Psychotherapy Flashcards
What are some (relative) contraindications for brief psychodynamic therapy?
-Severe depression
-Acute psychosis
-substance abuse
-EUPD
(Marked acting out, serious suicide attempts)
What is a technique used in Moreno’s psychodrama?
Representational role reversal
What are some signs of Resistance in pychoanalysis?
- asking irrelevant questions
- fidgetting
- intellectualising events
- being late for appointments
What is a problem with hypnosis?
-sudden removal of symptoms by suggestion under hypnosis can lead to rebound anxiety and depression
What are Yalom’s therapeutic factors in group therapy?
Universality (removes group members sense of isolation)
Altruism (the experience of helping anther group member)
Instillation of hope (seeing other members who have progressed in therapy)
Imparting information (learning from others)
Corrective recapitulation of the primary family experience (therapists analysis of transference)
Development of socialising techniques (practicing social skills)
Imitative behaviour (using other members as models)
Cohesiveness (feeling part of the group)
Existential factors (taking responsibility)
Catharsis (relief from expressing emotion)
Interpersonal learning (using feedback from other members)
Self understanding (insight)
Who was the founder of group analysis who propounded the idea of a social matrix?
Foulkes
type of family therapy in which past experiences of a family are thought to be responsible for present conflicts
Psychodynamic family therapy
Transference is most intense when working with which of the following client group?
EUPD
What is Transference?
Transferenceis the phenomenon whereby we unconsciously transfer feelings and attitudes from a person or situation in the past on to a person or situation in the present.
Which factors increase Transference?
Borderline personality disorder
Anxiety
Frequent contact with key worker
Ways to effectively manage
Recognise the importance of the relationship to the patient
Maintaining professional boundaries and clear limits in treatment
Interpreting the transference
Being a reliable therapist (missing appointments and being unreliable will complicate the transference)
What is Countertransference?
Countertransferenceis the response that is elicited in the therapist by the patient’s unconscious transference communications.
A projected role may be very different from any aspect of his or her personality and the recipient is able to recognise that this perception of his or feelings or behaviour is a product of the patient’s mind.
However, a role may be congruent with an aspect of the therapist’s personality and he or she may unconsciously accept and collude with the projection
What is socratic questioning and which Psychotherapy is it used in?
Socratic questioning (sometimes referred to as the Socratic method) involves a disciplined and thoughtful dialogue
Cognitive therapy uses a technique called Socratic questioning to elicit false beliefs called negative automatic thoughts.
Dichotomous thinking
The tendency to see things as black and white rather than shades of grey
Personalisation
Incorrectly assuming that things happen due to us. Attributing external events to oneself when there is actually no causal relationship
Overgeneralisation
Coming to a general conclusion based on a single piece of evidence
Arbitrary inference
Drawing of an unjustified conclusion
Selective abstraction
Concentrating on the negative while ignoring the positives
Catastrophising
Expecting disaster from relatively trivial events
Filtering
Selecting out only negative aspects of a situation and leaving out the positive
Control Fallacies
Believing we are responsible for everything (internal control fallacy) or nothing (external control fallacy)
Fallacy of Fairness
Believing that life is fair
Blaming
Holding other responsible for our distress
Shoulds
Preconceived rules we believe (often incorrect) which makes us angry when others don’t obey them
Magnification
A tendency to exaggerate the importance of negative information or experiences, while trivialising or reducing the significance of positive information or experiences
Minimisation
An undervaluation of positive attributes
Emotional Reasoning
Believing what we feel must be true
Fallacy of Change
Expecting others to change just because it suits us
Global Labelling
Exaggerating and labelling behaviour (e.g. when you fail at something, saying ‘Im a loser’)
Always Being Right
When the need to be right dominates all other needs
Heaven’s Reward Fallacy
Expecting our sacrifices will pay off
Magical thinking
Incorrectly believing that our actions influences the outcomes
Which psychologist developed theories about group dynamics?
Bion
What did Bion believe about group dynamics?
He believed that groups had a collective unconscious that operated in a similar way to that of an individual
What were the two types of groups Bion distinguished between?
He made the distinction between two types of group. The first was theworking group, which was one that was working well and getting the job done.
The second was thebasic assumption groupwhich was acting out primitive fantasies and preventing things from getting done.
What are the three basic assumption groups?
Dependency.Here the group turns towards a leader to protect them from anxiety. An example of this is when a group of strangers get together for the first time, there can be an awkward silence before someone finally takes initiative and plays the role of leader.
Fight-flight.Here the group acts as if there is an enemy who must be attacked or avoided. The enemy can be either within the group or external. The group may at times pursue and defeat the perceived enemy but will soon create another one. An example of this would be the way doctors in different specialities become so damming of one another.
Pairing.Here the group acts as if the answer lies in the pairing of two of the members. This may be in the form of a friendly pairing or an extremely hostile one.
Which therapy is based on Otto Kernberg’s theory of borderline personality organisation?
Transference focused psychotherapy
What is Otto Kernberg’s theory of borderline personality organisation (BPO)?
BPO is a concept that includes borderline personality disorder but also other less severe personality disorders.
BPO is characterised by
- Identity diffusion (failure to integrate aspects of self)
- Primitive defences (splitting, and projective identification)
- Characteristic object relations
- Variable reality testing
The aim of therapy is to resolve issues in these four areas by means of interpretation of the transference
What is Cognitive Analytic Therapy (CAT)?
Cognitive Analytic Therapy (CAT) is a blend of psychodynamic and cognitive ideas.
A reparatory grid was used to identify the key aspects of psychodynamic psychotherapy that made it useful.
CAT is therefore an attempt to pick out the useful parts of psychotherapy and make it more efficient.
It is also an attempt to create a form of therapy that would lend itself to research.
How long does CAT usually last?
It is a brief focused therapy normally lasting between 16-24 sessions.
Who developed CAT?
Anthony Rhyle
What are Traps in CAT?
Negative assumptions generate acts and then confirm assumptions.
A trap is a flawed thinking pattern / coping strategy that serves to aggravate rather than help an underlying problem.
Traps are things we cannot escape from. Certain kinds of thinking and acting result in a vicious circle when, however hard we try, things seem to get worse instead of better. Trying to deal with feeling bad about ourselves, we think and act in ways that tend to confirm our badness.
For example, a person has low self esteem, to cope with this they try to please everyone around them, they are then taken advantage of and end up feeling pathetic and worse.
What are Dilemmas in CAT?
Dilemmas. Options for action are conceived in the form of polarised choices.
In a dilemma, a person incorrectly considers that there choice is restricted to opposite actions, neither of which is satisfactory.
For example, a young girl is ridiculed by her parents when she talks about her problems. She grows up to believe that when she has problems she has only two options, either bottle feelings up be ridiculed.
What are Snags in CAT?
Snags. Appropriate goals are abandoned if unacceptable to self or others.
Snags are thinking patterns that restrict our actions due to a perception that we will be unsuccessful or will harm someone.
For example, as a child a man was raised by a mother who had regular bouts of depression. He felt unable to take problems to her for fear of being a burden. This view and approach to difficulties persisted into adulthood as he was unable to find emotional support through his marriage.
How does CAT work with regards to procedures?
CAT identifies maladaptive, cognitive, emotional, and behavioural patterns which are referred to as procedures.
CAT takes a procedural sequence model. First the problem or issue is appraised. The options available to the client are then discussed and a plan of action is created. The plan is put into place. The consequences are then evaluated. The summary of the problem along with the plan is often put into a letter written by the therapist to the client.
What are reciprocal role procedures (RRPs) and which therapy are they associated with?
CAT
These are patterns observed about the way we relate to others. Imagine a client who has been brought up by a stern, dominating father whom he chose to rebel against, an example of an RRP could be the way the same client is dismissive of therapy because he sees the therapist as a demanding authority figure.
Once the RRPs have been defined they are visually presented using a sequential diagrammatic reformulation.
What is a sequential diagrammatic reformulation?
Diagrammatic representation of an RRP in CAT
Who developed CBT?
Aaron Beck
What’s the aim of CBT?
seeks to help the client overcome difficulties by identifying and changing dysfunctional thinking
Negative automatic thoughts (cognitive distortions)
Which therapy uses collaborative empiricism?
CBT - treatment is present focused and based on collaboration between client and therapist and on testing beliefs (collaborative empiricism).
Structural Family Therapy
What’s the main assumption in Structural Family therapy?
What constitutes a healthy family system?
What are Dysfunctional families marked by?
The main assumption is that the family’s structure is wrong.
It is one where there are clear boundaries and no coalition
Dysfunctional families are thought to be marked by impaired boundaries, inappropriate alignments, and power imbalances
What are some key terms in Structural Family Therapy?
subsystems, hierarchy, boundaries, alliances and coalitions
Who developed Structural Family Therapy?
developed by Salvador Minuchin
Strategic Family Therapy
What’s the main assumption in Strategic Family therapy?
What are Dysfunctional families marked by?
Strategic therapy claims that difficulties in families arise due to distorted hierarchies.
Dysfunctional families are believed to communicate in problematic repetitive patterns (vicious cycles) that kept them dysfunctional. These patterns arise as intended solutions by the family to some symptom. The intended solutions then became the problem because the family had either over or under responded to the symptom through their interactions
What are some key terms in Strategic Family therapy?
task setting, and goal setting
Who developed Strategic Family Therapy?
Jay Haley and Cloe Madanes
What other name is Systemic Family Therapy known by?
Milan Model
Systemic Family Therapy
What’s the main assumption in Systemic Family therapy?
How are the interviews conducted?
Milan-Systemic therapists see the family as a self-regulating system which controls itself according to rules formed over a period of time through a process of trial and error. They are interested in the rule-maintaining characteristics of communication and behaviours, and assume that the way to eliminate a symptom is to change the rules.
An interview consists almost entirely of questioning of the family by the therapist. Questioning is a recursive and circular process, with each question building upon the family’s response to previous questions. Emphasis is placed on exploring differences between family member’s behaviours, emotional responses and their beliefs at differing points in time.
What are some key terms in Systemic Therapy?
hypothesising, neutrality, positive connotation, paradox and counter-paradox, interventive questioning and the use of reflecting teams
Who developed the Systemic Family Therapy?
Mara Selvini-Palazolli
What does Transgenerational Family Therapy aim to understand?
Transgenerational family therapy aims to understand how families, across generations, develop patterns of behaving and responding to stress in ways that prevents health development and lead to problems.
Which 7 interlocking concepts make up Transgenerational Family Therapy theory?
Seven interlocking concepts make up the theory
scale of differentiation
nuclear family emotional system
family projection processes
multi-generational transmission processes
sibling position profiles
emotional cut-off
triangles
What is Solution Focused therapy?
emphasises solutions over problems. In fact, it sees the problem as being maintained by a focus on the problem to the exclusion of the solution behaviour which is already happening.
Solution focused therapy philosophy:
The central philosophy of the model could be stated as:
- If it ain’t broke, don’t fix it.
- Once you know what works, do more of it.
- If it doesn’t work, don’t do it again, do something different.
How does the interview process work in Solution Focused family therapy?
The therapist collaborates with the family through in-depth questioning to focus on the solutions already being used by the clients.
This is underpinned by a belief that people have the capacity to develop their own solutions, even if they are not using it.
Blame, shame and conflict are seen as issues which impede people from realising these solutions.
The therapist is non-interventionist.
Silences are tolerated when they arise in order to see what happens next.
The presumption here is that the more the therapist intervenes, the more he or she will impose their own understanding and interpretation onto the family.
The focus is on the present and the future.
How a problem has arisen is not important.
The emphasis the family places on the problem is accepted by the therapist as he or she is not interested in changing the family’s definition
Which defense mechanisms are seen in Borderline personality disorder?
Projection and splitting
Which defense mechanisms are seen in phobias?
Repression and displacement
Which defense mechanisms are seen in OCD?
Isolation, undoing, and reaction formation
Which defense mechanisms are seen narcissistic PD?
Projection and splitting
Which defense mechanisms are seen agoraphobia?
Displacement
What are the components of Freud’s Structural theory?
Freud proposed the existence of three separate areas:-
Id
The Id is the area that contains the instinctive drives. It operates underprimary process thinking, acts according to thepleasure principle, and is without a sense of time.
Ego
The ego attempts to modify the drives from the Id with external reality. It operates on thereality principle. It has aspects that are conscious, preconscious, and unconscious. It is home to the defenses mechanisms.
Super ego
The super ego constantly observes a person and acts as critical agency. Freud claimed it developed from internalised values of a child’s main carers. The ego ideal is part of the super ego and represents ideal attitudes and behaviour. It is useful to think of the super ego as the conscience.
What is IPT? Which condition is it most notably used for?
IPT is a time-limited, structured form of psychotherapy.
It is based heavily on the belief that interpersonal factors impact heavily on psychological problems.
It is used for many conditions but most notably for depression.
What does IPT aim to intervene?
IPT aims to intervene at the level of social functioning, it does not focus on personality. Patients social functioning problems are thought arise from one of four areas
Grief
Role transitions
Interpersonal deficits
Interpersonal disputes
What’s the usual course of IPT?
normally runs from 10-16 one hour sessions
What are the phases of IPT?
IPT moves though 3 defined phases.
Phase 1 - Identification of the problem, sessions 1-3
Phase 2 - Working on the target problem area
Phase 3 - Termination
Sessions 1-2 involve data collection and formulation.
An interpersonal inventory is taken which is a register of all the key relationships in the patient’s life.
The problem is then organised into one of the four categories above. The remaining sessions explore the formulation in more detail.
What’s an interpersonal inventory?
An interpersonal inventory is taken which is a register of all the key relationships in the patient’s life.
Who developed IPT?
Harry Stack Sullivan - theory
Klerman and Weissman - therapy
Is IPT more or less effective than CBT in depression + PD?
IPT has been found to be less effective than CBT in treating people with depression and comorbid personality disorders
What was the finding about IPT vs Imipramine vs CBT in depression?
equal efficacy
What was the finding about IPT vs Imipramine vs CBT in severe depression
Imipramine = IPT > CBT
Who introduced the psychodynamic term ‘containment’ and what does it mean?
Bion. He used the term to describe the process of emotional containment which can be illustrated by the relationship between a mother and an infant.
Infants project unbearable feelings into their mothers who receive and accommodate them for a time, making them tolerable and acceptable again to the child.
Containment is important in many therapeutic relationships.
Containment is thought to occur when one person receives and understands the emotional communication of another without being overwhelmed by it, processes it and then communicates understanding and recognition
back to the other person. This process can restore the capacity to think in the other person.
What’s the purpose of a transitional object?
They function as substitute parents for children with separation anxiety
Which terms are associated with Winnicott?
Good enough mother. Winnicott introduced this term to emphasise the importance of being good enough rather than perfect. He believed children needed someone who would attend to them but not immediately so that they can learn to tolerate frustration.
Holding environment. By this Winnicott was referring to a psychic and physical space between the mother and infant that ensured the mother was there for the child when needed but allowed them to explore independently when ready.
Transitional object. Winnicott talked about the two separate realities for a child, the ‘me’ and the ‘not me’. The transitional object is one that represents another (e.g. Mother) and is regarded as the first ‘not me’ possession.
What are the therapeutic aims of long-term supportive psychotherapy?
Establishment of a therapeutic alliance taking into account psychological and practical barriers to engagement
Holding and containing (for the client and the multidisciplinary team)
Promoting awareness of transference issues (with the client and the team)
Promoting stability, by improving adjustment and coping as well as reducing relapses and the inappropriate use of services
Facilitating the maturation of defenses and promoting a better adaptation to reality
What is repetition compulsion?
Repetition compulsion is common in psychiatry - the urge to do the same thing over and over, especially in terms of relationship patterns.
Examples might include always ending up with an abusive partner and repeatedly forming relationships with people who let you down
What is the latent content of a dream?
Thought to be the true meaning of a dream, hidden behind the dreams symbolism.
What is the manifest content of a dream?
The manifest content of a dream refers to what is directly experienced. It is thought that beneath this there is a different meaning (the latent content) that is hidden to protect conscious mind.
What did Alfred Adler believe?
Believed that the main driving force in personality is a striving for superiority.
Important concepts of Carl Jung
Introduced the concept of the persona (mask) which is the part of the ego presented to other people. The other (more hidden) part of the self is the ‘shadow’.
Differentiated between the personal unconscious (which contains an individual’s personal memories) and collective unconscious (a set of memories and ideas that is shared amongst all of humanity).
Talked of archetypes (symbolic images in the collective unconscious). Important archetypes are anima (female principle), animus (male principle), the shadow, and the self.
What’s Erick Erickson known for?
Known for his stages of psychosocial development
Who developed attachment theory?
John Bowlby
Which psychologist Developed the concept of the defense mechanisms?
Anna Freud
What is Margaret Mahler known for?
Theories on child development
Three main phases, autistic phase, symbiotic phase, and separation-individuation phase.
What is brief psychodynamic psychotherapy?
Brief psychodynamic psychotherapy is a time limited treatment (often 10-12 sessions) based on psychodynamic therapy. There are several different subtypes.
When is brief psychodynamic therapy useful?
It is particularly useful when there is one specific focus or problem for the patient.
What factors are considered important for the success of this therapy?
Others factors that are considered important for the success of this therapy are a highly motivated patient and a patient who is able to think in feeling terms.
Good ego strength
The reduction in anxiety experienced in flooding therapy is referred to as?
Flooding
What is Flooding?
Flooding is a technique used in the treatment of phobias.
it encourages people to directly confront the phobia and remain until the anxiety is gone (a process called habituation)
Associated with high levels of anxiety and patients sometimes leave the situation before the fear response has been extinguished
Psychological therapies
Perls - founded Gestalt therapy
Moreno - founded psychodrama
Sullivan - interpersonal theory (1953)
Klerman and Weissman - interpersonal therapy (1970s)
Milton Erikson - revolutionised hypnotherapy
Maxwell Jones - developed the concept of the therapeutic community
Thomas Main - coined the term therapeutic community
Anthony Ryle - developed cognitive analytic therapy
Marsha Linehan - developed dialectical behaviour therapy
Albert Ellis - developed rational emotive therapy
Carl Jung - devised analytical psychology
Carl Rogers - client-centred therapy
Joseph Wolpe - systematic desensitization
Skinner - operant conditioning
Pavlov - classical conditioning
Abraham Maslow - hierarchy of needs
Yalom - therapeutic factors of group psychotherapy
Rappaport - community therapy
Miller - motivational interviewing
Beck - cognitive therapy
Tuke - moral therapy
Martell - behavioural activation
Fonagy and Bateman - mentalisation-based treatment
What’s Freud’s Topographical model of the mind?
Freud introduced his topographical model of the mind in his bookthe interpretation of dream. Mind divided into:
The conscious system
This refers to the part of the mind that is aware.
The preconscious system
This is the information that is known and can potentially be brought into consciousness.
The unconscious system
Freud believed that this area of the mind was outside conscious awareness. It operates on the primary process thinking, which means it is aimed at wish fulfilment. It is governed by the pleasure principle. It has no concept of time, and denies the existence of negatives, and is irrational as it allow the existence of contradictions.
Which names are associated with Therapeutic communities?
Tom Maine and Maxwell Jones
What happens in a Therapeutic community?
In these communities patients are normally residential along with staff. They essentially form a kind of group therapy whereby they have daily meetings in which community issues that arise are discussed. This gives the staff/therapists an opportunity to guide group therapy.
Feedback on patients behaviour by other patients is considered essential.
What are the four main values associated with therapeutic communities?
Therapeutic communities are associated with four main values
Democratisation.Every member of the community (including staff) should be considered equal.
Permissiveness.All members should be tolerant of others behaviour.
Communalism.Members should be intimate and socialise (i.e. Share facilities and not simply spend all day in their rooms)
Reality-confrontation.Members should be continuously given feedback on their comments and behaviours to avoid them distorting reality.
When is supportive therapy useful?
This type of therapy is suitable for most patients and is often the only therapy that can help when others have failed. E.g. Patients with complex and treatment-resistant psychosis
According to Freud, which of the following terms is used to refer to the unconscious need that a boy has for the exclusive love of his mother?
Oedipus complex
According to Freud, which of the following terms is used to refer to the unconscious need that a girl has for the exclusive love of her father?
Electra complex
Sequential Diagrammatic Reformulation (SDR) is a technique used in?
Cognitive analytical therapy.
A major aim of interpersonal therapy for depression is to?
Aid conflict resolution
The three R’s of Cognitive Analytical Therapy are
Reformulation, Recognition, Revision
which form of therapy targets distorted perceptions of signficant others (used in EUPD?)
Tranference focused therapy
What were Freud’s theory about aggression?
Aggressiom rises from which instinct?
Freud believed that aggression arose as a result of a primary instinct called thanatos (aka the death instinct). He suggested that each person had this drive which aimed to cause total destruction and death.
He also suggested that there was an opposing instinct called eros (the life instinct).
He described catharsis, which is a process of discharging libidinal energy and making us feel calm. Catharsis occurs when we watch an aggressive act or are involved in a mildly aggressive act.
What is Behavioural activation?
Behavioural activation is a formal therapy for depression which focuses on activity scheduling to encourage patients to approach activities that they are avoiding and on analysing the function of cognitive processes (e.g. rumination) that serve as a form of avoidance
Advantages of behavioural activation?
It is much more simple than CBT and involves much less cognitive therapy. An advantage therefore over traditional cognitive therapy for depression is that it is easier to train staff in its use.
Who developed behavioural activation?
Martell
What’s the theory of behavioural activation?
Behavioural activation theory holds that when people become depressed, many of their activities function as avoidance and escape from aversive thoughts, feelings or external situations. Depression therefore occurs when a person develops a narrow repertoire of passive behaviour and efficiently avoids aversive stimuli. As a consequence, someone with depression engages less frequently in pleasant or satisfying activities and obtains less positive reinforcement than someone without depression. To address this the patient is encouraged to identify activities and problems that they avoid and to establish valued directions to be followed. These are set out on planned timetables (activity schedules)
In behavioural activation, therapists tend not to become engaged in the content of the patients thinking. Instead they use functional analysis to focus on the context and process of the individuals response. The most common cognitive responses are rumination, fusion and self-attack.
What’s the standard number of sessions in a course of behavioural activation therapy?
Like standard CBT, a typical behavioural activation session has a structured agenda to review the homework and the progress towards the goals, to discuss feedback on the previous session and to focus on one or two specific issues. The number of sessions to treat depression would be between 12 and 24.
History of psychological terms
Winnicott - Good enough mother, transitional object
Carl Jung - Collective unconscious, archetype, anima, animus
Melanie Klein - Paranoid-schizoid position, depressive position, splitting
Sigmund Freud - Free association, transference, ego, super-ego, id, eros, thanatos, defense mechanisms, oedipus Complex, the unconscious
Wilfred Bion - Basic assumption group
Karen Horney - Womb envy
Erving Goffman - Total institution
Siegfried Foulkes - Foundation matrix
Barton - Institutional Neurosis
What is DBT?
It is form of CBT for patients with borderline personality disorder.
It developed from the failed attempts to treat chronically suicidal patients with CBT.
DBT assumes that people with BPD lack important interpersonal and emotional regulation skills, and that the skills they do have are inhibited by personal and environmental factors.
DBT combines behavioural therapy with aspects of Zen Buddhism (mindfulness and acceptance), along with dialectical thinking (to replace rigid dichotomous thinking).
5 functions of DBT?
DBT is generally considered to have five functions
Enhancing behavioural capabilities
Improving motivation to change
Assuring new capabilities generalise to the natural environment
Structuring the environment so that appropriate behaviours are reinforced
Enhancing motivation of the therapist (DBT has a specific focus on the therapists own motivation to continue the work and achieves this by regular debriefing sessions with the extended clinical team)
DBT hierarchy of treatment:
The treatment targets in order of priority are:
Life-threatening behaviours: e.g. suicide communications, suicidal ideation, and all forms of suicidal and non-suicidal self-injury.
Therapy-interfering behaviours: any behaviour that interferes with the client receiving effective treatment. These behaviours can be on the part of the client and/or the therapist, such as coming late to sessions, cancelling appointments, and being non-collaborative in working towards treatment goals.
Quality of life behaviours: includes any other type of behaviour that interferes with clients having a reasonable quality of life, such as disorders, relationship problems, and financial or housing crises.
Skills acquisition: refers to the need for clients to learn new skilful behaviours to replace ineffective behaviours and help them achieve their goals.
DBT skills include:
Mindfulness
Distress Tolerance
Interpersonal Effectiveness
Emotion Regulation
What is the paranoid-schizoid position according to Klein?
The paranoid-schizoid position represents a state of fragmentation where the mind divides the world into good and bad. It is charcterised by the defence mechanism known as ‘splitting’.
What is the depressive position according to Klein?
The depressive position follows the paranoid-schizoid position and is characterised by the ability to accept something can be both good and bad (ambivalence
What is condensation in dreams?
Condensationrefers to the way in which in a dream several concepts can be combined into just one symbol.
What is symbolisim in dreams?
Symbolismrefers to the use of symbols to disguise similar sounding or looking concepts or objects.
Who developed DBT?
Marsha Linehan
The Psychopathology of everyday life’ was written by?
Sigmund Freud
What is multisystemic therapy?
Multisystemic therapy (MST) is an intensive family and community based time-limited intervention for antisocial behaviour in young people.
How long is a course of multisystemic therapy?
MST typically consists of 3 to 4 meetings per week over a 3 to 5 month period. It is very intensive and a single therapist usually works with only 4 to 6 families at a time.
What is the multisystemic theory of change?
The MST Theory of Change is based on Bronfenbrenners model and sees the young person embedded in multiple systems, mainly the family, the peer group, the school and the community.
What the best predictor of the effectiveness of a psychodynamic psychotherapy?
Therapeutic alliance
What no of sessions is minimum for success in moderate to severe mental health problems?
Therapies of fewer than eight sessions are unlikely to be optimally effective for most moderate to severe mental health problems
Often 16 sessions or more are required for symptomatic relief, and longer therapies may be required to achieve lasting change in social and personality functioning
Do the patient’s age, sex, social class or ethnic group have any importance in choice of therapy?
No, and they should not determine access to therapies
Which factors are more important for success in interpretative vs. supportive therapy?
Interest in self-exploration and capacity to tolerate frustration in relationships may be particularly important for success in interpretative (psychoanalytic and psychodynamic) therapies, compared with supportive therapy
What is parapraxis?
Parapraxis is another term for a Freudian slip
Which psychologist is associated with the term Group dynamics?
Lewin
Central elements of CBT include:
Collaborative empiricism
Problem-orientated focus
Short-term treatment for uncomplicated disorders
Structured methods
Psychoeducation
Homework
Cognitive Methods Used in CBT:
Socratic questioning
Guided discovery
Examining the evidence
Identifying cognitive errors
Thought change records
Generating rational alternatives
Imagery
Role play
Rehearsal
Behavioural Methods Used in CBT:
Activity and pleasant event scheduling
Graded task assignments
Exposure and response prevention
Relaxation training
Breathing training
Coping cards
Rehearsal
Contraindication of CBT?
Severe dementia
Who derived objects relation theory?
Melanie Klein
What are the principles of objects relation theory?
Object relations theory is a variation of psychoanalytic theory, which places less emphasis on biological based drives (such as the id) and more importance on consistent patterns of interpersonal relationships. For example, stressing the intimacy and nurturing of the mother.
Whose work did play therapy emerge from?
Melanie Klein
Which form of psychotherpapy did Davanloo select patients with Oedipal focus, loss of focus and multiple foci?
Broad focus short term dynamic therapy
What is true about perfectionist patients and psychotherapy?
Perfectionist patients mainly benefit from long term therapy
Trust vs. Mistrust age and virtue
0 - 1½
hope
Autonomy vs. Shame age and virtue
1½ - 3
will
Initiative vs. Guilt age and virtue
3 - 5
purpose
Industry vs. Inferiority age and virtue
5 - 12
competency
Identity vs. Role Confusion age and virtue
12 - 18
fidelity
Intimacy vs. Isolation age and virtue
18 - 40
Love
Generativity vs. Stagnation age and virtue
40-65
Care
Ego Integrity vs. Despair age and virtue
65
Wisdom
Therapy for GAD
CBT
Therapy for OCD
CBT
Therapy for PTSD
EMDR, CBT
Therapy for Anorexia
CBT, IPT, family therapy, psychodymanic psychtoehrpay
Therapy for Bulimia
CBT, IPT
Therapy for EUPD
Mentalisation based therapy, DBT, CBT, therapeutic community, CAT
Which type of therpay do internalising vs externalising patients benefit from?
internalising patients benefit more from psychodynamic therpay
externalising patients - CBT
Therapy for Alcohol misuse
12 step, CBT, family therapy
Therapy for Schizophrenua
CBT, family therapy
Therapy for depression
CBT, CAT, IPT, psychodynamic
Therapy for Panic disorder
CBT
Therapy for Social phobia
CBT
Therapy for Specific phobia
CBT
Smith and Glass meta analysis findings
The findings provide convincing evidence of the efficacy of psychotherapy. On the average, the typical therapy client is better off than 75% of untreated individuals.
What are the components of systematic desensitisation?
relaxation training, construction of hierarchy, desensitisation
Which of the following statements best describes the therapeutic technique of shaping?
Reinforcing gradual approximations of a behaviour
Most patients engage in certain subtle behaviours while in a fearful situation that serve to maintain the fear. These behaviours are called
Safety behaviours
Aggression turned inward’ could be a psychodynamic explanation fo
Suicidal ideation
What are projective tests of personality?
Thematic Apperception test
Draw-a-person test, sentence completion tests Rorschach’s ink blots.
Which therapy is used to address bereavement associated with avoidance and denial?
guided mourning
Strange situation procedure - whats happens?
Researchers put the child and her mother alone in an experimental room.
The room has toys or other interesting things in it, and the mother lets the child explore the room on her own.
After the child has had time to explore, a stranger enters the room and talks with the mother. Then the stranger shifts attention to the child. As the stranger approaches the child, the mother sneaks away.
After several minutes, the mother returns. She comforts her child and then leaves again. The stranger leaves as well.
A few minutes later, the stranger returns and interacts with the child.
Finally, the mother returns and greets her child.
Strange situation procedure - who developed?
Ainsworth
What happens with Securely-attached children?
Free exploration, and happiness upon the mother’s return
The securely-attached child explores the room freely when his mother is present. He may be distressed when his mother leaves, and he explores less when she is absent. But he is happy when she returns.
If he cries, he approaches his mother and holds her tightly. He is comforted by being held, and, once comforted, he is soon ready to resume his independent exploration of the world. His mother is responsive to his needs. As a result, he knows he can depend on her when he is under stress
What happens with Avoidant-insecure children?
Little exploration, and little emotional response to the mother
The avoidant-insecure child doesn’t explore much, and she doesn’t show much emotion when her mother leaves. She shows no preference for her mother over a complete stranger. When her mother returns, she tends to avoid or ignore her
What happens with Resistant-insecure (also called “anxious” or “ambivalent”) children?
Little exploration, great separation anxiety, and an ambivalent response to the mother upon her return
Like the avoidant child, the resistant-insecure child doesnt explore much on his own. But unlike the avoidant child, the resistant child is wary of strangers and is very distressed when his mother leaves.
When the mother returns, the resistant child is ambivalent. Although he wants to re-establish close proximity to his mother, he is also resentful—even angry—at his mother for leaving him in the first place. As a result, the resistant child may reject his mother’s attempts at contact
What happens with Disorganised-insecure children?
Little exploration, and a confused response to the mother.
The disorganized child may exhibit a mix of avoidant and resistant behaviors. But the main theme is one of confusion and anxiety
Disorganized-insecure children are at risk for a variety of behavioral and developmental problems
What is Reactive attachment disorder (inhibited)?
This refers to children that have an abnormal pattern of relationships with caregivers that begin before age 5. Children tend to be inhibited, and show ambivalence towards caregivers. They are also hyper vigilant and are unresponsive to comforting.
*avoidant insecure children
What is Disinhibited attachment disorder?
At age 2 it manifests by clinging and non-selective focussed attachment behaviour. By age 4, diffuse attachments remain but clinging is replaced by attention seeking and indiscriminately friendly behaviour. In most cases there will be a history of marked inconsistency in early care givers involving multiple changes
*resistant insecure children
Token economy is used in which behaviour therapy?
Positive reinforcement
Who is credited with the introduction of eye movement desensitisation and reprocessing?
Francine Shapiro
What is the psychological treatment of choice in an adult with mild body dysmorphic disorder?
Exposure and repsonse prevention
Which defence mechanisms are associated with phobias?
- Repression (pushing away unaccpetable ideas)
- isolation (thoughts and behaviours are isolated so that their links with other thoughts or memories are broken)
- displacement (emotions and ideas are transferred from origina object to a less threatening one)
what are the mature defence mechanisms?
- Anticipation (realistically planning future inner discomfort)
- altruism (using constructive and instinctually gtaifying service to others to undergo a vicarious experience)
- humour (using comedy to express feelings without produciing an unpleasant effect on others)
- sublimation (altering soically objectionable aim to an acceptable one
- asceticism (eliminating the pleasurable effects of experiences)
- suppression
- identification
- introjection
What are the neurotic defence mechanisms?
Displacement Dissociation Intellectualisation Reaction formation Repression Isolation Regression Rationalisation Controlling Externalisation Undoing
What are the immature defence mechanisms?
Schizoid fantasy Projection Passive-aggressive behaviour Acting out Hypochondriasis Idealisation Projective identification
What are the psychotic defence mechanisms?
Distortion
Denial
Delusional projection
Splitting
A cognitive outcome you would hope to achieve following cognitive behavioural therapy for hypochondriasis
Better identification adn reattribution of symptoms
A patient in psychotherapy constantly turns to the therapist’s response in order to determine how worthy he is. Which of the following phenomenon is taking place?
Mirroring transference
“Identifying a safe place” approach is used in?
EMDR
Outside-in approach is used in
behavioural activation therapy
Reformulation approach is used in?
CAT
“Rolling with resistance” approach is used in?
Motivational interviewing
Socratic questioning is used in?
CBT, Cognitive Therapy
Task-setting stage is used in?
Strategic Family Therapy
The target age range for functional family therapy in the treatment of conduct disorder is
11-18
