SPSY 571- FINAL Flashcards
1
Q
What are the 5 STAGES OF CHANGE? (256)
A
- Precontemplation
- Contemplation
- Preparation
- Action
- Maintenance
2
Q
Pre-contemplation (Stages of change) (256)
A
- Client is not interested in changing
- Client may not think there is a problem/minimize & rationalize the problem
- attributes to fate, family, social influences, or genetics
3
Q
Contemplation (Stages of change)
A
-Client experiences an awareness of a problem or a need for change, but has not made a plan or commitment to change
4
Q
Preparation (Stages of change)
A
-Client establishes goals for change, outlines small steps, and even sets a time for start-up.
5
Q
Action (stages of change)
A
- Client is successful in taking action to modify their problematic thoughts, feelings, behaviors, or environments.
- they are committed, putting in time and energy to change
6
Q
Maintenance (Stages of change)
A
-Client consolidates the skills learned in the action phase, in order to prevent relapse.
7
Q
Techniques to address ambivalence about change
A
- Decisional balance sheet
- amplified reflection
- creating/amplifying the discrepancy between present behavior/clients broader goals
- Offering information or advice
- expressing faith/confidence in clients abilities to make desired changes
8
Q
Decisional balance sheet
A
- helps in clarification in decision making
- client describes cost and benefits of keeping things as they are and costs/benefits of changing
9
Q
Amplified reflection
A
-nonjudgemental but gentle exaggeration of the reason to sustain the behavior in order to evoke the other side of the ambivalence
EX: “you don’t want to have a tutor, but you do want to get into college.”
10
Q
amplifying discrepancy between present behavior and goals
A
EX: “you could stay at your current weight even though you want to feel healthier so you can have a baby”
11
Q
Offering information or advice
A
-clinician should ask client’s permission before giving suggestions or providing info.
12
Q
Expressing faith/confidence in clients ability to make change
A
- clinicians should encourage hope and self-efficacy.
- affirming strengths, reviewing past successes, reflecting their optimism
- acknowledge honor and grit
13
Q
Self-disclosure (Ch. 12: 388)
A
- can be important when working with members of oppressed/isolated groups
- clinicians may elicit more trust
- the client should experience it as a client-centered sharing rather than clinician-centered
14
Q
the miracle question (306)
A
- a solution-focused therapy technique
- used to help client gain new perspectives on their problems and focus on the positive desired goal rather than just on what is “wrong”
- EX: suppose a miracle happened tonight . . .
15
Q
Exception Questions (305)
A
-ask about situations or days in which “the problems” have not happened.
-encourages client to move out of stuck patterns of neg. thinking and see hope.
EX:Can you think of a specific time last week when you were more confident?
16
Q
transference (354)
A
-unconscious process by which early unresolved relational dynamics/conflicts are unwittingly displaced or “transferred” onto the current relationship with clinician and then reenacted through appropriate or “real” in the moment.
17
Q
positive transference (354)
A
- client idealizes the clinician and may experience him or her as incomparably wise, caring, and helpful.
- helps sustain the working alliance in spite of mistakes and disagreements.
18
Q
negative transference (355)
A
client is thought to unconsciously express or act out in the moment old, unhappy, stuck scenarios with the clinician as though the clinician were actually the exploiter/punisher/etc who has harmed the client in the past.
19
Q
Ethnocultural or racial transference (355)
A
- previous interethnic /interracial experiences are unconsciously displaced onto the clinician relationship.
- client may attach attributions to the clinician based on perceived ethnicity/race.
20
Q
hierarchical transference (356)
A
- clients may attribute power and knowledge to the clinician, simply because of the clinician’s role.
- may be relevant for people from cultures that emphasize differential status/hierarchy
21
Q
countertransference (356)
A
- clinicians unconscious reactions to the client.
- can replicate unresolved scenarios from the clinicians past.
22
Q
Motivational interviewing (258)
A
- 4 processes
1. engaging through empathetic understanding
2. focusing/helping clients establish what they want to change
3. evoking/eliciting client’s motivation for change.
4. planning or committing to the actions necessary to change.
23
Q
factors to consider when transferring client to another clinician (475)
A
- clinician can offer to speak to new clinician to help new clinician to learn about client.
- this may help clients to prevent them from having to repeat everything with new clinician
- other clients refuse and prefer to start with clean slate.
- follow up with client is important
- Ideal for both client and clinician to agree of referral.
24
Q
IS PATH WARM (439)
assessment tool for suicide warning signs
A
I (Ideation) S (Substance abuse) P (Purposelessness) A (Anxiety) T (Trapped) H (Hopelessness) W (Withdrawal) A (Anger) R (Recklessness) M (Mood Change)
25
SLAP (used to guide questions about suicide plans) (440)
S (Specificity)
L (Lethality)
A (Actual availability of imagined method)
P (Proximity of social helping resources)
26
Protective factors (440)
- help to lower risk of suicide
- factors include: satisfying family/social life, constructive employment or use of leisure time, purpose and meaning for living, religious/ethnic beliefs that provide hope.
27
Warning signs for suicide
- usually connote imminent risk
| - risk is evident over next few minutes/hours/days.
28
Risk factors (suicide)
- are related to what can best be described as lifetime risk
- time periods range anywhere from a year to several decades
- include memberships to high risk groups
- alcohol and substance abuse increase risk
- IS PATH WARM
29
Crisis
- a time of intense difficulty, trouble, or danger.
- a critical turning point in the progress of some state of affairs in which a decisive change, for better or worse, is imminent.
- presents both danger and opportunity
30
Psychological crisis
- occurs when a person feels unable to cope with perceived challenges that threaten to overwhelm his or her normal coping mechanisms.
- can come from single or combination of stressors
31
compound crisis
-crisis that rekindles unfinished business from previous crises.
32
delayed grief reaction
-survivor of a recent loss that suddenly experiences grief from an earlier loss that was not grieved at the time.
33
trauma
-term used to describe a catastrophic crisis that involves events so sudden, massive, and threatening that they overwhelm cognition and meaning making, feeling regulation, biological processes, habitual adaptive mechanism, and relational capacity.
34
worldview
- an individual's assumptions about how the universe operates and how people behave toward one another.
35
complex trauma
-refers to the reactions to repeated ongoing interpersonal violence/trauma such as that experienced by battered women or soldiers at war.
36
secondary traumatic stress (STS) (419)
-a response to hearing about or witnessing others' traumatic experience.
-may have some of the same symptoms as direct victim.
(Hate crimes can create STS)
37
common features of a crisis (420)
1. Precipitating/triggering event
2. Person perceived event as danger, loss, or threat
3. Culture influencing the way people understand, make meaning of, and react to events
4. Spiritual beliefs influence responses
5. Customary coping methods do not work/inadequate to the degree of threat
6. Person feels overwhelmed, anxious, disoriented, uncertain
7. Destabilization provides opportunity to destabilize at higher/lower level of functioning.
38
precipitating event
- a small thing that is the last in a series of upsetting events or hazardous circumstances that can overwhelm the individual or system.
- "the straw that broke the camels back"
39
coping mechanisms (423)
- methods people use to overcome, reduce, or accommodate the demands of stress.
- can be healthy or maladaptive, effective or ineffective
40
Decompensate (423)
-engage in self-harm and other maladaptive behaviors
41
Resilience (423)
-The capacity to adapt competently despite or because of adverse/hazardous conditions
42
Post-traumatic growth (424)
positive changes that arise from a struggle with trauma
43
sustain talk (259)
-Person's own arguments for not changing, for sustaining the status quo.
44
change talk (259)
-the person's statements about why change is good and useful
45
Intervention/treatment plans (265)
- plans for change spell out agreed-upon goals for the work to come and the people, methods, and resources proposed to achieve the goals.
- "road map" by which clinicians put their case conceptualization and theoretical perspectives into action
46
What is included in the treatment plan? (265)
- goals
- participants
- modalities
- techniques and strategies
- logistics
- other services and resources
- advocacy
- evaluation
47
T/F- Treatment plans should be written in clear and specific language that is co-created by the client and clinician.
TRUE
48
Empirically Supported Treatments (EST's) (268)
-clearly specified psychological treatments shown to be efficacious in controlled research with a delineated population
49
Commonly used EST's (269)
- Cognitive Behavioral Therapy (CBT)
- Dialectical Behavioral Treatment (DBT)
- Acceptance & Commitment Therapy (ACT)
- Interpersonal Therapy (IPT)
50
Cognitive Behavioral Therapy (CBT) (269)
- maintains that distorted thinking or faulty information processing is at the root of many of the problems that people present.
- helps to clarify and educate clients about, the self-undermining beliefs and attitudes that affect their emotions/behaviors.
-therapy that helps change/reframe your thoughts
51
Dialectical Behavioral treatment (DBT) (270)
focused on 4 areas:
- mindfulness
- interpersonal effectiveness
- emotional regulation
- stress tolerance
DBT is noted for self-calming, self-rewarding, self-distracting, and self-assertion
52
Acceptance & Commitment Therapy (ACT) (271)
- used to help clients learn to recognize within themselves a positive transcended self who has held onto positive aims and values, and who can observe and make hopeful, guiding comments to the stuck self.
- clients learn to "defuse" or distance themselves from negative words/experiences
53
Interpersonal Therapy (IPT) (271)
- a brief, 16-20 week process developed to help clients express and conceptualize the feelings associated with major depressive disorders.
- IPT emphasizes the importance of eliciting, validating, and empathizing with sad and angry feelings rather than avoiding them.
54
Solution-Focused Brief Therapy (SFBT) (272)
- work is usually limited to 5-10 sessions
- emphasis is on empowerment of clients through real-world experiences, practice, and learning.
- clinicians believe that clients have the answers to their problems within them.
55
Positive Psychology Interventions (PPI's) (273)
- focuses on clients positive traits, emotions, and activities.
- research shows that PPI's enhance feelings of well being and happiness by building and expanding the client's positive emotions, engagement with others, and capacity to lead a meaningful life.
56
Supervision (495)
- clinical internships provide weekly supervision
- cases assigned to advance learning, arrange coverage, oversee general work of clinicians, attend to development of students' values, knowledge, and skills.
57
T/F- State licensure mandates specified hours per week of advanced clinical supervision
TRUE
58
What does "parallel process" mean?
-reflects the idea that what happens in the relationship between the supervisor and the clinician parallels what is happening in the relationship between the clinician and the client.
59
What is group supervision? (499)
-Education and support meetings in which discussions of clinician-client dialogues, learning dilemmas, techniques, and case-planning concerns affirm the mutuality of the learning process.
60
T/F- Supervisors can often arrange for interns and counselors to come together at intervals for education and support?
TRUE
61
What is it called when 2 or more clinicians share their work and offer feedback and support as they would do in an agency supervision group?
-PEER SUPERVISION
62
T/F- when seeking outside consultation about a client, you do not have to protect the client's right to confidentiality.
FALSE
| - you are ethically required to conceal all identifying information about the client
63
consultation (500)
-process whereby clinicians at all levels of experience reach outside their normal learning and supervisory relationships to benefit from the perspective and advice of a seasoned mentor, who is typically valued for special skills in certain areas of practice.
64
What is compassion fatigue?
- an occupational hazard that is specific to the helping professions.
- often results from clinicians' empathizing and interacting intensely with people with severe problems.
65
T/F- compassion fatigue is the same as burnout
FALSE
66
BURNOUT
-a response to prolonged occupational stress found in those who work in caregiving relationships (such as health care providers and human services workers.)
67
What are the symptoms of burnout?
a. physical/psychological exhaustion
b. Depersonalization
c. frequent job changes
d. all of the above
D- ALL OF THE ABOVE
| also includes, "irritability"
68
compassion satisfaction (490)
-emotional reward that clinicians experience when they are able to help others.
69
What is an "impaired clinician"? (490)
-someone whose own personal mental health issues, stress, or other activities impact their ability to work effectively with clients.
70
T/F- it is frowned upon for clinicians to seek professional therapy?
FALSE
| -It is imperative that impaired clinicians receive professional help so they do not harm their clients
71
What is exploration?
-the clinician gathers initial information through the use of questions, prompts, and probes
72
Elaboration
-when the clinician encourages the client to expand on and enrich the details of the story.
73
T/F:
Exploration and elaboration are only used in the assessment phase to clarify and prioritize presenting problems and assets?
FALSE!
| -They are also crucial in establishing working agreements and in planning and implementation of interventions
74
What are the 3 layers or circles of personal territory?
1. Outer circle
2. Middle Circle
3. Inner circle
75
What is the outer circle?
- surface exploratory conversation between 2 ppl
- occurs early in the interview
- client assesses the trustworthiness, respectfulness, and reliability of clinician
76
What is the middle circle?
- deeper-level content is explored
| - more focused exploration which may elicit more painful detail, reflection, and affect.
77
what is the inner circle?
- houses feelings and content about frightening, taboo, or shame-bound areas.
- clients often discover things about themselves and their relationship with others
- embarrassment, reluctance, hesitation, and confusion manifest at this level
78
Is this outer, middle, or inner talk?
Clinician: can you tell me something about your work?
Client: I work as a painter for a large paint company. im a supervisor. I like the work and being outside.
OUTER CIRCLE
79
Is this outer, middle, or inner talk?
clinician: You mentioned things you like... are there things you don't like?
client: I find it hard to be the boss sometimes. Im not really comfortable telling people what to do. I hate it when someone screws up and I have to go after them.
MIDDLE TALK
80
Is this outer, middle, or inner talk?
clinician: Where do you think this "hating to get after people" comes from?
Client: I've always hated being bossed around myself. I was the youngest in the family and my brothers were always on my case. I guess I've never wanted to come across as a bully.
INNER TALK
81
What are the 6 techinques used in exploration and elaboration? (183)
1. questions
2. prompts
3. silence
4. reflection (including underlining and summarizing)
5. refocusing
6. initiating new topics
82
T/F:
| questions are used to gather information and build the client-clinician relationship
TRUE
-questions can also be used as an intervention to help clients gain new perspectives, cope with feelings, and come up with solutions for problem behaviors.
83
T/F:
| Attitudes toward questioning are not usually influenced by family and cultural norms?
FALSE
| they are very often influenced by family, cultural norms, and taboos
84
T/F
| The timing of a question does not matter
FALSE:
Clinicians must think about whether it is possible to get the same information by another means that will not disrupt client flow.
85
T/F:
| clinician questions can be non-verbal
TRUE!
Raising an eyebrow, cocking one's head, responding wide-eyed to statements can act as questions to which client can respond immediately and with goodwill.
86
Closed-ended question:
-a question that can typically be answered with a word or two after
ex: Do you live alone?
an: yes.
87
Open-ended question:
-questions that give the client more opportunity and flexibility in responding and elaborating.
Ex: what is your living situation?
88
what is a leading question?
- a question that suggests the answer the interviewer expects or prefers.
ex: "Was that when he hung up?"
89
Tried and True Questions:
Certain questions that have remained useful over many decades that seem to get the things that a clinician needs to know to assess, plan, and act wisely in clinical role.
ex: What brings you here to see me?
90
"are you going to do your homework now?" is an example of a type of question?
PSEUDOQUESTION
| -These are often directives or commands disguised as a question.
91
T/F:
| Reflection does not help to build empathy
FALSE
92
What are two benefits of silence?
1. helps to reflect on what has been said (help client to explore and elaborate more)
2. can be the best way to encourage clients to tell their story and leave room for it to unfold
3. allows client to make choices about where to take the story next
4. allows client to react to what is happening in the moment
93
Give an example of a dot dot dot reflection:
"you came home, fed the puppies, and then you. . . "
"So after you get your GED, you're going to . . ."
94
T/F
| underlining is another form of reflection
TRUE!
| The clinician underscores important content or experience by the strategic use of verbal/nonverbal emphasis
95
What does it mean to summarize?
- the clinician or client pulls together major ideas, themes, or patterns that have just been discussed and reflects them.
- summarizing is another form of reflection
96
What is "refocusing"
-When a client has left a specific topic or theme that the clinician deems important, the clinician returns the client back to the desired topic.
97
What are two important aspects of maintaining a "not-knowing perspective"?
1. it's okay not to know
| 2. clients know more than we do about the realities of their experience.
98
What is the term used when a client refuses to follow the clinician's lead or suggestions?
RESISTANCE
99
T/F
| Resistance to clinician questions should be seen as a negative trait of the client
FALSE!
| Clinicians should appreciate clients' needs to protect themselves from questions that might create more distress
100
Examples of responding to client resistance:
"This is a hard topic to talk about"
"you don't seem quite ready to discuss this yet."
"I can see that what I asked doesn't feel right to you; can we stop a min & discuss why?
101
The term used to describe the process by which individuals influence the type, frequency, or intensity of their emotional experiences.
EMOTIONAL REGULATION
102
T/F:
| Open-ended questions help in eliciting client feelings and help clients to focus on their reactions
TRUE!
103
People, circumstances, ideas, and events that stimulate emotional reactions
TRIGGERS
104
What do clients learn from the use of scaling questions?
- Clients learn to recognize the degree of feeling stimulated by each situation
- scaling is used to estimate the extent of emotional arousal on a scale from 1-10.
105
What are 2 techniques used to manage or contain negative feelings?
1. Identifying triggers
2. using scaling questions
3. developing a "stop" strategy
4. walking away
5. doing it over
6. self-calming strategies
7. mindfulness practice
8. medication
106
What are two techniques used to enhance positive feelings?
1. regularly eliciting success stories from client's past
2. recalling "3 good things"
3. encouraging positive relationships
4. random acts of kindness
constructing positivity portfolios
5. communing w/ nature
6. imagining best possible self
7. practicing loving kindness meditation
107
List two different reasons a clinician would introduce an alternative perspective
1. when client needs to broaden sense of possibilities
2. clinician needs to heighten and/or encourage a spirit of curiosity/exploration
3. clinician needs to counter the automatic thinking that tends to occur due to stress
108
These are examples of what type of questioning:
"How else could we see that?"
"Can you think of any other ways to explain this?
"What other kinds fo things could be going on?"
SOCRATIC QUESTIONING
| -Used to help clients elucidate new perspectives
109
What are 2 ways that a clinician can elicit new perspectives for a client?
1. brainstorming
2. role-plays
3. recording interactions
4. encouraging contact with others
5. developing new metaphors
6. using spiritual practices
110
What do coping questions help clients to do?
- helps clients to focus on how they have gotten where they are today, given the chronic adversity of their circumstances.
ex: "how have you managed given all that you're up against?"
111
The process of breaking a task into its component parts and then rewarding small steps-successive approximations to the desired behavior
SHAPING
112
What therapy techniques help clients to overcome their avoidance behaviors by exposing them to specifically identified anxiety-provoking stimuli?
EXPOSURE THERAPY
| -The goal is to eliminate anxiety through habituation
113
What is Virtual Reality Exposure Therapy (VRET)?
a type of exposure treatment to immerse severely anxious or traumatized clients in a computer-generated virtual environment relevant to each client's particular anxiety stimuli
114
T/F
| Clients are more likely to imitate the behavior of the model if they feel that the model is similar to themselves.
TRUE!
| -modeling can help people learn new behaviors, attitudes, values, or feelings by observing others.
115
what is a token economy?
-When client actually earns tokens or points for desired behavior and pays tokens for misbehavior
116
list 2 techniques in which a clinician can use influence to promote behavior:
1. offering suggestions
2. giving directives
3. accompanying the client
4. representing the client
5. calling authorities to enforce behavior change
6. warning client that relationship will be terminated unless client meets certain conditions
117
T/F:
clinicians should not recognize, validate, and celebrate clients' achievements in changing old behaviors and learning new skills
FALSE
| -validation can be an important social reinforcer, encouraging the client to continue the work.
118
Questioning techniques
- sustaining techniques
- dot dot dot
- closed-ended
- open-ended
- rat-a-tat
119
Techniques to address emotions
-scaling
-mindfulness practice
-medications
-self-calming techniques
-
120
techniques addressing behaviors
setting priorities
step-by-step
exposure therapy
modeling
