IPT/Marriage Flashcards
In the middle phase of interpersonal psychotherapy (IPT), the therapist focuses on the patient’s: (4x)
CURRENT RELATIONSHIPS
In pt with MDD and social phobia the IPT targets social isolation by (2x):
WORKING WITH THE PT TO HELP INCREASE SOCIAL CONTACTS, STRENGTHEN THE CURRENT RELATIONSHIPS.
During the initial phase of interpersonal psychotherapy (ITP), what problem is the therapist most likely to identify for therapeutic focus with the patient (x2)?
ROLE TRANSITION
F psychiatrist has been treating a 32 y/o married F pt w weekly psychotherapy for depressive sx, ambivalence about marriage. Therapy progressing well. Pt just learned she is pregnant, explores conflicted feelings about terminating pregnancy and her fears that unplanned pregnancy would trap her in marriage. Uncharacteristically, psychiatrist speaks strongly to pt about reasons not to make such a choice. Pt responds by saying “you are not going to make me feel guilty about this!” What statement would be most appropriate for therapist to make in response?
YOU FELT I WAS IMPOSING A MORAL JUDGMENT ONTO YOU, AND, APPROPRIATELY, YOU OBJECTED.
Which interview technique is illustrated by validating a patient’s inappropriate ED visit (eg. superficial wrist laceration) but also transitioning to their emotional needs?
CONFRONTATION
Interpersonal social rhythm therapy in bipolar focuses on what?
LIFESTYLE REGULARITY
IPT of adults w/ depression begins w/assessment of pt’s adjustment to stressful life events, role transitions and disputes, and:
QUALITY OF SOCIAL CONNECTIONS
Name a treatment modality that explicitly emphasizes giving pts a formal psych Dx and assigning them sick role:
INTERPERSONAL THERAPY
75 y/o pt has begun to experience insomnia and fatigue after the death of her husband. She describes feeling “down in the dumps”. She was previously active with many friends and social outlets. Psych MD decides that treatment should focus on pt’s grief as the primary problem in order to aid mourning and facilitate pt’s reintroduction into outside activities and relationships. What therapy is best?
INTERPERSONAL THERAPY
Intentionally assigning the sick role to a pt which serves to give the pt the permission and responsibility in order to recover is a tenet of which form of psychotherapy?
INTERPERSONAL THERAPY
Which Tx is contraindicated in initial treatment of pt experiencing domestic violence? (4x)
CONJOINT MARITAL THERAPY
What best illustrates a double bind in a family? (3x)
BETTY’S PARENTS ENCOURAGE COLLEGE, BUT COMPLAIN THAT EXPENSES WILL BE A HARDSHIP FOR THE FAMILY
Which psychosocial therapies for pts w/ schizophrenia has been shown to reduce relapse rates? (3x)
FAMILY PSYCHOEDUCATIONAL THERAPY
When conducting marital therapy with a couple who beginS to talk about divorce, what should the psychiatrist’s stance be? (2x)
FOCUS ON THE COUPLE’S RESPONSIBILITY TO DECIDE THE FUTURE OF THEIR RELATIONSHIP
What response is consistent with supportive therapy when a patient tells you their marital conflicts have resolved thanks to you the therapist?
IM HAPPY TO HEAR THAT THINGS ARE GOING WELL AT HOME AND THAT OUR WORK TOGETHER HAS BEEN HELPFUL
Wrap around process for youth
AN INDIVIDUALIZED, FAMILY-DRIVEN AND YOUTH-GUIDED TEAM PLANNING PROCESS
On initial psych eval, pt tells dr about recent infidelity, wants to make amends with spouse, what response would get additional info from pt?
TELL ME MORE ABOUT HOW THIS STARTED
Which of the following statements best describes the current conceptualization of family that informs family system theories and treatment approaches?
FUNCTIONING FAMILIES TEND TO HAVE CERTAIN SHARED CHARACTERISTIC ATTRIBUTES RATHER THAN COMMON STRUCTURES
Dysfunctional process in systemic therapy illustrated by mother telling 15yo son to confront his father about his excessive drinking.
TRIANGULATION
Which of the following approaches is likely to obtain the most accurate information on the factors influencing a family’s level of functioning
FAMILY COPING STRATEGIES IN RESPONSE TO PAST STRESSORS
During the initial interview of a couple presenting for therapy it is helpful to point out that the focus of therapy is primarily on the:
RELATIONSHIP PROBLEM
Typical phase of life problem in middle adulthood?
CARING FOR BOTH ONE’S CHILDREN AND PARENTS
9 yo f bib-parents for outpt evaluation due to behavior difficulties at home. Port daughter “explodes” when she doesn’t get her way. Bossy with friend. On interview, child is calm, cooperative and interactive, denies SI/HI and states “sometimes I just get mad.” What is the most appropriate level of care?
SEND THE PT HOME WITH PARENTS
9 yo f bib-parents for outpt evaluation due to behavior difficulties at home. Port daughter “explodes” when she doesn’t get her way. Bossy with friend. On interview, child is calm, cooperative and interactive, denies SI/HI and states “sometimes I just get mad.” At a follow up interview the physician learns the outbursts are related to parental disputes. What is the next treatment step?
EXPLORE REASONS FOR PARENTAL DIFFERENCES
9 y/o female bib-parents for outpt evaluation due to behavior difficulties at home. Reports daughter “explodes” when she doesn’t get her way. Bossy with friend. On interview, child is calm, cooperative and interactive, denies SI/HI and states, “sometimes I just get mad.” Which is the most appropriate initial diagnostic step?
OBTAIN A TEACHER REPORT
Which of the following principles is most commonly endorsed in parent management training programs for treatment of oppositional defiant disorder?
PARENTAL ATTENTION FOR PROSOCIAL BEHAVIOR
Beginning phase of therapy w child who was incest victim should first focus on what?
DEALING WITH PRIOR BETRAYAL AND ESTABLISHING TRUST WITH THE THERAPIST
5 y/o enacts fight between two dolls. What should therapist do?
DESCRIBE THE DOLL’S AFFECT WITHOUT ATTRIBUTING ANGER TO THE CHILD
Couple has sought couples’ therapy due to chronic episodic fighting. Solution focused therapist might make which intervention?
BETWEEN NOW & NEXT TIME, I WANT EACH OF YOU TO THINK ABOUT WHAT THE TWO OF YOU ARE DOING DIFFERENTLY IN TIMES OF NOT ARGUING
Interview w/ a pt w/ schizophrenia evokes feelings of confusion and frustration in the interviewer when the pt becomes silent. What response by the therapist would be the best approach to establishing rapport?
ACKNOWLEDGING THE INTERVIEWER’S FRUSTRATION AND INQUIRING IF THE PT FEELS SIMILARLY
In cases of recovered memory, the role of the therapist is to:
DEMONSTRATE EMPATHY FOR THE PATIENT WITHOUT ENDORSEMENT OF THE MEMORY
In split treatment, the role of the prescribing psychiatrist is?
EVALUATE THE PTS NEEDS FOR MEDICATIONS WHILE MAINTAINING REGULAR CONTACT WITH THE THERAPIST
Psychotherapy research shows which of the following practices in a therapeutic relationship is most supportive for improving outcomes?
COLLECTING FEEDBACK FROM THE PT ABOUT THE TREATMENT
Pt is often tardy. Supervisor warns not to be late. Pt has anxiety about losing job. When father dies he leaves town w/o telling supervisor. Again given warning. Next day a train causes him to be late. In therapy, the overlapping of multiple potential causes for tardiness is an example of what?
OVERDETERMINATION
Woman is unable to achieve orgasm with her partner. Treatment = directed masturbation + ?
COUPLES THERAPY
The basis for self-psychological strategy in marital therapy is best indicated by what?
DEMONSTRATING CONFLICTS ARISING FROM EACH SPOUSE’S NEED TO HAVE HIS/HER NEEDS MET BY OTHER
Couples therapy: what is the goal of acceptance work?
EACH PARTNER TAUGHT TO UNDERSTAND OTHER’S POSITION & RELEASE STRUGGLE TO CHANGE HIM OR HER
During initial eval of an individual for couple’s therapy, it is most critical to ask about:
DOMESTIC VIOLENCE
28yo homosexual M reports being victim of domestic violence and has not reported. What is the best response for the psychiatrist to make?
LISTEN TO PT’S CONCERNS AND EXPLORE THEM
A new psychotherapy patient arrives for a first appointment, accompanied by the spouse. The pt asks if the spouse can be present during the interview. Which of the following is the most appropriate immediate response by the psychiatrist?
CERTAINLY, IF THAT IS YOUR WISH, BUT I’D ALSO LIKE TO SPEAK WITH YOUR PRIVATELY AT SOME POINT.
Couples dissatisfied with each other and progressing toward divorce has which of the following?
EXPRESSION OF CONTEMPT AND STONEWALLING DURING INTERACTIONS
Couples therapy is contraindicated in which of the following situations?
UNEQUAL MOTIVATION
family psychoeducation programs for psychotic disorders reduce symptom severity and relapse risk by reversing what?
FAMILY MEMBERS EXPRESS CRITICISM, HOSTILITY AND BLAME TOWARDS THE PATIENT
This best describes the technique of reframing in family therapy:
NEGATIVELY EXPRESSED FEELING OR BEHAVIORS ARE EXPRESSED IN POSITIVE TERMS
Structural model of family therapy characterizes family as
COMPLEX SYSTEM COMPRISED OF ALLIANCES AND RIVALRIES
According to strategic and structural family therapies - underlying basis for analysis of symptoms in children, parents, and families
OBSERVABLE AND REPORTED FAMILY BEHAVIOR SEQUENCES
What is an important technique of structural family therapy?
OBSERVING THE RELATIVE INFLUENCE OF EACH FAMILY MEMBER ON THE OUTCOME OF AN ACTIVITY
Which practice is common to all couple and family therapies and contributes to a therapeutic outcome?
CONCEPTUALIZING DIFFICULTIES IN RELATIONAL TERMS
Therapist validates family’s strengths/resources in dealing w pt’s schizophrenia at bi-weekly family meeting. What stage of family psychoeducational model is this?
ENGAGEMENT
According to both strategic and structural family therapies, which of the following is the underlying basis for analysis of symptoms and dysfunction in children, parents, and families?
OBSERVABLE AND REPORTED FAMILY BEHAVIOR SEQUENCES
12 yo arguing w his single parent mother. Mother threatens consequences and child runs to grandmother who then scolds mother for being too harsh. Family dynamic is reflective of?
TRIANGULATION
What type of family therapy uses paradoxical directives, such as prescribing the symptom or behavioral sequence?
STRATEGIC
In what type of family therapy are the concepts of family hierarchies, boundaries, coalitions, and alliances seen as core concepts?
STRUCTURAL
Contraindication to family therapy
STRONG RELIGIOUS OR CULTURE BELIEFS AGAINST OUTSIDE INTERVENTION
In family therapy, a previously distant couple begins to communicate more frequently and intimately. After this happened the daughter who used to be close to mom, and has become less so as a consequence of above therapy changes, is more hostile to father. This behavior is called:
TRIANGULATION
Pt w/ schizophrenia has recently been discharged from the hospital after a first psychotic episode. Family-oriented therapy goals should include?
EDUCATING THE FAMILY ABOUT THE PATIENT’S ILLNESS AND PROVIDING SUPPORT FOR IMMEDIATE PROBLEMS
During family meeting for 75yo pt admitted for MI, how to address family unwilling to participate in discussion?
IDENTIFY THE INABILITY OR UNWILLINGNESS TO DISCUSS AS ONE OF THE FAMILY’S PROBLEMS
According to structural family therapy, what is the indicator of normal family functioning?
WELL DEFINED BOUNDARY BETWEEN PARENTS AND CHILDREN THAT PERSEVERES AUTHORITY AND FACILITATES OPEN COMMUNICATION
In the structural model of family therapy, the family is viewed as a:
SINGLE, INTERRELATED SYSTEM WITH AN EMPHASIS ON BOUNDARIES BETWEEN THE GENERATIONS.
A couple in therapy for relationship difficulties that are related in part to one partner’s frequent nagging of the other. The therapist recommends that the nagging partner intentionally nag the other partner three times a day, regardless of whether there is an urge to do so or not. This technique of prescribing the symptom is an example of:
PARADOXICAL INTENT
