NCMHCE General Definitions Flashcards
Manic Episode
Abnormally elevated, expansive or irritable mood
lasting at least 1 week (can be shorter if
hospitalized)
~~~
includes 3 or more of:
- Inflated self esteem or grandiosity
- Decreased need for sleep
- More talkative than usual
- Racing thoughts
- Distractibility
- Increase in goal-directed activity or psychomotor
agitation
- Excessive involvement in pleasurable activities with
disregard for negative consequences
- Significant impairment in social/work functioning
- Can include psychotic features
- DIG FAST
Hypomanic Episode
Persistent elevated, expansive or irritable mood
lasting at least 4 days
Same symptom list as manic episode except no
psychotic features.
MDE
Major Depressive Episode
Major Depressive Episode
5 or more of the following over a 2 week period
- Depressed mood (in minors, can be irritable)
- Diminished interest/pleasure
- Significant weight loss (in minors, consider
failure to make expected weight gains)
- Insomnia or hypersomnia
- Psychomotor agitation or retardation- Fatigue
- Feelings of worthlessness/guilt
- Cognitive impairment
- Recurrent thoughts of death/suicide
Criteria for Panic Attack
- Intense fear or discomfort develops rapidly,
peaks within minutes. - Includes 4 or more of:
Palpitations or increased heart rate, sweating,
trembling, shortness of breath, feeling of choking,
chest pain, nausea, dizziness, chills or heat,
numbness or tingling, derealization (including
blanking out), fear of losing control, going crazy,
or dying.
Obsessions
Recurrent, persistent thoughts, urges or images
that are intrusive and unwanted
Compulsions
Repetitive behaviors or mental acts that a person feels driven to perform.
What is a personality disorder?
A Personality Disorder is an enduring pattern of
inner experience and behavior that deviates
markedly from the expectations of the individual’s
culture, is pervasive and inflexible, has an onset in
adolescence or early adulthood, is stable over
time, and leads to distress or impairment.”
Co-Occurring Disorder Assessment Steps
- Engage the client
- Obtain permission from the client and paperwork of the client authorizations
- Identify family and friends to gather any additional information that may be useful
- Screen for and detect Co-occurring disorders
- Determine the severity of mental and substance use disorders
- Determine an appropriate care setting for outpatient, inpatient or day treatment
- Determine the diagnoses
- Determine disability and functional impairments
- Identify strengths and supports of the client
- Identify the cultural and linguistic needs and supports
- Identify any additional problem areas to address such as housing, employment, education,
social, physical health, spiritual and cognitive issues - Determine client’s readiness for change
- Plan the treatment
anhedonia
Inability to feel pleasure.
Double Bind
Same as a mixed message.
A double bind is a dilemma in communication in which an individual receives two or more reciprocally conflicting messages.
A wife sighs while telling her husband, “You can go out with the boys tonight if it’s what you really want to do.”
Enactment
A pattern of nonverbal interactional behavior between the two parties in a therapeutic situation, with unconscious meaning for both.
It is something that just happens in therapy, it is not a technique used by the therapist.
Agnosia
A symptom of dementia in which an individual cannot name or recognize objects
Alogia
Speech deficit
Anorexia Nervosa, Binge Eating/Purging type
Low body weight and binges/purges
Anorexia Nervosa, Restricting type
Restricts amount of food, exercises, does not binge
Avolition
Inability or unwillingness to begin and maintain activities
Classical conditioning
According to Pavlov, a behavior is learned when a stimulus is paired with an unconditioned stimulus to bring about a conditioned response
Conjoint therapy
Partners are in therapy together
Counter conditioning
When the person’s reaction (emotional response) to a stimulus is changed from one that is anxious or fearful to one that is positive and enjoyable.
To accomplish this, favored rewards should be paired with each exposure to the stimulus.
For example, if a dog is afraid of a delivery person, give the dog a treat every time the deliver person arrives. This will change how the dog responds to the delivery person.
CR - Conditioned Response
Conditioned response is a learned behavior
CS - Conditioned Stimulus
The conditioned stimulus (CS) is a learned stimulus that can eventually trigger a conditioned response.
For example, the sound of a bell is the conditioned stimulus in Pavlov’s experiment, and the dogs salivating would be the conditioned response.
Defense Mechanisms
Protect ego from anxiety (unconscious)
Dependent Variable
Variable measured in an experiment
Dissociative Amnesia
Inability to remember important personal information, reversible, may follow stressful events
Dyspareunia
Pain during intercourse; rare in men; medical reasons for pain must be ruled out
Ego
Psychic structure that handles reality and operates on the reality principle
Empathy
Understanding the client’s perspective
Epidemiology
Prevalence and incidence of diseases
Etiology
Cause(s) of disorders
Fixation
Freud - stuck at a stage of development
Id
Most primitive psychic structure that operate on the pleasure principle
Law of Effect
Thorndike: when behaviors are followed by positive gratification, the behaviors are likely to occur.
Example: Rat pushes on a lever and gets a pellet of food. The rat is likely to continue pushing on the lever based on the Law of Effect.
Moral anxiety
Guilt and shame that results from immoral behavior
Parasomnias
Abnormal behaviors during sleep
Parethesias
Tingling or numbness sometimes felt during a panic attack
Projective tests
Person responds to ambiguous stimuli; given to reveal unconscious conflicts; harder to fake than objective tests
Psychoactive drugs
Alter thinking/emotions/behaviors; stimulants, depressants, opiates, hallucinogens
Reliability
Test gives consistent results over time
Superego
Psychic structure that internalizes morality
Token economy
Positive behaviors are rewarded with tokens that are used to buy items/privileges of worth to the client.
Example: If the kid gets 1 point every time they are cooperative about doing homework. When they get 5 points they can trade them for an ice cream.
Unconditioned response
Unconditioned response that is naturally produced by a stimulus.
Example: gasping in pain after being stung by a bee
Transference
Client projects personal issues onto therapist
Kitchener’s 5 moral principles
- autonomy
- justice
- beneficence
- nonmaleficence
- fidelity
Autonomy
Autonomy refers to the concept of independence and the ability to make one’s own decisions.
Justice
Justice means treating each person fairly, but it does not mean treating each person the same way.
Beneficence
Beneficence refers to doing good or what is in the best interests of the client.
Nonmaleficence
Nonmaleficence means doing no harm to others.
Fidelity
Fidelity involves the concepts of loyalty, faithfulness, and honoring commitments.
Premack Principle
Reinforcing a target behavior by awarding some privilege or desired behavior afterward.
The Premack Principle can be implemented when you want to motivate a child to participate in an activity he or she does not want to do.
For example, “First brush your teeth, then you can play your favorite video”. “First finish your homework, then we can go outside”.
Contingency of Reinforcement
Contingencies of reinforcement are comprised of antecedents (events that occur immediately before a behavior), responses or behaviors, and consequences (events that occur immediately after a behavior).
The four contingencies are positive and negative reinforcement, punishment, and extinction.
Contingent reinforcement is used to enforce the notion that there is some type of consequence for both good and bad behaviors. The consequence is dependent on whether the person providing the reinforcement wants the behavior to stop or to continue.
Schema
A schema is a cognitive framework that helps organize and interpret information. We use schemas because they allow us to take shortcuts in interpreting the vast amount of information that is available in our environment.
4 types of schemas: person, social, self, event.
For example, your schema for your friend might include information about her appearance, her behaviors, her personality, and her preferences. Social schemas include general knowledge about how people behave in certain social situations. Self-schemas are focused on your knowledge about yourself.
Schemas can contribute to stereotypes and make it difficult to retain new information that does not conform to our established ideas about the world.
5 Stages of Grief
Can go in any order:
* Denial
* Anger
* Bargaining
* Depression
* Acceptance
What occurs in the DENIAL stage of grief?
In this stage, the world becomes meaningless and overwhelming. We are in a state of shock and denial. We go numb. We try to find a way to simply get through each day.
Denial and shock help us to cope and make survival possible. Denial helps us to pace our feelings of grief. It is nature’s way of letting in only as much as we can handle.
What occurs in the ANGER stage of grief?
Anger is a necessary stage of the healing process. Be willing to feel your anger. There are many other emotions under the anger, but anger is the emotion we are most used to managing.
Underneath anger is pain, your pain. It is natural to feel deserted and abandoned, but we live in a society that fears anger. Anger is strength and it can be an anchor, giving temporary structure to the nothingness of loss. It is something to hold onto; and a connection made from the strength of anger feels better than nothing.
The anger has no limits. It can extend not only to your friends, the doctors, your family, yourself and your loved one who died, but also to God. You may ask, “Where is God in this? The anger is just another indication of the intensity of your love.
What occurs in the BARGAINING stage of grief?
“If only…”
After a loss, bargaining may take the form of a temporary truce. “What if I devote the rest of my life to helping others. Then can I wake up and realize this has all been a bad dream?” We become lost in a maze of “If only…” or “What if…” statements.
We want life returned to what is was; we want our loved one restored. We want to go back in time: find the tumor sooner, recognize the illness more quickly, stop the accident from happening…if only, if only, if only.
Guilt is often bargaining’s companion. The “if onlys” cause us to find fault in ourselves and what we “think” we could have done differently. We may even bargain with the pain. We will do anything not to feel the pain of this loss. We remain in the past, trying to negotiate our way out of the hurt.
What occurs in the DEPRESSION stage of grief?
We withdraw from life, left in a fog of intense sadness, wondering, perhaps, if there is any point in going on alone? Why go on at all?
It’s important to understand that this depression is not a sign of mental illness. It is the appropriate response to a great loss.
The loss of a loved one is a very depressing situation, and depression is a normal and appropriate response. To not experience depression after a loved one dies would be unusual.
What occurs in the ACCEPTANCE stage of grief?
This stage is about accepting the reality that our loved one is physically gone and recognizing that this new reality is the permanent reality. We will never like this reality or make it OK, but eventually we accept it. We learn to live with it.
We may start to reach out to others and become involved in their lives. We begin to live again, but we cannot do so until we have given grief its time.
What is the most important element to consider when deciding to make a referral to another therapist?
The therapeutic alliance you have with the client.
What is the Glomar Response?
When someone asks if you are seeing someone as a client, and you response with, “I cannot confirm or deny that this person is my client.” That is the Glomar Response. It’s a neutral response that protects the client’s right to privacy.
Sensorium
Sensorium refers to one’s level of consciousness and degree of awareness of surroundings.
Short-term Goal
When establishing treatment goals, the therapist must think about what can reasonably be accomplished in a certain period of time. A short-term goal can be realistically achieved in 3 to 4 weeks.
Anything that goes beyond that time frame would be considered a long-term goal.
Words used when writing short-term goals.
reduce
improve
identify (current issues, not deep-seated root causes)
stabilize
Words used when writing long-term goals.
eliminate
master
explore
The exceptions are when a client’s behavior is dangerous. You might elect to eliminate that behavior as a short-term goal. You can also choose to master basic skills or master a specific number of skills as a short-term goal.
Psychasthenia
Psychasthenia is one of the scales on the MMPI-2 that’s used to measure obsessive-compulsive thoughts and behaviors; it also assesses abnormal fears, difficulty in concentration, guilt, and anxiety.
What does ‘utilization of review plan’ mean?
The term utilization of review plan means treatment plan review.
What is the MSJCC (Multicultural and Social Justice Counseling Competencies)
MSJCC is a framework to implement multicultural and social justice competencies into counseling theories, practices, and research.
Developmental domains reflect the different layers that lead to multicultural and social justice competence:
(1) counselor self-awareness
(2) client worldview
(3) counseling relationship
(4) counseling and advocacy interventions.
Discrete Data
Data that involves round, concrete numbers that are determined by counting.
Example: How many times in the past month did you have an emotional outburst?
Continuous Data
Data that falls on spectrum and can change over time.
Example: weight, temperature, height
Z-score
Distance from the mean measured in standard deviations.
-1 would be 1 standard deviation below the mean.
P-Value
Probability null hyposthesis is not true. Measured from 0 to 1.
Lower the P-Value, higher likelihood null hypothesis is false.
