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YEAR 3 > NURS 321 > Flashcards

NURS 321 Flashcards

1
Q

Interviewing/Coaching/Counselling/Psychotherapy

A

Interchangeable Terms about gathering data, objectively helping people to build on strengths, and focus on issues.

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2
Q

Intentionality

A

Importance of being in the moment and responding flexibly to the ever-changing situations and needs of clients

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3
Q

Cultural Intentionality

A

Acting with a sense of capability and flexibly choosing on action from a range of alternatives

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4
Q

Resilience

A

persons ability to recover from life’s challenges

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5
Q

Self-Actualization

A

Curative Force in Psychotherapy - human tendency to actualize themselves

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6
Q

Microskills

A

Specific communication skills that provide counsellors with many alternative ways to support clients

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7
Q

Emotional Regulation

A

Ability to control troublesome emotions and impulses

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8
Q

Prejudice

A

making a judgement in advance of due examination

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9
Q

Stereotypes

A

Fixed mental images of a group that are applied to all its members

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10
Q

Discrimination

A

Taking action against people because they belong to a category

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11
Q

Ethnocentrism

A

The tendency to regard one’s own ethnic group, nation, religion, or culture as better or more correct than others.

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12
Q

Oppression

A

Unjust or cruel exercise of authority or power

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13
Q

Posture of Reciprocity

A
  1. Identify cultural values embedded in our professional interpretations.
  2. Find out if members recognize these assumptions.
  3. Give respect to any cultural difference identified.
  4. Determine effective ways of adapting interpretations or recommendations.
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14
Q

Strengths Prespective

A
  • every individual has strengths.
  • we don’t know anyones capacity to grow and change.
  • we best serve clients by collaborating with them
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15
Q

Mandatory Ethics

A

Ethical functioning at the minimum level of the professional practice

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16
Q

RAP

A

Recognize
Anticipate
Problem-Solve

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17
Q

Johari Window Model

A

Open/Free Area (known and known), Blind Area (known to others, not to self), Hidden area (known to self, not to others), Unknown (unknown and unknown)

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18
Q

Informed Consent

A

Right of clients to be informed about their therapy and to make autonomous decisions pertaining to it.

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19
Q

Freud

A

Founder of Psychoanalysis - says behaviour is determined by irrational forces, unconsciousness motivations, and biological/instinctual drives

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20
Q

Aspirational Ethics

A

Doing what is in the best interest of the client, a higher standard

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21
Q

Fear-Based Ethics

A

Acting in a way to avoid punishment

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22
Q

Concern-based Ethics

A

How can you be the best nurse possible?

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23
Q

Positive-Ethics

A

Practitioners focused on doing their best for their clients

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24
Q

Professional Code of Ethics

A
  • Provides a basis for accountability
  • Protect individuals from unethical practice
  • Provide a basis for reflecting on and improving practice
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25
Q

Guiding Steps in Making Decisions (8)

A
  • Identify the problem/dilemma
  • Identify potential issues
  • Consult Code of Ethics
  • Consider Laws and Regulations
  • Seek support/guidance
  • Brainstorm possible solutions
  • Consider consequences of different decisions
  • Choose best course of action
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26
Q

Informed Consent

A

Ethical and Legal requirement which involves the right of clients to autonomy and decision-making. Included educating, empowering, and building trusting relationships with clients

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27
Q

Confidentiality

A

An ethical concept which is central to develop trust in a relationship

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28
Q

Western Therapeutic Models

A

Values of individual choice/autonomy are not congruent with cultures that value collectivism.

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29
Q

Individual and Environmental Factors

A

Not all are individual, important for counsellors to consider the clients community and challenges related to environmental realities.

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30
Q

Three Pillars of Evidence-Based Practice

A
  1. Looking at the best available research
  2. Relying on expertise
  3. Considering client preferences and culture
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31
Q

Dual or Multiple relationships

A

When a health care practitioner assumes multiple roles with a client

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32
Q

Nonsexual/nonprofessional

A

Supervisor and therapist, providing therapy to a friend, borrowing money from a client

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33
Q

Sexual relationship

A

Engaging in an emotional/sexual relationship with a current or former client

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34
Q

Professional Boundaries

A

Spaces between the nurse’s power and patient’s vulnerability

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35
Q

Boundary Crossings

A

Brief excursions across professional lines of behaviour that may be inadvertent, thoughtless or even purposeful while attempting to meet a special therapeutic need of the patient (ex. attending client’s wedding)

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36
Q

Boundary Violation

A

Serious Breach! Can cause harm AND is unethical. Can result when there is confusion between needs of nurse and patient.

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37
Q

Why are boundaries important in nursing?

A

Inspires confidence & trust
Demonstrates respect
Reflective of our ethical obligations
Uphold standards and legal requirement

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38
Q

Continuum of Professional Behavior

A

under-involvement - therapeutic relationship - over-involvement

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39
Q

Warning signs of boundary crossing

A

Excessive self-disclosure
Special Treatment/Favouritism
Believing that you are the only one who understands or help patient
Flirtation
Overprotective Behavior
Secretive behavior

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40
Q

Preventing Boundary Crossing

A
  • Be aware
  • Be cognizant of feelings/behaviour
  • Be observant of behaviour of other professionals
  • act in best interest of the patient
  • Evaluate interactions and relationships
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41
Q

Life Instincts

A

Serve to ensure survival and orientate humans toward growth, development, and creativity

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42
Q

Death instincts

A

An unconscious with to harm yourself or others, accounts for the aggressive drive of the human experience

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43
Q

Structure of Personality (ID)

A

Impulses that are biologically driven and unconscious

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44
Q

Structure of Personality (Ego)

A

Mediates between the ID and the reality

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45
Q

Reality Principle

A

Logical thinking to create plans of action to satisfy needs

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46
Q

Structure of Personality (Superego)

A

Developed to protect us from the danger of our impulses, rooted in parent expectations

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47
Q

Unconscious

A

The mind that exists beyond awareness - needs and motivation are unconscious

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48
Q

Anxiety

A

Feeling of dread that results from repressed feelings, memories, desires, and experiences that emerge to the surface of awareness

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49
Q

Reality Anxiety

A

Fear of real-world danger

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50
Q

Neurotic Anxiety

A

Fear of instincts getting out of hand, fear of punishment

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51
Q

Moral Anxiety

A

Guilt felt by acting outside of your moral code

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52
Q

Ego-Defense Mechanisms

A

Repression, Denial, Reaction formation, Projections, Displacement, Rationalization, Sublimation, Regression, Introjection, Identification, Compensation

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53
Q

Freuds Psychosexual Developmental Stages

A

Oral: inability to trust, fear of love
Anal: Inability to recognize or express anger, lack of autonomy
Phallic: inability to accept sexuality/sexual feelings

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54
Q

Crisis

A

A turning point in life that must be resolved to move forward

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55
Q

Psychodynamic Therapy

A

More limited objectives, less likely to use couch, have fewer sessions, use supportive interventions, focus on here/now of relationship, focus on practical concerns

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56
Q

Maintaining the Analytic Framework

A

Maintain neutrality and objectivity, regular and consistent sessions, consistent fees, consistent environment

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57
Q

Free Association

A

Encourage client to say whatever comes to mind, opens door to the unconscious

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58
Q

Interpretation

A

Pointing out, explaining and teaching the meaning behind behavior, dreams,defenses

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59
Q

Latent conent

A

Hidden motives, wishes, fears

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60
Q

Manifest content

A

Dream itself

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61
Q

Dream Analysis

A

Helps uncover the meanings of the manifest content

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62
Q

Resistance

A

Client’s reluctance to discuss/develop awareness of repressed experiences

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63
Q

Jung’s Perspective

A

Focus on psychological changes that occur in midlife

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64
Q

Object-Relations Theory

A

Concerned with attachment and separation

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65
Q

Self Psychology

A

How we use interpersonal relationships to develop our sense of self

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66
Q

Relational Psychodynamic Model

A

Therapy = interactive

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67
Q

Silence

A

Therapist listens without comment to support the client in sharing whatever thoughts arise, silence is essential!

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68
Q

Nonjudgmental Approach

A

Aware of not invalidating client’s behaviours and experiences, frame interpretations as hunches as opposed to declarations of truth

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69
Q

Monitoring countertransference

A

Maintaining awareness of spontaneous reactions to what the client says or does

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70
Q

Psychoanalytic therapy and Multiculturalism Strengths

A
  • everyone has background childhood experiences
  • Erikson’s theory
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71
Q

Psychoanalytic Therapy and Multiculturalism Shortcomings

A
  • Costly, western values.
  • Ambiguity can be problematic for clients who expect therapist to take an active role
  • Does not always address social, cultural and political factors that cause challenges
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72
Q

Leadership traits

A

Sense of identity, open to new experiences, stamina, committed to self-care, model effective behaviour, show vulnerability, use personal power and confidence

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73
Q

Trait Approach

A

Assumes leaders have inherent personal characteristics

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74
Q

Position Approach

A

Leadership that is defined by the authority of a particular person

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75
Q

Leadership-Style Approach

A
  1. Authoritarian Leader
  2. Democratic Leader
  3. Laissez-Faire Leader
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76
Q

Authoritarian Leader

A

Dictates the activities of members, has an absolute power over decisions, goals, and major plans

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77
Q

Democratic Leaders

A

Leader who seeks maximum involvement from group members

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78
Q

Laissez-Faire Leaders

A

Leader who participates minimally, little input

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79
Q

Distributed-Functions Approach

A

Every group member is a leader at times, nearly everyone can be taught to be an effective leader

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80
Q

Task Role Leader

A

Emerges in groups because they have the best idea and/or does the most to guide the discussion. Plays in aggressive role and may be disliked.

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81
Q

Maintenance Role Leader

A

Emerges in time of conflict, works toward group harmony, resolves tension, and works to strengthen bonds within the group

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81
Q

Conflict

A

Disagreement and/or discord among group members or different groups of people

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81
Q

Win-Lose Approach

A

an ineffective way to resolve conflict; increases distrust and decreases cohesion

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81
Q

No-Lose problem-solving

A

It is almost always possible for both sides to have their needs met”
1. All people have the right to have their needs met
2. What is in conflict almost never their needs but their solutions to those needs

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82
Q

Role Reversal

A

Each individual expresses their opinions AFTER restating the ideas and feelings of the opposing individual

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83
Q

Inquiry

A

Using gentle, probing questions to learn more about what the individual is thinking/feeling

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84
Q

“I” Messages

A

Decrease defensiveness and facilitate more open and honest communication

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85
Q

Disarming

A

Finding some truth in what the other individuals POV, then sharing agreement, even if you feel they are wrong

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86
Q

Stroking

A

Involves saying something genuinely positive to the person you are in conflict with

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87
Q

Mediation

A

Used to resolve conflicts between disputing groups - involves intervention of an acceptable and neutral party who has no decision-making power

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88
Q

Consensus

A

Majority agree to a decision

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89
Q

Simple Majority vote

A

highest # of votes win

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90
Q

Two-Thirds or Three-Fourths Majority vote

A

Same as simple majority but one side HAS to reach 66%

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91
Q

Delegated Decisions

A

One person is told to make decision (with parameters)

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92
Q

Multiple Voting

A

Involves several rounds of voting where alternatives become shorter and shorter

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93
Q

Polling

A

Helps gather feedback, opinions, preferences and insights from different individuals

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94
Q

Antecedent Conditions

A

Time pressure and stress, high cohesiveness and social identity, isolate from other sources of information.

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95
Q

Phases of Escalation

A
  1. Trigger phase
  2. Escalation Phase
  3. Crisis Phase
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96
Q

Trigger Phase of escalation

A

an event that causes stress, begins the escalation phase

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97
Q

Escalation-phase of escalation

A

anxiety builds resulting in an emotional response

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98
Q

Crisis phase of escalation

A

client experiences loss of self-control and total loss of reason. Violence can occur

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99
Q

Escalating Emotions

A

Calm
Anxious
Agitated
Aggressive
Violent

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100
Q

Assessing for signs of agitation

A

words - what are they saying?
tone - angry or calm?
facial expression
demeanor
hands
other people

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101
Q

Carl Rogers

A

Father of psychotherapy research, focus on STRENGTHS
client-therapist relationship as the foundation of change

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102
Q

Existentialism

A

Humans are faced with anxiety of creating an identity in a world that lacks intrinsic meaning - focus on death, anxiety, isolation

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103
Q

Humanism

A

More optimistic, individuals have natural potential that can be actualized to find meaning

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104
Q

Maslow & Humanistic Psychology

A

TOP:
self-actualization
Esteem needs
belongingness and love needs
safety needs
physiological needs
BOTTOM

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105
Q

Self-actualization

A

achieving one’s full potential, including creative activities

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106
Q

Esteem needs

A

Prestige and feeling of accomplishment

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107
Q

Belongingness and love needs

A

Intimate relationships, friend

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108
Q

Self-transcendence

A

Seeking meaning and purpose beyond yourself

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109
Q

Who founded Positive Psychology

A

Martin Seligman

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110
Q

Congruence

A

Genuineness or realness

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111
Q

Unconditional positive regard

A

Acceptance and caring

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112
Q

Accurate empathetic understanding

A

Ability to deeply grasp the subjective world of another person

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113
Q

Growth-Promoting Climate

A
  1. Genuine behaviour
  2. Acceptance
  3. Empathetic understanding
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114
Q

PCT Group Goals

A

Provide a safe climate where members can explore their feelings and experiences

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115
Q

PCT Leader Roles & Functions

A

Facilitates the group as opposed to directing it.
Helps members follow their inner direction

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116
Q

PCT Degree of Structure

A

Leader provides little structure/direction and allows group to determine how time is spent

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117
Q

PCT Strengths

A
  • Emphasis of truly listening and understanding the clients world from their internal frame of reference.
  • emphasizes persons ability to find answers to their own problems
  • importance on the counsellor as a person
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118
Q

PCT Limitations

A
  • minimal structure
  • non-directive nature may hinder productivity
  • not all people do well when left to draw own intrinsic resources
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119
Q

Person-Centered Expressive Arts Therapy

A

Founded by Natalie Rogers
Extends PCT to creative expression
Gains insight through movement, art, writing, and music

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120
Q

Emotion-Focused Therapy

A

Person-centered approach that focuses on understanding how emotions affect human function and change

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121
Q

Main goal of EFT

A

Help individuals access and process emotions in constructive ways

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122
Q

Behavior Therapy

A

Focus on directly observable behavior
Criticized by psychoanalytic practitioners

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123
Q

Areas of development in behavioral therapy

A
  1. Classical Conditioning
  2. Operant Conditioning
  3. Social-Cognitive Therapy
  4. Cognitive-Behavior Therapy
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124
Q

Classical conditioning

A

Occurs prior to learning and creates a response through pairing

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125
Q

Operant Conditioning

A

Learning that involves behaviors that are influenced by consequences
ex) positive/negative reinforcement, punishment

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126
Q

Social-Cognitive Approach

A

Involves reciprocal interaction between environment, personal factors, and individual behaviors - assumes people are capable of self-directed behavior

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127
Q

Self-efficacy

A

Individuals ability to master a situation and bring about change

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128
Q

Key Concepts of Cognitive Behavioural Therapy (7)

A
  1. Rooted in scientific principles and procedures
  2. Behaviour can be operationally defined
  3. Deals with current problems, not historical
  4. Clients must assume an active, engaged role
  5. Change can occur without examining underlying issues
  6. Assessment is ongoing throughout treatment
  7. Interventions are tailored for each individual
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129
Q

Goals of therapy

A

Client-led, specific and measureable
Goals: concrete, clear, understood and agreed upon by client and counsellor
Ultimate goal is to increase personal choice and create new conditions for learning

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130
Q

Functional Assessment (ABC model)

A

(A): Antcedents: particular situation/event that elicits
(B): Behavior: problematic reaction that results in
(C): Consequences: events that maintain behavior

131
Q

Behavior therapy “Bag of Tools”

A
  1. Operant Conditioning Techniques
  2. Progressive Muscle Relaxation
  3. Systematic Desensitization
  4. In vivo Exposure and Flooding
  5. Eye movement desensitization and reprocessing (EMDR)
  6. Social Skills training
  7. Self-management programs and self-directed behavior
132
Q

Operant Conditioning techniques

A
  • Positive reinforcement
  • negative reinforcement
  • extinction
  • positive punishment
  • negative punishment
133
Q

Positive Reinforcement

A

Adding something valued by the individual to increase the targeted bahviour

134
Q

Negative Reinforcement

A

When an individual employs a behavior to avoid an unpleasant condition

135
Q

Extinction

A

Withholding reinforcement

136
Q

Positive Punishment

A

Unpleasant condition added to help behavior decrease

137
Q

Negative Punishment

A

Reinforcement stimulus is removed to decrease specific behavior

138
Q

Progressive Muscle Relaxation

A

Specific, taught instructions on tensing and relaxing various muscle groups to help client cope with stress and achieve mental/muscle relaxation

139
Q

Systematic Desensitization

A

Clients imagine anxiety-provoking events while simultaneously engaging in behavior that competes with anxiety. Clients become less sensitive to anxiety-provoking event, time consuming by effective
- for clients with severe anxiety and/or phobias

140
Q

In VIVO exposure and flooding

A

Exposure to therapy that involves introducing clients to situations that contribute to problems

141
Q

In vivo exposure

A

= live exposure - clients engage in brief series of feared events

142
Q

Flooding

A

Similar to in vivo exposure, but involves prolonged exposure

143
Q

Eye Movements Desensitization and Processing (EMDR)

A

Exposure therapy that involves assessment, preparation, flooding, and cognitive restructuring
Developed to treat PTSD
Involves use of rapid, rhythmic eye movements

144
Q

Social Skills Training

A

Helps clients develop skills in interpersonal competence
Involves assessment, direct instructions, coaching, modeling, roleplaying and homework
ex) anger mgmt training

145
Q

Self-management programs and self-directed behavior

A

Therapist sharing their knowledge and skills to help clients develop skills and strategies to deal with their own problems without being dependent on experts
Cost-effective

146
Q

Self-Management Strategies

A
  • Teaching clients how to create realistic goals
  • Teaching clients how to translate goals to behavior
  • Teach clients how to evaluate progress and self-monitor
147
Q

Multimodal Therapy

A

Grounded in social-cognitive learning therapy, focus on specific relationship requirements and treatment strategies will work best for client

148
Q

Who developed Multimodal therapy

A

Arnold Lazarus

149
Q

Mindfulness and Acceptance-Based Approaches

A

Part of third generation behavioral therapy, includes mindfulness, acceptance, therapeutic relationship, spirituality, values, emotional expression

150
Q

Examples of Mindfulness and acceptance-based approaches

A

Mindfulness-based stress reduction (MBSR)
Mindfulness-based cognitive therapy (MBCT)
Dialectical Behavior therapy (DBT)
Acceptance and Commitment Therapy (ACT)

151
Q

Key characteristic of group conselling

A
  1. Therapist starts sessions with a behavioural assessment
  2. Treatment goals are collaborative and clearly defined
  3. Specific strategies/interventions are chosen based on goals
  4. Outcomes are objectively evaluated
152
Q

Relaxation Techniques

A

Helpful for anxious and stressed clients
Works immediately to help client feel better
Accessible on smartphones and easy to apply

153
Q

Self-Management Strategies

A

Helps client learning coping skills that can be applied in real life settings
Empowering

154
Q

Mindfulness

A

Promotes positive mental health
Accessible on smart phones
Helps people manage distraction, intrusive thoughts, enhance compassion for self and others

155
Q

Strengths from a Diversity Lens

A

Some people like more structure
Not always acceptable to show emotions
Task oriented, deals with the present
Increased “buy-in”
Focus on environmental conditions

156
Q

Limitations from a diversity lens

A

Therapist must be aware of influence of race, gender, ethnicity and sexual orientation
May examine client too closely and miss environmental and sociopolitical factors
Could be consequences to client changing behaviour

157
Q

Cognitive-Behavioral Therapy

A

oriented toward cognition and behavior and stresses role of thinking, deciding, questioning, doing and re-deciding
Aims to identify dysfunctional thought and behavioral patterns and replacing them with more positive patterns

158
Q

Key Concepts of CBT

A

Thought: how we think affects how we act/feel
Behavior: What we do affects how we think and feel
Emotion: What we feel affects what we think and do

159
Q

Elements of CBT

A

Active
Motivational
Directive
Structured
Collaborative
Problem-Oriented
Psychoeducation
Solution-Focused
Dynamic
Time-Limited

160
Q

Active element of CBT

A

Client must be actively involved in the therapy as a core and key participant

161
Q

Motivational element of CBT

A

Therapist must motivate the client towards collaborative change

162
Q

Directive element of CBT

A

Treatment plan must help client to understand and contribute to the recovery

163
Q

Structured element of CBT

A

therapy follows structure that approximates treatment plan with beginning, middle and end

164
Q

Collaborative element of CBT

A

Therapist must work with the client collaboratively for successful outcomes

165
Q

Problem-Oriented element of CBT

A

Focus on specific problems rather than vague assumptions and goals

166
Q

Psychoeducation element of CBT

A

teaching by client instruction, modeling, and role-playing

167
Q

Solution-Focused element of CBT

A

Works to generate solution and not simply gain insights

168
Q

Dynamic element of CBT

A

Help client identify and modify schema (basic template for understanding one’s world)

169
Q

Time-Limited element of CBT

A

Each session should stand alone

170
Q

Subtypes of CBT

A

Mindfulness-based cognitive therapy (MBCT)
Dialectical Behavioral therapy (DBT)
Acceptance and Commitment Therapy (ACT)
Rational Emotive Behavior Theraly (REBT)

171
Q

Rational Emotive Behavior Therapy (REBT)

A

Emphasizes importance of creating and maintaining unconditional acceptance of one’s self, others and life

172
Q

REBT Basic Assumptions

A

People contribute to thier own psychological problems by rigid and extreme beliefs they hold.
Cognitions, emotions, and behaviors interact significantly

173
Q

3 Basic musts (irrational beliefs) that lead to self-defeat

A
  1. I must do well to be loved and gain approval
  2. Others must trust me fairly and be kind
  3. My life and world must be comfortable, gratifying and just in order to provide me with all my needs.
174
Q

ABC Model of Personality

A

A - ACTIVATING Events
B - individuals BELIEF about A
C - emotional CONSEQUENCE

175
Q

Goals of Therapy

A

Challenge and confront faulty beliefs with contradictory evidence that is gathered and evaluated

176
Q

Goals of Therapy: assist clients in…

A

Achieving:
1. Unconditional self-acceptance
2. Unconditional other-acceptance
3. Unconditional life-acceptance

177
Q

Therapist’s Function & Role

A
  1. Point out and dispute irrational thoughts clients have
  2. Demonstrate to clients how they are continuously reindocrinating themselves with these thoughts
  3. Help clients change thinking and minimize irrational thoughts
  4. Encourage clients to create a rational philosophy of life
178
Q

Cognitive Therapy Techniques

A
  • disputing irrational beliefs
  • homework
  • bibliography
  • changing language and thinking patterns
  • psychoeducational methods
  • socratic dialogue
179
Q

Emotive Therapy Techniques

A
  • rational emotive imagery
  • humor
  • role playing
  • shame-attacking exercises
180
Q

Putting Theory into Practice ABCDE model

A

A: ACTIVATING event of adversity
B: BELIEFS about event or adversity
C: the emotional CONSEQUENCES
D: DISPUTATIONS to challenge self defeating belief
E: EFFECT or consequence of challenging self defeating belief

181
Q

Role-Playing

A

Therapist takes on role of someone with issues similar to the client. Client works to address the unhelpful thoughts/emotions the therapist is having and come up with life-enhancing beliefs

182
Q

Shame-Attacking

A
  • helpful for those hwo seek approval
  • clients encouraged to do something to attract attention from other while practicing positive self-talk.
183
Q

Cognitive Therapy (CT)

A

Set out to develop evidence-based therapy for depression.
Goal is to help clients become aware of negative thinking that influenced depression

184
Q

Cognitive Therapy (CT) Developer

A

Aaron Beck

185
Q

Aaron Beck’s Cogitive Triad

A
  1. One’s SELF: “I’m worthless and hate myself”
  2. The WORLD/ENVIRONMENT”: “why does no one care about me”
  3. The FUTURE: “things will never get better”
186
Q

Cognitive Distortions

A

When we think about things in distorted wats we experience distorted emotional and behavioral reactions

187
Q

Examples of Cognitive Distortions

A

Arbitrary Inferences
Selective Abstraction
Overgeneralization
Magnification/Minimization
Personalization
Labelling/Mislabelling
Dichotomous thinking

188
Q

Arbitrary inferences

A

Conclusions drawn without evidence (ex. catasrophizing)

189
Q

Selective abstraction

A

Forming conclusions on isolated detail or while ignoring other information

190
Q

Overgeneralization

A

Holding extreme beliefs based on one incident

191
Q

Magnification/Minimization

A

Viewing something in greater or lesser light than the actual event

192
Q

Personalization

A

Relating external events to yourself, even if there is no basis for the connection

193
Q

Labeling/Mislabeling

A

Portraying yourself based on imperfections/past mistakes

194
Q

Dichotomous thinking

A

Categorizing experiences as either–or extremes

195
Q

Characteristics of a Group

A

People see themselves as members
Interaction among members
Shared goals
Two or more people

196
Q

Principles of Group Dynamics

A
  • members must have a strong sense of belonging to the group
  • barrier b/w leaders and members must be broken down
  • more attractive a group is to its members, greater influence it has on its members
197
Q

Aspects of Group Process (membership)

A

Satisfaction (reward), problems, influence upon others (social pressure), each member influencing others (reciprocal or mutual control), cohesiveness, compatibility, norms and social climate, morale, reference group

198
Q

Factors affecting group activity

A

size of the group, threat reduction/degree of intimacy, distributive leadership with focus of control, goal formation, flexibility, consensus/degree of solidarity, process awareness and evaluation

199
Q

Group norms

A

spoken or unspoken rules that guide how team members interact, collaborate effectively and work efficiently

200
Q

Group norms three functions

A

predictive: basis for understanding behavior of others
relational: some norms define relationships
control: regulate the behavior of others

201
Q

Components of Cohesiveness

A

more participation, more conformity, more success, more communication, more personal satisfaction, more productivity

202
Q

Benefits of Group counselling

A

cost-effective, focus on narrow goals, aimed at symptoms relief (problem-solving, interpersonal skills), realistic

203
Q

Structured Groups

A

Educational focus, designed to deal with info deficit, teach skills for effective living

204
Q

Counselling groups

A

Focus on interpersonal process and problem-solving related to thoughts, feelings and behavior. Helps members resolve problems in their own ways. Emphasizes discovering inner strengths

205
Q

Universality

A

when groups members are able to see similarity in the human struggles of others with their own struggles

206
Q

Group leader musts in groups (feedback)

A

create a climate of safety, encourage honest feedback, ensure feedback is given with care and compassion, act as a role model

207
Q

Pre group stage

A

group theme, proposal, member recruitment, member selection

208
Q

Stages of a group session

A

Initial stage
Transition stage
Working stage
Final stage

209
Q

Initial stage of group sessions

A

Involves orientation and explanation
Members may be anxious/insecure
members can bring expectations and concerns (group norms, fears, identifying personal goals, clarifying personal themes, creating a safe space)

210
Q

Group leader functions (Initial stage)

A

teach members how the group works, discuss confidentiality, develop rules/norms, assist members to express fears, develop trust, open and present, degree of structure, establish concrete personal goals, address issues openly, teach and encourage basic skills

211
Q

Transition stage of group counselling

A

members may have anxiety/reluctance/defensiveness and conflict. Members need to take risks. Leader has to deal with resistance and provide encouragement

212
Q

Group Leader functions (transition stage)

A

Teach how to recognize anxiety and defensive reactions. Create a safe climate. Be a role model, encourage members to share.

213
Q

Working stage in group counselling

A

Productiveness. Mutuality and self-exploration increase. Focus on behavior change.

214
Q

Group Leader functions (working stage)

A

reinforce positive behaviours, look for themes, provide opportunity for feedback, support members in risk taking.

215
Q

Final stage in Group counselling

A

Identify what was learned and how it can be applied to daily living. Activities (terminating, summarizing, integrating, interpreting group experience) - bring closure.

216
Q

Group leader functions (final stage)

A

deals with feelings of separation, address unfinished business, review experience, identify coping mechanisms, build support clarify meaning, recognize grieving as normal

217
Q

Guidelines for Forming and Leading a group

A

homework, planning a session, relaxing before you start the meeting, cues upon entering the room, seating arrangements, introductions, clarifying roles, agenda

218
Q

Opening a group session

A
  • ask people to state what they want out of the session
  • give members a chance to express thoughts
  • encourage people to report progress and difficulties
  • encourage to share what the group means to them
  • makes observations about previous meetings
  • use structured exercise that can assist members identify concerns
219
Q

Community Agency

A

Any institution designed to provide social and psychological services to the community

220
Q

Community workers

A

Human service and community health workers, with diverse education and training, whose primary duties revolve around serving their community

221
Q

Becoming a skilled community practitioner

A

become familiar with resources in community, have cultural knowledge of clients, use strengths-based perspectives, alter interventions to meet client needs, teach clients, connect with community

222
Q

Roles of community worker (advocate)

A

speaking on behalf of others, helps clients effectively deal with institutional barriers that impede personal, social, academic and career goals

223
Q

Roles of community worker (change agent)

A

confronting and bringing about change within the system. Assist clients in developing power to bring about change

224
Q

Roles of community worker (consultant)

A

encourage people from diverse cultures to learn skills. Help design preventative programs

225
Q

Roles of community worker (advisor)

A

Initiates discussions with clients about ways to deal with environmental problems that contribute to personal problems

226
Q

Roles of Community workers (facilitator of Indigenous support systems)

A

Encourage clients to make use of the resources in their communities

227
Q

Roles of community worker (facilitator of indigenous healing systems)

A

recognize mistrust that exists and refer clients to healers of their choice

228
Q

Community interventions (direct client services)

A

outreach activities in a population at risk for developing mental health issues

229
Q

Community intervention (indirect client services)

A

Focus on client advocacy, works to empower disenfranchised groups

230
Q

Community intervention (community services)

A

Focus on preventative education, geared to population.

231
Q

Community intervention (indirect community service

A

Attempts to change social environment to meet the needs of the population as a whole

232
Q

Outreach

A

Not waiting for people to come in seeking help - practical

233
Q

Educating the community

A

Helping community become aware of resources and find ways to mitigate barriers to treatment and reduce stigma

234
Q

Mobilizing community resources

A

Helpers wishing to mobilize resources should possess certain knowledge and skills

235
Q

10 Axons of choice theory

A
  1. only person whose behavior we control is our own
  2. all we can give another person is info
  3. all long-lasting psychological problems are relationship problems
  4. problem relationship is always part of our present life
  5. what happened in the past affects today but we can only satisfy our current needs
  6. We can satisfy our needs by satisfying pictures in our quality world
  7. All we do is behave
  8. all behaviour is total behavior made of 4 components (acting, thinking, feeling and physiology)
  9. All total behavior is chosen but we control acting and thinking
  10. All total behavior is designated by verbs and named by recognizable part
236
Q

Reality Therapy

A

Based on choice theory - humans are social in nature and behavior is goal centered

237
Q

Who started Reality therapy

A

William Glasser and added to by William Wubbolding

238
Q

Glassers belief of reality therapy

A

unhappiness is a result of the way people choose to behave

239
Q

View of Human nature

A

we are born with 5 genetically encoded needs that drive us
these needs vary in strength
as a social being we must give/receive love (primary need)
When we feel bad, one of the 5 needs are not being met
we do not satisfy needs directly
From birth we build info in our mind of anything we want
We develop an inner album of specific wants
People we are closest to are the most important to our quality world

240
Q

5 Basic Needs

A
  1. Survival (food, shelter, safety, urge to reproduce)
  2. Love and belonging (connectedness and relationships)
  3. Power (competence, achievement, and internal control)
  4. Freedom (autonomy, ability to make choices)
  5. Fun (pleasure, enjoyment, knowledge)
241
Q

Key concepts of reality Therapy

A

Focuses on PRESENT not past
Avoid discussing symptoms and complaints
Understand total behavior (only thing we can do directly is act and think)
Total behavior is acting, thinking, feeling and physiology

242
Q

Seven deadly habits (reality)

A

criticizing, blaming, complaining, nagging, threatening, punishing, bribing or rewarding to control

243
Q

Seven caring habits (reality)

A

supporting, encouraging, listening, accepting, trusting, respecting, negotiating differences

244
Q

Process of reality therapy

A
  1. establish supportive relationship
  2. explore clients needs, wants & perspectives
  3. Evaluate how effective they are in getting what they want
  4. Make a plan to do better
  5. Commit to plans
245
Q

Goal of Reality therapy

A

To help clients be connected/reconnected with people that satisfies them and to consistently live in QUALITY WORLD or a place where they wanted to live

246
Q

Procedure of Reality therapy (WDEP)

A

W - wants and needs
D - direction and doing
E - Self-evaluation
P - Planning

247
Q

Reality Therapy Planning (SAMIC)

A

S - Simple
A - Attainable
M - Measurable
I - Immediate
C - Controllable

248
Q

Choice therapy founder

A

Robert Wubbolding

249
Q

Choice theory vs reality theory

A

choice - train track (directs where you go, underlying concepts)
reality - train and delivery system (practicality)

250
Q

Explanation of behavior in choice therapy

A

everything we do is chosen from within ourselves, emphasizes thinking and acting (form of CBT), behavior is purposeful and designed to close the gap between what we want and what we perceive we are getting.

251
Q

Modernist Approach

A

Objective reality can be described and observed
objective - known through scientific method
client seeks therapy when faced with a problem

252
Q

Postmodernist Approach

A

clients are experts of their lives, there is not one right or wrong way to live life

253
Q

Social contructionism

A

values the clients reality without questioning its accuracy

254
Q

History of Social Constructionism

A

Focus on diversity, multiple frameworks, and integration, provides a wider range of perspective in counselling practice, change begins by deconstructing power of narratives

255
Q

Not-Knowing Position

A

Therapist retain their expert knowledge BUT enter conversation with client curiosity and interest in discovery - ENTER CLIENTS WORLD

256
Q

Collaborative Language Systems Approach

A

Not-knowing position
Intent isn’t to challenge, but to assist in telling and re-telling

257
Q

Solution-Focused Brief Therapy (SFBT)

A

Future focused goal-oriented, focus on strengths, constructing solutions instead of problem solving

258
Q

SFBT Basic Philosophy

A

Change is constant and inevitable
Clients are experts & define goals
Future oriented
Solution Focused
Emphasis on what is possible & changeable
Short-Term and small changes needed
CHANGE-TALK

259
Q

SFBT Key Characteristicsq

A

Average length of therapy is 3-8 sessions
Most common length is ONE session
Main goal: help clients efficiently resolve problems and move forward as quickly as possible

260
Q

SFBT Basic Assumptions

A

Clients have resources/strengths to resolve complaints
Therapist - identify & amplify change
Small change is all that is needed
Focus on what is possible and changeable

261
Q

Positive orientation

A

Based on assumption that people are healthy and competent and have the ability to construct solutions that can enhance their lives
Therapist: recognize competencies they already possess

262
Q

SFBT Therapeutic Process

A
  1. Client describes problems
  2. Therapist helps clients develop well-formed goals
  3. Therapist asks about times when problems were not present or less severe
  4. At the end, therapist offers clients summary feedback, and give encouragement
  5. Therapist and client evaluate progress made using a rating scale
263
Q

SFBT Therapeutic goals Criteria

A
  1. Start-based: positive terms, what client wants
  2. Specific: concrete, observable, detailed
  3. Social: what significant others would notice and how they might respond - how do these responses affect the client
264
Q

SFBT Therapist Role

A

Not-Knowing Person
Clients are experts
Create climate of mutual respect, dialogue, and affirmation
Help client imagine how they would like life to be different

265
Q

SFBT Client-Therapist Relationship Possibilities

A
  1. Customer-Type relationship
  2. Complainant relationship
  3. Visitors
266
Q

Customer-type relationship

A

Client and therapist jointly identify a problem and a solution to work toward

267
Q

Complainant relationship

A

A client describes a problem, but is not able or willing to take an active role in constructing a solution

268
Q

Visitors Relationship

A

Clients come to therapy because someone else thinks they have a problem

269
Q

SFBT techniques

A

Pre-Therapy Change
Exception questions
Miracle question
Scaling questions
Coping questions
Reframing
Formula First Session Talk (FEST)
Therapist Feedback
Terminating

270
Q

Pre-Therapy Change

A

What have you done since you made the appointment that has made a difference in your problem?

271
Q

Exception Question

A

Direct clients to times in their lives when the problem did not exist (reminds clients that all problems are not “all powerful”)

272
Q

Miracle Question

A

If a miracle happened and the problem you have was solved, what would be different in your life?

273
Q

Scaling Questions

A

On a scale of 0-10, where are you with respect to…

274
Q

Coping Questions

A

Ask about how clients somehow manage to keep going in spite of the adversity they face

275
Q

Formula First Session Talk (FFST)

A

A form of homework a therapist might give clients to complete between their first and second session

276
Q

Therapist Feedback

A

A summary provided to the client - strengths noted, signs of hope, commentary on what the client is doing well to work toward goals
1. Compliments
2. Bridges
3. Suggesting tasks

277
Q

Terminating

A

Therapists assist clients in identifying things they can do to continue the changes they have already made

278
Q

Who founded Motivational Interviewing

A

William Millar and Stephen Rollnick

279
Q

Who founded Solution-Focused Brief Therapy

A

Steve de Shazer and Insoo Kim Berg in the 1980s

280
Q

Motivational Interviewing (MI)

A

Humanistic, client-centered, psychosocial, modestly directive
Brief and applicable across a variety of problem areas - similar to PCT and SFBT

281
Q

MI basic philosophy

A

Clients possess abilities, strengths, resources, and competencies

282
Q

How does MI differ from PCT

A

Deliberatively directive while staying within the clients frame of reference

283
Q

Goal of MI

A

Reduce client ambivalence to change and increase client motivation

284
Q

MI Basic Principles

A
  1. Therapists strive to see the world from clients perspective
  2. Designed to evoke and explore discrepancies and ambivalence
  3. Reluctance is viewed as an expected part of the process
  4. Therapists support client self-efficacy
  5. Once client’s are ready for change, therapists focus on strengthening commitment and implementing a change plan
285
Q

MI Stages of Change

A

Precontemplation Stage
Contemplation Stage
Preparation Stage
Action Stage
Maintenance Stage

286
Q

MI Precontemplation Stage

A

No intention of changing behavior anytime soon

287
Q

MI Contemplation Stage

A

Awareness of problem, consideration of change, no plans or commitment

288
Q

MI Preparation Stage

A

Individuals plan to take action immediately and small changes are noted

289
Q

MI Action Stage

A

Steps are taken to modify behavior and solve problems

290
Q

MI Maintenance Stage

A

Work is done to consolidate gains and prevent relapse

291
Q

MI Techniques

A

Nonpathological, health-promoting emphasis
Reframing resistance
Use of clients strengths and resources
Skills improve with deliberate practice

292
Q

Narrative Therapy Founder

A

Michael White and David Epston

293
Q

Narrative Therapy (NT)

A

Strengths-based approach
Emphasizes collaboration between client and therapist
Goal is to help clients see themselves as empowered

294
Q

NT Basic Philosophy

A

Focus on respectfully listening to clients stories
Searching for times in clients life that they were resourceful
Avoids labelling and diagnosing
Dominant stories (events that clients internalized)

295
Q

NT Key Concepts

A

Stories
Listening (normalizing judgement, AVOID totalizing language, double listening)

296
Q

Normalizing Judgement

A

Judging someone on what is deemed the “normal curve” (ex. mental health, intelligence, normal behavior)

297
Q

Totalizing Language

A

Reducing the complexity of the individual by assigning an all-embracing, single description to the person

298
Q

Double Listening

A

Separating the person from the problem while listening to the story

299
Q

NT Therapeutic Process

A

Collaborate with client to name problem
Personify problem and attribute oppressive tactics to it
ID how problem has disrupted, dominated, or discouraged the client
Discover moments of strength and resilience

300
Q

NT Therapist Role

A

Active facilitators
Demonstrate care, interest, respect, openness, empathy, fascination
Apply the “not-knowing” position
Help clients create a preferred story line
Avoids language of diagnosis, intervention and assessment

301
Q

NT Therapeutic Techniques

A

QUESTIONS
Externalization and deconstruction
Searching for unique outcomes
Alternative stories and Reauthoring
Documenting the evidence

302
Q

Integration

A

To combine, mix, blend or coordinate different elements into a whole

303
Q

Integrative Perspectives

A

Characterized by openness to various ways of integrating diverse theories and techniques
Enhance the efficiency & applicability

304
Q

Types of Crises

A

Here-and-Now
Normal
Adverse child experiences (ACES)

305
Q

Here-and-Now Crises

A

Demand rapid action (ex. flood, fire, sexual assault, school shooting, sudden diagnosis)

306
Q

“Normal” Crises

A

Considered part of life (ex. breakups, divorce, job loss, death)

307
Q

Adverse child experiences (ACES) Crises

A

Crisis in childhood
Often leads to long-lasting trauma (ex. bullying, parent illness/death, moving, parent divorce/remarriage)

308
Q

2 Major Phases of Crisis/Trauma counselling

A
  1. Working through initial trauma
  2. Appropriate follow-up and counselling
309
Q

Crisis/Trauma Counselling

A

Most pragmatic and action-oriented form of helping
Concerned with action and useful result for the client

310
Q

4 Core Principles of Trauma-Informed Care

A
  1. Trauma has widespread impacts and there are many pathways to recovery
  2. It is important to recognize the signs and symptoms of trauma in patients and families
  3. Knowledge about trauma needs to be integrated into all systems
  4. It is important to not re-traumatize patients, family members, and staff
311
Q

Values/Principles of Trauma-Informed Care

A

Safety
Trustworthiness
Choice
Collaboration
Empowerment

312
Q

Safety in Trauma Counselling

A

What does the client need for safety and survival NOW
Offer verbal reassurance that the crisis is over
Connect them with immediate resources

313
Q

Calming & Caring in Trauma Counselling

A

Establish a therapeutic relationship
Show a client you care and listen
Do not minimize the crisis

314
Q

Normalizing in Trauma Counselling

A

Not “survivors” or “victims” - normalize experience by recognizing that they are reacting the same as anyone in the situation would
Resilience does not eliminate pain

315
Q

Debriefing the story in trauma counselling

A

Clients need to tell their stories again and again
LISTEN

316
Q

Assessment of Strengths and resources in trauma counselling

A

Watch for signs of strength and resilience

317
Q

Action and Advocacy in trauma counselling

A

Do not overpromise
Answer questions honestly and clearly - provide info

318
Q

Follow-Up in trauma counselling

A

Arrange to meet for a debrief

319
Q

Strategies for working with hostile or involuntary members

A

Model respect and treat with respect
Allow members to vent their unhappiness over their forced involvement in the group
Establish goals that are meaningful to them
Utilize the disarming technique
Do not subject yourself to extensive verbal abuse
If abuse continues, meet with supervisor to discuss options

320
Q

Disarming

A

Involves finding some truth in what the other person is saying and then expressing your “agreement” even if you feel that the other person is largely wrong, unreasonable, irrational, or unfair

321
Q

Intimate Partner Violence (IPV)

A

Abuse or aggression that occurs in a romantic relationship

322
Q

Risks IPV (relationship factors)

A

Conflict or dissatisfaction in the relationship
Male dominance in the family
Economic stress
Having multiple partners
Disparity in educational attainment

323
Q

Risks IPV (community and societal factors)

A

Gender-inequitable social norms
Poverty and low social and economic status of women
Weak legal sanctions against IPV within marriage
Lack of womens rights
Broad social acceptance of violence as a way to solve conflict
Armed conflict and high levels of general violence in society

324
Q

Interventions for IPV

A

Priority = safety plan (phone/keys/legal documents, packed bag hidden, # of shelter, referral numbers)

325
Q

Considerations for Individuals who are homeless

A

Mental illness is common in homeless population (especially substance use and depression)
Tend to have significant medical conditions (liver disease, TB, AIDS, pain, diabetes, HTN)
Many have trouble maintaining relationships of any type

326
Q

Positive WOMEN: exposing injustice

A

factors people bring with them into health care setting
barriers to building relationships
marginalization
complex multifaceted considerations
power of understanding
needs for relationships, connection and beneficial communication

327
Q

Risk factors for suicide

A

Severe anxiety, depression, alcohol/drug use, sleeplessness, hopelessness, employment problems, relationship loss, physical/sexual abuse, serious health issues, financial issues

328
Q

High risk populations for suicide

A

Men and boys, individuals serving federal sentences, survivors of suicide loss or attempts, indigenous youth, all inuit regions in Canada

329
Q

Assessment and Intervention for Suicidal clients

A

Look for signs of: actual threat to hurt/kill themselves, seeking access to pills/guns, talking/writing about death.
Avoid asking “WHY?”
IMMEDIATE crisis support

YEAR 3 (14 decks)

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