Theories Flashcards

1
Q

Narrative therapy theory of change

A

Theory-separating patient from the problem and creating a new narrative or story which emphasizes client’s strengths.

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2
Q

Narrative therapy role of the therapist

A

Collaborator
Investigator
Co- author
Views client as expert on their own lives
Takes individuals culture into account ; SO, gender religion

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3
Q

Narrative therapy treatment goals

A

De-construct problem saturated stories in order to create more helpful stories

Re-authoring the story- having a new story emerge

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4
Q

Narrative therapy interventions

A

Externalizing the problem
Social constructivism
Deconstructive questions
Mapping the influence - detailed description of the problems effect on the person
Identifying unique outcomes - times in clients life when they have been able to resist the influence of the problem.
Enlisting a witness
Writing a letter to self or others to reauthor the story

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5
Q

Narrative therapy Phases of treatment

A

Beginning - client is invited to tell their problem saturated stories ( reason for treatment)

Middle- the problem is externaliZed . Mapping the influence / effects of the problem, identify explore unique outcomes - reauthor story, enlist witness

End phase -document and support new story , write a letter to self or other.

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6
Q

Post modern therapies

A

Narrative therapy

Solution focused therapy

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7
Q

Solution focused theory of change

A

Change occurs through accessing clients strengths and resources - emphasizes finding solutions to a problem , not on discovering the cause or origins of the problem .

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8
Q

Solution focused Therapist’s role

A

Therapist is a consultant , coach

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9
Q

Solution focused treatment goals

A

Client implements small and large changes to achieve their preferred future

Client builds on current strengths and resources

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10
Q

Solution focused interventions

A

Miracle questioning
Scaling questions - client is asked to rate problem on scale and ask how they would move up and down the scale
Presupposing change - asking questions focusing on progress
Coping questions- how have you coped?
Affirmations/ compliments - affirming how hard it is for the client to even come to therapy for example .

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11
Q

Solution focused phases of treatment

A

Beginning - join with client competencies, envision preferred future , begin to identify clients strengths , use solution oriented language ; come up with achieveable goals

Middle - identify strengths, resources and traits client has already used to deal with problem, utilize solution talk, identify exceptions to problems , utilize scaling questions to reflect on change, compliment client / cheerlead.

End- assist client to maintain change, identify hurdles or perceived Barriers.

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12
Q

What does a systems therapist do?

A

A systems therapist looks at the client in the context of the system (the family and culture).

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13
Q

Systems therapies- What does homeostasis mean?

A

Homeostasis is a family’s predictable pattern of function . Often times the symptom is supported by families homeostasis. When interventions are introduced there is going to be a stage of disequilibrium until family finds a new homeostasis.

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14
Q

Systems- Bowen therapy- what is the theory of change?

A

Change occurs by understanding multigenerational dynamics and increasing differentiation.

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15
Q

Bowen ( systems) family therapy- therapists role?

A

Coach / educator - on how problems have been transmitted.
Supervisor
Investigator - of dynamics
Neutral - not taking sides- making members talk directly to each other.

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16
Q

Bowen (systems) family therapy; treatment goals

A

Reduce anxiety ( anxiety / tension when family is in crisis) heightened arousal due to family problem
Self differentiation
Decrease emotional fusion - family members have different feelings

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17
Q

Bowen ( systems ) therapy; key concepts

A

Triangles
Differentiation of self - seeing yourself as a distinct other with different thoughts and emotions
Nuclear family emotional system - one persons emotional state affects others in the family
Family projection process - how parents project their emotional problems onto a child
Multigenerational transmission process- differences in differentiation over time
Emotional cutoff - cutting someone off from family due to u resolved emotional issues.
Genogram - assessment and treatment tool- family graph

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18
Q

Bowen ( systems ) family therapy interventions

A

Therapist has a non anxious secure presence
Reframing
Genogram
De-triangulation
Increasing differentiation
Teaching I statements
Opening cut off relationships
Interrupting arguments / escalation
Therapist models new ways to communicate and interact
Bibliotherapy- assigning reading material

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19
Q

Bowen phases of treatment

A

Beginning - create genogram of emotional connections , differentiation , triangulation , and identify any dysfunctional patterns.

Early/ middle - teach and model differentiation through communication skill building , detriangulation , encourage reunification from cutoff fam members , teach fam how to take responsibility for their feelings and thoughts

End - review new skills and progress. Overview of family projection process and when to use new skills learned - i statements , differentiate.

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20
Q

Strategic therapy ( systems ) theory of change

A

Change occurs through action oriented directives and paradoxical interventions .

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21
Q

Strategic therapy - role of therapist

A

Delivers directives that facilitate change , particularly around patterns of communication

Focused on solving problem / eliminating symptoms

Designs a specific approach for each persons presenting problems.

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22
Q

Strategic therapy interventions

A

Paradoxical directives - ( prescribing the symptom) maneuvers that are in apparent contradiction to the goals of therapy- gives client control.

Positioning - therapist takes more exaggerated view
Homework- directives to change dynamics
Prescribing symptom- therapist tells them to enact the symptom/ problem
Restraining - discourage change to quickly to facilitate faster change
Ordeals - unpleasant tasks assigned when symptoms occur

23
Q

Strategic phases of treatment

A

Beginning - define the problem , state goals , and what would be the signs of change

Middle- review attempted solutions , assign ordeals , prescribe problem , relabel behavior , instruct the client to respond to the problem in a new way .

End -plan for maintenance of new behavior , plan for future challenges , emphasize positive changes made.

24
Q

Structural family therapy (systems) theory of change

A

Change occurs through restoring the families organization

25
Q

Structural family therapy; therapists role

A

Therapist is actively involved
Joins the families culture using their language
Like the “friendly uncle”
Helps family understand how structure can be changed

26
Q

Structural fam therapy treatment goals

A

Restructure fam system to allow for symptom relief and problem solving

Change dysfunctional transactional patterns and create new ways of relating

Help create flexible boundaries

27
Q

Structural fam therapy Primary concepts

A

Family maps
Alliances
Coalitions -
Hierarchy - leadership and direction provided by the adults
Subsystems -families organize themselves by generation , relationship and necessity; example- parent subsystem…. etc.
disengaged boundaries - fam members are isolated for one another can lead to AOD use as well as rigid boundaries.
Enmeshed boundaries - overly dependent and too closely involved.
Joining - therapists first task , involves blending in with the family , adapting the family’s affect style , and language .

Tracking - therapist pays attention to how family’s interact ; boundaries , roles , coalitions..

Mimesis- therapist tracks family’s style of communication and uses it

Unbalancing supporting someone who is in a one down position thus changing hiercarchal position.

28
Q

Structural fam therapy phases of treatment

A

Beginning -join with family , accommodate and challenge rules of family system , assessment / mapping of family hierarchy, alignments , boundaries, reframing of problem to include the whole systems problem.

Middle -highlight and modify interactions , utilize enactment of issues to challenge participants and unbalance system .

End - review progress made , reinforce structural change , provide tools for future.

29
Q

Satir communicAtions therapy /Satirian therapist / communications therapist

Theory of change

A

Change happens through self awareness and improved communication. Humanistic systems approach. Very growth oriented.

30
Q

Satir communications therapy

Role of therapist

A

Active facilitator
Resource detective - looking for untapped strengths and family’s uniqueness
Therapist is genuine and warm- idea of being congruent
Honest and direct

31
Q

Satir communicAtions treatment goals

A

Goal is to increase congruent communication , improved self - esteem / confidence , and personal growth

32
Q

Satir communicAtions

Key concepts

A

Incongruent communication: discrepancies between verbal and nonverbal cues.

Styles of communication
Dysfunctional styles ; placater, blamer, computer , distracter.

Family life chronology - fam history - idealist , values , rules , disruptions , moves and major events . How events are carried out presently.

33
Q

Satir communicAtions

Interventions

A

Modeling communication - I statements , express feelings directly, be honest.

Family sculpting - put people into a spatial metaphor to represent family member characterizations

Take responsibility - encouraging clients to take responsibility for how they feel , therapist will point out sarcastic comments

Metaphors and story telling - to understand their roles

Transforming roles -

34
Q

Satir communicAtions

Phases of treatment

A

Beginning - establish rapport , sense of equality and hope. Assess communications patterns, stances and concerns , identify tx goals , family life chronology.

Middle- increase fam congruent communication , support and strengthen each persons individual sense of uniqueness and self - esteem.

End - help family practice , implement , and integrate changes and increase awareness of larger familial patterns.

35
Q

Psychodynamic approaches

Which are they?

A
Object relations 
Self psychology 
Adlerian therapy 
Depth psychology 
Attachment based therapy
36
Q

What is the psychodynamic approach

A

People have unconscious motivations , drives , and processes that impact how they function. These are constructed by early childhood caregiving dynamics. Therapeutic relationship is a tool for therapy.

37
Q

Object relations psychodynamic

Theory of change

A

Change occurs through both reparative experiences within the treatment relationship and from new insight into and modification of entrenched object relations pathology.

38
Q

Object relations

Role of therapist

A

Neutral
Emphasis on transference and countertransference
Therapist as a new and good object

39
Q

Object relations

Treatment goals

A

Providing reparative experiences and building new internal structures
Gaining insight to how past relationships impact clients functioning - changing past object relations pathology
Improving relationships with self and others

40
Q

Object relations

Key concepts

A

Objects : refers to persons in the external world individuals seek objects ( others) from birth

Internalization: early infant caretaker interactions lead to the person internalizing basic attitudes towards self and others

Self and object representations - infants form images of themselves and others - these become internal structures

Ego- the structure responsible for dealing with the world , for instituting defense mechanisms , for internalizing external objects and for integrating and synthesizing self and object representations.

Splitting - when two contradictory states are compartmentalized and not integrated. Such as love and hate. Two extreme views of people.

Projection- projecting undesirable feelings or emotions onto someone else, rather than admitting to or dealing with unwanted feelings.

Projective identification-refers to psychological process where someone projects a thought or belief onto someone else- and that person will begin to behave as though he is in fact actually characterized by that thought or belief .

Interjection- subject replicates behaviors attributes from their world including from people. Aggression from little boy who watches dad perpetrate dv.

41
Q

Object relations

Phases of treatment

A

Beginning - establish a holding environment , build rapport and therapeutic alliance through listening and exploration of clients experience, empathy and neutrality.

Middle- promote insight and growth through interpretation. Confront resistance and primitive defense mechanisms , focus on transference / countertransference dynamic, identify and process projective iD

End - work through termination and abandonment issues. Consolidate interpretations. Review insights gained in therapy.

42
Q

Self psychology

Theory of change

A

Change occurs through empathic attunement and strengthening self structures through optimal responsiveness . Re -parenting of the client.

43
Q

Self psychology

Role of therapist

A

Emphasis on empathic understanding
Optimal responsiveness
Allows emergence of self object transference and repair of disruptions

44
Q

Self psychology

Tx goals

A

Developing self cohesion and self esteem
Being more in touch with themselves
Locating better self objects

45
Q

Key concepts

A

Self - objects - early caretakers
Self object needs - mirroring , idealization of others , twin / alter ego
Mirroring - approving and confirming responses
Optimal frustration - self object is needed but not accessible - potential problem
Mirroring transference - the patient seeks acceptance from therapist of the self
Twinship transference - patient sees himself like therapist . Feels validating
Idealizing transference - patient looks up and admires therapist ( good thing)
Adversarial transference - a therapist that they can disagree with in order to grow and still be safe.
Experience - near empathy- therapist steps into clients shoes and imagines what it’s like - body sensations - mirrors it back to them.

46
Q

Self psychology

Tx interventions

A

Establish holding environment
Provide experience near empathy
Repair disruptions of self object transference
Addressing enactments
Empathizinf with losses and blows to self
Mourning loss of self objects

47
Q

Self psychology

Phases of tx

A

Early - establish holding environment where therapist is able to provide containment. Provide experience near empathyS. Explore clients problem and history.

Middle - repair disruptions of self object transference , address enactments , empathizing with losses and blows to self , mourning loss of self objects , mourning ambitions and fantasies , identify alternative self objects .

End - reflect on tx process, acknowledge and process issues related to termination.

48
Q

Adlerian therapy

Theory of change

A

Occurs by increasing clients self -awareness and challenging and modifying his or her fundamental premises , life goals , and basic concepts.

49
Q

Adlerian therapy

Role of therapist

A
Accepting 
Encouraging 
Respectful 
Optimistic 
Co- thinker 
Relationship is collaborative and built on trust
50
Q

Adlerian treatment goals

A

Challenge clients basic premises and life goals
Develop socially useful goals and increase social interests
Believes that therapist should help clients incr see social interest and become a bigger part of the community. Adlerian is the only theorist that has this as tx goal.
Increase sense of belonging
Parenting goals- if children are acting out it’s because they feel like they don’t belong

51
Q

Adlerian therapy

Primary concepts

A

Altruism- people who practice report higher levels of happiness
Inferiority- inferiority feelings are always present as a motivating force in behavior . Adler proposed that inferiority feelings are the source of all human striving . Individual growth results from compensation , from our attempts to overcome our real or imagined inferiorities.
Early recollection- used as an assessment tool. Stories of events before age 10. Include what client thought and felt at that time.

Family constellation- ecploration of fam atmosphere and relational dynamics that prevailed when young .

Lifestyle assessment - identifying through a questionnaire or clinical interview what clients underlying goals are- through early recollections.

Social context - widened view that problems were not simply intrapsychic and incorporated the notion that the social context of persons lifestyle contributed as well .

Social interest - therapeutic goal was to develop social interest where client had genuine feelings of empathy for others instead of a need to conquer their feelings of inferiority.

52
Q

Adlerian therapy

Interventions

A

Dream interpretation - Adler considered dreams as an open pathway to true thoughts emotions and actions. Dreams enable us to see our aggressive impulses and actions

Summary- shares result of assessments as a narrative that is discussed with client

Role playing - middle stages of therapy . Practice new behavior

Guided imagery- change negative imprints form childhood.

Encouragement - helping client build courage. Becoming aware of strengths and feeling more connected towards other. Not focusing on problem
.

53
Q

Adlerian

Phases of tx

A

Beginning - establish relationship , make contact before problem , become aware of assets and strengths ; completes lifestyle assessment and family constellations . Summary is shared with client. Focus on dynamics that may have influenced sense of self , inferiority and the world.

Middle - encourage self understanding and insight through interpretation. Overcome feelings of insecurity through therapists optimism, collaborate to increase social connectedness.

End -putting insights into practice . Encouraging clients to take risks with new bx to act as if they are the people they want to be .