PSYC 508 Personality Theories Flashcards

1
Q

ABCPA

A

A type of behavior analysis assessment; stands for Antecedent, Behavior, Consequences, Person Variables, and Assets. Focuses on using behavioral descriptions rather than trait descriptions.
Antecedent refers to the setting characteristics, or the conditions in which the problem behavior occurs.
Can refer to a physical setting, day/time, or social context.
Can also refer to other behaviors, cognitions (schema, expectancies, rules, knowledge), and emotions (mood/affect, fears, etc).
Behavior refers to the explicit identification and definition of the problem behavior.
Internal frame of reference - you want to hear how the patient/client describes their problem
Consequences refer to what occurs after the behavior.
Person Variables refer to how the person views themselves and the world around them.
Can include expectations, emotions/affect, skills/competencies, goals, evaluation standards, self-labeling and self-talk
Assets refer to things the person does well; can help to resolve the problem behavior.
This type of assessment allows a total view of the person and their problems, which helps in formulating the treatment plan.

EXAMPLE: A 35 year old woman has come to treatment for a problem overeating. The therapist conducts an ABCPA analysis by taking a closer look at the problem bx.The behavior (B) is overeating - considered a behavioral excess. The Antecedents (A) that she reports are feeling stressed or upset frequently at night time. The reinforcing consequences (C) of the behavior is the pleasure that comes from eating and the distraction from the upsetting emotions. However, she is also experiencing the negative consequence of gaining weight. Therapist and client also come up with the list of client assets and person variables that will help in treatment plan.

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2
Q

Attachment Patterns/Styles

A

Bowlby developed Object Relations theory of attachment. Objects refer to people, and it is how you form relationships with other people. Bowlby suggests the sense of self (child) develops from relationship w/ mother (original object). Ainsworth suggested attachment has 4 distinct patterns; avoidant, secure, ambivalent, and disorganized. Secure attachment is associated with positive emotional health and high self-esteem whereas the other three (considered insecure attachments) are associated with poor cognitive development and poor social relationships.

EXAMPLE: A mother comes into therapy complaining of depression, and she explains to the therapist that she did not feel connected to her baby when she was born as a result of postpartum depression. The mother said it was difficult for her to get out of bed at times when the baby cried. Now the mother no longer suffers from postpartum depression; however, the mother says that every time the now toddler cries, the mom is responsive and attempts to fulfill the baby’s needs. In return, though, the toddler cries and does not make eye contact with the mother. It was apparent to the therapist that the baby formed an insecure avoidant attachment during the mom’s postpartum depression.

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3
Q

Authentic Existence

A

humanistic concept used in existential theory and thearpy; describe a person who is taking responsibility for their life and for the freedoms they have, and who has an accurate understanding of themselves and the world around them
Helping the client develop an authentic existence is the goal of existential therapy

EXAMPLE: Client in counseling reveals that he became a Lawyer because he comes from a family of lawyers. He discloses that he always felt called to be an artist. The counselor, being of existential orientation, works with the client on taking responsibility for his life and striving for growth. The counselor helps the client come up with ways in which he can lead an authentic existence-maybe join an art club, take the time on the weekends to create something.

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4
Q

Big 5 Personality model/traits

A

The Big Five personality traits, also known as the five factor model, is a model based on common language descriptors of personality.
These descriptors were grouped together using a statistical technique called factor analysis (i.e. this model is not based on scientific experiments).
This widely examined theory suggests five broad dimensions that describe the human personality and psyche. The five factors have been defined as openness to experience, conscientiousness, extraversion, agreeableness, and neuroticism, often listed under the acronym OCEAN.
Beneath each proposed global factor, a number of correlated and more specific primary factors are claimed. For example, extraversion is said to include related qualities as gregariousness, assertiveness, excitement seeking, warmth, activity, and positive emotions.

EXAMPLE: John came into therapy because he was experiencing anxiety over the fact that he was unable to pick a major, or even determine what career path interested him. The counselor gave John the NEO-PI which is based on the big 5 personality model to determine his personality traits and work together to explore different majors and career paths.

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5
Q

Client centered/Person-centered theory/therapy

A

a humanistic approach developed by Carl Rogers; based on his theory of personality which asserts that humans have a natural tendency towards growth, learning, and change - actualization tendency
Also includes self-theory (self-concept vs ideal self), phenomenology (value of subjective experience) , and conditions of worth (self requires positive regard; if child receives conditional pos regard, creates internal conflict and incongruence b/c person denies aspects of self-concept to meet conditions)
Psychopathology results from a failure to learn from experience and it continues when clients accept projected parental conditions of worth instead of modifying self concept based on day-by-day personal experiences
Non Judgemental atmosphere facilitates psychological health
Therapist offers client UPR, empathy, and genuineness - 3 necessary therapeutic conditions; therapist also role model for congruence between real and ideal self
Therapists are non-directive and should not educate clients; client expert on themself
Facilitate change
Not technique driven
Research supports PCT as effective intervention but not a ton of research; PCT not manualized
Potential weakness: focus on self may not fit all culture’s worldviews; focus on emotional expression might not fit with other cultures; culturally diverse client may prefer expert advice and directive therapies

EXAMPLE: A client came to therapy with anorexia. Her mother had repeatedly told her when she was young that the only way to win a husband was to stay thin and made Kara diet at a very young age. Kara came to think being thin was the only way to be acceptable & she would only be lovable if she was thin. Utilizing a person-centered approach, the therapist conceptualizes Kara’s pathology to be a result of her mother’s conditions of worth that taught her to deny the part of her that enjoys and likes food.

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6
Q

Cognitive avoidance

A

a term that represents several strategies, such as distraction, worry, and thought suppression, aimed at avoiding or escaping thoughts about undesirable situations or problems.
Similar to avoidance bxs seen in operant conditioning; cognitive avoidance also negatively reinforced because of relief they experience
A type of coping
Must be prevented when carrying out exposure therapy or SD
Contributes to several psychological disorders such as PTSD. Client avoids thinking and talking about trauma and therefore, trauma remains unprocessed.

EXAMPLE: You are working with a client that has PTSD and conducting exposure therapy with their trauma narrative. During exposure, you must make sure that the client is not engaging in cognitive avoidance and distracting him/herself from processing the narrative.

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7
Q

Cognitive dissonance

A

from Festinger’s research. Occurs when there is a discrepancy between a client’s thoughts, beliefs, or attitudes and bxs or when a person holds two conflicting views simultaneously - causes discomfort for the client. Festinger suggests a person has innate drive to reduce this cognitive dissonance - done through changing beliefs and actions or justifying and denying onset of beliefs or actions. Used in MI in attempt to motivate change to resolve discrepancies.

EXAMPLE: You’re treating a client with a heroin addiction that has discussed wanting to be “healthy” and “mindful.” It is clear that she values those things, but that she experiences cognitive dissonance because she is still using and that’s not healthy. You decide to use MI to attempt to resolve the dissonance and motivate her to change.

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8
Q

Common factors in psychotherapy

A

a model developed by Jerome Frank; theory the proposes that different approaches in psychotherapy and counseling share common factors that account for much of the effectiveness of a txt and elicit change.
In contrast to the view that the effectiveness of psychotherapy/counseling is best explained by specific or unique factors (notably, particular methods or procedures) that are suited to treat particular problems.
Factors include but not limited to: therapeutic alliance, positive expectations or hope, and extratherapeutic client resources - all therapies allow for corrective emotional experience
Frank’s model shared therapeutic components:
An emotionally charged, confiding relationship; a healing setting; a rationale, conceptual scheme, or myth; and a ritual

EXAMPLE: You’re treating a client with PTSD and you’re trying to decide between two treatments so you turn to the research. You find that both txs you are considering produce similar results. You conclude that this may be due to common factors in psychotherapy and you decide to think more about the client as a person and what therapy she might prefer.

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9
Q

Conditional vs Unconditional positive regard

A

terms developed by Carl Rogers and used in Rogerian therapy, positive regard is the perception of love and respect from others. The need for this positive regard develops as the self emerges.
Positive regard can be conditional or unconditional.
In unconditional positive regard, the positive regard is when others accept and love the person for who they are, regardless of mistakes or if something is wrong. The positive regard is never taken away from the person if it is unconditional, and tend to allow people to self actualize.
UPR core necessary condition for therapeutic relationship
In conditional positive regard, love and acceptance are only given when the person is or behaves a certain way and meet certain conditions in order to obtain positive regard. If conditions are not met, then no positive regard is given.
If given conditional PR, person acquires conditions of worth and rejects parts of themselves in order to be considered acceptable.

EXAMPLE: A client came to therapy presenting symptoms of anorexia. Her mother had repeatedly told her when she was young that the only way to win a husband was to stay thin and made Kara diet at a very young age. Kara came to think being thin was the only way to be acceptable & she would only be lovable if she followed these guidelines. The therapist explained to Kara that her mother’s conditional positive regard was contingent upon her weight. This contributed to her anorexia.

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10
Q

Conditions of Worth

A

A term coined from Carl Rogers, this refers to messages sent from society and other people (typically parents) in a client’s life that tell them they are only lovable or acceptable when they conform to certain guidelines. When conditions of worth are placed on a person, they will deny parts of their self-concept in order to meet these conditions. This can have a negative influence on the client, as these conditions tend to be incorporated into their idea of self worth at a young age. Conditions of worth cause incongruence between the real & ideal self and ultimately to pathology. Conditions of worth can be helped by the therapist giving unconditional positive regard (warmth) to the client. conditions

EXAMPLE: A client came to therapy presenting symptoms of anorexia. Her mother had repeatedly told her when she was young that the only way to win a husband was to stay thin and made Kara diet at a very young age. Kara came to think being thin was the only way to be acceptable & she would only be lovable if she followed these guidelines. Utilizing a person-centered approach, the therapist explains to Kara that her mother’s conditions of worth contributed to her pathology.
Another example would be if a teenaged client entered therapy for anxiety over getting straight A’s because that’s the only way her parents will pay positive attention towards her, she considers being a straight A student as a condition of worth.

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11
Q

Countertransference

A

A term developed by Sigmund Freud & related to psychoanalytic theory, this is a process that occurs in therapy when the therapist projects their past feelings or attitudes about something in their own lives onto the client, thereby distorting the way they perceive and react to the client and contributing to bias. It is important for the therapist to be aware of countertransference because it leads to confusing and/or harmful reactions in therapy.

EXAMPLE: A therapist is seeing a client who is depressed following a miscarriage. The therapist herself has also experienced a miscarriage. The therapist found herself expressing much more empathy than she usually did with clients and recognized it as countertransference. While keeping an eye on her reactions, the therapist allowed her personal experience to help her with the client.

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12
Q

Defense mechanisms

A

A term originally coined in psychoanalytic theory, largely by Anna Freud, this refers to an unconscious process by which a person attempts to preserve the integrity of their self-image and keep their ego from experiencing anxiety. Defense mechanisms can also be used as coping mechanisms to protect against psychological harm/stress. Includes three primal defenses: denial, repression & regression; also includes undoing, projection, reaction formation, rationalization, sublimation & displacement. Freudian psychology states that normal, healthy individuals do use defense mechanisms, which only become unhealthy when they lead to maladaptive behaviors.

EXAMPLE: Brian presented to treatment because his wife insisted he go to therapy or they would get a divorce. She says that he has anger problems. The therapist discovered that much of Brian’s anger was actually at his boss, but that the defense mechanism of displacement caused him to take out his anger on a safer target, his wife.

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13
Q

Electicism

A

a therapeutic approach that incorporates a variety of therapeutic principles, philosophies, and techniques. Two types of this integration are technical and theoretical. Technical involves tailoring treatment to the individual utilizing techniques from different schools without necessarily subscribing to the theoretical positions behind them. Theoretical integration aims to synthesize the best aspects of two or more theoretical approaches beyond a blending of techniques to create a richer outcome.

EXAMPLE: The therapist chooses to take a technical eclecticism approach to therapy with her clients. She often incorporates mindfulness techniques from DBT without incorporating all of the modules of DBT or subscribing to the theoretical position of dialectics. In addition, she incorporates cognitive therapeutic techniques such as reframing if a client is struggling with negative thought patterns. This particular therapist tailors therapeutic techniques to each client
Ex: For example, most psychologists accept certain aspects of behaviorism, but do not attempt to use the theory to explain all aspects of human behavior. Using a humanistic approach to therapy in your practice, but use behavioral techniques.

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14
Q

Emotion focused therapy

needs ex

A

developed by Johnson and Greenberg; a short-term structured therapy originally developed for couples.
Includes elements of attachment theory, systems theory, and client-centered therapy
Goal is to help people accept, express, regulate, make sense of, and transform emotion
Views emotion as driving force in human motivation and action
3 Stages: cycle de-escalation; changing patterns of interaction; and consolidation of change
Used to treat couples, families, depression, and trauma. NOT useful for anxiety typically
EXAMPLE:

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15
Q

Existential Theory/Therapy

A

a philosophical style of therapy, it focuses on the person as a whole. Like humanists, existentialists in psychology felt that behaviorism and psychoanalysis focused on a narrow aspect of human nature and that a broader view was needed.
Humans are “condemned to freedom” (burden) and must make meaning in their lives
Focus on responsibility, free will, and the present/future (past does not determine future)
Emotions usually serve a function
Emphasizes authentic existence
Psychopathology is related to diminished self-awareness; Goal is to increase self-awareness and help clients face “ultimate concerns” of existence: death, freedom, isolation, and meaninglessness
In general practitioners view technical interventions as artificial or phony; techniques detract from the authentic relationship between therapist and client

EXAMPLE: John was admitted to inpatient therapy at a drug and alcohol rehab center. He had a 2-year-old son and his girlfriend had recently left him. When meeting with the counselor he repeatedly talked about his difficult upbringing and his alcoholic father. John told the counselor that he was destined to be an addict. The counselor used existential therapy to work with John to take responsibility for his actions and live with greater meaning & values.

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16
Q

Factor analysis

A

a way to take a mass of data and shrinking it to a smaller data set that is more manageable and more understandable. It’s a way to find hidden patterns, show how those patterns overlap and show what characteristics are seen in multiple patterns.
A statistical procedure used to determine whether the variability among observed variables may be explained by fewer unobserved variables called factors
Mathematical procedure for reducing a set of intercorrelations to a small number of descriptive explanatory concepts

EXAMPLE: Factor analysis was done in the research leading up to the Big 5 Personality model. It examined correlations between 1700 different descriptive words typically used to describe personality and narrowed them down to 5 identifiable factors.

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17
Q

Fixation

A

A term in psychoanalysis and developed by Sigmund Freud, fixation occurs when there is unresolved conflict at one or more Freud’s psychosexual stages of development. Both frustration and overindulgence can cause fixation.
Influences one’s personality and contributes to psychopathology.
For example, if overindulged during oral stage, the individual is more receptive. If frustrated during the oral stage, the individual is more aggressive.

EXAMPLE: Mary came to therapy for excessive binge eating. The therapist utilized a psychodynamic perspective and looked to Mary’s past to see if she progressed normally through Freud’s psychosexual stages, specifically the Oral stage. The therapist theorized that if her needs weren’t met at that stage, she is fixated at this stage, and this would explain the binge eating.

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18
Q

Gestalt Therapy

A

Developed by Fritz Perls & Laura Posner, this is a humanistic/existential therapy, which focuses on the present and how we perceive ourselves in the context of others.
Underlying belief in an individual’s self-actualizing potential
Gestalt “experiments” can activate the actualizing potential and move clients towards growth. (i.e. empty chair technique)
Gestalt therapy is phenomenological and focuses on here-and-now
“Gestalt” is a German word referring to the unified whole and the theory views mind-body as inseparable - they comment on clients’ physical position, posture, etc and interpret these as representing emotional or cognitive events within the person
Reality is subjective and all people exist within an environmental field - cannot be ignored
Emphasizes self-regulation process (requires knowing and owning what one senses, feels, needs, or wants)
Therapist acts as supportive guide and helps client become aware of needs, sensations, and desires, then helps them deal with these experiences authentically and directly
Therapist and client collaborative experts; mutually responsible for change/success
Overall not technique driven, less focus on assessment and diagnostic procedures

EXAMPLE: Tara was leading a therapy group at a rehab center, and was employing a Gestalt therapy technique called the empty chair. She asks one of the group members to sit in the center with an empty chair and speak to it as if it were her mom. This technique can help the client know and own her emotions surrounding their relationship.

19
Q

Humanistic Therapy

A

Pioneered by Maslow & Rogers. A group of therapies that developed in reaction to psychoanalysis and behaviorism. Humanistic therapists believed that psychoanalysis was negative and deterministic, while behaviorism ignored the uniqueness of the human condition. Humanistic therapies focus on human potential for growth and a person’s ability to actively shape their own future, believing that humans have a natural tendency to move towards self-actualization. Humanistic therapy considers the client the expert on themselves, considers growth to be continuous throughout life and considers humans as active in choosing their lives. The general goal is to help the client achieve self-actualization. Maslow believed that self-actualization could only be achieved if basic needs were satisfied.

EXAMPLE: A counselor was working with Carla, a first time mom. Carla commented on how she was worried about keeping a roof over her new baby’s head as her landlord was trying to evict her. As a humanistic therapist, the counselor realized that Carla needed to work on satisfying her basic needs before they could move onto larger goals such as striving for self-actualization. The counselor worked with Carla to try and get into safe housing.

20
Q

Insight/Catharsis

needs ex

A

A term from psychodynamic theory and developed by Freud and Breuer. In psychodynamic therapy, the therapist guides the client towards insight and catharsis. A main goal of psychoanalytic theory is to gain insight, which is to understand intrapsychic conflicts and interpersonal relationships, understand the historical roots of current problems, then integrate them into current life and increase ego strength. During this type of therapy the therapist and client work through feelings of resistance and transference by repeating elaborating and interpreting. Successfully achieving insight should enable the client to release or free their emotions, the experience of catharsis, providing relief from repressed emotions. The examination and discussion of feelings in psychoanalytic therapy provide catharsis and intellectual /emotional insight which is essential for change.
EXAMPLE:

21
Q

Internal Frame of Reference (IFR)

A

A person’s phenomenological description of their subjective experience, or how they see the world/problems. Rogers emphasized this with humanistic therapy in that a person must know the “self” in order to help the “self.” A therapist must empathetically enter the client’s IFR; the client’s IFR can also be generalized to other schemas - their view of the world, beliefs, etc. Counselor must prevent form introject his/her own frame of reference on the counseling relationship

EXAMPLE: A client was told throughout her childhood that she was stupid and worthless. She explains to the therapist that she fears applying to graduate school because she doesn’t think she will be able to succeed. The therapist attempts to take on the client’s internal frame of reference in order to empathically understand her experience and reflects, “You are unsure about your decision to apply to graduate school because you fear that you are not competent to succeed. I can see that it is tough for you to sit with that fear.”

22
Q
Interpersonal Psychotherapy (IPT)
(needs ex)
A

developed by Klerman, Paykel, and Weissman in 1970’s; short term therapy focused on resolving interpersonal relationships/problems and improving symptomatology. Based on notion that interpersonal relationships affect mood & vice versa
Theoretically based in attachment theory; believes bonds formed with caretakers are basis for attachment styles later - but focuses on affect on present relationships
Slight CBT influence but cognitive-behavioral issues are addressed only as they affect social relationships
Focuses on four main problems; 1) Grief & Loss 2) Interpersonal Disputes 3) Role Transitions 4) Interpersonal Deficit - work on 1 or 2 of these
Originally developed as a treatment for depression (EST for depression) but is now used on other mood disorders like BP and eating disorders
EXAMPLE:

23
Q

Interpretation

A

a technique used in psychoanalysis developed by Freud, this technique is the explanation of hidden meaning behind what the client says. Interpretation is considered the specific intervention of the analyst and the driving force of therapeutic change. Timing is important. The client might regard interpretations as threatening if used too early in the course of therapy; resistance should be expected and leads to further interpretation. The therapist may apply this technique to dreams, resistance, transference, or the working through process.
Also used by Adlerian therapists to facilitate insight and bring about action; the third stage of Individual/Adlerian therapy

EXAMPLE: You are working with a client that is having a hard time holding a job. After many sessions of psychoanalysis, you offer up your interpretation and say, “Is it possible that you have left jobs in the past when you have been up for promotion because you doubt your competence to take on more responsibility at work?”

24
Q

Person-behavior-environment reciprocal interaction

A

A primary aspect of Bandura’s Social Learning Theory also called reciprocal determinism. An individual’s behavior both influences and is influenced by personal factors and the environment. As personality develops in someone, all three aspects - the individual, their behaviors, and their environment are interacting influencing one another.

EXAMPLE: You have client with social anxiety that thinks he is ugly and boring. (Personal Factor) His thoughts cause him to act awkward and be short with people at parties. (Behavior) His behavior causes the people around him to ignore him and not want to get to know him. (Environment). You explain that his personal factors, behavior, and environment are all influencing one another. You argue that by changing his cognitions in therapy, his behavior and environment might change as well.

25
Q

Person Situation debate

A

a debate between personality theorists about what is most important for determining a person’s bx - the person/traits of the person, or the situation (environment).
sparked by an influential book by Walter Mischel he argued that ratings on traits fail to predict actual bxs
Interactionism is principle that aspects of personality & situations work together to determine behavior
Generally, traits are superior in predicting general behavior patterns, while situations are better at predicting specific behaviors

EXAMPLE: Tara was a therapist that strongly believed in the person side of the person situation debate in psychology. She believed that all traits were consistent across situations. Because of this, she administered the NEO-PI to all of her clients. Tara felt that she was better able to understand and predict her clients behavior because the assessment pointed out key personality traits.

26
Q

Person Variables

A

part of Mischel’s theory of personality. As opposed to environmental factors, these are internal factors that influence behavior. Person variables include social learning and cognitive processes that develop within a sociocultural context and are unique to the person. Person variables mediate between stimuli and responses, and include competencies, plans, emotions, expectancies, goals, values and evaluative standards. Should be assessed in clinical interviews

EXAMPLE: When formulating a tx plan for clients, it is important to take into account the client’s person variables because they influence the client’s bxs. For instance, when treating a pt with substance use disorder it is important to assess their expectations about recovery because they might influence the length/intensity needed for successful treatment. Expectations are a person variable.

27
Q

Potentially harmful treatments

A

A treatment where harm lies in either the nature of the intervention or in the improper application of the intervention.
This may also come from characteristics of the therapist, where low levels of warmth and empathy along with charismatic, confrontational, and intrusive characteristics tend to increase risk of client deterioration
Some client variables also play a role, specifically borderline personality disorder and psychopathic personality traits (difficult/challenging clients)
Can result in harm to client/family, worsening/new symptoms, excessive dependency on therapist, tx dropout, and/or long-term negative effects (losing trust - resistance to future treatment, impact others/family/relationships).
According to Lillienfield; characteristics include documented harmful psychological or physical effects on clients or others (eg relatives). The harmful effects are enduring and do not merely reflect an exacerbation of symptoms during treatment, the harmful effects have been replicated by independent investigative teams.

EXAMPLE: Critical incident stress debriefing has been found to increase some people’s risk for developing PTSD. It is considered a potentially harmful tx and is rarely used because of the enduring harmful effects that has been observed.

28
Q

Primary Processes and the pleasure principle

needs ex

A

A term from psychoanalytic theory developed by Freud; a way of controlling behavior that is developed first in the life span. The pleasure principle is what drives the id; it seeks instant gratification for all needs, wants, and desires - mostly biological. The primary processes are directed to satisfy the Id - work to resolve tension created by pleasure principle. They are directed to immediate gratification and include obtaining an object or fantasizing the object by day/night dreaming. These ignore reality and logic and the immediate gratification is only temporary or causes frustration.

29
Q

Projective Hypothesis Techniques

A

the projective hypothesis says that when people attempt to understand an ambiguous or vague stimulus, their interpretation of that stimulus reflects their needs, feelings, experiences, thought processes, etc and can reveal personality structure.
Most common techniques are projective personality tests such as the Rorschach inkblot test, the TAT or the draw-a-person
Have fallen out of favor in recent years.
Usually these types of tests require extensive training & there’s low evaluator agreement
Most fall flat when psychometric properties are examined i.e. low reliability low validity

EXAMPLE: You are seeing a client and you ask them to interpret a black ‘blob’ while using the Rorschach inkblot. According to the projective hypothesis the client saying that she sees a crab in the image might be indicative of her mood at the time of testing.

30
Q

Psychodynamic Theory

A

Developed by Freud, this theory says that psychopathology arises from early childhood experiences - past focused.
Includes Freud’s 5 stages of psychosexual development. Fixations can arise from troubles in a certain stage and also contribute to psychopathology
De-emphasizes environmental and social factors
The mind is made up of the unconscious, preconscious, and conscious; bxs largely motivated by unconscious
The mind also consists of an id (governed by pleasure principle/primary process; biological desires typically outside of awareness), ego (governed by reality principle/secondary process - rational thought, in awareness; helps cope with id’s drives), and superego (conscience and ego ideal or internalized father figure- pos desire to emulate adult standards)
Therapy:
Therapist viewed as expert; his/her interpretations are valued
Acts as blank slate and listens for unconscious conflicts and motivations that underlie client’s patterns of behavior
Goal is to bring the unconscious into conscious awareness; primarily accomplished through therapist interpretations. Another goal is to help clients develop greater self-control over maladaptive impulses
Techniques include free association, dream analysis, resistance & transference. Dreams considered royal road to the unconscious.
in more recent years; less focus on sexual instincts as prime motivating factor, ego considered as separate from the ID with its own independent motivations (ego psychology)

EXAMPLE: Mary came to therapy with the goal of quitting her excessive smoking. The therapist utilizes psychodynamic theory, and looks to Mary’s past to see if she had any negative early childhood experiences, specifically during her Oral stage. The therapist theorizes that if her needs weren’t met that she is fixated at this stage and that would explain the smoking.

31
Q

Psychosexual Stages

A

In psychodynamic theory, these stages are considered to be how personality is developed. Developed by Freud, this is a sequence of stages which is controlled by libidinal energy concentrated in erogenous zones. Erogenous zones includes:
Oral: gratification or frustration [birth to 1]
Anal: retention/elimination functions inactive/active and aggressive [1-3 yr old]
Phallic: Oedipal and Electra complexes; boys and girls, castration anxiety and penis envy: identification w/ father/mother [3-5]
Latency: period of repression [5-12]
Genital: onset of puberty, catharsis: mature libidinal attachments
Adult personality is determined by the way we resolve conflict within each stage
Psychopathology is thought to come from a fixation in one of these stages (related to childhood experiences typically).
Research does not really support these stages

EXAMPLE: Mary came to therapy for excessive binge eating. The therapist utilized a psychodynamic perspective and looked to Mary’s past to see if she progressed normally through Freud’s psychosexual stages, specifically the Oral stage. The therapist theorized that if her needs weren’t met at that stage, she is fixated at this stage, and this would explain the binge eating.

32
Q

Psychosocial stages

A

Theory of personality developed by Erik Erikson, who believed that Freud put too much emphasis on sexuality; focused his theory on social interactions stemming from his belief that a desire to be with other people is a person’s primary drive.
Suggests we continue to develop throughout the lifespan
Each developmental stage is characterized by a unique crisis that must be resolved
The crisis is not a catastrophe, but rather a turning point marked by both increased vulnerability and enhanced potential
More successfully an individual resolves each crisis, healthier development will be.
PROS - good face validity, crosses lifespan; CONS - vague about causes of development, tool rather than factual analysis
1- trust vs mistrust - hope-infancy
2- autonomy vs shame - will - early childhood
3- initiative vs guilt - purpose - play age 3-5
4- industry vs inferiority - competency - school age 5-12
5- ego identity vs role confusion - fidelity - adolescence 12-18
6- intimacy vs isolation - love - young adult 18-40
7- generativity vs stagnation - care - adulthood 40-65
8- ego integrity vs despair - wisdom - maturity 65+

EXAMPLE: Louise was a 70-year-old woman that came to you for tx. She was bitter about becoming old and commented that now that they were retired they were just “waiting to die.” The therapist recognized that Louise was entering the Integrity vs. Despair psychosocial stage and was unable to look back on life with a sense of fulfillment. The therapist decided to help Louise to look back on her life with a more positive outlook.

33
Q

Rational emotive behavior therapy

A

a cognitive behavioral therapy put forth by Albert Ellis, based on the idea that distress is not created by events themselves but by judgments and beliefs about those events
Based on belief that humans have a strong tendency to think irrationally, causing psychological distress, but also that humans have the power to alter their thinking
Therapist is confrontational in order to get client to think about their thinking
Therapist is the expert and infers logical errors and irrationality
ABC’s A (antecedent event) → B (beliefs about event) and → C (consequences)
This therapy is designed to get the person to dispute their irrational beliefs by appealing to the lack of evidence for the belief
Goals include changing maladaptive thoughts and instilling critical thinking

EXAMPLE: You are seeing a client that found a missed call from another woman on her husbands phone. She believes that he is hiding things from her and must be cheating on her. She has kicked him out of the house and is refusing to speak to him. Her therapist utilizes REBT and helps to identify her underlying irrational thought patterns and belief. She then challenges these irrational beliefs, honestly and bluntly, by saying, “Aren’t you jumping to conclusions by not speaking to him about this?”

34
Q

Resistance

A

a phenomenon often encountered in clinical practice in which clients either directly or indirectly oppose changing their behavior, or refuse to discuss, remember or even think about presumably clinically relevant experiences
May include pauses, inability to recall, shifts in topic, avoidance behaviors, or disagreements
Initially a key concept of Freud’s, referring to patients blocking memories from consciousness and interfering with treatment requiring that these memories become available
in other treatments such as MI , it can be seen as a natural part of the treatment process, and an opportunity to develop dissonance and create motivation for change

EXAMPLE: You’re providing CBT to a client with substance use disorder. She has either refused to or forgotten to do her homework the past couple of weeks. This opposition to change be indicative of tx resistance. You should consider using MI to create/elicit motivation for change.

35
Q

Rogerian theory/therapy

A

A client-centered therapy developed by Carl Rogers based on his theory of personality. He believed individuals are innately good and have a tendency toward growth.
This tendency can be thwarted by negative environmental influences such as conditions of worth placed on the individual.
Therapist offers the client unconditional positive regard, empathy, and genuineness (3 core)
Serves as role model for congruence between the real and ideal self
Creates a supportive environment in which clients feel able to look at themselves honestly & acceptingly
Therapy is nondirective and the goal is to help client become fully functioning, valuing all parts of the self and their experiences
The end goal is self-actualization- a “fully functioning person” open to experiences, living in the present (existential living), experiential freedom, and creativity.

EXAMPLE: A client came to therapy with anorexia. Her mother had repeatedly told her when she was young that the only way to win a husband was to stay thin and made Kara diet at a very young age. Kara came to think being thin was the only way to be acceptable & she would only be lovable if she was thin. Utilizing a Rogerian theory, the therapist conceptualizes Kara’s pathology to be a result of her mother’s conditions of worth that taught her to deny the part of her that enjoys and likes food.

36
Q

Secondary processes and the reality principle

needs ex

A

From psychoanalysis and developed by Freud, the reality principle and secondary processes are one of the principles and processes of controlling behavior. The idea is that ego develops due to ineffectiveness of the id and its primary processes. Ego is in service of the id, and the reality principle holds that it can delay gratification in order to satisfy the id’s instinct in a realistic and socially appropriate way. This functions from the ego. The ego’s success depends on the secondary processes and make up the thinking and problem solving involved in order to satisfy instinctual needs. Success of Ego depends upon its secondary processes of thinking and problem solving in order to satisfy instinctual needs.

37
Q

Self actualization

A

a term most closely associated with the work of Mazlow; also used by Rogers in PCT. Refers to the alignment of a person’s view of themselves, their experiences, and who they want to be (self concept) – basically, congruence and reaching one’s highest potential
Humanistic theories believe that people have a tendency to strive for self actualization
Self actualization is achieved within the climate of unconditional positive regard that is provided during the treatment process, if not in actual life previously
A person who is self actualized is open to experience (accurately perceives one’s feelings and experiences in the world), living existentially (in the present), organismic trusting (trusting their own thoughts and feelings as accurate), experiential freedom (acknowledging one’s freedoms and taking responsibility for one’s own actions), and creativity (participating fully in the world, including contributing to the lives of others).

EXAMPLE: A counselor was working with Carla, a first time mom. Carla commented on how she was worried about keeping a roof over her new baby’s head as her landlord was trying to evict her. As a humanistic therapist, the counselor realized that Carla needed to work on satisfying her basic needs before they could move onto larger goals such as striving for self-actualization. The counselor worked with Carla to try and get into safe housing.

38
Q

Self concept

A

term utilized in various psychological theories including person-centered theory; describes an individual’s organized set of perceptions about self and relationships. Develops as we interact with the world (experiences + introjected values); both stable and changeable. The self concept is a type of schema that helps in the processing of perceiving, evaluating and regulating oneself in terms of the real self and the ideal self (who we think we should be).

EXAMPLE: Client in counseling reveals that he became a Lawyer because he comes from a family of lawyers. He discloses that he always felt called to be an artist. The counselor works with the client and helps the client come up with ways in which he can lead a life that more closely aligns with his self concept-maybe join an art club, take the time on the weekends to create something. That is, how can he make his real self more like his ideal self or who he thinks he should be

39
Q

Self efficacy

A

originally part of Bandura’s self efficacy theory; a person’s belief about their ability to succeed in specific situations or accomplish certain tasks.
Related to person’s locus of control
Is situation specific and not an overall trait
Determinant of behavior initiation, maintenance, and energy expenditure
Can be increased via modeling and skills therapy
Influences a person’s goals
Fundamental to behavior change

EXAMPLE: An overweight client came into therapy presenting w/ sxs of depression and major self esteem issues. Had been overweight for years and felt that it was a worthless cause to try and lose weight. Therapist worked with her to increase her self-efficacy by building upon small tasks that she could complete, like walking around the block once a week, then increasing it to twice a week, etc etc.

40
Q

Self monitoring

A

A type of observation in which a client monitors their own behaviors, thoughts and/or feelings. Self monitoring is useful for low-frequency behaviors or private events. Self monitoring, like direct observation, is subject to reactivity of monitoring in that a person may decrease an undesired behavior unconsciously when they start monitoring that behavior. Those with high self monitoring capabilities are able to alter their behavior to fit a wide variety of situations yet those with low self monitoring are more consistent across situations. Ex: diaries, recordings, etc.; parent, roommate, etc. can also record things; how/when to record target behaviors, explicit instructions are necessary; problems: reactivity, reliability, validity, and compliance; clients record their own (problem or other) behavior in the (natural) environment where it occurs or when they have an opportunity to record

EXAMPLE: Melanie came to therapy presenting symptoms of OCD - she was frequently washing her hands and it had come to severely disrupt her personal, professional, & social life. The therapist asked Melanie to keep a diary and self-monitor her bx, keeping track of how many times she washed her hands and how long it took for her to complete these behaviors. This would help the therapist get a better picture of her compulsions.

41
Q

Sustain vs change talk

A

In motivational interviewing, sustain talk refers to the client’s stated reasons not to make a change or to maintain the status quo; the extent to which the client defends status quo/resistance to change
Change talk refers to the extent to which the client argues for change
The MI counselor actively listens for change talk in its various strengths from weak to strong.
the objective of MI is to facilitate high levels of change talk and low levels of sustain talk
Both types are made by the client in their own words, allowing the client rather than the counselor voice the arguments for change. this dialogue is then utilized by the counselor to discuss the client’s ambivalence towards change.
This can be augmented with the use of a decision matrix.

EXAMPLE: You’re utilizing MI with a client in order to discuss the client’s ambivalence about getting sober. The client has spent the last few minutes verbally defending her choices, really focusing on sustain talk. In order to explore the other end of things and elicit change talk, you might say something like, “What would be something good about changing your situation?”

42
Q

Trait theory

A

Developed initially by Allport, Cattell, and Eysenck, trait theory overtook type theory in personality research. Trait theory is a personality theory that conceptualizes personality as a set of traits, or enduring dispositions to respond in a particular manner.
Traits are thought to be relatively stable over time and consistent across situations
Generally measured using psychological - responses are considered “signs” of inferred traits.
Have a number of traits, 5 that stand out the most often which were proposed by Goldman and extended by McCrae & Costa.
One disadvantage of trait theory is that it ignores the situation/environment as a source of control over a person’s behavior.

EXAMPLE: Tara is a clinical psychologist that subscribes to trait theory. She believes that traits are consistent across situations and predictive of bxs. Because of this she administers the NEO-PI to all of her clients when they first come in to see her. She feels that she is better able to understand and predict her clients behavior after learning more about some of their traits.

43
Q

Transference

A

First discussed by Freud, this is a process in therapy in which the client projects onto the therapist past feelings or attitudes that they have towards significant people or situations in their lives. If the client is reacting to the therapist in a way that seems odd or inconsistent with the situation, transference may be occurring. It is not helpful for the therapist to react to the transference. Instead, the therapist should use the opportunity to go deeper with the client and collaborate with the client to determine the origin on the feelings.

EXAMPLE: Woman came to therapy after a particularly difficult break-up with presenting symptoms of depression. While interacting with the male counselor she had feelings of anger and hostility towards him and said that she felt that “all men were deceitful.” The therapist recognized these feelings to be transference, and worked on diving deeper into these feelings, collaboratively trying to determine the origin of them.

44
Q

Warmth, empathy, genuineness (WEG)

A

Encouraged the most in Rogerian therapies, but applied to most therapies. Refers to the 3 therapist characteristics that are necessary and sufficient conditions for change: warmth, empathy and genuineness.
Warmth refers to showing unconditional positive regard to the client as well as being nonjudgmental caring and accepting of client despite possibly disagreeing with the client’s actions/beliefs.
Empathy refers to the therapist putting themselves in the shoes of the client with accurate/sensitive entries into the client’s IFR, thinking WITH and not FOR the client.
Genuineness refers to the therapist being transparent with the client and staying true to themselves. The therapist maintains genuineness by being congruent and neither having a superior attitude nor using professional jargon.
When all three are presented by the therapist and perceived by the client, it turns into trust and builds a strong therapeutic relationship
important to note that its the client’s perception of the therapist’s WEG that is important

EXAMPLE: Samantha has just begun therapy, and she has expressed to her therapist that she is not quite comfortable with the idea of being in therapy. The therapist ensures her that her feelings are completely normal and that it will take time to build a trusting relationship, demonstrating empathy. She also shared that she had similar concerns the first time she went to therapy- demonstrating genuineness. The therapist continues to demonstrate these core conditions along with UPR in order to gain her trust and build a healthy therapeutic relationship.