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PMHNP > Theoretical Models > Flashcards

Theoretical Models Flashcards

1
Q

Freud theoretical assumptions

A 
Preconscious: forgotten memories
Conscious
Unconscious: memories that cannot be brought to consciousness
Id: instinctual drives
Ego: rational self
Superego: perfection principle
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2
Q

Freud Key concepts

A

Relief behaviors to reduce stress
Ego Defense mechanisms: compensation, denial , displacement, identification, intellectualization, introjection, isolation, projection* , rationalization*, regression**, sublimation **, suppression **, undoing

  • primitve/narcissitic
    • imature
  • ** Neurotic
  • *** Mature
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3
Q

Freud goals and techniques

A

Goals:
Make the unconscious conscious
Strengthen the ego

Techniques:
Interpretation of behaviors and thoughts
Free association

Psychodynamic: emphasis on the past, intrapsychic, transference, working alliance
Address conflicts from the past
Best matched with the client who has mature defenses and some object constancy

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4
Q 
Interpersonal Theory (Harry Stack Sullivan)
Key Concepts
A

Anxiety chief disruptive force
Interpersonal security: feelings associated with relief from anxiety
Integration of the: “good me”, “bad me”, “not me”
“not me” develops in response to intense anxiety; denial of feelings is used to relieve anxiety
Treatment of depression & anxiety

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5
Q

Interpersonal Theory: Harry Stack Sullivan

Major themes & Coping strategies

A 
Major themes:
Grief
Role disputes
Role transitions
Interpersonal conflicts

Coping Startegies:
Security operations: system of defense against anxiety
Selective inattention: not attending to details that cause anxiety
Dissociation: Putting threatening thoughts out of awareness

** Examine communication patterns; role play; interpersonal communication

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6
Q 
Transactional Analysis (Eric Berne) 
Key concepts
A

Focuses on past and current decisions
Emphasis on thinking, feelings, and behavior
Ego States: P-A-C; Parent: shoulds/oughts; Adult: objective reasoning; Child: impulses & feelings

Strokes: positive, conditional, unconditional, negative, games, rackets, life scripts

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7
Q 
Transactional Analysis (Eric Berne) 
Therapeutic Strategies
A

Structural analysis: awareness content and functioning of the PAC ego states
Transactional analysis: description of what people say/do to themselves and others
Family modeling: imagining past situations and role of others in interactions
Analysis of rituals and pastimes: how they structure time
Analysis of games and rackets: understanding transactions with others
Script analysis: life patterns are identified and analyzed

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8
Q 
Gestalt Therapy (Frederick Perls)
Key Concepts
A

Individual is responsible for finding his own way in life
Individuals must accept personal responsibility
The now: the past is gone the future is not yet here
Unfinished business: nags at the person until confronted
Avoidance: means to keep from facing unfinished business
Layers of neuroses: Superimposed “growth disorders”

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9
Q 
Gestalt Therapy (Frederick Perls) 
Therapeutic Strategies
A 
Increased awareness of the self:
Patient feelings
Awareness of the moment
Body messages 
Energy
Avoidance 
Blocks to awareness
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10
Q

Dialectical Behavioral Therapy (Marsha Linehan)

Central tenets

A

Therapist position is one of guidance in persuasive dialogue leading to a different perceptual view
Change and acceptance
Clients are doing the best they can, getting better is hard work
Therapist is a change agent, compassionate flexibility

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11
Q

Dialectical Behavioral Therapy

Elements

A

Weekly one hour therapy sessions
Weekly group skills training
Skills coaching by electronic connections
Team consultation for therapist to assure fidelity

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12
Q

Dialectical Behavioral Therapy

General principles

A

Time is needed to learn and practice
Missing more than one session necessitates a therapy hiatus
Suicide and self-harm behaviors are problems to be resolved
Mindfulness is used to manage emotional escalation
Distress tolerance, emotional regulation, interpersonal effectiveness (communication), and self-management
Boundaries of relationship are made clear

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13
Q

Dialectical Behavior Therapy

Stages

A

Stage one: Focus is on therapy-engaging and therapy interfering behaviors. Diary cards
Stage two: Focus on non-traumatizing therapies. Regulation of emotions while thinking through the dialectics of emotional mindedness and rational mindedness into “wise mindedness”
Stage three: Skills development to deal with trauma. Exposure therapy
Stage four: Focus on self efficacy move toward termination
DEARMAN: describe, express, assert, reinforce, be mindful, appear confident, and negotiate

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14
Q

Person Centered Therapy (Carl Rogers)

Key Concepts

A

Client has the potential for becoming aware of problems and means to resolve them
Focus on development of self-direction
Health: congruence of ideal self and real self

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15
Q

Person Centered Therapy (Carl Rogers)

Therapeutic Strategies

A
  • Provide a safe climate conducive to client self-exploration
  • Enable client to move toward: openness, greater trust in self, willingness to process, increased spontaneity
  • Relationship is of primary importance
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16
Q

Person-centered Therapy (Carl Rogers)

Therapist qualities/techniques

A
  • Genuineness; warmth; accurate empathy; respect; permissiveness; unconditional positive regard
  • stresses attitudes of therapist
  • active listening and hearing
  • reflection on feeling, clarification, and “being there”
17
Q

MI OARS

A
  • Open-ended questions
  • Affirmations
  • Reflections
  • Summaries
18
Q

MI DARN-CAT

A

Preparatory phase: Desire, Ability, Reason, Need

Predictive phase: Commitment, Activation, and Taking Steps

19
Q 
Behavioral Therapy (Pavlov, Skinner, Bandura, Wolpe)
Therapeutic Strategies
A
  • Change cognition, affect, and behaviors: alter dysfunctional thinking
  • Change self-defeating emotional conflicts
  • Abnormal behaviors seen as “problems of living” that need to be adjusted
  • Focus is on here and now
  • Treatment is individually tailored to each client focused on behaviors
20
Q

Relational-Emotive Therapy (Albert Ellis)

Key Concepts

A
  • Neurosis is irrational thinking and behavior
  • Emotional disturbances are rooted in childhood but continue through re-indoctrination in the now
  • The client’s belief system is the cause of emotional problems
  • Clients examine validity of certain beliefs
21
Q

Relational-Emotive Therapy (Albert Ellis)

Strategies

A
  • Eliminate client’s self-defeating outlook on life
  • Assist clients to acquire a more tolerant and rational view of life
  • Therapist functions as teacher and client as student
  • A personal relationship is not essential
  • Client gains insights into problems and then practices to change self-defeating behaviors
22
Q

Cognitive Behavioral Therapy (Aaron Beck)

Key concepts

A
  • Based on personality theory that asserts how one thinks largely determines how one feels and behaves
  • The processing of information is crucial for the survival of any organism
  • Cognitive distortions created by pathologies like depression and anxiety create a “systematic bias”
23
Q

Cognitive Behavioral Therapy (Aaron Beck)

Tenets

A

*Collaborative Empiricism: Therapist and client collaborate to identify and address dysfunctional interpretations
Cognitive Therapy: Each disorder has its own cognitive content requiring differing treatment approaches
* Techniques: Link symptoms, conscious beliefs, and current experiences through talk therapy to alter old patterns
*Primary thinking recognizes the negative and irrational part of the human experience; Secondary thinking views the world in positive and rational terms

24
Q

Cognitive Behavioral Therapy (Aaron Beck)

CBT approaches to cognitions

A
  • Collaborative guided discovery
  • Socratic dialog: Memory, translation, interpretation, application, analysis, synthesis, evaluation
  • Downward arrow: If this is true, then what happens
  • Labeling cognitive distortions
  • Reattribution: Critical examination of one’s role in outcomes
  • De-catastrophizing
  • Automatic thoughts record
  • Thought stopping
  • Cognitive restructuring
25
Q

Cognitive Behavioral Therapy (Aaron Beck)

CBT approaches to behavior

A
  • Assertiveness training
  • Contingency management
  • Other techniques: bibliotherapy, cinema therapy, guided relaxation, social skills training, psychoeducation
26
Q

Trauma Informed Care

Key concepts

A
  • Exposure to stressful events are stored dysfunctionally in the brain
  • Characteristic symptoms: hyperarousal, avoidance, intrusive thoughts, and dissociation
  • Goals of care are safety, developing awareness through mourning, meaning, transcendence, and incorporation of the trauma event into on’e life
  • Evidence-based Strategies: CBT and EMDR; goal is “adaptive resolution”
27
Q

Hidegard Peplau 6 nursing sub-roles

A

Mother-surrogate: Provide basic needs
Technician: Perform technical aspects of nursing
Manager: Manage environment for health improvement
Socializing agent: Enhance patient’s social life
Health teacher: Educate patient, family, community
Counselor/psychotherapist: assist patients in developing adaptive coping skills

28
Q

Group Therapy: Yalom’s Therapeutic/Curative Factors

A
  • Principle of Universality: Appreciation for commonality of experience
  • Experience hope that problems can be solved
  • Education
  • Increased self-esteem through helping others
  • Correction of maladaptive behaviors; Social skills development
  • Role modeling; insight through interaction with others
  • Security through a sense of belonging
  • Express emotions in a safe environment; catharsis
  • Existential factors: find life direction; accept responsibility for quality of life
29
Q

Group Therapy

A
  • Forming
  • Stroming
  • Norming
  • Performing
  • Adjourning
30
Q

Family Systems Theory (Murray Bowen)

Key Concepts

A

*Family: interlocking relationships
*Anxiety: Reaction of an emotional unit to perceived threat
*Differentiation of self: individual identity
*Fusion: Ways that people borrow/lend self to another
*Cutoffs: Immature separation of people
*Emotional reactivity: Reactions without separating thoughts and feelings
*Triangles: Building blocks of any emotional system
Use “I think” rather than “I feel” responses

31
Q

Strategic Family Therapy (Haley & Erickson)

Key concepts

A
  • Families inadvertently develop strategies to solve problems that become problems
  • Focus on the expression of dysfunction vs. the history of the problem
  • Therapist designs novel strategies for eliminating problematic behaviors
32
Q

Structural Family Therapy (Minuchin)

Key concepts

A
  • Three elements of family organization: Structure, Subsystems, Boundaries
  • Diffuse boundaries (enmeshed): more chaos
  • Rigid boundaries (disengaged): less emotional support
33
Q

Solution Focused

A
  • Focused on finding solutions
  • Prisons, schools, legal systems, clinically
  • Miracle questions

PMHNP (19 decks)

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