Midterm Flashcards
1
Q
Emphasizes the role of thinking in how people feel and what they do (behavior)
A
Cognitive Behavior Therapy
2
Q
Study of observable behavior
A
Behaviorism and Learning Theory
3
Q
Theoretical underpinnings of behavior therapy
A
Systematic Desensitization
Contingency Management
4
Q
Two cognitive approaches that put cognition into the forefront of psychotherapy
A
Beck: Cognitive therapy
Ellis: Rational Emotive therapy
5
Q
Aaron Beck
A
Cognitive Therapy
-looked for new ways of understanding depression
Cognitive Triad
An alternative to psychoanalysis
-focus on unconscious memories and emotions from the past vs. conscious mind in the present
-educating the client about the relationship between thoughts and feelings
6
Q
Cognitive Triad
A
Cognitive triad results in negative thinking errors in which individuals misinterpret facts and experiences and make negative assumptions about the self, the world, and the future
-e.g., situation: bad score on test
7
Q
Albert Ellis
A
Rational Emotive Therapy
- individuals hold a unique set of assumptions/beliefs about themselves and their world that affect their reactions to the various situations they encounter
- some assumptions/beliefs are largely irrational, rigid, absolute that lead to emotional disturbance
- musterbation
- activating events -> (irrational) belief -> emotional consequence -> disputing thoughts -> effective thoughts
8
Q
Musterbation
A
i must achieve well or I’m a failure; others must treat me well or they are bad; conditions must be perfect or my life is wrong
9
Q
Donald Meichenbaum
A
- focused on children as well as adults
- self-statements guide one’s behavior
- self-instructional training
- replace maladaptive behavior and emotional responses with self-statements that facilitate control of those
- model self-instruction; child practices overtly and then covertly
10
Q
Common Principles
A
- problems are conceptualized in terms of current cognition and behavior
- learning principles: maladaptive behaviors and cognitions are learned as adaptive ones are learned
- focuses on specific, clearly defined goals
- collaboration between client and therapist
- structured and time limited
11
Q
Common Treatment Components
A
- psycho-education
- identifying beliefs and assumptions
- teaching cognitive and behavioral strategies
- practicing and applying new coping strategies outside therapy
- relapse prevention
12
Q
Case Conceptualization
A
- Framework for making sense of assessment data
- a set of hypothesis about the factors that cause/maintain the target behaviors
- roadmap for target assessment and treatment (what to treat, how to treat, treatment monitoring/evaluation)
- guided by empirical data, theoretical orientation
13
Q
Steps in Case Conceptualization
A
- identify target behaviors and contributing factors
- arrive at a diagnosis/diagnostic impression
- synthesize the data and produce hypotheses regarding contributing and maintaining factors for each problem
- treatment planning
- outcome monitoring and evaluation plan
14
Q
Identifying Target Problems
A
- consider response ‘modes’ (behavior, affective/emotional, cognitive
- topography (frequency, intensity, duration)
- operationalization (stranger test)
- rank the target behaviors in terms of treatment priority
- developmental history
- contextual information
- other contributing factors (individual, protective and resiliency factors)
15
Q
Assessment of Target Problems
A
- record review
- interviews
- rating scales
- observations
16
Q
Consideration for Children and Adolescents
identifying target behaviors
A
- use graphics, drawing, and metaphors
- use items from rating scales
- invite collaboration
- somatic symptoms associated with emotional problems
- listen and avoid advice giving
17
Q
Arrive at a Diagnosis
A
- Diagnostic Impression
- in what way is it useful?
18
Q
Synthesis and Initial Hypotheses
A
- synthesize the data and develop hypotheses about the causes/contributing factors, antecedents, and maintaining factors of each target behavior/goal
- tell a coherent “story” that explains the development and maintenance of the problem
19
Q
Treatment Planning
A
Determine problems to be targeted and the order
-consider priority, feasibility, severity
-collaborative goal setting
-consider input from child, teacher, and parent
Intervention selection
-manual-based intervention
-modular-based intervention
20
Q
Modular-Based Interventions
A
Benefits
-interventions are tailored to individual needs/problems
-flexible delivery of interventions
Considerations
-require good case conceptualization skills
21
Q
Example Modules
A
- cognitive restructuring
- exposure/relaxation
- psychoeducation
- self-monitoring
- self-praise/self-talk
- problem solving
- assertiveness skills
- communication skills
- activity scheduling
- relationship building
- emotional awareness
- behavior initiation
22
Q
Outcome Evaluation
A
- ongoing assessment of target behaviors along with assessment of contributing and maintaining factors
- formative assessment vs summative assessment
- progress monitoring tools
- norm-referenced rating scales
23
Q
Goal Attainment Scaling
A
Ideographic approach to assessment
- individualized, criterion-referenced measure of change
- suitable for individual and group outcome analysis of highly diverse and individualized treatment
24
Q
Writing Goals for GAS
A
SMART
- Specific
- Measurable
- Attainable
- Relevant
- Time limited
25
GAS Advantages
- individualized
- time efficient, non-intrusive, easy data collection, inexpensive, easy to interpret
- can be used as a self-assessment
- can be used by multiple informants across settings
- social validity and clinical utility
26
Percentage of Non-overlapping Data
- change in time-series data from baseline to treatment phases
- the number of data points in the treatment phase that exceed the highest (or lowest) baseline data points divided by the total number of data points in the treatment phase
- Effect size
- strong: PND > 80
- no effect: PND < 60
27
Age vs Developmental Level
| Developmental Considerations
Development is heterogeneous within age
Developmental readiness for treatment
-is a child able to engage in different aspects of treatment, cognitively, socially, and emotionally?
28
Cognitive Development
| Developmental Considerations
Metacognition: ability to use knowledge about one's own cognitive processes to achieve goals
Generate alternative responses to complex social situations
Means-ends thinking
-brainstorming solutions to difficulties
-evaluate solutions
-plan steps to obtain a desired goal
29
Social Development
| Considerations
Social perspective taking
Theory of mind
-enables children to understand others have beliefs, feelings, and intentions that are distinct from their own and influence the way others behave
30
Emotional Development
| Considerations
Emotion recognition, labeling
Emotion causality
Emotion display rules
Multiple emotions
31
Developmental level determine what they can learn and generalize
Considerations
Can a child apply a skill in a different situation?
| What can a child generalize with and without support?
32
What makes a treatment "developmentally oriented"?
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Consideration of critical developmental tasks and milestones
Developmental sequence of skills
-social problem solving
Considerations of social context
Use developmentally sensitive strategies
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33
Deficiency
lacking careful information processing where it should be beneficial
34
Distortion
- distorted, dysfunctional thinking processes
| - more salient for internalizing
35
CBT with Children
- appropriate session length
- expand child's emotional vocabulary
- identify and dispute maladaptive thoughts
- teach self-instructional, problem-solving techniques
- role play specific skills
- provide opportunity to practice learned skills
- reinforce positive behavior and skill mastery
36
Micro Skills
- attending behavior
- questioning
- responding
- noting and reflecting
- client observation
- confrontation
- focusing
- influencing
- reflect content and feeling
37
Benefits of Micro Skills
- helps the client feel that they are heard and respected
- elicit engagement in further expression and momentum
- provides an opportunity for client's self-exploration and awareness
- express counselor's interest and understanding
- provides an opportunity for clarification
- requires continuous alert tracking of the client's verbal and nonverbal responses
38
Consideration of Questioning Techniques
Excessive questions
-Questions put the counselor in control
Multiple questions at once
-Tell me about yourself – what you like to do, who do you live with, how many siblings do you have, how are you getting along with your family..
Questions as statements
-What do you think of trying relaxation instead of yelling at your brother?
Why questions
39
Facilitating self-awareness and growth
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Active listening
Focus on the client
-Client dealing with difficult life situation, others as a source of problem – Bring the focus back to the client’s experience
Pay attention to nonverbal
Use a problem-solving approach
Set clear, measurable goals
```
40
Motivational Interviewing Technique
- A collaborative, person-centered form of guiding to elicit and strengthen motivation for change: therapist as a helper in the change process
- Gentle, respectful method for communication
- Assumptions: Individuals are capable for beneficial change; facilitate and allow an individual to drive the process
- Express empathy through reflective listening
- Develop discrepancy b/w client goals/values and current behavior
- Support self-efficacy and optimism
- “you” statement to affirm and to empower
41
Psychoeducation
educating patients and families on the facets of a disorder
42
Anger
| Caveats and Tips
- Explore anger for children with internalizing problems
- Group psychoeducation – classroom, grade, school
- Psychoeducation for parents and teachers
- Increasing children’s engagement
- Watch how much you’re talking
- Use drawing, toys, visual
- Use checklist (in addition to open questions)
- Do a pre-post test on the content
- Not limited to one session: Revisit throughout treatment
