapes involved a stranger?
Completed - 4%; attempted - 8%
What percent of college rapes involved classmates?
35%
What percent of college rapes involved friends?
34.2%
What percent of college rapes involved boyfriends or ex-boyfriends?
23.7%
What is the rate of completed rape between 15th birthday and college years?
15%
What percent of college students reported being stalked?
27% (males - 24%; females - 29%)
What percent of college males have experienced psychological/verbal abuse as victim or perpetrator?
81%
What percent of college females have experienced psychological/verbal abuse as victim or perpetrator?
87.5%
What percent of college males and females have experienced physical aggression as perpetrators?
Males - 37%; females - 35%
What percent of college males and females have experienced physical aggression as survivors?
Males - 39%; females - 32%
What percent of high school females reported being physically and/or sexually abused by a partner?
19%
What percent of students who reported physical fights were in 8th grade/
10%
What percent of high school males and females reported moderate physical violence by a partner?
Males - 31%; females - 20%
What percent of high school males and females reported severe physical violence by a partner?
Males - 15%; females - 23%
What percent of physical and sexual assaults occur during the relationship?
Physical assaults - 69%; sexual assaults - 78%
What percent of rapes and physical assaults occur before and after the relationship?
Rapes - 25%; physical assaults - 18%
What percent of rapes, physical assaults, and stalking occur after the relationship?
Rapes - 6%; physical assaults - 4%; stalking - 43%
What percent of men and women who are physically assaulted experience multiple incidents?
66% (2/3)
What percent of women raped report 2-9 rapes by the same partner?
50%
What percent of women and men have 10 or more incidents of physical assault?
Women - 20%; men - 11%
What percent of women have 10 or more incidents of rape?
15%
What are risk factors for homicide by perpetrator?
High frequency of violence Physical injuries Violent behavior outside the home Rape of partner Possession or use of weapons Threats to hit and/or kill partner Killed or abused pets Controlling and psychological maltreatment Survivor leaving the perpetrator
What is the top risk factor for homicide by perpetrator?
Killed or abused pets
What are some reasons that women stay in an abusive relationship?
Power differential Fear of public exposure Fear of disclosure of sexual/affectional orientation Learned helplessness Economic constraints Fear of being seriously hurt or killed Fear of losing children Psychological dependency
What is the rate difference of intimate-offender attacks on women separated from their husbands and divorced and married women?
Rate of women separated from their husbands is about 3x higher than divorced women and 25x higher than married women
What percent of intimate homicide victims physically separated from the perpetrator prior to death?
65%
What percent of survivors of domestic violence had documented history of physical abuse?
88%
Why might the reaction of children be worse?
Exposure at stage in development
What percent of men who frequently abuse partners also frequently abuse their children?
50%
What percent of children are aware of the violence even if parents try to keep it from them?
80-90%
How might violence affect infants?
May not develop attachment to caretakers
How might violence affect preschool children?
May regress developmentally and have sleep disturbances including nightmares
How might violence affect school-age children?
Depression, anxiety, violence toward peers, fears of going to school or being separated from their non-violent parent
How might violence affect adolescents?
Re-creating violent relationships, attempt suicide, abuse drugs and alcohol, run away from home
What should be included in an assessment of relationship violence?
Ask specific questions about all forms of abuse
Ask about particular incidents
Get details
Develop safety plan
What should be included in a crisis intervention for relationship violence?
Identification of community, medical, and social resources
Facilitation of access to community resources
Minimization or elimination of specific dangers
What should be included in the safety plan for relationship violence?
Avoid rooms that may contain possible weapons
Avoid rooms with no exit
Get to a room that locks from the inside and take a phone
Have an escape plan and escape word
Call 911
Tell neighbors to call 911 if they hear suspicious noises
Keep purse and car keys close
Decide what to do with pets
Have escape bag ready
Know where client can go
Take pictures of injuries for future
What are types of interventions for relationship violence survivors?
Individual counseling
Group counseling
Psychoeducation
Community level interventions
What are important steps in any intervention?
Ensuring safety
Provision of validation and support
Identification of personal consequences and effects from IPV
Resolution of associated emotional and psychological difficulties
Promotion of insight and self-empowerment
Facilitation of personal problem-solving ability
Promotion of access and usefulness of social supports
Provision of ongoing therapeutic support as needed
What are some interventions for children who have lived in violent homes?
Play therapy/individual therapy if child is older
Family therapy with just the children
Group therapy with other children who live(d) in violent homes
Family therapy with survivor and children, but without the perpetrator
What is the key to counseling a suicidal client?
Get clients past where suicide makes sense
What is the 10th leading cause of death in the U.S.?
Suicide
How many people die by suicide each year?
Approximately 45,000
What percent of all completed suicides do firearms account for?
51%
What is the most prevalent demographic to complete suicide?
White male (especially older white male)
What age group has the highest suicide rates?
Older adults
Why is the suicide rate lower than it probably actually is?
Miscategorized as accidents (especially in older adults)
How much higher are suicide rates for people with serious chronic illness?
3-5x higher
Which type of suicidal patients had more predisposing risk factors and less support: delayed-onset or acute-onset?
Acute-onset
What percent of individuals with TBI report suicidal thoughts, plans, and attempts in a 5-year post-injury period?
17%
Males complete suicide at how many times the rate of females?
4x
Females attempt suicide at how many times the rate of males?
3x
Suicide is the 3rd leading cause of death among which age group?
10-24 year olds
What methods of suicide were young people more likely to use?
Firearms, suffocation, and poisoning
Are boys or girls more likely to die from suicide?
Boys
What is the percent of male and female deaths by suicide for the 10-24 age group?
Males - 81%; females - 19%
What racial group have the highest rates of suicide-related fatalities among youth?
Native American/Alaskan Native
What percent of people who attempt or complete suicide have shown some warning signs?
75%
What are some risk factors of suicide?
A history of previous suicide attempts Family history of suicide Factors of the mind and body Factors from the environment Factors you take part in, experience, or learn
What are some protective factors for suicide?
Effective clinical care for mental, physical, and substance use disorders
Easy access to a variety of clinical interventions and support for help seeking
Family and community support
Support from ongoing medical and mental health care relationships
Skills in problem solving, conflict resolution, and non-violent handling of disputes
Cultural and religious beliefs that discourage suicide and support self-preservation instincts
What does IS PATH WARM stand for?
Ideation Substance abuse Purposelessness Anxiety Trapped Hopelessness Withdrawal Anger Recklessness Mood change
What are three approaches to suicide/suicidality?
Prevention
Intervention
Postvention
What should be included in a suicide assessment?
Identify risk factors Identify protective factors Conduct suicide inquiry Determine risk level/intervention Document
What is a “doorknob confession”?
When a client reveals suicidal ideation/plan at the end of the therapy session
What is more effective than any other individual intervention for suicide?
Psychotropic medications plus any form of counseling
What has been shown to be effective in preventing youth suicide?
No-suicide contracts
What should be included in a no-suicde contract and/or safety plan?
Specifics as to client actions, agreements, phone numbers, time limits
Concrete wording and clear directions for actions when in a crisis
Individualized items for client written in collaborative manner
Context sensitive information
Positive focus on what client can do when suicidal
Anticipation of potential problems and alternative methods of action when suicidal
What are some issues which increase violence?
Substance abuse/addictions
Impulsivity
Low ego strength
Low social support and social isolation
Emotion press from fear, rage, hatred, or similar emotions
Immediate and easy access to violent target
Past criminal history
Mental illness especially with poor reality testing
What percent of mental health workers feared for their lives at one time?
29%
What percent of mental health professionals will be psychologically or physically assaulted during their professional lifetime?
60%
What percent of psychologists reported having been physically attacked by at least one client?
20%
What percent of psychologists reported having been afraid that a client would attack them?
Over 80%
What percent of psychologists reported having had fantasies that a client would attack?
Over 50%
What percent of psychologists had summoned the police or security personnel for protection from a client?
Over 25%
What percent of psychologists reported obtaining a weapon to protect themselves against a client?
3%
What is of the most importance while look after aggressive clients?
The safety of the client, clinicians, staff, and other clients and potential intended victims
What are critical safeguards in the treatment of potentially dangerous clients?
Adequate caregiver training and the availability of appropriate supervision
What are the stages of crisis management with aggressive clients?
Immediacy Control Assessment Disposition Referral Follow-up
What is the key to the stage of immediacy?
Communicating respect, honesty, trustworthiness, detachment, and empathy
What are the phases of acting-out behavior?
Calm –> trigger –> agitation –> acceleration –> peak –> de-escalation –> recovery
What should be the first and foremost consideration when warning signs indicate that danger is imminent?
Safety
What are the levels of disturbance?
Level 1 - disruption confined to one area, but no threat to clients or staff
Level 2 - disruption forces are mobile and/or pose a threat to clients and/or staff
Level 3 - disruption is widespread with large-scale client participation and is a serious threat to clients and staff
What is vicarious trauma?
The stress resulting from engaging in an empathic relationship and helping or wanting to help a traumatized or suffering person
What does vicarious traumatization represent?
The resulting cognitive shifts in beliefs and thinking that occur after direct practice with victims of trauma or crisis management
What is compassion fatigue?
An intense personal experience, with a sudden onset, arising when caregivers are overwhelmed by patient suffering or trauma
What is a key component of compassion fatigue?
Empathy experienced by caregivers for individuals in distress
What is burnout?
A response to prolonged stress; a state of physical, emotional, and mental exhaustion that results from long-term involvement in work situations that are emotionally demanding
What are signs of burnout?
Diminished energy and exhaustion Indifference towards work Isolation and withdrawal Decreased job satisfaction and lowered expectation Postponement of client contact Negativism Anger and resentment Guilt and blame
What is the goal of the crisis response box?
Managers and employees can immediately access information essential to crisis management
What is the goal of psychological first aid?
Defusing and debriefing for crisis management
What is the central idea of psychological first aid?
Protect –> direct –> connect
What is the protect part of psychological first aid?
Protect from further harm and from further exposure to traumatic stimuli
Create a “shelter” or safe haven for them
Protect from onlookers and the media
What is the direct part of psychological first aid?
Kind and firm direction
Direct ambulatory survivors away from the site of destruction, away from severely injured survivors, away from continuing danger
What is the connect part of psychological first aid?
Supportive, compassionate, and nonjudgmental verbal or nonverbal exchanges
Help survivors connect to loved ones and pets, to accurate information and appropriate sources, to where they will be able to receive additional support
What individuals will be especially at risk during extraordinary circumstances?
Clients, students, and staff with disabilities
What should a helper do during extraordinary circumstances?
Identify the type of crisis
Evacuate or stay in place
Defusing and/or debriefing
What is defusing?
The process of helping through the use of brief conversation
What are the stages for crisis incident stress debriefing?
Preparation Introduction Fact phase Thought phase Reaction phase Symptom phase Teaching phase Re-entry phase
What are the three types of traumatized individuals?
Victim - destroyed by the trauma
Survivor - recovers, but spends the rest of life seeking sanctuary and safety via overcontrol/undercontrol and lives a “dialecticic” black/white lifestyle
Thriver - heals the trauma and grows wiser and strong “at the broken places”
What type of responses are there in the face of terror?
Many idiosyncratic responses
What disorder is wildly overdiagnosed?
PTSD
What kinds of issues does trauma begin to elicit as the terror overwhelms the individual at the type of the trauma?
Symptomatic issues
What are the 4 decisions that an individual can make when faced with a trauma?
Fight
Flight
Freeze
Submit
What two parts of the body are no longer in balance during trauma?
Limbic system and prefrontal cortex
What is the diagnostic definition of PTSD?
Exposure to actual or threatened death, serious injury, or sexual violence in one or more of the following ways:
- Directly experiencing the traumatic event
- Witnessing, in person, the event as it occurred to others
- Learning that the traumatic event occurred to a close family member or close friend
- Experiencing repeated or extreme exposure to aversive details of the traumatic event
How long should trauma last to be classified as PTSD?
More than one month
What is depersonalization?
Persistent or recurrent experiences of feeling detached from and as if one were an outside observer of, one’s mental processes or body
What is derealization?
Persistent or recurrent experiences of unreality of surroundings
What is the diagnostic definition of acute stress disorder?
Person was exposed to death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence in one or more as follows:
- Direct exposure
- Witnessing in person
- Indirectly, by learning that a close relative or close friend was exposed to trauma
- Repeated or extreme indirect exposure to aversive details of the event
How long should trauma last to be classified as acute stress disorder?
3 days to 1 month
What is Type I trauma?
Short term, unexpected traumatic events
What is Type II trauma?
Sustained and repeated ordeal stressors; series of traumatic events or exposure to prolonged traumatic event
What are the stages of the treatment of trauma?
Stage 1 - relationship building and safety, or safety and stabilization
Stage 2 - remembrance and mourning or processing traumatic memories
Stage 3 - reconnection
How must you begin treatment of trauma?
Establishing relationship and relationship building
Where must you restore control in treating trauma?
Basic needs Regulation of body functions Management of symptoms Control of self-destructive behaviors Environmental issues
What would treatment look like for a single acute trauma?
Rudimentary sense of safety within a few weeks with adequate social support
Stabilization of symptoms in 3 months - hastened by brief treatment that empowers survivor
Hostile or unprotective environment can hamper or stop the establishment of sense of safety
Usually short-term therapy or crisis intervention is sufficient
What would treatment look like for prolonged, repeated trauma?
Initial stage protracted and difficult due to danger to self
Rebuilt ego functions damaged in captivity
Be able to take initiative, carry out plans, and exercise independent judgment
Longer course of psychotherapy necessary
What would treatment look like for chronic child abuse?
Extremely complex and time consuming
Self-care severely disrupted
Self-Harming behavior
May be struggle between therapist and survivor with therapist sometimes feeling he/she cares more about the survivor’s survival than the survivor does
What are the goals of stage 2 of treating trauma?
Enhancing self-reflective processing of emotion and information rather than just overcoming avoidance of traumatic memories
Develop the ability to choose whether, when, and how to recall and make sense of traumatic memories
What tasks are included in stage 3 of treating trauma?
New self
New relationships
New belief system
New meanings
What is EMDR?
Evidenced-based psychotherapy for PTSD
What does Shapiro’s Adaptive Information Processing model posit?
Much of psychopathology is due to the maladaptive encoding of and/or incomplete processing of traumatic or disturbing adverse life experiences
What are three prongs of EMDR?
Targets past experiences
Current triggers
Future potential challenges
What are the phases of EMDR?
Client history Preparation Assessment Desensitization Installation Body scan Closure Reevaluation
What is tapping related to?
Acupressure and the use of body meridians
What is brain spotting?
The direction in which people look or gaze can affect the way they feel; therapists help people position their eyes in ways that enable them to target sources of negative emotion
What is somatic experiencing?
Framework to assess where a person is “stuck” in the fight, flight, or freeze responses and provides clinical tools to resolve these fixated physiological states
What is ego state therapy/internal family systems?
Addresses “part” and assumes that “parts” are a normal part of human development; attempt to increase internal communication and decrease internal conflict among different aspects of self
What are exiles?
Young parts that have experienced trauma and often become isolated from the rest of the system in an effort to protect the individual from feeling the pain, terror, and fear of these parts
What are managers?
Parts that run the day-to-day life of the individual; attempt to keep the individual in control of every situation and relationship in an effort to protect parts from feeling any hurt or rejection
What are firefighters?
Group fo parts that react when exiles are activated in an effort to control and extinguish their feelings; can do this in any number of ways; have the same goals as managers but different strategies
