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Individual Counselling > Test 1 > Flashcards

Test 1 Flashcards

1
Q

What are the three phases of the therapeutic relationship?

A

Engagement phase
Working phase
Termination Phase

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2
Q

When does the termination phase of the therapeutic relationship begin?

A

First contact

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3
Q

To create a climate in which clients can examine their thoughts, emotions, feelings and actions and eventually arrive at a solution that is best for them

A

The role of the psych nurse

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4
Q

To assist individuals in finding answers that are most congruent with their own values

A

Job of psych nurse

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5
Q

The unconscious experience in which the client projects emotions or previous experiences onto the clinician

A

Transference

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6
Q

In regards to change we need to reflect on what three things
Reflection process?

A

The what
The so what
The now what

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7
Q

Provide safe, competent and ethical practice
Respect for inherent worth and right of choice and dignity of persons
Health, mental health and wellbeing
Quality Practice

A

RPN Code of Ethics

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8
Q

Identify problem and potential issue
Look at RPN guidelines
Consider laws, regulations, policies and practice guidelines
Seek consultation
Brainstorm possible actions
Reflection on consequences of possible actions
Decide what appears to be the best course of action

A

Steps of Ethical Decision Making

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9
Q

To informed consent
Refuse treatment
Advanced health directives
Provision of least restrictive type of mental health care
Confidentiality and privacy

A

Clients Rights

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10
Q

Suspected child abuse or neglect
Client requires hospitalization
Information is made an issue in court
When clients request their records to be released to a third party

A

Situations where there is a legal duty to disclose

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11
Q

Assess persons risk for danger towards another
Identify persons being threatened
Take appropriate action to protect
Protect suspected child
Suspect abuse of dependent adult or older adults

A

Counsellors have the duty to protect

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12
Q

Maintaining boundaries are always the responsibility of who

A

Psychiatric nurse

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13
Q

Establish and maintain trust
Set the tone and direction
Create and maintain a safe environment
Be aware of our responsibility to others
Be cognizant of the need for feedback

A

Counsellors and boundaries

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14
Q

A deviation from a typical therapeutic activity that is harmless and non-exploitative

A

Boundary crossing

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15
Q

Frequently appear harmless and often begin as innocent situations
Not recognized or felt as a violation until something goes wrong
Often crossing the line is a process with many small steps before an actual violation occurs

A

Characteristics of boundary violations

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16
Q

Are dual relationships a boundary violation?

A

Yes

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17
Q

Role, Time, Place and space, financial, physical contact, social media are all examples of potential

A

boundary violations

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18
Q

Judging someone without knowing them, on the basis of what they look like or what group they belong too

A

Prejudice

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19
Q

What typically leads to microaggressions

A

Unconscious biases

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20
Q

Identify basic assumptions
Learn more about own background
Willing to identify and examine personal worldviews
Pay attention to common ground
Be flexible

A

Guidelines for working effectively with diverse backgrounds

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21
Q

Level 1: Listens and acts interested
Level 2: Accurately reflects back what client has said
Level 3: Emphasizes articulating the unverbalized back to the client
Level 4: Validated behaviour in terms of cause
Level 5: Normalizes
Level 6: Radical Genuineness

A

6 Levels of Validation

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22
Q

Balance irreverence as well as the differential by making the treatment provider more vulnerable in a session

A

Reciprocal Communication

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23
Q

Who developed psychoanalysis

A

Freud

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24
Q

Irrational forces, unconscious motivations, biological and instinctual drives

A

How psychoanalysis determines behaviour

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25
Q

Understood as a source of motivation that encompasses sexual energy but goes beyond to include all life instincts

A

Libido

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26
Q

According to psychoanalytic theory, ____________ and __________ drives make people act as they do

A

Aggressive and sexual

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27
Q

Describe the unconscious

A

Lies deep below the surface and includes drives and instincts

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28
Q

What are the 3 parts of the Freuds personality theory

A

ID
EGO
Superego

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29
Q

First year - Oral
Ages 1-3 - Anal
Ages 3-6 - Phallic
Ages 6-12 - Latency
Ages 12-60 - Genital

A

Freud’s Psychosexual Stages

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30
Q

Ego defense mechanisms often operate on what level?

A

Unconscious

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31
Q

Expanded Freuds theory into different psychosocial Crisis based on different basic virtue

A

Eriksons psychoanalytic theory

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32
Q

______ perspective on personality development includes the following:
Multidisciplinary approach with the emphasis on being compelled to find meaning in life
Achieving individuation is an innate and primary goal of life
Individuation is the harmonious integration of the conscious and unconscious aspects of personality

A

Jungs

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33
Q

According to Jungs perspective on personality development how are dreams are seen as messages from the _________________

A

Collective unconsciousness

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34
Q

Goal is to make the unconscious conscious and strengthen the ego so behaviour is based on reality

A

Psychoanalytic therapy

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35
Q

Describe some aspects of the psychoanalytic therapy process

A

Very long approach
Blank-screen of the therapists fosters transference

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36
Q

Maintaining the analytic framework
Analysis of resistance
Analysis of transference
Free association
Interpretation
Dream analysis

A

Psychoanalytic therapy steps

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37
Q

Describe catharsis

A

The release of tension and anxiety that results from bringing repressed feelings and memories into the conscious

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38
Q

Focuses on the ABC model. Antecedents, behaviour and consequences. All behaviour is communication and that behaviour is influenced by antecedents and consequents.

Client participation is required and the client must be motivated by change

A

Main concept of behaviour therapy

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39
Q

Always begins with an assessment which is ongoing
Treatment plan is systematically formulated
Goals are determined collaboratively
Objective evaluation
Focus of treatment is on changing actions

A

Behaviour therapy characteristics

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40
Q

Pavlov dog experiment

What happens prior to learning creates a response through pairing

A

Classical conditioning

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41
Q

Developed by Skinner

Involves a type of learning in which behaviours change based on positive and negative reinforcement, punishment and extinction

A

Operant conditioning

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42
Q

the most powerful change agent and involves addition of something of value after a behaviour

A

Positive reinforcement

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43
Q
  1. Progressive muscle relaxation
  2. Develop a gradual anxiety hierarchy
  3. Client repeatedly imagines confronting situations until it fails to produce feelings of anxiety
A

3 steps involved in systematic desensitization

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44
Q

Exposing the client to anxiety provoking event rather than imagining it

A

In Vivo Exposure

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45
Q

Intense prolonged exposure to the actual anxiety provoking stimuli

A

In Vivo flooding

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46
Q

Used for PTSD
Comprised of bilateral eye movement paired with cognitive techniques

A

EMDR

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47
Q

Key elements include
Assessment, direct instruction, coaching, modeling, role playing and homework assignments

A

Social Skills Training

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48
Q

Helping clients to select realistic goals, translate goals into target behaviours, create an action plan and self-monitor and evaluate their actions

A

Self-management programs and self-directed behaviour

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49
Q

Foundational theory which serves as a basis for psychiatric nursing practice.

Used client rather than patient

Described the importance of therapeutic relationship

A

Rogers Person-Centered Therapy

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50
Q

Humans at their core are trustworthy and positive

Humans are capable of making changes and living productive, effective lives

Humans innately gravitate toward self-actualization

Given the right conditions, individuals strive to move forward and fulfill their creative nature

A

View of human nature by person-centered therapy

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51
Q

Assumption counselor knows best
Validity of advice giving or teaching
Belief that clients cannot resolve their own problems without help

A

Person-Centered Therapy challenges these traditional beliefs

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52
Q

Personal characteristics of the therapist

Quality of the therapeutic relationship

Counselors creation of a growth-promoting climate

A

Person Centred therapy emphasizes

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53
Q

Congruence
Unconditional positive regard
Accurate empathic understanding

A

3 attributes that create a growth-promoting climate

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54
Q

Two persons are in psychological contact

The first, the client, is experiencing incongruence

The second, the therapist is congruent or integrated in the relationship

The therapist experiences unconditional positive regard or real caring for the client

The therapist experiences empathy for the clients internal frame of reference and endeavors to communicate this to the client

The communication to the client is of the therapists understanding and unconditional positive regard is minimal

A

6 conditions for personality changes

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55
Q

Focuses on the quality of the therapeutic relationship

Engage in co-assessment with the client and does not value traditional assessment and diagnosis

Provides a supportive therapeutic environment

Client is the agent of change and healing

Serves as a model of a human being struggling toward greater realness

Therapists must be presence

Use of immediacies

A

The person-centered therapist must

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56
Q

Founded by Rogers daughter
Creative art forms are used to promote healing, self discovery, self awareness and insight and to connect us to our feelings

A

Person-Centered Expressive Arts Therapy

57
Q

Emphasizes awareness, acceptance, and understanding of emotion and the visceral experiences of emotion

Emotional change can be the primary pathway to cognitive and behaviour change

Ex; Tapping

A

Emotion-Focused therapy

58
Q

involves paying attention to your thoughts, feelings, physical sensations and actions in the here and now and comes from a place of curiosity

A

Mindfulness

59
Q

Explain the difference between formal and informal mindfulness practice

A

Formal practice include mindfulness related to or incorporating mindfulness
Informal practice involves bringing focus and awareness to daily activities

60
Q

Developed by Zinn

Involves mindfulness mediation, body awareness, yoga and exploration of patterns of behaviours

A

Mindfulness based stress reduction

61
Q

Centers on
An expanded view of psychological health
Broad view of acceptable outcomes in therapy
Acceptance and mindfulness
Creating a meaningful life

A

Mindfulness and acceptance based therapies

62
Q

Mindfulness that also incorporates principles and practices of Cognitive behavioral therapy

A

Mindfulness-based cognitive therapy

63
Q

Developed by miller and rollnick.

Deliberately directive and aimed at reducing client ambivalence about change and increasing intrinsic motivation

A

motivational Interviewing

64
Q

When should MI be used and not used

A

Used when the individual has any ambivalence about change

65
Q

Express empathy
Non-judgmental approach
Reflective listening
Explore discrepancies and ambivalence
Reluctance to change is expected
Support clients self-efficacy
Strengthen clients commitments to change
Is not a type of therapy but a way to engage in conversation

A

Principles of MI

66
Q

When using MI the clinician must not ask what type of questions

A

Questions that will signal resistance

67
Q

What must the clinician do when change talk occurs

A

Reflect, affirm, and ask for elaboration or examples

68
Q

Statements that signal a desire, ability, reasons, need or commitment to change

A

Change talk

69
Q

When the therapist encounters resistance the clinicians can

Highlight clients right to autonomy , join in resistance, reflection is helpful and do not give advice

A

Rolling with resistance

70
Q

Importance of change (willingness)

Confidence in change (ability)

Priority (Readiness)

A

Motivation to change

71
Q

Pre-contemplation
Contemplation
Preparation
Action
Maintenance

A

steps of the change process

72
Q

Spirit of MI
OARS
Elicit and strength change talk
Recognize/responding to change talk
Rolling with resistance
Develop and negotiate change plans
Consolidate client commitment
Switch between Mi and other counselling styles

A

different stages of MI

73
Q

Open-ended questions
Affirmations
reflective listening
Summaries

A

OARS

74
Q

repetition and rephrase

A

Simple reflection

75
Q

Psychological distress is largely a function of disturbances in cognitive processes

A

premise of CBT

76
Q

Changing cognitions to produce desired changes in affect and behaviour

A

CBT focus

77
Q

Thoughts and attitudes bring feelings, behaviours and physical sensations

Includes thoughts, behaviours and emotions

A

CBT thought triangle

78
Q

Eliciting automatic thoughts/cognitive distortions
Testing cognitive distortions
Behavioural experiments
Activity scheduling
Graded task assignments

A

CBT interventions

79
Q

Ellis.

People disturb themselves as a result of the rigid and extreme beliefs they hold about events more than the events themselves

ABCDE framework
- Activating event (does not cause the consequence)
- Belief about activating event (causes the consequence)
- Consequences (emotional and behavioral)
- Disputing (client begins to recognize and challenge irrational beliefs)
- (developing a new) effective philosophy

Involves “must” statements

A

Rational Emotive Behaviour Therapy

80
Q

Insight-focused therapy with an emphasis on changing negative thoughts and maladaptive beliefs.

Believes that psychological problems are an exaggeration of adaptive responses resulting from commonplace cognitive distortions

A

CBT-Beck

81
Q

Peoples thought processes are accessible to introspection
Peoples beliefs have highly personal meaning
People can discover these meanings themselves rather than being taught or having them interpreted by a therapist

A

CBT-Beck assumptions

82
Q

Negative views about the world, oneself and about the future

A

Becks negative triad

83
Q

All or nothing thinking
Overgeneralization
Mental filter
Disqualifying the positive
Jumping to conclusions (both mind reading and fortune telling)
Magnification (catastrophizing and minimization)
Should statements
Labeling and mislabeling
Personalization
Emotional reasoning

A

Becks cognitive distortions

84
Q

Involves identifying and integrating clients strength at each phase of therapy

Has four step model
- Search: What is going right
- Construct: What are the obstacles
- Apply: Teach skills
- Practice: Practice skills to increase resistance

A

Strengths Based cognitive therapy - Padesky and Mooney

85
Q

Basic assumption is that distressing emotions are typically the result of maladaptive thoughts and that as a prerequisite to behaviour change; clients must notice how they think, feel, and behave and what impact they have on others

A

Cognitive behaviour modification - Meichenbaum

86
Q

Dialectics (aim to balance acceptance and change)
Zen (Acceptance)
CBT (change principles)

A

Perspectives of DBT

87
Q

DBT was originally created to treat what?

A

BPD

88
Q

Emotional, behavioural, interpersonal, cognitive, self dysregulation

A

DBT helps with

89
Q

Clarity and compassions are utmost importance in conducting DBT
Therapeutic relationship is a real relationship between equals
DBT therapists can fail
DBT can fail even if the therapist doesn’t

A

Basic assumptions of DBT

90
Q

Clients cannot fail
Clients are doing the best they can
Clients must learn new behaviours in all contexts
Clients may not have caused their problems but must solve them

A

Assumptions about DBT Clients

91
Q

Aim to find balance
Move away from extremes into common ground
Focus on balancing validation and problem solving

A

role of a DBT therapist

92
Q

Solve the problem
Feel better about the problem
Tolerate the problem
Stay Miserable

A

Problem solving options

93
Q

Improve behavioral control and skills (focus on safety)
Safe expression of emotion
Increase self-respect
Resolve feelings of incompleteness

A

Stages of DBT

94
Q

Skills training group
Individual therapy/treatment
Phone coaching
Consultation team

A

Components of comprehensive DBT

95
Q

Skill modules of DBT include

A

Mindfulness
Emotional regulation
Distress tolerance
Interpersonal effectiveness

96
Q

STOP
- Stop, Take a break, observe, proceed mindfully

TIPP
- Temperature, intense exercise, paced breathing, paired muscle relaxation

A

Distress tolerance strategies

97
Q

Describe interpersonal effectiveness strategies

A

DEARMAN
- Describe, express, assert, reinforce, mindful, appear, negotiate

GIVE
- Be gentle, act interested, validate, use easy manner

FAST
- Be fair, no apologies, stick to values, be truthful

98
Q

Therapists must target the most harmful behaviour then move on to focusing on reasons for session attendance

A

targeting DBT

99
Q

Vulnerability
Prompting event
Links
Behaviour
Consequences

A

Chain analysis steps

100
Q

Devils advocate
Use of metaphors
Make lemonade out of lemons

A

Dialectical strategies

101
Q

Irreverence
Reciprocal communication

A

communication strategies in DBT

102
Q

Consultation to the client
Environmental intervention
Consultation team

A

three components of case management

103
Q

anything that overwhelms a persons capacity to cope and is time limited

A

Crisis

104
Q

Is the employment of a variety of direct and action-orientated approaches to help individuals find resources within themselves and/or externally deal with a crisis

A

Crisis counselling

105
Q

Restoration of psychological balance

Aim to cope with the immediate difficulty

More direct approach on part of the counsellor

A

Crisis interventions objectives

106
Q

Help person cope effectively with the crisis situation and return to their usual level of functioning

Decrease anxiety

Teach crisis-management techniques

A

Crisis intervention goals

107
Q

Listen
Assessment
Develop an action plan
Termination

A

Steps for crisis intervention

108
Q

Start by being non-directive

Be collaborative by working together on a joint plan

Be directive if the person does not or will not make a plan

A

Developing a crisis action plan

109
Q

Identify risk factors
Assessment of mood symptoms
Explore suicidal ideation
Explore suicidal plan
Determine intent
Assess clients level of self control
Develop a plan to keep the client safe

A

steps of a suicide assessment

110
Q

Psychache (subjective mental pain)
Perturbation (sense of tension, anxiety)
Adamance

A

Assessing risk and lethality psychiatric nurses look at these

111
Q

Helplessness, hopelessness, lethality, impulsivity, resignation and acceptance of suicide equation, ideation, substance use, primary psychiatric disorder, lethality of plan

A

Things that contribute to a high risk suicide scale

112
Q

Stoicism
Adaptability and coping capacity
Alternative solution seeking
Spirituality
Supports

A

Protective factors against suicide

113
Q

Results from event or events that is experienced or witnessed by an individual as physically, emotionally harmful or life threatening that has lasting adverse effects on the individuals functioning

A

Individual trauma

114
Q

Unexpected
Person was unprepared
Person could not do anything to stop it

A

Common elements of individual trauma

115
Q

Avoid discussing trauma
ask for to much detail
Minimize the aspect of trauma has had on persons life
Conduct trauma therapy if not trained

A

Trauma informed clinicians must not

116
Q

Make sure the nurse acknowledges that what happened to the client was ____ but the client themselves are not ______

A

Bad and not bad

117
Q

Safety
Trustworthiness and transparency
Peer support
Collaboration and mutuality
Empowerment, voice and choice
Cultural historical and gender issues

A

Key principles of a trauma-informed approach

118
Q

Is the emotional residue of exposure that counselors have from working with people as they are hearing their trauma stories and become witnesses to the pain, fear, and terror that trauma survivors have endured.

A

vicarious trauma

119
Q

Instances when client doesnt report a history of childhood trauma (could be due to no memory, embarrassment, or shame)
Mandatory reporting requirements may affect relationship/honesty
Impact that the work has on the workers themselves

A

Three challenges that clinicians face working with clients with histories of childhood trauma

120
Q

The unconscious experience in which the clinician projects emotions or previous experiences onto the client

A

Countertransference

121
Q

Code of Ethics: Provide ____, competent and ethical practice

A

Safe

122
Q

Code of Ethics: Respect for _______________ and right of choice and dignity of persons

A

Inherent worth

123
Q

Code of Ethics: Health, ____________ and wellbeing

A

Mental health

124
Q

Code of Ethics: ___________ Practice

A

Quality

125
Q

A harmful or potentially harmful act that transgresses from the psychiatric nurses typical role or actions

A

Boundary violation

126
Q

Responsiveness
Self involving self-disclosure
Personal disclosure
Warmth
Genuiness

A

5 Reciprocal Communication Strategies

127
Q

Demanding Child, ruled by the pleasure principle and is unconsciousness

A

id

128
Q

Traffic cop, ruled by reality principle and is conscious

A

ego

129
Q

judge, ruled by moral principle and aims to suppress desires of ID and try to make the ego act more rationally

A

superego

130
Q

Repression/denial
Reaction Formation
Projection
Displacement
Rationalization
Sublimation
Regression
Introjection
Identification
Compensation

A

Defense mechanisms

131
Q

involves doing a behaviour to escape a negative stimulus

A

Negative reinforcement

132
Q

is withholding reinforcement from a previously reinforced event

A

Extinction

133
Q

is adding a negative stimulus after a behaviour

A

Positive punishment

134
Q

is removing a reinforcing stimuli after a behaviour

A

Negative punishment

135
Q

Intense prolonged exposure to an imagined life event

A

Imaginal flooding

136
Q

Paraphrasing and reflection of what is not verbalized

A

Complex Reflection

137
Q

reflecting back what the client said in an amplified (positive) manner

A

Amplified reflection

138
Q

Used to determine ambivalence. Recognize the sustained behaviour talk and the change talk

A

Double-sided reflection

Individual Counselling (2 decks)

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