Midterm Flashcards

1
Q

Emphasizes the role of thinking in how people feel and what they do (behavior)

A

Cognitive Behavior Therapy

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2
Q

Study of observable behavior

A

Behaviorism and Learning Theory

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3
Q

Theoretical underpinnings of behavior therapy

A

Systematic Desensitization

Contingency Management

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4
Q

Two cognitive approaches that put cognition into the forefront of psychotherapy

A

Beck: Cognitive therapy
Ellis: Rational Emotive therapy

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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

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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

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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
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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

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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
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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
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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
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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
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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
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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)
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15
Q

Assessment of Target Problems

A
  • record review
  • interviews
  • rating scales
  • observations
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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
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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
Q

GAS Advantages

A
  • 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
Q

Percentage of Non-overlapping Data

A
  • 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
Q

Age vs Developmental Level

Developmental Considerations

A

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
Q

Cognitive Development

Developmental Considerations

A

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
Q

Social Development

Considerations

A

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
Q

Emotional Development

Considerations

A

Emotion recognition, labeling
Emotion causality
Emotion display rules
Multiple emotions

31
Q

Developmental level determine what they can learn and generalize
Considerations

A

Can a child apply a skill in a different situation?

What can a child generalize with and without support?

32
Q

What makes a treatment “developmentally oriented”?

A
Consideration of critical developmental tasks and milestones
Developmental sequence of skills
-social problem solving
Considerations of social context
Use developmentally sensitive strategies
33
Q

Deficiency

A

lacking careful information processing where it should be beneficial

34
Q

Distortion

A
  • distorted, dysfunctional thinking processes

- more salient for internalizing

35
Q

CBT with Children

A
  • 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
Q

Micro Skills

A
  • attending behavior
  • questioning
  • responding
  • noting and reflecting
  • client observation
  • confrontation
  • focusing
  • influencing
  • reflect content and feeling
37
Q

Benefits of Micro Skills

A
  • 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
Q

Consideration of Questioning Techniques

A

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
Q

Facilitating self-awareness and growth

A
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
Q

Motivational Interviewing Technique

A
  • 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
Q

Psychoeducation

A

educating patients and families on the facets of a disorder

42
Q

Anger

Caveats and Tips

A
  • 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