Theories Flashcards

1
Q

Cognitive Behavioral Therapy (CBT)

A

B.F. Skinner

symptoms are learned and reinforced by environment

not events perse but rather the person’s assumptions, expectations, and interpretations of events which are responsible for the production of negative emotions

effective for depression, anxiety disorders, alcohol and drug use problems, marital problems, eating disorders, and severe mental illness

emphasis on helping individuals learn to be their own therapists.

Through exercises in the session and “homework”, patients/clients are helped to develop coping skills

emphasize what is going on in the person’s current life, rather than what has led up to their difficulties.

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2
Q

CBT art therapy

A

art is a cognitive process that uses thinking, sensing, and identifying as well as understanding emotions

artist is uncovering mental images and messages, recalling memories, making decisions, and generating solutions

Art provides a concrete record of inner processes that can be discussed and altered

  1. identifying and recording negative thoughts
  2. distance from cognitions / recognize schema
  3. cognitive re-structuring - analysis of faulty logic, hypothesis testing, alternative interpretations, enlarging perspective, and decatastrophizing
  4. experimenting with physically altering a negative image through art expression.
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3
Q

CBT concepts

A

stimulus-response

behavioral conditioning

behavioral modification

simple stimulus-response behaviors: first level behaviors like automatic habits

Second-level behaviors included language, imagery, thinking, and affect.

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4
Q

CBT strategies to change behaviors

A

Facing one’s fears instead of avoiding them.

Using role playing to prepare for potentially problematic interactions with others.

Learning to calm one’s mind and relax one’s body.

six basic steps in CBT:
(1) establishing a good therapeutic rapport

(2) having a problem focus

(3) identifying irrational thoughts

(4) challenging irrational thoughts

(5) testing the validity of thoughts

(6) substituting irrational thoughts with rational ones

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5
Q

Core principles of CBT

A

unifying goal of CBTs is behavioral adaptation

Psychological problems are based, in part, on faulty or unhelpful ways of thinking.

Psychological problems are based, in part, on learned patterns of unhelpful behavior.

People suffering from psychological problems can learn better ways of coping with them, thereby relieving their symptoms and becoming more effective in their lives.

three guiding principles:
(1) context engagement—re-examining problematic situations in order to imagine novel responses

(2) attention change— helping clients sustain or shift attention in order to better adapt to various situations

(3) cognitive change —gaining perspective or altering meanings of emotionally significant situations

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6
Q

CBT strategies to change thinking patterns

A

Learning to recognize one’s distortions in thinking that are creating problems, and then to reevaluate them in light of reality.

Gaining a better understanding of the behavior and motivation of others.

Using problem-solving skills to cope with difficult situations.

Learning to develop a greater sense of confidence in one’s own abilities.

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7
Q

Trauma-informed therapy

A

The adoption of the PTSD diagnosis by the DSM III in 1980

no overarching definition

shifts focus from “whats wrong with you” to “what happened to you”

acknowledges that health care organizations and care teams need to have a complete picture of a patient’s life situation — past and present — in order to provide effective health care services with a healing orientation

Realize the widespread impact of trauma and understand paths for recovery

Recognize the signs and symptoms of trauma in patients, families, and staff

Integrate knowledge about trauma into policies, procedures, and practices

Actively avoid re-traumatization.

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8
Q

Narrative Art Therapy

A

“Finish the story”

put fragments of trauma into ITR / change story from present tense to past with a definitive end.

simple, clear drawing materials

8 drawings
“Before” and an “After” picture serve as bookends that set the story in time.
- drawings that depict each aspect of the ITR - w/ thoughts, feelings, Body sensations

Under no circumstances should the therapist let the client leave a session without making certain he or she is grounded and fully oriented

“And now, we see that this very important story in the life of (client’s name) is truly over—and we can finally say, ‘The end!’”

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9
Q

The Instinctual Trauma Response (ITR)

A

Tinnin and Gantt (2014)

startle
attempt to fight or flee
freeze
altered state of consciousness (ASC)
Automatic obedience
Efforts at self-repair

Body sensations accompany each aspect

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10
Q

Humanistic

A

umbrella term for client centered, existential, gestalt, logotherapy, and narrative therapy.

focuses on a person’s individual nature, rather than assuming that groups of people with similar characteristics have the same concerns

emphasis on positive traits and behaviors and developing ability to use instincts to find wisdom, growth, healing, and fulfillment

since humanistic therapists may not focus on diagnosing a client, those with symptoms of certain personality disorders may not achieve success with this approach

therapist’s ways of being and attitudes are more influential, in terms of helping clients change, than are techniques or interventions designed to get clients to change

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11
Q

Humanistic art therapy

A

Josef Garai

three primary tasks
(1) being present, accessible, and open to clients
(2) honoring clients’ thoughts and feelings in the immediate experience
(3) engaging in artistic self-expressive activity along with clients

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12
Q

Gestalt Therapy

A

Fritz Perls

art therapy - Janie Rhyne

experiential and present focused

integration of thoughts, feelings, and actions

hot seat

empty chair

role playing

psychodrama

here and now focus of time

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13
Q

Gestalt art therapy

A

Janie Rhyne, Joseph Zinker, Violet Oaklander, Mala Betensky

genuine contact with client

emphasis on here and now

Gestalt: whole form or configuration which is greater than the sum of its parts.

art allows people to know themselves as a whole person in a short time

encourage and insist on responsible, honest, direct, and authentic communication between the person and therapist

individuals can deal effectively with their life problems

stresses assumptions of personal responsibility for the course of one’s life

Dreams are assumed to represent existential messages that reflect current ways of being in the world

perceiving and becoming aware of what is obviously there

Without pushing for interpretations, we explore the dimensions of the drawing and elaborate its impact, through active, present experiencing

focus on the active movement in the art done by clients.

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14
Q

client-centered treatment

A

requires the therapist to be empathic, open, honest, congruent, and caring

every person has worth, dignity, the capacity for self-direction, and an inherent impulse toward growth

assist people in becoming more autonomous, spontaneous, and confident

therapists genuineness

complete acceptance

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15
Q

Person-Centered Expressive Arts Therapy

A
  • Natelie Rogers
  • believe in ability of individuals to find appropriate self-direction
  • psychological climate is empathic, honest, and caring
  • use the arts to let go, to express, and to release
  • All people have an innate ability to be creative.
  • Personal growth and higher states of consciousness are achieved through self-awareness, self-understanding, and insight
  • Self-awareness, self-understanding, and insight are achieved by delving into our emotions.
  • Our feelings and emotions are an energy source
  • The expressive arts lead us into the unconscious.
  • “the creative connection.” - one art form can lead into another easily
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16
Q

Humanistic techniques

A

Congruence: being authentic, open, and genuine as they interact with the individual who is in therapy.

Empathetic understanding: not only understanding what the client is feeling and saying, but also communicating that understanding to the client. The individual should feel heard, seen, and understood.

Reflective listening: actively listening to the individual and then summarizing what the client has said in their own words. This strategy can help reinforce what the client is saying, allow them to reflect back on their own words, and clear up potential misunderstandings.

Unconditional positive regard: accepting the individual without judgment. It is characterized by a caring attitude that plays an important role in fostering self-worth, personal growth, and self-awareness.

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17
Q

Existential

A

Friedrich Nietzsche and Soren Kierkegaard

death, freedom, isolation, meaninglessness

focuses on concepts that are universally applicable to human existence including death, freedom, responsibility, and the meaning of life

therapy should be
aimed at challenging individuals to find meaning and purpose in life

focus on individual not symptoms

All people have the capacity for self-awareness.

Each person has a unique identity that can be known only through relationships with others.

People must continually re-create themselves because life’s meaning constantly changes.

Anxiety is part of the human condition.

emphasizes a person’s capacity to make rational choices and to develop to their maximum potential

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18
Q

Existential art therapy

A
  • Bruce Moon
  • primary thrust of therapy is engaging the client in a creative struggle with the ultimate concerns of human existence
  • one of the underlying realities of human existence is that we are ultimately alone

using the art process as a metaphor for choice and free will

(1) the capacity for self- awareness
(2) freedom and responsibility
(3) creating one’s identity and establishing meaningful relationships with others
(4) the search for meaning, purpose, values, and goals
(5) anxiety as a condition of living
(6) awareness of death and non- being

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19
Q

Who existential therapy is good for

A

treating psychological concerns that are thought to result from an inhibited ability to make authentic, meaningful, and self-directed choices

Interventions often aim to increase self-awareness and self-understanding.

Symptoms: excessive anxiety, apathy, alienation, nihilism, avoidance, shame, addiction, despair, depression, guilt, anger, rage, resentment, embitterment, purposelessness, psychosis, and violence

life-enhancing experiences: relationships, love, caring, commitment, courage, creativity, power, will, agency, presence, spirituality, individuation, self-actualization, authenticity, acceptance, transcendence, and awe.

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20
Q

Existential Approaches

A

responsibility and freedom focus

find meaning in the face of anxiety

confronting negative internal thoughts rather than focusing on external forces like societal pressures or luck.

Fostering creativity, love, authenticity, and free will

The goal: To make more willful decisions about how to live, drawing on creativity and love, instead of letting outside events determine one’s behavior.

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21
Q

Transpersonal Therapy

A

Abraham Maslow and associates in the 1960 - stemmed from Carl Jung

emphasis on role of healing spirit

spiritual traditions and rituals

positive influences and role models

focus on a broader conception of how a person achieves meaning, purpose, and happiness

increase sense of empowerees

“reaching beyond humanistic concerns.”

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22
Q

Maslow’s Hierarchy of Needs

A

self actualization

self esteem

love and belonging

safety and security

physiological needs

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23
Q

Transpersonal Approaches

A

honesty, open mindedness, self-awareness

address the person’s needs to improve other areas of life such as relationships or life satisfaction and spiritual emergencies

draw from a variety of different religions and spiritual practices for tools and methods

Meditation

Guided visualization

Hypnotherapy

Dream work

Art-marking

Music therapy

Journaling

Holotropic breathwork

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24
Q

Spiritual Therapy

A

Mimi Farrelly-Hansen

part of a holistic approach to treating mental health symptoms and diagnoses

integrates spiritual or religious beliefs and practices into the therapeutic process.

acknowledges that you have unique spiritual and existential beliefs, values, and experiences about what it means to be human, that influence your understanding of yourself, others, and the world around you

the spirit is the most powerful and most important factor in a complete healing

techniques:
mindfulness
sacred texts
prayor
rituals

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25
**Psychodynamic**
- ego, id, superego - defense mechanisms - transference and countertransference - free association - resolution of internal conflicts - libido - aggression - defense mechanisms: automatic, unconscious strategies for reducing anxiety - helps the therapist to know where a person is “stuck” (developmentally), what is being defended against (feared impulses), and how (favored coping and defense mechanisms) - Sigmund Freud (Ego Psychology) - less focused on the patient-therapist relationship and more focused on the patient’s relationship with their external world - Individuals who have the capacity to be self-reflective and are looking to obtain insight into themselves and their behavior are best suited to this type of therapy. - longer term than CBT - our behavior and feelings as adults are rooted in our childhood experiences - scribble technique complements the psychoanalytic principles of projection and free association
26
Ernst Kris
regression in service of ego wrote psychoanalytic exploration in art (1959)
27
Amplification (analytic approach)
originally form of dream interpretation (Jung) subjective: active imagination to find associations to the symbol. objective: themes from mythology, religion, and other sources to illuminate the symbol
28
Object Relations
humans have innate drive to form and maintain relationships and relationships with people around us shapes our personality - the “object” in object relations theory refers to the who and what in which a person’s libidinal energy is invested. - “libidinal energy”: constitutional reservoir of energy and life that is part sexual, part aggressive, but is more than either. - human behavior is conceptualized within a tripartite system of id, ego, and superego, which, when unbalanced, creates the conflicts manifesting themselves in the range of defenses and symptoms characteristic of the neuroses. - The therapist cannot actually be that which the patient lost, yet the therapist’s presence and actual living with the patient’s problems serve to repair the original damage and problem
29
Melanie Klein
early fantasy life of infant - projection and introjection - splitting defense (borderline personality disorder)
30
DW Winnicott
- good enough mother - transitional space - transitional object - holding environment - Winnicotts squiggle game - object-relations
31
Margaret Mahler
mother/child dyads - developmental stages of human attachment normal autism: infant respponds primarily to body sensations and internal stimuli normal symbiosis: caretaker and baby form attachment and merged as one rapproachment: child drawn to and runs from caretaker separation/individuation: "object constancy
32
transitional space
intermediate area of experience where there is no clear distinction between inner and outer reality art and play
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transitional object
object that is important to the child because it represents something beyond what it actually is stuffed animal, blanket, artwork
34
Psychodynamics
Uncovering traumatic events that had been repressed (“making the unconscious conscious”) thought to be the key to recovery from neurotic illness conscious unconscious defense mechanisms: projection displacement sublimation dream symbolism
35
transference (psychodynamic)
client’s unconscious projection of feelings onto the therapist originate in repressed or unfinished situations helps to identify distorted perceptions, which are assumed to be based on unresolved conflicts from the past patients’ attachment to the art work gradually replaced their dependence on the therapist (Naumburg)
36
countertransference (psychodynamic)
symbolic ways in which the therapist perceives and responds to the patient clue to what is being evoked in the therapist by the patient
37
Ego
The “compromise” effected by the “ego” consists of finding some way to satisfy or discharge the impulse, without offending either the environment (reality) or the individual’s moral code (“superego”)
38
Id (psychodynamic)
source of repressed (forbidden) wishes (impulses, ideas). These impulses (the “instinctual drives”) constantly strive for discharge (satisfaction) and are expressed in a disguised form, because only in that way can they bypass the “censor” (the force serving to keep unwelcome ideas out of awareness)
39
Psychodynamic Approaches
therapist helps the patient to understand and gain control over previously unknown sources of distress through questions, clarifications, confrontations, and other forms of intervention—especially interpretations, in which possible connections may be tactfully proposed. free association dream analysis focus on recognizing, acknowledging, understanding, expressing, and overcoming negative and contradictory feelings and repressed emotions helping the patient understand how repressed emotions from the past affect current decision-making, behavior, and relationships. help those who are aware of and understand the origins of their social difficulties but are not able to overcome problems on their own. Patients learn to analyze and resolve their current difficulties and change their behavior in current relationships through deep exploration and analysis of earlier experiences and emotions.
40
dream analysis / dream work (psychodynamics)
Only idiosyncratic associations to the manifest content can lead to the hidden significance of the dream
41
Thanatos (psychodynamic)
aggressive drive
42
Psychodynamic effective for
depression those who have lost meaning in their lives and have difficulty forming or maintaining personal relationships social anxiety disorder eating disorders problems with pain relationship difficulties borderline personality disorder *less used in instances of psychosis, post-traumatic stress disorder, and obsessive-compulsive disorder.
43
**Family Systems **
Dr. Murray Bowen. each members behavior and emotions are interdependent and influence functioning of family unit personalities, emotions, and behaviors of grown individuals are a result of their birth order, their role within their family of origin and the coping mechanisms helps individuals resolve their problems in the context of their family units work individual and together 8 interlocking concepts
44
family systems people
Nathan Ackerman Jay Haley Salvador Minuchin Murray Bowen Hanna Kwiatkowska
45
societal emotional process (family systems)
Broader social and cultural forces can influence family relationships.
46
sibling position (family systems)
Birth order can affect the dynamics between children, siblings, and parents.
47
emotional cutoff (family systems)
Family conflict with no resolution may lead some people to sever a relationship entirely.
48
multigenerational transmission process (family systems)
Small differences in differentiation between children and parents can lead to large differences among extended family members over time.
49
family projection process (family systems)
Parents may displace their feelings or anxieties onto their children, who then may displace their own feelings or anxieties onto others.
50
nuclear family emotional process (family systems)
Relational patterns that occur in the family, including marital conflict, dysfunction in a spouse, impairment of one or more children, and emotional distance.
51
differentiation of self (family systems)
The sense of individuality a person develops, rather than relying on others in their family or social groups.
52
Triangles (family systems)
The relationship dynamic between three people, which may influence relationships with others in the family.
53
family systems effective for
family conflict Substance use disorder Alcohol use disorder Depression Anxiety Bipolar disorder Personality disorders Eating disorders Coping with physical disabilities and disorders
54
**Positive Psychology**
Martin Seligman emphasizes traits, thought patterns, behaviors, and experiences that are forward-looking and can help improve the quality of a person’s day-to-day life goal is to minimize negativity in one’s thinking and behavior and to develop a more optimistic and open attitude that will enhance rather than disrupt one’s social, professional, and spiritual life optimism spirituality hopefulness gratitude happiness creativity perseverance justice meaning and purpose free will
55
Positive Art Therapy
promote well-being by building upon what is good in our lives. negativity bias— an evolutionary mechanism that naturally commands our attention and propels us to channel resources toward correcting what is not functioning in our environment Recent research demonstrates that experiencing high levels of well-being leads to greater physical health and longer life, improved work performance, good citizenship, and stronger social networks and societies PERMA Positive Emotions Engagement Relationships Meaning Achievement just the process of doing art evokes positive emotions. -Depict three positive events that happened during the day and what about you or the situation made them happen -represent a positive memory -identify the things that you value and give your life meaning -depict a door that closed and a door that opened -visualize and make symbols for people and creatures who matter to you or someone who you admire
56
Seligman's Perma model
P Is for Positive Emotions: The pursuit of positive emotions will not necessarily improve your well-being. However, the experience of positive emotions through savoring your day-to-day moments may well boost well-being. E Is for Engagement: Being engaged with life is important for well-being. Otherwise, your mind and body will run on automatic and you may suffer tedium and little meaning. R Is for Relationships (Positive Ones): We thrive when we are connected in meaningful relationships. M Is for Meaning: A sense of meaning and purpose is essential to well-being. A Is for Accomplishment and Achievement: We each need to succeed and accomplish the goals we set. This quest for self-improvement is essential.
57
**Solution Focused**
Insoo Kim Berg, Steve de Shazer, and their colleagues in the late 1970s focus on clients present and future goals accept client as expert in an equal position of collaboration with therapist finding solutions in the present and exploring one’s hope for the future in order to find a quick and pragmatic resolution of one’s problems
58
**Solution focused techniques**
Goal setting neutralizing resistance - remove outside issues and focus on problem exception finding questions- can you think of a time when that problem didnt happen miracle question facilitating change 0-10 scale empathic support narrative therapy
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**Attachment Theory**
John Bowlby 1960s brief, process-oriented form of counseling client-therapist relationship is based on developing or rebuilding trust and centers on expressing emotions looks at the connection between an infant’s early attachment experiences with primary caregivers, usually with parents, and the infant’s ability to develop normally and ultimately form healthy emotional and physical relationships as an adult
60
secure attachment
strong early attachment led to safety, security, and support, which then led children to develop healthy connections with others
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anxious attachment
insecure, threatened, suspicious, and fearful of being rejected
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avoidant attachment
develops during early childhood, particularly in those who do not experience sensitive responses to their needs or distress causes a low tolerance for emotional or physical intimacy and, sometimes, struggles with building long-lasting relationships
63
disorganized attachment
can often lead to inconsistent behavior in relationships want to be close to another person but then pull away out of fear often the result of maltreatment, abuse, or trauma by a parent or caregiver when you're young
64
reactive attachment
trauma- and stressor-related condition of early childhood caused by social neglect and maltreatment aware of what happens around them, but they don't respond emotionally to what's going on may not show or seek affection from caregivers or others and prefer to be alone.
65
**Developmental**
art therapy focus mostly on normal artistic development, and general principles of cognitive development (Piaget) focus on explaining how children change and grow over the course of childhood center on various aspects of growth, including social, emotional, and cognitive development. treatment goals: sensory stimulation skill Aquisition adaptation
66
**Freud's Psychosexual Developmental Theory**
Failing to resolve the conflicts of a particular stage can result in fixations that can then have an influence on adult behavior. The Oral Stage Age Range: Birth to 1 Year Erogenous Zone: Mouth The Anal Stage Age Range: 1 to 3 years Erogenous Zone: Bowel and Bladder Control The Phallic Stage Age Range: 3 to 6 Years Erogenous Zone: Genitals The Latent Period Age Range: 6 to Puberty Erogenous Zone: Sexual Feelings Are Inactive The Genital Stage Age Range: Puberty to Death Erogenous Zone: Maturing Sexual Interests
67
**Erikson's Psychosocial Developmental Theory**
Successfully managing the challenges of each stage leads to the emergence of a lifelong psychological virtue. Stage 1: Trust vs. Mistrust (Infancy from birth to 18 months) Stage 2: Autonomy vs. Shame and Doubt (Toddler years from 18 months to three years) Stage 3: Initiative vs. Guilt (Preschool years from three to five) Stage 4: Industry vs. Inferiority (Middle school years from six to 11) Stage 5: Identity vs. Confusion (Teen years from 12 to 18) Stage 6: Intimacy vs. Isolation (Young adult years from 18 to 40) Stage 7: Generativity vs. Stagnation (Middle age from 40 to 65) Stage 8: Integrity vs. Despair (Older adulthood from 65 to death)
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**Piaget's Cognitive Developmental Theory**
Sensorimotor Stage: (birth - age two) infant's knowledge of the world is limited to his or her sensory perceptions and motor activities. Behaviors are limited to simple motor responses caused by sensory stimuli. Pre-Operational Stage: (2 - 6) child learns to use language. children do not yet understand concrete logic, cannot mentally manipulate information, and are unable to take the point of view of other people. Concrete Operational Stage: (7 - 11) children gain a better understanding of mental operations. begin thinking logically about concrete events but have difficulty understanding abstract or hypothetical concepts. Formal Operational Stage: (12 to adulthood) people develop the ability to think about abstract concepts. Skills such as logical thought, deductive reasoning, and systematic planning also emerge during this stage. - deductive reasoning: general to particular (cause to effect) - inductive reasoning: detailed facts to general principles (ability to generalize) - transductive reasoning: cause and effect may be confused or inaccurate
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Bowlby's Attachment Theory
both children and caregivers engage in behaviors designed to ensure proximity. Children strive to stay close and connected to their caregivers who in turn provide a safe haven and a secure base for exploration.
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Bandura's Social Learning Theory
Albert Bandura By observing the actions of others, including parents and peers, children develop new skills and acquire new information.
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Vygotsky's Sociocultural Theory
parents, caregivers, peers, and the culture at large were responsible for developing higher-order functions Through interacting with others, learning becomes integrated into an individual's understanding of the world zone of proximal development: gap between what a person can do with help and what they can do on their own
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**Dialectical Behavioral Therapy (DBT)**
Marsha Linehan effective with history of self harm and borderline personality acquisition of skills takes precedence over uncovering maladaptive thinking. strong educational component designed to provide skills for managing intense emotions and negotiating social relationships treatment of choice for borderline personality disorder, emotion dysregulation, and a growing array of psychiatric conditions group instruction and individual therapy sessions, both conducted weekly for six months to a year, dialectic: real life is complex, and health is not a static thing but an ongoing process hammered out through a continuous Socratic dialogue with the self and others goals: (1) identify and solve problem(s) (2) address behaviors that undermine the therapeutic process (3) work on problems that interfere with quality of life (4) gain skills related to self-care, self-soothing, and mindfulness (5) learn to ask for help when needed (6) keep the patient invested In the treatment process through weekly team meetings
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DBT useful for
Personality disorders, including borderline personality disorder Self-harm Post-traumatic stress disorder Bulimia Binge-eating disorder Depression Anxiety Substance use disorder Bipolar disorder
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DBT techniques
Individual sessions usually last an hour group meetings, usually consisting of four to 10 people, are designed to run for an hour and a half to two hours present-oriented and skills-based patients are asked to practice their skills between sessions (homework) Mindfulness distress tolerance Emotion regulation interpersonal effectiveness, allowing a person to communicate with others in a way that is assertive, maintains self-respect, and strengthens relationships
75
**Motivational Interviewing**
William R. Miller in 1983 and further developed by Miller and psychologist Stephen Rollnick The first goal is to increase the person’s motivation and the second is for the person to make the commitment to change. helps people resolve ambivalent feelings and insecurities to find the internal motivation they need to change their behavior practical, empathetic, and short-term process that takes into consideration how difficult it is to make life changes often used to address addiction and the management of physical health conditions such as diabetes, heart disease, and asthma 4 key principles
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express empathy (motivational interviewing)
The therapist listens carefully to the patient and conveys that they understand the patient’s feelings, beliefs, and experiences.
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support self-efficacy (motivational interviewing)
clients possess the strength and ability to grow and change—even if past attempts at change have failed. supports the patient’s belief in themselves that they can change. calling attention to the patient’s skills, strengths, or past successes.
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roll with resistance
therapist avoids becoming defensive or argumentative if they encounter resistance help the patient identify the problem and solution themself. The therapist doesn’t impose their viewpoint on the patient but helps the patient consider multiple viewpoints.
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Develop Discrepancy (motivational interviewing)
identify discrepancies between their present circumstances and their future goals. What thoughts and behaviors do they need to change to achieve those goals? guides the patient in spotting this discrepancy and solutions to reduce it.
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motivational interviewing techniques
O.A.R.S. Open-ended questions: encourage patients to think deeply or differently about a given problem. Affirmations: recognize a client’s strengths, which can instill confidence, or self-efficacy, in their ability to change. Reflections: listening to the patient and reflecting back a response, which can demonstrate empathy as well as point out discrepancies between their current behaviors and goals. Summaries: recapping at the end of a session.
81
Group Therapy Theory
- Forming, Storming, Norming, Performing, Termination - specific focus: educational, career, social, or personal. - emphasizes interpersonal communication of conscious thoughts, feelings, and behavior within a here-and-now - often problem oriented, and members largely determine content and aims. - Group members typically do not require extensive personality reconstruction, and their concerns generally relate to the developmental tasks of the life span. - growth oriented - provides empathy and support to create trust that leads to sharing and exploring concerns. - members assisted in developing existing skills in dealing with interpersonal problems
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Art Therapy Theory
use of creative techniques such as drawing, painting, collage, coloring, or sculpting to help people express themselves artistically and examine the psychological and emotional undertones in their art clients can interpret the nonverbal messages, symbols, and metaphors often found in these art forms, which should lead to a better understanding of their feelings and behavior so they can move on to resolve deeper problems
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5 benefits of art therapy
Perception and self-perception: Art helped the participants focus on the present moment, identify their emotional responses, and connect their emotions and body awareness. Personal integration: They strengthened their identity and self-image. Emotion and impulse regulation: They improved the ability to regulate and control emotions. Behavior change: They learned to change their behavioral responses to themselves and others, perhaps through the self-directed nature of art-making. Insight and comprehension: They verbalized their emotions and experiences.
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**Jungian**
Carl Gustav Jung psycho-spiritual approach emphasis on myth and symbols bring together conscious and unconscious parts of the mind to help a person feel balanced and whole collective unconscious & universal archetypes mandals and its uses
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synchronicity
event in outside world coincides meaningfully with state of mind
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temenos
sacred, protected space personal container and sense of privacy that surrounds analytical relationship indicated by images of quaternary nature (mandalas)
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individuation
differentiation development of individual personality depends on relationship btwn ego and unconscious leads to realization of self as greater than ego
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Self
wholeness center of psyche appears in dreams, myths, and fairytales or in form of totality symbol (circel, square, cross)
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Ego
central complex out of self that ego develops
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Puer aeternus
eternal child child-god forever young older man whose emotional life at adolescent level coupled with too great dependence on mother
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Trickster
descriptive of unconscious shadow tendencies of ambivalent mercurial nature
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Shadow
hidden or unconscious aspects of self good and bad repressed or never recognized often experienced through projection
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Hero
heros journey quest or task leading toward forging identity
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Complex (Jung)
group of memories and interpretations related to archetype
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Archetype
primordial, structural elements of psyche insticntual images universal patterns or motifs basic content of religions, mythologies, legends, and fairy tales
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Active imagination
assimilating unconscious contents through self expression give voice to sides of personality normally not heard first stage like dreaming with open eyes spontaneous or induced
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Jungian Analysis
specializing in neurosis bringing unconscious to consciousness less emphasis on transference
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individuation (Jung)
achieve unity between the conscious and unconscious mind closest someone could come to God.
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Jungian techniques
Dream analysis: dreams are communications from the unconscious mind. Word association: specific words are said and therapist record how long it takes the patient to respond with the first thing that comes to mind. Art or dance therapies: painting, drawing, and dancing are conduits through which the unconscious mind can express itself and that the exercises themselves may help repair the areas of a patient’s ailments that come through their art-making. exploring the "shadow" focuses more on the source of a problem than on its manifestations or symptoms
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Jungian analysis influenced......
modern-day lie detector test Jackson Pollock Myers-Briggs personality test
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introversion (Jung)
basic personality style characterized by a preference for the inner life of the mind over the outer world of other people
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extroversion (Jung)
personality trait typically characterized by outgoingness, high energy, and/or talkativeness
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**Behavioral Therapy **
Edward Thorndike all behaviors are learned and that behaviors can be changed umbrella term including CBT applied behavior analysis exposure therapy Cognitive behavioral play therapy Acceptance and commitment therapy DBT
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behavioral therapy techniques
Systematic desensitization "classical conditioning" Aversion therapy: teaching people to associate a stimulus that’s pleasant but unhealthy with an extremely unpleasant stimulus reinforcement punishment shaping modeling
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Waldeson's Couple Art Evaluation
four specific drawing tasks explore and express various dimensions of the couple's relationship structured to evoke particular dynamics and interactions between the partners first task - self-portrait. express their self-perception and personal identity independently of their partner. second task - exchange their self-portraits and then alter the portrait created by their spouse. represents the influence and impact each individual has on the other, highlighting the reciprocal nature of their relationship. third task - abstract portrait of the marital relationship. separately create a drawing that represents their view of the relationship as a whole. emphasizes the personal and subjective interpretations of the shared bond from the perspective of each partner. fourth task - joint scribble. both partners work together on a single piece of paper, adding to a joint scribble without any specific instructions other than to interact through the drawing. designed to reflect the couple's ability to cooperate and communicate non-verbally, showcasing the dynamics of their partnership in real-time.
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It is critical to the program that each client completes an extensive packet of forms during their intake. You will need to assemble various forms to be completed during the initial interview, including:
medical history payment schedules goals and objectives insurance forms disclosure forms
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Expressive arts therapy
inclusion of any of the arts therapies—art, music, dance/movement, drama, and poetry/writing underlying belief - principle of unconscious expression expression, imagination, active participation, and mind-body connection
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*What section of the Code of Ethics-General Ethical Standards is art therapists shall ensure regular contact with clients and prompt rescheduling of missed sessions found
responsibility to clients
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​*Art therapists obtain written, informed consent from clients or legal guardians (if applicable) before using clinical materials and client artwork in any teaching, writing, and public presentations. Reasonable steps are taken to protect client identity and to disguise any part of the artwork or videotape that reveals client identity."
client artwork ethical principle
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**Adlerian therapy model**
Alfred Adler understanding unique perceptions and experiences strive for sense of belonging and significance To challenge clients' basic premises and life goals Help clients achieve personal success and become contributing members of society
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**Cognitive theory**
Jean Piaget and Howard Gardner intellectual functioning: level of functioning, capacity for symbolic functioning, and concrete to abstract thinking memory perception sequencing problem-solving development of a person's thought processes how thought processes influence how we understand and interact with the world.
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Howard Gardner
multiple intelligence theory - word - logic - picture - music - body - person - self
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**D.W. Winnicott's theory of attachment**
best known idea is explanation of child’s habit of becoming very attached to a favorite blanket or toy - Interaction with this material object tends to lessen anxiety and also help the child adapt to change. "good enough" mother continuum of separation individuation
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Social / Interactive
development of social and family roles dev of social responsibility potential for regression in dev
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psychosexual concepts
libido: aggression: oedipal complex: (how Freudian concepts may be manifested in art and behavior)
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**Rudolph Arnhem's theories of perception**
continuum of gross to fine motor skills normal dev of eye-hand coordination
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Motor Development
heredity and diet play important roles girls accelerated in physical growth boys develop more muscle tissue by adolescence phylogenetic reflexes (birth) voluntary movement crawls, creeps, stands precise pincer grasp walks alone (12-15months) runs, climbs (18 months) delights in scribbling builds tower of 9 cubes (3 years) improved eye-hand coordination (4 years) copies square, triangle (4-5) uses scissors (5-6 yrs) basic motor skills present by 6 years but need refinement - ride bicycle, skip rope, play sports
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**Victor Lowenfeld dev stages**
scribble (2 years) Preschematic (3-4 years) Schematic (5-6) Drawing Realism (Gang) (7-10) Pseudo-naturalistic (crisis) (11-13) Period of Decision (14+)
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Period of Decision (Lowenfeld & Edwards)
14+ years Art is something to be done or left alone Natural development will cease unless a conscious decision is made to improve drawing skills Students are critically aware of the immaturity of their drawing and are easily discouraged. Lowenfeld's solution is to enlarge their concept of adult art to include non-representational art and art occupations besides painting (architecture, interior design, handcrafts, etc.) Support: Encourage artistic prompts that are inspired by emotions. Study work of master artists to experience a vast range of styles and techniques that can be mimicked and added to a child’s “toolbelt of skills.”
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Pseudo-naturalistic "crisis period" (Lowenfeld & Edwards)
11-13 years end of art as spontaneous activity as children are increasingly critical of their drawings. focus on the end product - strive to create "adult-like" naturalistic drawings. Light and shadow, folds, and motion are observed with mixed success, translated to paper. Space is depicted as three-dimensional by diminishing the size of objects that are further away. The beginning of adolescence marks the end of artistic development among most children, due to frustration at "getting things right." Those who do manage to weather the crisis and learn the "secret" of drawing will become absorbed in it. Edwards believes that proper teaching methods will help children learn to see and draw and prevent this crisis. Support: Balance observational drawing with art based in meaning. Show artwork where the outward appearance is secondary to the emotional response or message sent to the viewer. Continue to practice perspective, shading, anatomy and composition as well as color theory.
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Drawing Realism "Gang Stage" (Lowenfeld & Edwards)
7-10 years schematic generalization no longer suffices to express reality. more detail for individual parts but is far from naturalism in drawing. Space is discovered and depicted with overlapping objects in drawings and a horizon line rather than a base line. Children begin to compare their work and become more critical of it. While they are more independent of adults, they are more anxious to conform to their peers. (9-10 years) children try for more detail, hoping to achieve greater realism, a prized goal. Concern for where things are in their drawings is replaced by concern for how things look The passion for realism is in full bloom. When drawings do not "come out right" (look real) they seek help to resolve conflict between how the subject looks and previously stored information that prevents their seeing the object as it really looks. Children struggle with perspective, foreshortening, and similar spatial issues as they learn how to see. Support: Introduce techniques to simplify complex forms for drawing, such as finding basic geometric shapes in objects. Explore one-point perspective to continue growth with spatial relationships. Encourage experimentation with abstract (non-objective) drawing to increase the scope of art awareness. Practice shading, anatomy, and simple composition.
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Scribble Stage (Lowenfeld & Edwards)
2 years enjoyable kinesthetic activity, not attempts at portraying the visual world. After six months of scribbling, marks are more orderly name scribbles Random scribbles begin at age one-and-a-half, but quite quickly take on definite shapes. Circular movement is first because it is most natural anatomically. Support: Give toddlers ample opportunities to make marks with a variety of easily grasped tools. Use colorful materials and introduce papers with a range of textures.
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Schematic (Lowenfeld & Edwards)
5-6 years schema: a definite way of portraying an object, modified when he needs to portray something important. The schema represents the child's active knowledge of the subject. definite order in space relationships: everything sits on the base line. develop a set of symbols to create a landscape. (blue line and sun at the top of the page and a green line at the bottom become symbolic representations). Landscapes are composed carefully, giving the impression that removing any single form would throw off the balance of the whole picture. Support: Discuss basic atmospheric perspective and overlapping to enhance an understanding of spatial relationships. Simple figure drawing increases awareness of all the parts of the body to be drawn. Continue to invite children to tell stories and talk about their work.
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Preschematic (Lowenfeld & Edwards)
3-4 years conscious creation of form (3ish) - provides a tangible record of the child's thinking process. first representational attempt is a person - usually with circle for head and two vertical lines for legs. other forms develop, clearly recognizable and often quite complex. Children continually search for new concepts, so symbols constantly change. tell stories or work out problems with her drawings, changing basic forms as needed to express meaning. (4 or 5ish) Often once the problem is expressed, the child feels better able to cope with it. Support: Ask children to explain their drawings and tell the stories that spring from their work. Avoid guessing what symbols may be; ask and listen.
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**Rhoda Kellogg dev stages**
restricted her focus to line formations formal design emerges before pictorialism left to their own devices and provided with appropriate materials, children will self-educate themselves artistically and develop a uniquely individual sense of aesthetics. Pattern (24-31 months / 2-3) Shape (24-36 months / 2-3) Design (36 - 48 months / 3-4) Pictoral (48 months / 4years)
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Design Stage (Kellogg)
3-4 years 1. Combines: units of two diagrams 2. Aggregates: Units of two or three diagrams. 3. Mandalas: Sanskirt word for circle. Child proceeds from mandalas, to suns, to humans. Mandaloid formations are perceived by children long before the first diagrams are made. 4. Suns: The sequence from mandala to sun is a prevailing sequence that appears only after the child has drawn complex aggregates. The sun and mandala provide stimulus for the child’s first drawings of humans. 5. Radials: A formation with lines that radiate from a point or small area usually from the center. Early radials appear to be formed from a rhythmic motion, and do not require eye control. these forms can appear by 18 months in the form of placement patterns.
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Pictoral (Kellogg)
4 + years 1. Humans: The first humans are made when the child joins the face aggregate with body parts that form a modified mandala. 2. Animals: Early animals resemble humans that are horizontal. Usually by this time children are influenced by pictures of animals books. 3. Buildings: Are drawn by combining diagrams in various ways, not by observing houses. 4. Vegetation: Early trees resemble armless humans. 5. Transportation: Children draw common formulas for boats and wheeled vehicles whether or not they have seen them. Pictorial labels for these formulas may not be used by the child until an adult uses them. 6. (5 years) Children copy schemas favored by society: often a time of crisis in child art. Kindergarten teachers seldom appreciate spontaneous art, and give children formulas to copy. Once formulas for objects which are “acceptable” to adults are learned , the child will make combinations of them into scenes. 7. (6 years) Most children stop all spontaneous art activity by the age of eight or so, those that go on usually study and practice the techniques to master various media.
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Shape Stage (Kellogg)
2-3 years 1. Emergent Diagrams: Emergent Diagrams are formed when the total configuration implies a shape. 2. Diagrams: Definite shapes drawn in outline form.
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Pattern Stage (Kellogg)
2-3 years 1. basic scribbles: Classified into 20 different types these marks appear to be spontaneous with or without eye control. 2. Placement patterns: Require both seeing and the eye’s guidance of the hand.
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Hanna Kwiatkowska
research and family art therapy coauthored a short book that helped introduce the field of art therapy to the general public
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Edith Kramer
- art as therapy - influenced by Freud - goal of therapy: establishing possibility of sublimation (primitive urges transformed by ego into socially productive outlets - art) - work with children - synthesis of content and form was achieved by transforming emotional material into fully formed images - emphasizes the intrinsic therapeutic potential in the art-making process
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Judith Ruben
psychoanalytic understanding of patient is enhanced through art expression as therapy
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relationship between verbal therapy and art therapy
transference to art object permanence of art object externalization of inner material through artwork how art therapy provides means for illustration of world view of clients and families
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**acceptance and commitment therapy**
Steven C. Hayes action-oriented approach stems from behavior therapy and cognitive behavioral therapy learn to stop avoiding, denying, and struggling with inner emotions accept that deeper feelings are appropriate responses to certain situations that should not prevent them from moving forward in their lives core principles: - acceptance - cognitive diffusion - being present - self as context - values - committed action
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**environmental / ecotherapy approaches**
belief that human wellbeing is connected to natural world utilize healing power of nature goals: alleviate stress enhance well being ecological interconnectedness
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**Feminist Theory**
acknowledges and addresses impact of gender-based inequalities and power dynamics on mental health social, cultural, and political factors influence experiences goal: empower clients promote self-determination challenge oppressive norms foster sense of agency
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**Social Justice Approaches**
Protests are full of strong emotions which are often released in art Art therapists are social activists Artistic activism is a practice aimed at generating aeffect Strategic arts-based peacebuilding Art therapists viewed as most useful in leadership At roles in social movements Visualizing injustices: Create art to spark change, not just shock “What do you want policy makers to know about your experience as a ___” Representing voices: Can use your art to create image of your experience Ensure stories are not exploited or misunderstood Using these images to create an exhibit Bringing people together: Portable studio/ urban art therapy studio Art used as a way to begin discussion Imagining solutions: Imagination is core to social justice
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**Socially-engaged Practice**
community based efforts and social activism incorporates advocacy, education, and direct involvement in community initiatives recognizes societal context where people live empower clients within therapy and communities collaborative efforts to address systemic issues and promote positive change for individuals and larger social environments
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**Psychoanalytic art therapy**
Margaret Naumburg: “release” of unconscious imagery through “spontaneous” art expression was therefore central to her approach to education, as well as to her later development of what she called “dynamically oriented art therapy. attempted to stimulate free association
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Margaret Naumburg
- "mother of art therapy" - influenced by Jung and Freud - art psychotherapy (art in therapy) - spontaneous drawings within the framework of psychoanalysis - free associations - art productions were viewed as symbolic communication of unconscious material in a direct, uncensored, and concrete form
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Elinor Ulman
founded The Bulletin of Art Therapy in 1961 - The American Journal of Art Therapy after 1970 published the first book of collected essays on art therapy
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**Internal Family Systems (IFS)**
Richard Schwartz within each individual, there are multiple sub-personalities "parts" understand, communicate with, and harmonize various parts self-leadership and compassion
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**Somatic Approaches**
focus on physical sensations, movements, and experiences connection between mind and body emotional issues can manifest physically and vice versa mindfulness breathwork body awareness somatic experiencing most effective for: trauma, stress, anxiety
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**systems Theory**
views individuals as part of larger systems problems and behaviors not fully understood isolation reciprocal influence btwn individuals and environments
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Creative Axis Model
Goren-Bar Stage 1: Contact. initial period, contact with the art form Stage 2: Organization. organizes the various elements Stage 3: Improvisation. uses trial and error to explore materials and characteristics of the medium Stage 4: Central theme. theme becomes clear and person invests more attention and effort in that particular aspect of the artwork Stage 5: Elaboration (Variation). person is preoccupied with the modification, development, or improvement of the artwork. Stage 6: Preservation. ending of the experience (distancing, preserving the work, putting it away, or presenting it)
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**Expressive Therapies Continuum**
Sandra Graves-Alcorn & Vija Lousebrink Understanding what is happening in the brain can help us to develop experientials Less about dominance and more about communication between sides of the brain cognitive symbolic perceptual affective kinesthetic sensory
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**stages of change / Transtheoretical Model (TTM)**
process individuals go though when making behavior change 1: pre contemplation 2: contemplation 3: preparation 4: action 5: maintenance change is dynamic and individuals may cycle through multiple times before lasting change
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**Kohlberg's Moral Development Theory**
stages of moral reasoning level 1 - premoral - obeys rules to avoid punishment - conforms to receive favors or rewards level 2 - morality of conventional role-conformity - conforms to avoid disapproval or dislike by others - conforms to avoid censure by legitimate authorities level 3 - morality of self-accepted moral principles - accepts social contract, democratic ideas - develops individual principles of conscience moral thinking evolves from focusing on self-interest to considering broader ethical principles provides insight to how individuals grapple with ethical dilemmas
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** Language Development**
- birth-5 months: coos, Vocalizes pleasure and displeasure sounds differently, Makes noise when talked to - 6-11 months: Understands "no-no", Babbles, "ma-ma" or "da-da" without meaning, Tries to communicate by actions or gestures, Tries to repeat your sounds, Says first word - 12-17 months: Answers simple questions nonverbally, Says 2 to 3 words to label a person or object, Tries to imitate simple words, Vocabulary of four to 6 words - 18-23 months: 50 words, pronunciation unclear, common foods by name, animal sounds, pronouns, 2-word phrases - 2-3 years: spatial concepts, pronouns, descriptive words, 3-word sentences, Speech more accurate, Answers simple questions, question inflection, plurals, regular past tense verbs - 3-4 years: Groups objects, Identifies colors, most speech sounds, Strangers able to understand, describe use of objects, poems and recognizes language absurdities, Expresses ideas and feelings, verbs that end in "ing,", Answers simple questions, Repeats sentences - 4-5 years: spatial concepts, complex questions, Speech is understandable, some irregular past tense verbs, Describes how to do things, Lists items, Answers "why" questions - 5 years: time sequences, Carries out series of 3 directions, Understands rhyming, Engages in conversant, 8 or more words sentences, compound and complex sentences, Describes objects, Uses imagination to create stories
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Expressive language
childs skill in speaking and communicating orally
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receptive language
ability to comprehend spoken language
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syntax
grammar or sentance structure
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overregularization
tendency of child to make language regular
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echolalia
child repeats same sounds over and over - not normative beyond babbling period
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**hand-eye coordination development**
- 0-6 months: Grabbing objects and passing things between hands. - 6-12 months: Using thumb and forefinger for pincer grip and picking up smaller objects. - 1-2 years: Stacking blocks, holding a pencil and using a spoon. - 2-3 years: Drawing circles or simple shapes, turning pages of a paper book and beginning to control a ball. - 3-5 years: Developing better use of cutlery, showing intention with the fine placement of small objects and beginning to write. - 5-7 years: Coloring within the lines, being able to do and undo buttons and beginning to play sport.
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**Rudolph Arnehim's theory of perception*
perception is strongly identified with thinking, artistic expression is another way of reasoning
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denial
refusing to accept reality or facts blocking external events from awareness to avoid emotional distress
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repression
unconsciously pushing distressing memories or thoughts out of awareness
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projection
when people attribute their unacceptable thoughts or feelings to others
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displacement
transferring feelings from original source of distress onto safer, more acceptable target
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rationalization
explaining unacceptable behavior or feeling in rational or logical way avoiding true reasons for behavior
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regression
when individual reverts to earlier stage of development in response to stress or conflict
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reaction formation
behaving in way that is opposite to ones true feelings b/c those feelings are socially or personally unacceptable
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sublimation
channeling unacceptable impulses into more acceptable or socially valued activities
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intellectualization
focusing on facts, logic, and abstract reasoning to avoid dealing with emotional content
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dissociation
person disconnects from thoughts, feelings, memories, or sense of identity
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undoing
attempt to reverse or undo thought or behavior that is deemed unacceptable by engaging in opposite behavior
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splitting
tendency to view people or situations as all good or all bad
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acting out
engaging in destructive or risky behaviors as way of expressing feelings that are otherwise difficult to verbalize
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fantasy
retreating into imaginary world to escape painful realities
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compartmentalization
process of separating conflicting thoughts, behaviors, or emotions into separate mental compartments to avoid distress that arises from coexistence
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Florence Cane
- sister of Naumburg - art educator - developed kinesthetic warm up
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Edward Adamson
- worked with patients in psychiatric hospital - studio approach
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Rita Simon
- art therapy in psychiatic after care - 4 basic art styles archaic linear archaic massive traditional linear traditional massive - creative initiative as main vehicle for mental health
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Daniel Goleman
emotional intelligence - ability to interact with others - read emotional cues - communicate effectively
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Shaun McNiff
humanist and Jungian approaches dialoguing with artwork Lesley college art therapist as "Shaman" movement, drumming, and vocalizing to expand on imagery in artwork
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Pat Allen
studio approach embracing mysterious nature of creative process artists authentic experience