Therapeutic Techniques Flashcards
Bibliotherapy
Recommending helpful books to client.
Cognitive Technique
Cognitive Reframing
Changing the way people see things and helping them find different ways to view things.
Cognitive Technique
Cognitive Rehearsal
Client imagines a difficulty scenario. Therapist then guides the person through a step-by-step process for facing and handling the situation. The patient then practices these steps mentally.
Cognitive Technique
Cognitive Restructuring
Identifying and challenging irrational beliefs or thoughts.
Cognitive Technique
Covert Desensitization
Pairing relaxation techniques with imagained anxiety-provoking images.
Cognitive Technique
Covert Extinction
Imagining an award being given after reducing an unwanted behavior.
Used in treating paraphilias.
Cognitive Technique
Covert Reinforcement
Things one says or does to oneself to make oneself feel good or bad.
Cognitive Technique
Floatback Technique
Typically used at start of EMDR to help client identify a specific time a negative thought began.
Cognitive Technique
Socratic Questioning
A form of questioning used to examine thoughts.
Can be used to examine ideas, get to root causes of thinking, analysis, to uncover irrational thoughts, to explore current situation.
Clarification
Look for evidence
Question viewpoint
Analyze outcomes
Cognitive Technique
Abreaction
Release of emotional tension achieved through recalling a repressed traumatic experience.
Affective Technique
Body Awareness / Body Scan
Helping clients to make connections between their emotions, thoughts, and physical responses.
Affective Technique
Catharsis
Discharge of pent-up emotions to relieve symptoms.
Affective Technique
Empty Chair
Typically used in Gestalt therapy.
Used to explore relationships with others or aspect of self.
Affective Technique
Focusing on Here and Now
Typically used in Gestalt Therapy.
Includes sharing of past events and future aspirations, but the focus is on the client’s feelings NOW in reaction to past and future.
Exaggeration Technique
The person in therapy is asked to repeat and exaggerate a particular movement or expression, such as frowning or bouncing a leg, in order to make the person more aware of the emotions attached to the behavior.
Gestalt Technique
Psychodrama / Role Play
Role-playing allows clients to identify their feelings surrounding a given situation while simultaneously learning how others may feel.
These exercises also help clients learn to apply words to their feelings and more successfully navigate any interactions they may have with others.
Affective Technique
Assertiveness Training
Based on the idea that we have a right to express thoughts, needs, and feelings as long as it is done in an respectful way.
Behavioral Technique
Aversion Therapy
Patient is exposed to a stimulus while also being subjected to some form of discomfort. Purpose is to associate something negative with stimulus in order to stop behavior in response to stimulus.
Behavioral Technique
Behavioral Extinction
Removing an award when engaging in undesired behavior as a way to reduce the behavior.
Behavioral Technique
Clinical Modeling
Therapeutic demonstration of desired behavior. Could be any behavior, such as breathing, grounding, etc.
Behavioral Technique
Contingency Management
Typically used with substance abuse.
A person is rewarded for behavior if they stick to the guidelines of their treatment plan.
Behavioral Technique
Exposure and Response Prevention (ERP)
ERP is a form of behavioral therapy that exposes a person to conditions that provoke obsessions so that they may practice reducing their compulsive response.
Behavioral Technique
Flooding
A form of exposure therapy in which the client is exposed to a painful memory with the goal of reintegrating their repressed emotions with their current awareness.
Behavioral Technique
Graduated Exposure Therapy
An ABA behavioral therapy.
Graduated exposure is the process of exposing the client slowly and methodically to a stimulus in order to reacclimate them and make it so they don’t respond to the stimulus.
For fear of dogs, they might start by talking about dogs, then drawing a dog, then looking at pictures, then videos, then maybe watching a dog from the car window, finally meeting a dog behind a fence, and eventully being with the dog.
Behavioral Technique
Implosion (or Implosive) Therapy
Similar to flooding, but the client not only thinks of experience, they conjure all their senses while imagining the experience in order to evoke stronger emotions.
Behavioral Technique
In-vivo Desensitization
Same as Systematic Desensitization.
Person is gradually introduced to something they are phobic of as a way to reduce the phobic response.
Behavioral Technique
Systematic Desensitization
Person is gradually introduced to something they are phobic of as a way to reduce the phobic response.
3 Stages:
1) Graded: gradually facing your fears.
2) Repeated: Exposure is repeated; practice facing fears until client feels comfortable.
3) Prolonged: staying in the feared situation long enough for the anxiety to decrease. Usually 20-30 minutes.
Behavioral Technique
Paradoxical Intention
A cognitive technique that consists of persuading a patient to engage in his or her most feared behavior to desensitize them to the fear related to the experience.
Example may be asking client to get up and present when they have fear of public speaking.
CBT technique
Prolonged Exposure Therapy (PE)
Based on Emotional Processing Theory which posits that PTSD is a result of avoiding thoughts and feelings about the event. PE interrupts the avoidance pattern to facilitate processing of traumatic memories and emotions.
Behavioral Technique
Response Cost
Giving a negative consequence for an undesired behavior.
Behavioral Technique
Sensate Focusing
Set of specific sexual exercises for couples to help increase personal awareness of the sexual experience.
Behavioral Technique
Family Mapping/Genogram
A pictorial display of a person’s family including information about relationships and behavior patterns (such as addiction, infidelity, divorce, etc.).
Family Sculpting
Asking family members to physically arrange themselves in a tableau that represents family dynamics.
Family Tracking
Therapist meticulous tracks family stories to create a timeline of events in an effort to identify specific events that keep the family system operating as it does.
Free Association
Psychoanalytic technique that asks the client to speak about whatever comes to mind without requiring they stick to a specific topic. Can often help with gaining insight into complex thought processes.
Hydrotherapy
Use of exercises in a pool for treatment of physical conditions such as arthritist or partial paralysis.
Motivational Interviewing
Originally developed to treat substance abuse.
Semi-directive, client-centered counseling style for eliciting behavior change by helping clients to explore and resolve ambivalence about changing.
Assumes that responsibility and capability for change lies within the client
Therapist’s task is to create a set of conditions that will enhance the client’s own motivation for and commitment to change
Mobilize the clients inner resources, helping relationships, support intrinsic motivation for change
Miracle Question
Solution Focused Technique
“If you could wake up tomorrow and one thing could be different, magical or not, what would it be?”
Recreational Therapy
A systematic process that utilizes recreational activities to address the assessed needs of the client. Not evidence based.
Script Analysis
Considers that from the early transactions between mother, father, and child, a life plan evolves. This is called the script, or ‘unconscious life plan.’ Script analysis is based on the assumption that a persons’ behavior is based on this script.
Transference Focused Psychotherapy (TFP)
A highly structured, twice-weekly treatment based on object realations model and can be used with borderline personality disorder.
Treats BPD by concentrating on the relationship between the therapist and patient.
Build Rapport
Use strategies to build therapeutic alliance: clarify issues, validate, normalize, empathic response,
Therapeutic Silence
Staying quiet to allow client time to process and continue speaking.
Paraphrase
Restate what the client has said.
Therapeutic Confrontation
Therapist provides direct, reality-oriented feedback to a client regarding the client’s own thoughts, feelings or behavior
Reflection of Meaning
Statements used by psychotherapists to restate, paraphrase, or uncover therapy clients’ emotional reactions to situations, thoughts, behaviors, or interpersonal interactions.
Push Button Technique
The push button technique is used in Adlerian therapy.
The client is asked to visualize a happy event and recall the associated feelings. Then the client is asked to visualize an unhappy event and the associated feelings. Finally, the client returns to the happy event, experiencing the happier feelings.
This technique helps clients see that they are responsible for how they feel, both good and bad feelings.
Spitting in the Soup
Pointing out discrepancies between words and actions as a means of facilitating change.
“I notice that you talk about how meaningful your work is to you, yet you also show up late to work.”
“I hear you saying that you want to get together more often, but I also notice that you often don’t return my calls.”
Adlerian Technique
Premack Principle
Reinforcing a target behavior by awarding some privilege to engage in a more desired behavior afterward.
Parents use the Premack principle when they ask children to eat their dinner (low desire behavior) before eating dessert (high desire behavior).
Behavioral Technique
Reframe
Change how a person is looking at a situation.
Instead of “Why is this happening to me?” reframe to think, “What can I learn from this?”
CBT Technique
Reattribution
A technique which tests automatic thoughts and assumptions by considering alternative causes of events. This particularly helps when clients perceive themselves as the cause of problem events.
“Is it possible there are other factors that led to this incident?”
CBT Technique
Decatastrophizing
A form of cognitive reappraisal that can help us think differently about emotional situations.
“What are you worried will happen?”
“How likely is it to happen?”
“If that happens, how can you cope?”
CBT Techniques
Decentering
Within mindfulness-based treatments, decentering is an ability to observe thoughts/feelings as temporary events in the mind rather than true reflections of reality and the self.
“You think you will always be sick. Instead of accepting that thought as reality, perhaps consider other possibilities.”
CBT Techniques
Modeling
Learning that occurs through observation and imitation alone, without comment or reinforcement by the therapist. Could be the therapist modeling or client watches a video.
CBT Technique
Dream Work in Gestalt
The general principles in dream interpretation in Gestalt therapy (unlike Freudian/psychoanalytic) is that the therapist does not make any interpretations. The meaning of everything in a dream is determined by the client.
Gestalt Technique
Reversal
Clients are encourage to act in behaviors that are less prominent, for example it the client is passive he/she would act aggressively.
Gestalt Technique
Staying with the Feeling
Encourages the client to stay with their feeling through asking them about the client’s awareness, instructing the client to give a voice to their feeling, and encouraging the client to act out their feeling.
Gestalt Technique
Develop a Discrepancy
The idea is to explore the client’s current behavior and where they would prefer to be in order to elicit desire to change.
“How does not exercising fit into your desire to lose weight?”
Motivational Interviewing Techique
Roll with Resistance
Going with client resistance instead of confronting it. Use motivational interviewing techniques to go with resistance:
“Rolling with Resistance” involves a number of different possible approaches. They share some common features:
- Avoid argumentation
- Reflective listening
- Encourage the other person to come up with possible solutions rather than forcing suggestions on them.
Motivational Interviewing Technique
Shift Focus
Keeping the focus on the current concern when client tries to detour.
“You probably think it’s my fault my wife left.”
“I don’t want to assign blame. I am interested in what you were saying about making the relationship better.”
WDEP Model
- explore WANTS and needs
- examine life DIRECTION
- self-EVALUATION
- make PLANS
Reality Therapy Technique
Dispute Irrational Beliefs
Disputing irrational beliefs is the primary method of REBT.
There are different kinds of disputations:
* Functional disputes – questioning whether the belief helps accomplish desired goals.
* Empirical disputes – questioning whether the “facts” are accurate.
Rational Emotive Behavior Therapy Technique
“Blow up” Technique
The ‘blow-up’ technique: this is a variation of ‘worst - case’ imagery, coupled with the use of humour to provide a vivid and memorable experience for the client.
It involves asking the client to imagine whatever it is they fear happening, then blow it up out of all proportion till they cannot help but be amused by it.
Rational Emotive Behavior Therapy Technique
Shame Attacking
Shame attacking exercises are behavioral exposure assignments that have people perform behaviors that they fear or experience shame about doing.
Perhaps the title shame attack is a misnomer, as people often experience social anxiety about doing these behaviors.
This technique is effective at helping people learn to deal with anxiety.
Rational Emotive Behavior Therapy Technique
Time Projection
The therapist asks the client to imagine the feared event coming true, then asks the client to consider how they would feel 6 months after the event occured.
Designed to show that one’s life continues after a feared or unwanted event has come and gone.
Rational Emotive Behavior Therapy Technique
Scaling Question
Using a 1 to 10 scale to have client rate where they are with something.
“On a scale of 1 to 10, how would you rate your anxiety?”
Solution Focused Technique
Coping Question
Asking client how they cope with a specific challenge to help them see they are capable.
“There is so much homework but you get it all done. How do you keep it all organized?”
Solution Focused Technique
Exception Question
Asking client about a time when current feelings were not present.
“Tell me about a time you weren’t angry at your mom.”
Solution Focused Technique
Paradoxical Injunction
A therapeutic technique in which a client is directed by the therapist to continue undesired symptomatic behavior, and even increase it, to show that the client has voluntary control over it.
As if
This is a form of encouraging and motivating clients to be the way they desire to be, “acting as if” the transition has already occurred.
Assertiveness Training - Feminist
This technique provides specific training and insight to raise women’s awareness of their interpersonal rights, assist in transcending stereotyped sex roles, and alter negative belief systems to change daily patterns, actions and interactions
Behavioral rehearsal
and role-playing
The client imagines a target situation, and the therapist guides the client through a step-by-step process of successfully coping with the situation.
The client then practices the steps in a mental rehearsal in a variety of ways
Catastrophe Scale
Addresses awfulizing. Have the client write a scale from 0 - 100% in 10% intervals. Zero is the most relaxing experience you can think of, and 100 is the greatest trauma you can imagine.
Example: scale might range from “watching cricket with my dad” (zero) to “losing my dad, job, and house in one swoop” (100).
Chaining
Involves the series of smaller behaviors that are linked to the desired complex behavior. Each step is prompted and reinforced, strengthening all of the parts of the chain that move toward the desired behavior
Circular Questioning
This is a technique for interviewing hypothesis validation in which each family member comments on the behavior and interactions of other family members
Congruence
The therapist is real and/or genuine, open, integrated and authentic during their interactions with the client.
Deconstruct the problem
The narrative therapist would work with the individual to break down or deconstruct their stories into smaller, more manageable parts in order to clarify the problem.
Deconstructing makes the problems more specific and reduces overgeneralizing; it also clarifies what the core issue or issues may be.
Schema Therapy
In CBT, recognizing automatic thoughts and how they make patients feel and behave is sufficient. However, in schema therapy, the focus is to do all of the above while changing the schemas so that they are no longer a hindrance to the patient’s adult life.
5 Schema Domains:
* Abandonment/Instability.
* Mistrust/Abuse.
* Emotional Deprivation.
* Defectiveness/Shame.
* Social Isolation/Alienation.
An integrative approach that brings together elements from cognitive behavioral therapy, attachment and object relations theories, and Gestalt and experiential therapies.
Parent-child interaction therapy (PCIT)
PCIT combines play and behavioral therapy to assist adults in relating to their children who have mental health or other disorders.
Parents and caregivers learn specific skills to improve communication with their children.
PCIT is primarily designed to treat children ages 2 to 7.
Emotionally Focused Therapy
Emotion-focused therapy (EFT) is a therapeutic approach based on the premise that emotions are key to identity. According to EFT, emotions are also a guide for individual choice and decision making. This type of therapy assumes that lacking emotional awareness or avoiding unpleasant emotions can cause harm.
Emotionally focused therapy is primarily used to treat couples and families and addresses issues of adult attachment and bonding.
Stress Innoculation
Stress inoculation is a CBT technique that combines relaxation skills with self-talk, role-playing, rehearsal, and systematic desensitization to help individuals master stressful events.
Steps include:
1) preparing for the stressor
2) confronting and directly managing the stressors
3) coping with the stressor
4) reinforcement.
Shaping Technique
Shaping is the use of reinforcement of successive approximations of a desired behavior. Specifically, when using a shaping technique, each approximate desired behavior that is demonstrated is reinforced, while behaviors that are not approximations of the desired behavior are not reinforced.
An example of shaping is when a baby or a toddler learns to walk. They are reinforced for crawling, then standing, then taking one step, then taking a few steps, and finally for walking. Reinforcement is typically in the form of lots of praise and attention from the child’s parents.
5 basic principles of motivational interviewing
- Express Empathy
- Develop Discrepancy: to help clients see and feel how their current behavior threatens important personal goals or is inconsistent with more central personal values.
- Avoid Argumentation: makes clients defensive; resistance may indicate a need to change strategies
- Roll with Resistance: use resistance to help build motivation; acknowledge ambivalence as natural
- Support Self-efficacy: explore past successes in other problem areas and apply to present situation. Client is responsible for choosing and carrying out personal change.
Core counseling skills used in Motivational Interviewing
- Open questions
- Affirmations
- Reflections
- Summarizing
- Attending to the language of change
- Exchange of information
What are the 4 processes of Motivational Interviewing that help direct the flow of conversation?
- Engage: The goal is to establish a productive working relationship.
- Focus: An agenda is negotiated that draws on both the client and practitioner expertise to agree on a shared purpose.
- Evoke: In this process the clinician gently explores and helps the person to build their own “why” of change. Ambivalence is normalized.
- Plan: Planning explores the “how” of change.
RULE guidelines for Motivational Interviewing
- Resist making it right.
- Understand motivation of the client
- Listening with empathy
- Empower the client
Imaginal Exposure
Vividly imagining the feared object, situation or activity.
For example, someone with Posttraumatic Stress Disorder might be asked to recall and describe his or her traumatic experience in order to reduce feelings of fear.
Virginia Satir’s family sculpting technique
The therapist asks one or more family members to arrange the other members (and lastly themselves) in relation to one another in terms of posture, space, and attitude to portray the arranger’s perception of the family.
Constructive Confrontations
Constructive confrontation can be a useful counseling intervention which can help clients become more self-aware.
If used effectively, therapists can help their clients identify certain behaviors they may overlook as well as address unresolved issues which they may be avoiding. This will help improve their overall well-being.
Reflecting Feelings
One way to think about reflecting feelings is to imagine that you are holding up a mirror to the person’s emotions. You are not trying to change or fix the emotions, but simply acknowledging and reflecting back what you see and hear. This can be an incredibly powerful therapeutic tool, because it helps the person feel heard and understood.
It also allows the person to see their emotions from a different perspective, which can be helpful in managing and coping with them.
What areas would be assessed as part of a biopsychosocial intake?
Biological, psychological and social factors, including:
* presenting problem
* personal and family history
* medical history
* substance use history
* developmental history
* socio-economic history
What are the 3 non-judgemental R’s in Counseling?
- Radical Acceptance: listening without judgement
- Resonance: the experience of emotional connection and attunement between client and counselor.
- Resource Building: focus on strengths; prioritizes existing strengths and wellness above deficits and disease.
Behavioral Experiment
Planned experiential activities to test the validity of a belief.
A woman with depression doesn’t go to work on days when she feels bad. On these days she stays in bed all day watching TV. Her behavioral experiment involves pushing herself to go to work on days she’s tempted to stay in bed to see if getting out of the house improves her mood.
SOLVED technique
S: Select an issue you want to solve.
O: Open your mind and brainstorm all potential solutions.
L: List the potential advantages and disadvantages of each potential solution.
V: Verify the optimal solution; decide which choices are practical or desirable.
E: Enact the plan.
D: Decide if the plan works.
Behavioral Activation
Behavioral activation is based on the theory that, as individuals become depressed, they tend to engage in increasing avoidance and isolation, which serves to maintain or worsen their symptoms.
One of the main ways people use behavioral activation is to increase pleasurable feelings and create a sense of meaning.
Behavioral Activation Techniques:
* Self-monitoring of activities and mood
* Activity scheduling
* Activity structuring
* Problem-solving
* Social skill training
* Hierarchy construction (ranking how easy certain activities are to accomplish)
* Shaping (training healthy behaviors)
* Reward
* Persuasion
* Behavior contract (signing a contract with friends and family so that they will only reinforce healthy behaviors)
* Life area assessment (determining in which areas of life one desire success)
Behavior Experiment
Planned experiential activities to test the validity of a belief.
Example: You have the client identify an irrational belief, then plan a behavior that can be used to test it. For example, “My co-workers do not like eating lunch with me.” Then the person asks co-workers to eat lunch with them. After they do this, they describe what happened.
Thought Experiment
A thought experiment is a hypothetical situation in which a hypothesis, theory, or belief is laid out for the purpose of thinking through its consequences.
Bracketing
The intentional setting aside of a counselor’s personal values from his or her professional values in order to provide ethical and appropriate counseling to the client.
Linking
In group therapy, linking involves the therapist comparing members to each other based on the infromation shared in the group. Finding commonalities between group members encourges them to link and work together.
Play Therapy
Play therapy is a type of therapy where a therapist uses play, toys, and games to help the child explore, express, and safely experience the difficulties they are working through.
Using play, the therapist uncovers insights otherwise unable to be heard and recognized through normal dialogue.
Successive Approximation
a CBT technique that involves breaking an overwhelming task down into smaller, less daunting steps.
This CBT technique works for people who have difficulty completing a task.
4 Common Solution Focused worksheets
- Miracle worksheet
- Exceptions to the Problem Worksheet
- Scaling Questions Worksheet
- SMART+ Goals Worksheet
