nchmce Flashcards
1
Q
Conduct disorder timeline
A
symptoms must have occurred in last 12 months
-can have childhood onset
2
Q
Why is assessment and treatment problematic for conduct disorder?
A
Due to the multiplicity of behaviors contributing to it.
Need to gather info from multiple sources of info & utilize the child behavior checklist (CBCL)
3
Q
What are specific traits of counselors needed to work with conduct disorder?
A
Must be able to assess client MOTIVATION (MI interview with emphasis on values)
Must be able to handle crisis situations
Utilize unconditional positive regard with firm, consistent boundaries
4
Q
Differential diagnosis for conduct disorder
A
Adhd, Oppositional defiant disorder (ODD), Depressive & bipolar disorders, adjustment disorder, intermittent explosive disorder
5
Q
One of the best approaches for conduct disorder is…
A
Parent Management Training (PMT).
Modifying dysfunctional family dynamics can reduce disruptive behavior
6
Q
What info can you ethically NOT share with probation officers?
A
a client’s past crimes
7
Q
What is empathic attunement?
A
The act of trying to identify the feelings of the client & recognizing those same emotions
8
Q
Specifiers for eating disorders
A
Behavior lasts at least 3 months
Mild: average of 1-3 episodes/week
Moderate: 4-7
Severe: 8-13
9
Q
During the session, you observe your client shaking as they speak. What should you do?
A
Share your observation to the client as a way of exploring its meaning. Don’t just recognize it and move on.
10
Q
Summarization vs. paraphrasing
A
summarize: taking the clients words and repeating them back (usually longer)
paraphrase: repeating back understanding in your own words
11
Q
What does it mean to explore client’s beliefs?
A
Gain better comprehension of their thought patterns & behaviors
12
Q
What should you do if the client doesn’t recognize much therapeutic progress?
A
Ask them to explain further. This provides an opportunity for the client to discuss her perception of the therapeutic process.
13
Q
What framework is one of the best to use with couples? Especially when there are big differences in emotional responses?
A
EFT - designed for couples rooted in attachment theory.
It aims to help couples understand and reshape their emotional responses to increase security
Great for dealing with trust/attachment issues
14
Q
What is the sound relationship house?
A
Gottman method for couples therapy includes the following building blocks:
1) Build love maps
2) Share fondness and admiration
3) Turn toward instead of away
4) The positive perspective
5) Manage conflict
6) Make life dreams come true
7) Create shared meaning
8) Trust
9) Commitment
15
Q
What would be the major and primary factor you would want to first consider and evaluate when choosing to see each client for individual therapy? (after previously doing couples)
A
Ethical considerations
16
Q
When can you breach confidentiality during group therapy?
A
To obtain reimbursement for services
17
Q
In pre group interviews, what info must be discussed?
A
Details regarding the group (who, what, when, cost)
Possible misconceptions about the group
Attendance requirements
Goal setting
18
Q
What is the house tree person test?
A
personality assessment tool for inner conflict and emotional processes
19
Q
What stages are in the Tuckman Group model?
A
Forming
Storming
Norming
Performing
Adjourning
20
Q
What does the forming stage consist of? What are it’s characteristics?
A
Forming and developing effective relationships, learning how to work together, identifying shared goals
Leaders dominate more in this stage
Characteristics: lack of unity, polarization around issues, discussion, ANXIETY, worried about what others think, intros, getting members to contribute
21
Q
What does the storming stage consist of? What are it’s characteristics?
A
Group members typically have emotional responses to the tasks in the group and perceived requirements for change (i.e., resistance, hostile, denial)
Characteristics: tension, disruption, fragmentation, addressing challenges, solving conflicts
22
Q
What does the norming stage consist of? What are its characteristics?
A
Group members accept the group and the idiosyncrasies of fellow members. Group norms are developed and acceptance is prioritized.
Characteristics: high levels of intimacy/sharing, cohesiveness, harmony, group leader can step back and “steer” when needed
23
Q
What does the performing stage consist of? What are its characteristics?
A
Group has established its interpersonal norms, it becomes an entity capable of diagnosing and solving problems and making decisions.
**this stage is not always reached by groups
Characteristics: openness, insight, understanding, mutual trust & support
24
Q
What does the adjourning stage consist of? What are its characteristics?
A
Goals accomplished. Involves termination.
Recognition for participation & achievement. Opportunity for members to say personal goodbyes.
25
What is Bowen's Family System theory?
theory that views individuals as part of a larger family system.
Views family as an emotional unit and uses systems to describe complex interactions
26
What are the 3 subsystems in family systems theory?
Subsystems = systems within larger systems
siblings, parents, child/parent
27
Techniques of Family Systems theory
Detangling
Genogram
I positions/statements
Triangles (work to create healthy balance & support)
28
What are the three models of strategic therapy?
MRI: Mental Research Institute
Haley & Madanes Strategic Approach
Milan Systemic model
**all about communication & positive/negative feedback loops
29
What are paradoxical interventions?
techniques designed to eliminate the undesirable behavior while encouraging a undesirable behavior
kid won't eat dinner, allow kid to each as much candy as they want
**From strategic family therapy
30
What is the main process/premise of the Milan systemic family model?
Interested in past/present family relationships
1. conditions necessary for change
2. hypothesis
3. neutrality
4. games
5. equifinality
31
Techniques used in Milan family model?
Circular questions
Positive connotations
Invariant prescriptions (parent required to spend time away from kids to break unhealthy patterns)
Rituals
32
What is Jungian therapy?
Exploration of the collective unconscious. Believes humans are connected to each other/their ancestors through shared experiences.
Techniques:
Individuation (parts of self differentiate from other)
Dream analysis
Journaling
33
What is free association in psychoanalytic theory?
Aims to deepen your self-understanding by looking at whatever thoughts, words or images come freely to your mind
34
What is Filial Therapy?
A play therapy approach & pyschoeducational family intervention. Therapist trains/empowers parents in child-centered play sessions.
35
What is structural family therapy?
Assesses subsystems, boundaries, hierarchies & coalitions within a family (it's structure)
and focuses on direct interactions between family members (enactment)
as the primary method for change.
36
What is the Minuchin Joining Technique?
Found in structural family therapy.
Therapist shares empathetic relationship to "join" the family & helping to identify, explore & adapt boundaries
37
What is the main premise/process of Adlerian therapy?
-Emphasizes uniqueness of the individual
-Individuals striving for success, connectedness with others & contribution to society are hallmarks of mental health
-poor mental health occurs when individual develops poor strategies to manage feelings of inferiority (believed to have developed during childhood)
38
4 stages of Adlerian therapy are:
1) engagement: establish therapeutic relationship
2) assessment: invite client to tell story & listen for coping skills/approach to life
3) insight: encourage development of self-understanding
4) reorientation: help client to make new choices that reinforce new insights
39
What is the inferiority & superiority complex in Adlerian therapy?
Inferiority complex: normal feelings of incompetence exaggerated, feeling it's impossible & hopeless to reach goals
Superiority complex: high opinion of self, bragging, often quick to argue
40
What are common techniques of Adlerian therapy?
-exploration of the family constellation (birth order)
-reporting earliest recollections
-confronting faulty beliefs
-exploration of social dynamics
-spitting in the client's soup: uses comments to make certain behaviors less desirable
-push button: shows clients they can create whatever feelings they want by thinking about them. (think of a good mem/feelings, then switch to bad)
-Encouragement
-Confrontation
-Task setting
-Catching oneself: client notices and stops when engaging in problem behavior
41
What is Transactional Analysis?
Part of psychoanalytic therapy
Early life experiences shape the life scripts a person plays
Consists of 3 ego states:
Parent (behaves using rules provided in childhood - taught)
Child (behaves emotionally based on thoughts/feelings replayed from childhood - felt)
Adult (behaves using logic & facts - learned)
42
Common techniques of transactional analysis
Contracts
Script analysis
Role playing
Structural analysis
Empty chair
43
What is the main process/premise of behavioral therapy?
Environmental consequences shape behavior. Goal is to increase desirable behaviors. Focus is on PRESENT causes of behavior.
Learning occurs through positive/negative reinforcement, positive/negative punishment or extinction
44
What are techniques of behavioral therapy?
-role playing & rehearsal
-chaining (breaking down tasks into small steps)
-exposure/guided imagery
-systematic desensitization
-graded task assignments
-hypothesis testing: creating a hypothesis to solve problems until one is consistently right
45
What should you do if a client reports a non suicidal self-injury that's become infected?
Breach confidentiality in order to seek medical attention for the client.
46
How should you respond when a client challenges your competency as a counselor?
Explore/discuss their role as a client and yours as a therapist. This provides opportunity for the client to explore connections between feelings/behaviors
47
What is the purpose of engaging a client in a breathing exercise at the end of session?
To help manage their stress - we can't leave them dis-regulated. It's our job we help they relax and feel more comfortable before leaving.
48
What is an initial step in respond to a BDP client's relationship interactions?
Explore underlying securities linked to behavior. BDP people feel anxious and use manipulation to feel secure.
Thus, it's important to first explore the underlying insecurities linked to manipulative behavior. Then, therapists can teach the client skills on better interactions.
49
What is the timeline to update a depression diagnosis that's in remission?
2 months with no symptoms
50
Specifiers for Persistent Depressive Disorder
2 years in adults, 1 year in children
51
Differentials for Persistent Depressive Disorder
MDD, psychotic, personality
52
Any time you need to build trust/rapport with a client, what framework is best to use?
Person centered
53
Criteria for Major Depressive Disorder (MDD)
5 symptoms must be present for at least 2 weeks
MDD experience depressive episodes with a gap of at least 2 months between
54
What is contextual family therapy?
All about fairness and loyalty, inter generational patterns
What motivates family members
Uses genogram
Four dimensions:
1) facts
2) individual psychology
3) systematic transactions - rules, power, alignments, triangles
4) relational ethics - basic needs and real relationships with concrete consequences
55
What is multi-directed partiality?
An attitude that allows a therapist to empathize with each family member
and then maybe take sides?
56
What theories use constructive confrontation?
Gestalt, motivational interviewing, multicultural & feminist theory
**goal is to address incongruencies and work through them together. Can help clients get out of their own way and uncover true motives.
only use when a secure relationship is established. and approach with neutrality.
57
What is the main process/premise of DBT?
Dialectic = two concepts that seem like opposites can be true at the same time
Focuses on acceptance and change through 4 skills:
-mindfulness
-distress tolerance
-emotional regulation
-interpersonal effectiveness
58
What disorders is DBT best for treating?
BDP!!
Also PTSD, self-harming behavior and suicidal adolescents
59
Main process/premise for ACT?
Uses acceptance and mindfulness, combined with commitment to behavior change.
increases psychological flexibility, aim is not get rid of difficulties, but to be present and move towards valued behavior
uses lots of metaphors, great for treating anxiety and depression
60
6 processes ACT uses
1) acceptance
2) cognitive distancing
3) perspective-taking
4) mindfulness
5) values clarification
6) committed action
61
DBT vs. ACT
DBT = more structured/systematized approach, regulating intense emotions, interpersonal relationships
ACT = more personal/experiential, emphasis on values & compassion, living in the present moment, psychological flexibility
62
What is schema focused therapy?
Principle founded on CBT and other therapies. Believes when our basic childhood needs weren't met, we develop maladptive ways of interacting in the world.
Schema therapists help clinets change their entrenched, self-defeating life patterns via cognitive, behavioral and emotion-focused techniques
63
What are schemas?
pervasive, deeply held patterns of thinking and behavior
64
Main process/premise of reality therapy (Glasser)?
Focuses on current issues affecting the client. Taking action and make decisions is key.
Less about diagnosis, more about taking control
Paradox & confrontation are helpful in breaking through resistance
65
What are 5 basic psychological needs according to reality therapy?
Power
Love & belonging
Freedom
Fun
Survival
**human problems occur when 1 or more needs are not met
66
What is WDEP in reality therapy?
W/WANTS: what the individual wants
D/DOING: what the individual is doing to progress
E/EVALUATION: assessing the effectiveness of the individual's behaviors
P/PLANNING: plan a course of action to change the behavior
67
What are the stages in the trans-theoretical model of change?
Precontemplation: people do not intend to take action
Contemplation: people intent to start the healthy behavior in the near future (within 6 months), recognize they have a problem
Preparation: people are determined, ready to take action in the next 30 days and start taking small steps. They believe their behavior change can lead to a healthier life
Action: people have recently changed their behavior, intend to keep moving forward
Maintenance: people have sustained the behavior change (more than 6 months). Moving forward. Prevent relapse.
Termination: no desire to return to their unhealthy behavior and are sure they won't relapse (rarely reached)
68
What are 3 main alcohol treatment programs?
AA - 12 step
Smart recovery - science based
Rational recover - the person both desires and is capable of abstinence, but recognizes the desire to keep using as well
69
What is the premack principle?
An opportunity to perform a more preferred behavior (like a dog playing fetch), increases the likelihood that they will complete a less preferred behavior (dropping the ball at the owners feet)
70
What is Exposure & Response Prevention (ERP)?
Used for anxiety & OCD
Gradually exposes people to situations designed to provoke a persons obsessions in a safe environment. Mindfulness is a big part of this.
71
What are the 6 areas of Holland's Needs theory?
Realistic: do-er
Investigative: thinker
Artistic: creator
Social: helper
Enterprising: persuader
Conventional: organizer
for career counseling
72
What are developmental domains of multicultural and social justice counseling competencies?
-counselor self-awareness
-client worldview
-counseling relationship (attitudes/beliefs, knowledge, skills, action)
-advocacy
73
Stages of grief
1) denial
2) anger
3) bargaining
4) depression
5) acceptance
74
What is Johari's Window?
helps improve self-awareness
open, blind, hidden, unknown
75
What are Kohlberg's stages of moral development?
Three levels of moral development, each split into 3 stages.
Scientific study did not approve of this model because it was not objective.
Level 1: preconventional (ages 3-7); moral reasoning based on reward & punishment
Level 2: conventional (ages 8-13); moral reasoning based on external ethics
Level 3: postconventional (adulthood) moral reasoning based on personal ethics
76
logotherapy
Logotherapy is a psychological approach developed by Viktor Frankl that focuses on helping individuals find meaning in their lives. It emphasizes the individual’s will to meaning and finding fulfillment from within rather than relying solely on outside sources of pleasure or gratification. One technique used in logotherapy involves values awareness exercises that help clients identify, prioritize and live life according to their own values and beliefs. These exercises involve helping clients recognize the power of personal choice, identify and assess life values, develop goals that align with their values, and explore strategies to live according to those values in order to increase self-fulfillment. Values awareness exercises provide an opportunity for individuals to reflect on what matters most in their lives and create meaningful change. By helping clients reconnect to their values, they are able to create a life that is more in line with their core beliefs and desires.
77
What is delayed expression for PTSD?
When a person is diagnosed with PTSD at least 6 months after a traumatic event
78
What is the best additional action [after safety] to address client's self-harming behaviors?
Address comorbid conditions. Other conditions may contribute to her self harm tendencies as well.
79
What is our primary ethical obligation when a client is at high risk of suicide?
Promote the client's welfare. ensure all involved in her care are informed.
80
What is ambivalence?
A psychological conflict where the client lacks the certainty/ability to make choices.
i.e. engaging in therapy while still taking meds/alcohol. She's counter-actively operating with her decisions.
81
What therapeutic skill is most helpful in building rapport with a client who doesn't want to attend counseling?
Listening & attending skills
82
When can you terminate services in court-mandated therapy?
Depends on the treatment requirements dictated by the court. Client must meet the treatment conditions to the court's satisfaction
83
Criteria for acute stress disorder
Indirect/direct exposure to a traumatic event. Symptoms must be present for at least 3 days up to 1 month.
Intrusion, dissociation, avoidance, arousal
If longer than one month, could be PTSD (adjustment, panic, psychotic, dissociative, OCD, traumatic brain injury)
84
How long must ADHD symptoms be present? And where? What are the clusters?
6 months, must be evident before age 12
Issues must be experienced in at least two unique settings (I.E. home and school)
Clusters are inattentiveness & hyperactive impulsivity
85
Timeline for adjustment disorders
Develops within 3 months of stressors and is resolved within 6 months of termination of stressor
86
What is adjustment disorder with mixed disturbance?
Emotions & conduct [behavior]
87
Duration for agoraphobia diagnosis?
6 months
88
Treatment option for agoraphobia
systematic desensitization
89
Differentials for agoraphobia
Specific phobia, separation anxiety, social anxiety, acute stress, PTSD, panic, MDD
90
Alcohol use disorder criteria
Problematic pattern
At least two criteria must be manifested in a 12 month period
91
Age criteria for antisocial personality disorder
The client must be 18 to diagnose. BUT there must be evidence of conduct disorder that began before age 15.
92
Characteristics of antisocial personality disorder
Lack of remorse, pattern of disregarding/violating the rights of others, lying, failure to conform to social norms
93
Timeline for GAD
at least 3 of the criteria must be met for more days than not over 6 months
94
Diagnosis criteria & timeline for autism
Must have:
-difficulty in social emotional reciprocity
-difficulty in nonverbal communication
-difficulty developing & maintaining relationships
symptoms must be present in developmental years (as early as 12-24 months), continuing into adulthood
95
Differentials of Autism?
Rett, selective mutism, ID, ADHD, language disorder, social pragmatic, stereotypic movement, schizo
96
Criteria for avoidant personality disorder
At least four symptoms must be present for a persistent/lifelong pattern
chronic feelings of inadequacy. intense fear of rejection
Usually starts in childhood, into adolescence, continuing into adulthood
97
Cluster C personality disorders entail
Characterized by anxious or fearful behavior, such as nervousness
examples: avoidant, dependent, OCD
98
Cluster B personality disorders entail
Characterized by dramatic, emotional or erratic behavior & unpredictable responses
examples: antisocial, borderline, histronic & narcissistic
99
Cluster A personality disorders entail
Characterized by odd or eccentric behavior
examples: paranoid, schizoid, schizotypal
100
What is a detrimental comorbidity for bipolar disorder?
alcohol use - increases risk of suicide
101
When must you obtain additional informed consent from a client?
To share records with other professionals OR if you want to record a session
102
What is the Internal State Scale (ISS)?
self-report instrument used to differentiate between mood states in those who've been diagnosed with Bipolar
103
What are examples of unconscious process in pschodynamic theory?
projection & transference - all about how the unconscious can contribute to psychological distress
104
What is oppositional defiant disorder? (ODD)
A childhood behavioral disorder. Involves a pattern of angry/irritable mood, argumentative/defiant behavior or vindictiveness.
Symptoms usually begin before age 8, minimum duration 6 MONTHS
examples: temper tantrums, arguing with adults, refusing to comply
105
What age does conduct disorder emerge?
Between ages 10-12 for boys, ages 14-16 for girls
106
What is conduct disorder?
bullying, physical aggression, cruelty, fire-setting, breaking curfew/law, trespassing, truancy
107
Difference between ODD & Conduct disorder
-conduct onset appears later
-CD usually leads to legal issues, ODD generally doesn't (leads to more mood disorders if anything)
108
T or F: if left untreated, ODD can turn into CD
true
109
Criteria for disruptive mood dysregulation
Onset before age 10
Tantrums that happen 3 or more times/week
Irritable mood between tantrums
Unable to control extreme emotions
-symptoms last at least 1 year, any break in symptoms lasts less than 3 months
focuses on emotions over conduct
110
What is reflection of meaning?
Statement that connects the client's experience to a deeper meaning system
"You feel scared right now since you and your husband got into 3 fights. Fighting means that your relationship might end and you'll be alone."
111
What is reflection of feeling?
Attempt to identify and reflect the client's perceived emotional state.
"I've put my resume out everywhere!"
"You feel frustrated and discouraged that it seems so hard to secure employment."
112
What is summarizing?
A shorter version of the original statement, focuses on the main points/ideas.
113
What is paraphrasing?
A restatement of the original text in your own words. Roughly at the same level of detail.
114
Best assessment for assessing mania/hypomania
young mania rating scale
115
What is akathisia?
mixed state in which the client is depressed and agitated simultaneously in bipolar disorder.
highest risk factor for clients to develop and carry out suicide
116
What is interpersonal and social rhythm therapy? What is it good for treating?
Good for bipolar disorder
Helps clients understand patterns which lead to mood episodes. Good for reducing length of time clients are in the depressive stage.
117
Difference between mania and hypomania
Length of time - hypomania is shorter/milder
118
Characteristics of histrionic personality disorder
-center of attention
-inappropriate sexually seductive behavior
-shallow expression of emotions
-physical appearance to get attention
-feigned hopelessness & over embellishment of suffering
-pattern begins by early adulthood
119
Characteristics of borderline personality disorder
-intense fear of abandonment
-emotional instability (mood swings, intense outbursts, impulsivity, lack of emotional control)
-self image issues (distorted sense of self)
-onset early adulthood, wanes with age
120
Characteristics of narcissistic personality disorder
-persistent pattern of exaggerated self-importance, expects to be recognized as superior
-wants unlimited success, power
-believes they're special or unique
-lots of admiration
-lacks empathy
121
Bipolar 1 disorder
Experience of depression and MANIC episodes. Manic episodes must last at least ONE WEEK.
Rapid cycling
Age of onset 18
122
Bipolar 2 disorder
HYPOMANIC & depressive episodes. Hypomanic must last at least 4 DAYS and depressive lasting at least 2 WEEKS.
Age of onset early 20s
123
What is the Internal State Scale?
Self report instrument that is used to differentiate between mood states in clients who have been diagnosed with bipolar disorder
124
Differentials of bipolar
ADHD (b/c of distractibility & irresponsible behaviors)
MDD, GAD, Panic, Psychotic, Personality
125
What is a good short term goal in treatment?
Identify irrational thoughts
126
What is a potential ethical dilemma for group therapy?
Sending out communication to all attendees without having/considering authorized methods of contact
127
When two group members are arguing back and forth, what's your role as the group leader?
Interject verbally to de-escalate the situation.
It's your responsibility to balance conflict that arises in group
128
What does joining in group therapy mean?
establishing rapport, building trust, creating a safe place for clients to explore their concerns and challenges
129
Corey & Corey Group Counseling Stages
1. Initial (screening, orientation, determining structure)
2. Transition (finding acceptance, dealing with conflicts, resistance)
3.Working (main work happens, people share)
4. Final - prep for and termination
130
What does linking in group therapy mean?
connecting people with others by what they have in common
131
Congruence
Being aware of oneself and one's experiences and perceiving it correctly
reality vs. non reality/idealistic
132
From a psychoanalytic perspective, what are you trying to accomplish when exploring feelings?
Gain insight into the client's feelings AND motivations related to her struggles
133
Pyschodynamic terms
Superego
ID
134
Autonomy
means to honor the right to make individual decisions
135
Beneficience
means to do good for others
136
nonmaleficence
do no harm
137
Fidelity
Means to be loyal and committed
138
Veracity
honesty
139
Freud's Structure of Personality
id: internal desires (impulses)
ego: conscious (mediates between id and superego)
superego: morality/being a good person
140
Transference
the act of the client unknowingly transferring feelings about someone from their past onto the counselor
141
Countertransference
therapist's reaction to client's feelings (patient thinks of me as their mom, so I start acting like their mom)
142
What is aversion therapy?
Aversion therapy causes the patient to reduce/avoid an undesirable behavior by conditioning him to associate the behavior with an undesirable stimulus.
(putting nail polish remover on nails to quit nail biting)
143
Binge Eating Disorder Specifiers are dependent on...
Frequency of binge eating episodes the client engages in per week
144
What is personalization thinking error?
taking things personally when they are not connected to you or caused by you
145
What is the "black and white thinking" thinking error?
When the client thinks in extremes
never
always
no one loves me
completely worthless
146
What is a common long term goal in CBT?
Develop healthy though patterns and beliefs that contribute to a positive sense of self-identity
147
What is active listening?
Being fully engaged & giving complete attention to the client, being aware of nonverbal communication and clarifying responses
148
What is attending?
Giving the client full attention and letting the client know they are being heard
(visual/eye contact, verbal reactions, tone of voice, shutting out other distractions)
149
What is a clarifying response?
Checks in with the client to verify understanding of what the client has said. Can take the form of:
Paraphrasing, summarizing, reflecting back words
150
What is a 504 plan?
law that prohibits schools from discriminating against kids with disabilities. this plan can highlight educational adjustments to ensure kid's receive equal learning opportunities
151
What are good classroom strategies to address inattentiveness?
Sitting toward the front of the classroom, read-aloud quizzes
152
Key behavioral strategy for ADHD kiddos?
Self management skills via positive reinforcement
153
What is the main premise and process of Gestalt therapy?
-Focuses on the client's experience in the here and now
-unfinished business of the past emerges and is dealt with so the client can live more fully in the present
-therapist assists in self awareness of what the client is doing and how they are doing it
-promotes direct experiencing vs. just discussing situations
-personal responsibility/unfinished business
154
What are common techniques of Gestalt therapy?
-empty chair/internal dialog (convo between opposing poles of personality)
-body awareness/body work
-game of dialogue (top dog/underdog) - client is asked to play out both sides of a conflict
-fantasy (guided imagery)
-exaggeration
-dream work - not analyzing but bring dreams to life
-role play/rehearsal exercise
-making the rounds - interacting with each person in a group
-constructive confrontation
-playing the projection
-staying with feelings
155
What does Gestalt therapy target?
unlocking blocked feelings, anxiety, grief, anger and depression
156
Main premise and process of solution focused therapy?
Shift from problem talk to solution talk
-no such thing as normal
-not necessary to know cause of problems, negativity gets in the way
-if it's not working, do something else
-draws attention to "exceptions"
157
What is the exception question?
"tell me about times when you... when was the last time you...?" Build on previous success
158
What is the miracle question?
asks the client to imagine and discuss a possible world where problems are removed and issues are addressed
159
Key concepts of solution focused therapy
Assess readiness to change: Can either be a visitor, complainant or customer
Getting clients aware of their strengths and resources, beginner's mind, language and meaning
160
What are common techniques of solution-focused therapy?
Formula first-session task: observing life between first and second session, assessing what they want to see continue
miracle questions
exception questions (including scaling questions)
compliments (shaped as questions: wow, can you tell me more about how you did that?)
161
What is the main process/premise of solution focused therapy?
-thoughts drive one's feelings and behaviors - not external events
-therapist helps identify client's negative distorted thoughts and modify them
-therapist helps reinforce coping skills to help client prepare for triggers
162
Key concepts of CBT
Automatic thoughts are based on faulty logic/errors in reasoning & can lead to cognitive distortions, such as:
-all or nothing thinking
-personalization
-ignoring the evidence
-over generalization
Schemas (core beliefs) can either be adaptive or maladaptive
163
What are common CBT techniques?
-Socratic dialogue (reevaluation of dysfunctional thoughts)
-Grounding (can use FIRST when people are very anxious)
-Cognitive restructuring: replacing stress-producing thoughts with more balanced thoughts
-Decatastrophizing: "what if" challenges catastrophic thinking
-Decentering: ability to observe thoughts and feelings as objective events in the mind, rather than personally identifying with them
-Modeling: learning occurs through observation and imitation alone - no reinforcement from therapist
-Imaginal exposure
-Stress inoculation (combo of relaxation skills with role-playing/systematic desensitization)
-Homework, pyschoeducation
-Bibliotherapy
-Behavioral experiments
-Selective abstraction: when a detail is taken out of context and believed while everything else in the context is ignored
-Mind reading: person assumes others are judging them or thinking negatively about them without any evidence or confirmation
-Re attribution: tests automatic thoughts by consideration alternative causes of events. Helpful when clients perceive themselves as the cause of problem events
164
What is a good CBT strategy for couples?
Gottman Theory & the 4 Horsemen
165
What are the four horsemen in Gottman's theory?
1) Criticism (attack on character)
2) Contempt (sarcasm, mocking, eye rolling, hostile humor)
3) Defensiveness (when feeling attacked, respond with blame)
4) Stonewalling (often response to contempt; withdrawal, shut withdrawal)
166
Main premise & process of existential therapy?
Humans have free choice & can create purpose and meaning in life. Humans are free and responsible.
Therapists guide through 4 anxiety-based areas:
1) death
2) freedom & responsibility
3) isolation
4) meaningless
no set techniques
167
What is logotherapy?
Created by Victor Frankl (an extension of existential therapy) - the search for meaning and purpose. This can be found outside of ourselves
Focuses on the present and future, taking ownership of life, focus on what's meaningful to them - VALUES & CONNECTION WITH OTHERS
168
What is the main premise and process of narrative therapy?
Focus on meaning in life in narrative form/language. Narrative exercises focus on self-defeating thoughts.
Goal: re-author our lives to our preffered way of living
Externalize (people are NOT the problem)
Deconstruction
Letters, ceremonies, reflection, mapping the influence
169
What is Motivational Enhancement Therapy? What are common techniques?
Short term program for addictions to help increase client's motivation to change. Helps individuals identify and resolve ambivalence regarding substance use. Rates individuals willingness to change.
(basically motivational interviewing)
Double sided reflection (show both ways a client is feeling or what they are experiencing)
affirmation
reflect
emphasizing autonomy
170
Common techniques of person centered therapy?
Active listening
Empathy
Unconditional positive regard
Reflecting the feeling/paraphrasing nonverbals
Congruence (understanding the client's subjective world and communicating this to the client)
171
What is Rational Emotive Behavior Therapy? (REBT)
Helps people change their thoughts, feeling sand actions (Albert Ellis)
-thinking pattern change
-emotions cause our problems
-behaviors need to change
Process is focused on ReEducation (ABC theory). Uproots shoulds and oughts
Therapist is the teacher, client is the student
Client MUST feel unconditional positive regard
Client does cognitive homework, dispute irrational beliefs, changes ones language
172
What is REBT often used for?
Moderate anxiety disorders, neurotic disorders, eating disorders, psychosomatic, addiction, sexual dysfunction, poor interpersonal skills, depression, unsatisfactory relationships
Most effective when people can reason well
173
Advantage & limitations of REBT?
Pro: time-limited, practical (desired results often occur between 1-18 months). uses education and collaboration to help people change thoughts, behaviors, emotions quickly.
Con: belief system of therapist can be imposed on client due to therapist as teacher
174
What are techniques of REBT?
-devil's advocate (client argues for change)
-homework
-double standard: if client is holding a "should" or self-downing about their behavior, would they hold their best friend to the same core belief?
-Catastrophe scale/catastrophizing - worst outcome, using reality to contradict fear
-blow up - worse case scenario then blow it out of proportion until the client finds it funny
-paradoxical - therapeutic technique where client is encourage by therapist to continue undesired symptomatic behavior (and even increase it) to show the client has control over it
-emotive imagery: correcting emotional reactions to a real/imagined event
-role playing
-confrontation, humor, metaphors
-dispute irrational beliefs and cognitive erros
-postpone gratification
-cognitive restructuring
-shame attacking : expose client to fear of shame by acting in a way that anticipates disapproval while engaging coping skills, do things despite the fear
-time projection: client imagines themself a week, month, etc. after feared/difficult event
175
What are exposure therapy strategies in REBT?
Techniques involving the client to engage in a stressful behavior to show it is never as bad as they imagine. Go through with he scary behavior will challenge and shrink the distorted thought.
-Invivo - in person/real life
-imaginal - imagined
-flooding - most anxiety provoking right away
176
How do you establish a baseline for a client's substance use? What can provide you info about the client's drug use?
Laboratory drug testing
177
What are the four main diagnostic categories for conduct disorder?
1) aggression (towards animals & people)
2) destruction (of property)
3) deceitfulness
4) violation of rules
178
MAST (Michigan Alcohol Screening Test)
Developed to screen for alcohol problems in the general population
Questions relate to work/family/social life
Asks about drinking behavior and negative consequences
Shorter test, more benefitial to treatment planning
Not meant to diagnose
ages 18+
179
CAGE Questionnaire
Used to screen for potential alcohol problems/dependency
Cut Down, Annoyed, Guilty, Eye Opener (4 questions)
designed for adults, but can be adapted for adolescents
180
AUDIT (Alcohol Use Disorder Identification Test)
Assesses alcohol consumption, drinking behaviors and alcohol-related symptoms (10 questions)
developed by WHO
for adolescents & adults
181
Addiction Severity Index (ASI)
This is a semi-structured interview with seven subscales addressing problems in the areas of family/social status, medical status, employment and support, drug use, alcohol use, legal status, and psychiatric status. Ages 18+
182
Rapid Alcohol Problems Screen (RAPS4)
Ages 18+
4 item screening tool designed to identify possible alcohol problems in individuals
Assesses drinking patterns & associated consequences related to alcohol abuse
183
Simple Screening Instrument for Alcohol and Other Drugs (SSI-AOD)
For adolescents & adults
Contains 16 yes/no questions that assess individual's drug, alcohol and other substance use AND their attitudes/behaviors related to substance use
184
Drug Abuse Screening Test (DAST)
Ages 12+
Self-report questionnaire that focuses on presence & extent of substances use, like frequency & amount used
Addresses social consequences due to use, cravings for drugs & physical/psychological effects
185
Substance Abuse Subtle Screening Inventory (SASSI) - Adult SASSI & Adolescent SASSI
For adolescents & adults
Can be used to assess severity of individual's substance use disorder & identify individuals who are at risk for having a substance us problem
Questions focus on person' attitudes & beliefs about drugs/alcohol and past usage patterns
186
Readiness to Change Questionnaire (RCQ)
18+ Self-report measure that assesses individual's readiness to change their substance us behavior, based on the stages of change model
187
Timeline Follow-Back Assessment
for adolescents & adults
Calendar-based assessment tool that collects detailed info about individual's substance use, allowing for evaluation of patterns/changes over time
188
CRAFFT
ages 12-21
Consists of 6 questions to help assess an adolescent's current alcohol and/or substance use & risk level
189
Alcohol Screening & Brief Intervention for Youth (ASBI-Y)
Ages 9-18
Brief screening to identify children & adolescents who are at-risk for alcohol-related issues; asks two age specific questions about personal and friends' drinking
190
Brief Addiction Monitor (BAM)
ages 18+
17 item self report questionnaire used to monitor individual's progress in treatment including:
RISK factors, PROTECTIVE factors and overall USE
191
TWEAK
ages 18+
Originally used to screen for risky drinking during pregnancy
Same questions as CAGE, but has two additional questions about tolerance to alcohol and blackouts.
192
Functional Behavioral Analysis Assessment
The study of a particular behavior, what elicits it and what reinforces it.
This enables the clinician and client to target the specific part of the sequence of events (trigger - reinforcement) that needs to change.
193
Biopyschosocial Assessment
Personal medical/mental health history, family medical/mental health history, substance use history, current health rhythms. (I..e, who is your PCP?)
Assesses development, history, social, substance use, abuse/trauma
Presenting problem is part of a biopsychoscoial model
194
What does the bio part of the biopsychosocial assessment entail?
Questions about medical issues, age, developmental milestones or physical characteristics.
This area would assess the MEDICAL problems negatively impacting the client's life.
195
Early Childhood Inventory-4 (ECI-4)
Parent/teacher rating scale that measures the behavioral symptoms of the most relevant DSM-IV disorders among PRESCHOOL children.
The list of disorders include: ADHD, oppositional defiant disorder, conduct disorder, and a range of anxiety/depressive disorders
196
Holland Self Directed Search
A career development & exploration tool that matches your aspirations, activities and talents to the career choices and educational opportunities that fit you best
RIASEC - realistic, investigative, artistic, social, enterprising & conventional
197
Conners 3rd Edition
- An assessment that measures behaviors in children from 6-18 years of age.
-used to assess ADHD and the disorders most common comorbid conditions (i.e., conduct disoder, oppositional defiant disorder)
198
Cleveland Adolescent Sleep Questionnaire
Best for oppositional defiant disorder
Used to measure excessive daytime sleepiness
Self reported
199
CAMS
assessment of managing suicidality & planning treatment
Can be administered to as young as 5
200
Mini Mental State Examination (MMSE)
A test that is used to measure cognitive ability, especially in late adulthood. (i.e., dementia)
Tests orientation, attention, calculation, recall, language & motor skills
201
House Tree Person Test
a projective personality test in which an individual draws a house, a tree, and a person -
the primary purpose of the HTP is to measure aspects of a person's personality through interpretation of drawings and responses to questions. It provides clinically useful information about a person's psychological, emotional & mental health status
202
Columbia Suicide Severity Rating Scale (CSSRS)
Best one for assessing suicidality
-Evidenced based tool to evaluate risk & protective factors for clients of all ages and can be used in multiple settings
203
Mental Status Exam (MSE)
Assesses mood, affect, speech, thought process & appearance
204
What are the different thought processes in a MSE?
Circumstantiality - nonessential info of thoughts
Tangentiality - disturbance of thoughts
Coherent
205
Agoraphobic Cognition Questionnaire (ACQ)
14-item measurement that screens for faulty cognitions about potential consequences of panic and anxiety.
There are two subscales, which are loos of control and physical concerns.
206
Screening, Brief Intervention, Referral to Treatment Toolkit (SBIRT)
An evidence based approach to identify individuals who use alcohol and other drugs at risky levels.
Has been proven to be valid and reliable in identifying and improving outcomes for people who use substances
207
Beck Depression Inventory (BDI-II)
21 item self-report inventory measuring the severity of depression in adolescents & adults
208
CAPS 5
30 item structured interview that is used to make PTSD diagnosis
209
Global Assessment Scale (GAS)
Designed specifically to provide a comprehensive picture of the client's current mental state & functionality
210
Psychotic Symptoms Rating Scale
assesses the severity of and features of hallucinations and delusions
211
Multidimensional Anxiety Scale for Children (MASC 2)
Assesses anxiety across four domains. It's appropriate for children ages 8-19.
212
Vineland Adaptive Behavioral Scales, 3rd edition
Thoroughly assesses the child's independent display of skills needed in normal daily living
Diagnoses/classifies intellectual and developmental disabilities
213
Child Behavior Checklist
Assesses a variety of behavioral and emotional problems in children/adolescents
(i.e., anxiety, depression, somatic, ADHD, oppositional defiant disorder and conduct problems)
Completed by caregivers
214
EAT-26
Widely used standardized self-report measure of symptoms and concerns of eating disorders
215
Structured Clinical Interview for DSM-5 (AKA diagnostic interview; SCID-5)
Semi-structured interview guide for making DSM-5 diagnosis
Made up of 10 diagnostic modules, very comprehensive in nature. Covers 39 of the most common diagnoses that are seen by clinicians, and screens for 17 more
Therapist does not go through every module, but begins the interview by asking a series of questions to help narrow down which diagnosis modules will be relevant
216
Cultural Formation Interview
16 questions; gain assessment data on cultural influence on key presenting problem
(i..e, how would you describe your problem?)
217
California Psychological Inventory (CPI)
Self-report measure of behavior and personality.
Consists of 434 T/F questions and identifies personality characteristics, traits and thinking styles
218
Wechsler Preschool & Primary Scale of Intelligence (WPPSI)
Uses subtests to determine a child's verbal and performance IQ scores, as well as processing speed
For ages 2.5 - 7.25
219
Wechsler Intelligence Scale for Children
an IQ test that assesses cognitive abilities in children between 6 and 16
Used in educational settings to identify strengths/weaknesses in cognitive functioning & to inform educational/intervention planning
220
Woodcock-Johnson Psychoeducational Battery-Revised (WJ-R)
Commonly used measure of children's achievement measuring various aspects of scholastic ability
Tests cognitive abilities, scholastic aptitude & achievement in different subjects (reading, math, writing). Used for specificB learning disorders in reading.
221
Behavior Assessment System for Children (BASC-3)
Measures adaptive & behavior problems in school settings; can differentiate between attention & hyperactivity problems
222
Problem-oriented screening instrument for teenagers
Identifies problems with substance use & other current functioning areas
Ages 12-19
223
Columbia Impairment Scale
Parent/teacher questionnaire used to measure ADHD & oppositional defiant disorder symptoms
224
Columbia Mental Maturity Scale (CMMS)
An individually administered test that estimates the general reasoning ability of children ages 3 years 6 months through 9 years 11 months
225
Outcome Rating Scale
Measures the client's perspective of change or improvement (or lack thereof) in relation to where they started
226
Auditory Continuous Performance Test (ACPT)
Screens for auditory attention deficits. Aids in diagnosis of ADD or ADHD. For ages 6-11.
227
Combat Exposure Assessment
7 item self report. Assesses wartime stressors.
228
What is critical incident stress debriefing?
A group therapy process conducted soon after a traumatic event. Story telling process. Normalizes recovery.
229
Emotional Needs Questionnaire
Part 1: Questionnaire with top 10 emotional needs, each partner rates the degree that need is a part of their life and the degree their partner fulfills that need.
Part 2: Each partner ranks their top 5 needs.
230
Thematic Appreciation Test (TAT)
PROJECTIVE test that involves describing ambiguous scenes to learn more about a person's emotions, motivation and personality
AKA picture interpretation technique
231
Five Facet Mindfulness Questionnaire (FFMQ)
A multifactoral scale that has practical psychometric properties.
The five factors of the FFMQ are: observe, describe, act with awareness, non-judging of inner experience & non-reactivity
232
Behavioral Summarized Evaluation (BSE)
20 item rating scale designed for the measurement of behavioral parameters which could be related to biological data in autistic children
233
Minnesota Multiphasic Personality Inventory (MMPI-2)
Most widely used assessment for adult psychopathology; useful in formulating the client's diagnosis and selecting treatment strategies
234
Mood Disorder Questionnaire
Brief, self-report screen instrument that can be used to identify patients most likely to have bipolar disorder
235
Denver Developmental Screening Test (DDST-II)
Identifies young children with developmental problems
4 domains are assessed: personal-social, fine motor & adaptive, language and gross motor
236
DSM-5-TR Level 1 Cross-Cutting Symptom Measure
A self rated measure that assess mental health domains that are important across psychiatric diagnoses. It is intended to help clinicians identify additional areas of inquiry that may have significant impact on treatment and prognosis.
Level 2 assessment is more in depth in certain domains
237
What is behavioral diversion?
redirect client's focus away from problematic behaviors. focus on alternative behaviors instead.
i.e., replacing anxious thoughts with deep breathing
238
What is behavioral activation?
often used for depression
helps people improve their mood by engaging in activities that are meaningful/enjoyable to them (i.e., gardening)
239
What is the SRS Outcome Rating Scale
Four item assessment tool used to evaluate the quality of the therapeutic alliance between a client and their therapist
measures how the client feels about the therapeutic relationship & therapy process
240
What is exposure and responsive
behavioral technique for OCD, fears & anxiety
develop coping skills, helps patients learn that they don't need to engage in rituals to manage anxiety
241
Differentials of BDP 1
Borderline, MDD, ADHD, Bipolar 2, GAD
242
differentials for borderline
bipolar, depressive, avoidant, narcissist, histrionic
243
Important factor to consider when making a psychotic diagnosis for a multicultural client
Cultural background & relationship history
