Interventions Flashcards
1
Q
What are the foundational counselling skills?
A
- Active listening = so clients know their story has been heard, not rehearsing what you will say
- Empathic responding = only useful if the perceptions connect to and reflected back with empathy to clients are accurate. Any “you feel” statements identify and labelling feelings are linked to “because” statements that then outline the circumstances that lead to the feeling/s.
- Reflection and summarisation = reflections can be minimal (key words or phrases), moderate (paraphrase a short version and clarification of what the client has said), or summative (longer reflection including various items discussed or observed - often at the beginning, middle and end of a session). The purpose is to encourage clients to elaborate on their experiences, experience a sense of being understood, and provide opportunities to correct the psychologist
2
Q
What are the three R’s of therapeutic relationships?
A
- Resistance = clients may feel both positively and negatively about treatment, and psycholgoist may discuss gently any resistance or ambivalence in treatment.
- Ruptures = when there has been a misunderstanding or interpersonal conflict between the therapist and client, which has disrupted the working alliance.
- Re-enactment = is ongoing when the same type of problem or interaction the client is having with others in their wider life is being played out in the therapy session
3
Q
What are the general steps in cognitive therapies?
A
- Creating a supportive atmosphere to reduce anxiety
- Using socratic dialogue, draw out the client’s beliefs and assumptions
- Clients are encourage to test their beliefs and assumptions
- Clients are assisted in modifying their thoughts through guided discovery involving more adaptive thoughts which can also be tested
4
Q
What does rational emotive behaviour therapy help clients to do?
A
Identify and challenging irrational beliefs by looking at:
Activating events
Beliefs
Consequences of these
Disputing the thoughts then checking the
Effect of the changed thinking and the new
Feelings associated with the changed thinking
5
Q
How is cognitive therapy linked to emotion regulation?
A
- Emotions involve feelings, cognitive appraisals, physiological responses, and tendencies to behave in certain ways.
- Emotions are dysfunctional when they interfere with adaptation and the ability to choose behaviour adaptively.
- Cognitive strategies are used to regulate emotions e.g. labelling emotions (to regulate amygdala activation), distraction of attention from negative aspects of the situation to neutral or positive aspects thuse reducing negative emotions, reappraisal of the meaning of an emotion eliciting situation, problem solving rather than rumination or thought suppression
- Can also use chain analysis to help clients identify vulnerability factors, activating events, as well as thoughts, feelings and behaviours in response to said events
6
Q
What is the purpose of behavioural experiments?
A
- Behavioural experiemtns are experiential, homework activities that help gather information to test the valididty of a certain belief or test new beliefs e.g. removing a safety behaviour
- They can increase therapy collaboration and active engagement in therapy
- E.g. telling clients not to think of a pink elephant makes them think of one, and therefore pushing away unwanted thoughts actually makes them present in one’s mind
- Some experiments may show beliefs to be true sometimes, and not true a lot of the time = encourages cognitive flexibility and ability examine one’s own beliefs for veracity
7
Q
What techniques are used in motivational interviewing?
A
- Giving advice
- Removing barriers
- Providing choice
- Decreasing desirability
- Providing feedback
8
Q
What are the fundamental components of motivational interviewing?
A
- Collaboration
- Evocation
- Autonomy
Therapist’s role = to evoke the client’s motivation to change (not provide the client with motivation), and the client remains free to make whatever change, or not, that they wish to. Therapists must resist the urge to engage in a righting reflex.
9
Q
How is relapse prevention used in MI?
A
SNAP (Smoking, Nutrition, Alcohol, Physical Activity)
- Clients clearly identify their goals
- Identify negative emotions that influence their propensity to use drugs or not engage in their daily exercise reigme
- Identify relationships that are influencing their propensity to make an unhealth choice
- Use journalling to become aware of circumstances that are unfavourably influencing their propensity to make healthy choices (e.g. dates, situations, people, choices, learning from situations)
- Problem-solve danger situations which generally present in a theme e.g. social pressure, thinking patterns, cravings, or negative emotions
- Clients remind self of reasons for remaining healthy/engaging in healthy behaviours and choose to engage with healthy and supportive people, places conducive to positive behaviours and activities.
10
Q
What does psychoeducation entail?
A
- Educating the client about their psychological illness
- The mastery of techniques that can be used to control symptoms and managing psychological conditions
Psychoeducation empowers clients to self-treat outside of therapy, and post cessation of treatment = encourages them to live more independent and adaptive lives.
Psychoeducation recognises the biopsychosocial antecedents of psychological illness.
11
Q
How is behaviour modification used in therapy?
A
- It applies behaviourist principles (e.g. punishment and reinforcement) on observable and measurable behaviours to create behaviour change.
- It acknowledges that behaviour is controlled by antecedents and consequences and changing these will increase or decrease associated behaviour
- Schedules of reinforcement may be used throughout therapy e.g. continuous reinforcement early on in behaviour change, then intermittent or ratio reinforcements later on when previously learned behaviours are being maintained
12
Q
What is the use of exposure therapy interventions?
A
Exposure therapy (or prolonged exposure) is designed to modify a pathological fear structure by providing corrective information that is incompatiable with the fear. I.e. clients are encouraged to confront feared and avoided situations or objects.
13
Q
How is exposure therapy performed?
A
- Can be in vivo = systematic, gradual confrontation with real-life objects/situations that trigger fear and avoidance
- Can be imaginal = vividly imagining the feared situation or object and client is not to avoid them or the triggered fear or anxiety
- When exposed to the feared event, object/memory the client is encouraged to detail the events, thoughts, feelings and sensations they experienced in their anxiety-provoking situation
- The goal is to produce habituation (process of diminishing anxiety) of distress when thinking about the trauma. The client learns through experience that they can cope with the feared event or object/memory thus improving self-efficacy and reducing anxiety
14
Q
What are the 4 steps in exposure?
A
- Preparation = clients must be aware of what is involved and prepared to engage in treatment after having the advantages and disadvantages of the treatment explained
- Creation of an exposure hierarchy = generate a list of situations or activities that create discomfort or are avoided completely, and each item on the list is then assigned a subjective units of distress frm 0-100 to create a hierarchy
- Initial exposure = hierarchy is presented to client and exposure begins. Therapists ask for SUDS repeatedly as they are exposed to stimuli and exposure continues until SUDS reduce
- Repeated exposure = clients repeat the exposure experience on their own as homework to aid in beneficial therapy transfer
15
Q
What is behavioural activation used for?
A
- Helping a client set up a schedule of activities can help move them from an inactive state to being more productive and active.
- The goal is to increase behaviours that are likely to result in a client being rewarded internally (sense of accomplishment) or externally (social attention).
- It helps increase mood by decreased rumination due to focussing on new activities.
- Behavioural activation shows that one can feel more motivated once they start doing an activity, rather than waiting for motivation.
- Graded task assignment is where the task in broken down and clients complete one small part of the task at a time e.g. for those who are too anxious or depressed.
16
Q
How is skills training incorporated in therapy?
A
- Skills training involves problem solving, anger management, emotional self-regulation, social interactions, stress management, parenting ability, and basic self-care.
- Skills training is generally present in most evidence-based psychological treatments (i.e. does not occur in isolation, but as part of a wider therapeutic intervention)
- E.g. social skills training can be part of treatment for social anxiety, ASD, and psychotic disorders.
- E.g. problem-solving skills, emotion regulation and mindfulness can be used for addiction to develop ability to identify targets for behavioural intervention and increase ability and motivation to resist relapse.
17
Q
What is self-management in therapy?
A
- Self-management = a person behaving in a way to influence another behaviour
- Based on behaviourism principles that certain behaviours immediately follow related antecedent events and/or are reinforced by following events. In the absence of immediate external rewards and punishments, a person behaves in a way designed to control another of their own behaviours
18
Q
How are relaxation strategies used in therapy?
A
- Purpose of relaxation strategies = rapid, reliable and easy-to-apply means for coping with moderating anxiety
- Progressive Muscle Relaxation = noticing the difference between tension and relaxation via active tensing and relaxing of muscle groups
- Breathing retraining = for those who hyperventilate when anxious, clients are taught to re-breathe by cupping their hands over their mouths and breathe into their hands until the symptoms of hyperventilation (dizziness or feeling light headed) are decreased. Slow, diaphragmatic breathing can also be used to help clients calm themselves (exhale longer than inhale and in a consistent rhythm)
