therapeutic modalities Flashcards
Most likely to be enhanced by the strategies of putting the pt at ease, finding the pt’s pain and expressing compassion, evaluation pt’s insight, and showing expertise: (5x)
RAPPORT
The factor most consistently associated with therapy outcome in psychotherapy research: (3x)
STRENGTH OF THERAPEUTIC ALLIANCE
A set of feelings that a patient reenacts in the therapeutic relationship are called: (x2)
TRANSFERENCE
Business executive hospitalized for bleeding ulcer repeatedly argues with a well-liked head nurse and threatens to leave AMA. Best action for C&L psychiatrist is: (2x)
LISTEN TO PT’S COMPLAINTS ACKNOWLEDGE HIS DISCOMFORT WITH THE PASSIVE POSITION THAT HE IS UNACCUSTOMED TO
Common theme in psychotherapy in the elderly: (2x)
LOSS
As opposed to long-term psychotherapy, time-limited therapy more likely to: (2x)
SELECT CENTRAL ISSUE AS FOCUS
For the treatment of pts with compulsive sexual behavior, the best results have been seen with which of the following approaches? (2x)
TWELVE STEP GROUPS
Two most powerful predictors of outcome in any form of psychotherapy are: (2x)
EMPATHY AND THERAPEUTIC ALLIANCE
The best response to a pt who reports a fixed false belief that his neighbor is poisoning his dog and sitting all day at the window monitoring is: (2x)
EMPATHIZE WITH THE PT, BUT AVOID DIRECT CONFRONTATION ABOUT THE DELUSION
Psychotherapy where pts realistically evaluate their interactions w others & therapist offers direct advice/helps pts make decisions/ignores transference issues. (2x)
INTERPERSONAL PSYCHOTHERAPY (IPT)
Most likely represents an acceptable boundary crossing by a therapist as opposed to a boundary violation: (2x)
RECEIVING COOKIES AS AN EXPRESSION OF GRATITUDE BY A PT NEAR TERMINATION.
Therapeutic empathy is best described as the therapist’s ability to: (2x)
GRASP PT’S INNER EXPERIENCE FROM PT’S PERSPECTIVE
Motivational interviewing often used as part of the treatment of which conditions? (2x)
SUBSTANCE ABUSE
Therapeutic technique where therapist instructs the patient to hold onto a symptom: (2x)
PARADOXICAL INTERVENTION
Without evident distress, pt calmly reports to the psychiatrist, “Since I was last here, my significant other dumped me.” The doctor responds by pointing out the discrepancy between the pt’s affect and the content described. This response is an example of: (2x)
CONFRONTATION
Psych resident dislikes alcoholic pts and avoids working with them. In discussing the problem, says that pts are hopeless and unmotivated and she can’t empathize with them. Example of? (2x)
COUNTERTRANSFERENCE
Catharsis is: (2x)
VERBAL EXPRESSION OF SURPRESSED TRAUMATIC EXPERIENCES AND FEELINGS
barrier to widespread use of telepsychiatry
PHYSICIAN DISSATISFACTION
Example of behavioral analysis strategy
AT WHAT POINT DURING THE DAY DID YOU FIRST NOTICE YOU WERE THINKING ABOUT CUTTING
Pt BIB police to ED with disorganized behavior. Pt askes are you a real psychiatrist?” Best response?
Recent meta- analyses have suggested what with regard to the use of psychotherapy to treat depression?
OTHER PSYCHOTHERAPIES HAVE EFFICACY COMPARABLE TO CBT
Psychiatrist’s mind wanders during sessions, what should the psychiatrist do?
EXAMINE INNER THOUGHTS AND FEELINGS
What theory is the basis of mentalization-based therapy?
BOWLBY’S ATTACHMENT THEORY
During initial psych interview, pt tearfully discusses painful ending of romantic relationship. What should Dr. say to establish therapeutic alliance?
IT SOUNDS LIKE THIS HAS BEEN VERY DIFFICULT FOR YOU.
Psychiatrist behavior of raising eyebrows, leaning towards pt, saying “Uh-huh”
FACILITATION
Redirecting discussion by talking about irrelevant stuff
RESISTANCE
During a clinical interview, the physician recapitulates what the pt has said so far and says to pt “I just want to make sure that I’ve got everything right up to this point”. This is an example of:
SUMMATION
When psychiatrist asks about mania, pt responds, “that sounds exactly like my cousin,” and proceeds to tell long story about cousin but doesn’t answer the psychiatrist’s request. This is an example of:
TANGENTIALITY
In initial psych interview, pt frustrated that his last psychiatrist had brief visits & “just gave me another pill every time.” Interviewing psychiatrist responds “so you would like your psychiatrist to listen & understand you before adjusting your meds.”
CLARIFICATION
Pt who had difficult childhood calls therapist mother’s name and quickly corrects error. What is this an example of?
PARAPRAXIS
Pt w/ BMD who has been making progress in long-term psychodynamic psychotherapy enters session obviously distraught. After listening to scattered seemingly unimportant details of recent daily life, therapist asks if pt is avoiding something too uncomfortable to talk about. Pt responds w intense anger/distress. “I just heard you are getting a divorce, I am sick about it. Here I am counting on you to help me sort out my chaotic life and messed-up relationships, and you can’t even keep your own marriage together! What are you, some kind of hypocrite? I think I should leave and find someone who knows what they’re doing!” Best response for the therapist to make?
I AM GOING TO NEED A MOMENT TO THINK ABOUT WHAT YOU’VE SAID AND ARE FEELING BEFORE I CAN RESPOND.
8yr old evaluated for asthma, found to have ADHD symptoms, put on stimulant, behavioral problems continue, sent to psychiatrist and psychologist, this is an example of what level of collaborative care?
SHARED (INTEGRATED) CARE
17 y/o receiving counseling for school truancy. Student understand truancy is not a desirable behavior and is discusses ways to improve school attendance. What stage of change is student in?
PREPARATION
College student in therapy, the Dean calls therapist requesting info about the student’s therapy due to recent reports from a dorm supervisor. Therapist should:
REFUSE THE DEAN’S REQUEST FOR INFORMATION
An important counter-transference issue in an interethnic psychotherapeutic relationship is:
DENIAL OF DIFFERENCES
Abstinence compliance increases with random UDS. This is ex of:
PARTIAL REINFORCEMENT
A new pt asks therapist, “are you Christian?” What is best response?
ARE YOU CONCERNED THAT IF WE ARE NOT OF THE SAME RELIGION, I WON’T BE ABLE TO TREAT YOU PROPERLY?’
Exchange during initial interview after pt’s former therapist closed his practice: pt expresses concern about new therapist being too young/inexperienced, states she doubts new therapist can provide any new insights. Best response to further goal of getting to know pt, establish whether therapy w new therapist would be appropriate IT CAN BE VERY HARD TO START OVER WITH A NEW THERAPIST. HOW HAVE YOU BEEN FEELING ABOUT HAVING TO END YOUR TREATMENT WITH DR. BROWN?”
A patient repeatedly becomes distressed after what seems, even to the pt, to be minor disappointments. The patient also seems to suffer from extreme narcissistic vulnerability. A therapist utilizing self-psychology would be most likely to interpret this due to which of the following factors?
A LACK OF DEVELOPMENTALLY APPROPRIATE EMPATHY FROM CAREGIVERS