Treatment/Intervention Flashcards
reciprocal inhibition
idea that 2 incompatible bxs can’t happen at the same time, the stronger response will inhibit the weaker (e.g., fear will inhibit pleasure)
counterconditioning
based on reciprocal inhibition; focused on weakening a maladaptive conditioned response by strengthening an incompatible response
examples:
-sensate focus
-systematic desensitization (exposure w/ relaxation techniques)
-assertiveness training
-aversive counterconditioning for SUD, paraphilias
covert sensitization
imaginal aversive counterconditioning
prolonged exposure is an example of…
classical extinction: CS (e.g., feared memory) presented without US (e.g., danger)
generalized reinforcers
take on value b/c they give access to other reinforcers (e.g., tokens, $)
contingency contracting
used when there are problematic interactions b/w 2 or more ppl; therapist helps them ID the bxs they most want from each other and helps them negotiate a contract for exchange
DRO
differential RF of other behaviors (e.g., child is ignored when whining and then gets RF for quieting down or on-task bx)
escape learning
an aversive stimulus cannot be avoided, but once it starts, emitting a desired bx can stop it
avoidance learning
an averse stimulus can be avoided by emitting a desired bx; typically, a discriminative stimulus (cue) lets the subject know it’s time to perform the bx
symbolic modeling
filmed modeling, for social learning purposes (e.g., modeling how to do an exposure)
Ellis is associated with…
Rational Emotive (Behavior) Therapy (REBT), the first CBT approach
REBT
-first CBT approach born out of Ellis’s dissatisfaction w/ psychoanalysis
-direct, straightforward, confrontative
-confronts client’s irrational beliefs, which are believed to be the root of emotional disturbances
-A-B-C model like CPT -> DEF (Disputing intervention, Effective philosophy adopted, [new] Feelings)
-uses direct instruction, persuasion, logical disputing of irrational beliefs, modeling, HW, relaxation, rehearsal
-transdiagnostic
Beck’s cognitive therapy
-says that sxs arise from maladaptive AUTOMATIC THOUGHTS
-emphasis on empirical hypothesis testing to change beliefs, as opposed to Ellis’s more confrontative approach (REBT)
-uses Socratic questioning, HW, bx assignments, daily logs, activity scheduling
-Goal: ID and test out negative beliefs, develop alternative and more flexible schemas –> rehearse new, more adaptive thoughts and bxs
-Beck coined the term “logical errors”
-more collaborative than REBT
maladaptive cognitive triad of depression
by Beck:
1) negative view of the self - self as defective, inadequate
2) negative view of the wold
3) negative view of the future - hopelessness
Meichenbaum is associated with…
Cognitive Behavior Modification (CBM)
-type of CBT; focus on “self-statements,” collaboration, Socratic Qs
1) self-instruction therapy
2) stress inoculation training
Self-Instruction Therapy
-by Meichenbaum, form of bx modification (CBT-based)
-combines modeling and graduated practice to help ppl who have difficulty with task completion (esp. for ADHD)
-5 steps: therapist models, therapist verbalizes, pt verbalizes, pt silently talks thru task, independent task performance
protocol analysis
person learning a task describes the steps they are taking to solve it aloud; shows their problem-solving strategy
Stress Inoculation Training (SIT)
-by Meichenbaum, form of bx modification (CBT-based)
-based on idea that bolstering a person’s repertoire of coping responses to milder stressors decreases susceptibility to other stressors
phases:
1. education and cog. preparation
2. coping skills acquisition - relaxation, self-statements, imagery
3. application of skills (imaginal and in vivo) - on a graduated basis, focus on relapse prevention
-empirical support for tx of PTSD (also used for anxiety, stress, anger probs, medical probs)
Rehm is associated with…
Self-control model of depression: integrative CBT view of depression
says depression is caused by:
1. negative self-evaluation
2. lack of self-RF
3. high rates of self-punishment
Marlatt is associated with…
relapse prevention approach to SUD (CBT-based)
-views addiction as an over-learned habit; normalizing relapse, expecting it
-relapse to be seen as a setback to learn from, rather than recovery being all-or-nothing
-work on IDing triggers; most common being negative emotional states
-developing new skills for dealing w/ triggers
key dialectic of DBT
acceptance on the one hand and change on the other
Freud’s view of human nature…
-deterministic (inevitable)
-bx determined by irrational forces, unconscious motivations, biological and instinctual drives, and psychosexual events of the first 6 yrs of life
life instinct vs. death instinct
life = libido
death = aggression
per Freud, these rule the id
reality principle
awareness of the real world and consequences of bx
driver of the ego, per Freud
primary vs. secondary process (per Freud)
-2 kinds of mental fx
-primary: dreams, hallucinations; urgent attempt to reduce tension, even at the expense of reality
-secondary: thinking and speaking, focus on meeting demands of reality, ability to delay gratification
ego defense mechanisms
-used by the ego to control the anxiety caused by urges of the id
-meant to prevent the id’s unacceptable impulses from entering consciousness
-the major one is REPRESSION (aka motivated forgetting)
alloplastic reactions
blaming or trying to change the external environment in response to stress
-seen in BPD, narcissistic PD
autoplastic reactions
blaming or trying to change oneself in response to stress
-seen in MDD, anxiety dx
displacement
defense mechanism; transferring emotion from the original object onto some substitute
reaction formation
defense mechanism; engaging in bx that is the opposite of the id’s real urges
sublimation
defense mechanism; finding a socially acceptable way of discharging energy from forbidden unconscious desires
ego psychology
-extension of psychoanalysis; focus on the ego’s capacity for integration and adaptation
-rather than the ego being beholden to the id, it’s seen as guiding a person’s capacity to master life
-major players: Hartmann, Anna Freud, Erikson
Heinz Hartmann
-ego psychologist
-said ego did not arise out of the id, but develops in parallel; therefore, ppl are driven not only by their passions, but by their thinking
-distinguished b/w defensive ego fx and ego autonomous fx
-“conflict-free sphere:” ego fxs that have no conflict w/ the id, incl. memory, perception, learning, locomotion
Anna Freud
-ego psychologist
-emphasis on the ego’s capacity for mastery (it reconciles id drives w/ the demands of reality all the time)
-worked w/ children; interpreted their words rather than their play
-believed in developing a positive bond w/ child clients, rather than being a blank slate
Erikson
-ego psychologist + psychosocial life span theory
-believed development occurs in response to social crises; the ego matures w/ resolution of these sequences
-describes human bx as interaction b/w internal world of the psyche (id, ego, superego) and the external social world
Object-Relations Theory
-psychodynamic; deals w/ the capacity to have mutually satisfying relationships
-“object” refers to relationship of the infant to another person
-believe a child is “object-related” from birth, meaning the there is an inherent drive for relationships (the baby doesn’t JUST show interest in mom for food, like Freud thought)
-therapy seen as an opp to experience different object relations from those experienced as a child
-focus on integrating “split off” parts of the self -> OBJECT CONSTANCY
-help the client differentiate a clear sense of self and form balanced attitudes toward others
-therapist is active, NOT a blank slate
Melanie Klein
-object-relations theorist
-described SPLITTING as a major defense mechanism: used when baby has hostile feelings toward a loved object –> “splits” the love object into 2 parts (1 good, 1 bad), prevents object constancy
-saw play as the child’s free association; conducted child therapy similar to adult psychoanalysis
D.W. Winnicott
-object-relations theorist
-described importance of being a “good enough mother”
-pathology results from adopting a false self to please others
-importance of the “transitional object”
Margaret Mahler
-object-relations theorist
-described 6 stages of development
-SEPARATION: becoming a discrete physical entity by physically distancing
-INDIVIDUATION: becoming a psychologically independent person through maturation of ego fx
Kohut is known for…
-self psychology & theory on the development of narcissism
-“primary narcissism:” healthy narcissism when baby is focused on getting own needs met; w/ appro caretaking, baby will develop a healthy self w/ appro narcissism
Self Psychology
-e.g., Kohut
-focus on empathic attunement
-prefer “experience near” interpretations rather than “experience distant” ones (like in classical psychoanalysis)
-theory of healthy narcissism
Neo-Freudians
-focus on impact of social and cultural factors on personality
-psych. disturbance results from faulty learning, maladaptive style of interacting w/ the environment
-psychotherapy is interpersonal; therapist helps client examine difficulties in relating to ppl, correct misperceptions/misinterpretations of others
-e.g., Harry Stack Sullivan, Karen Horney, Erich Fromm
Harry Stack Sullivan
-neo-freudian
-known for INTERPERSONAL THEORY: personality exists only in emotional exchange b/w ppl –> led to IPT for depression
-developmental model:
1. prototaxic (0-7 mos): serial, uncoordinated sensations
2. parataxic (8-11 mos): sequential sensations, temporal causality
3. syntaxic (12-24 mos): causal sensation, logical/analytical thinking, prediction
Interpersonal Therapy (IPT)
-tx for depression; based on Stack Sullivan’s interpersonal theory
-connects client’s presenting problem to interpersonal difficulties; 1 of 4 problem areas targeted (grief, role dispute, role transition, interpersonal deficits)
-time limited, present-focused
Karen Horney
-neo-freudian focused on NEUROSIS
-neurosis is culturally defined; develops in children from feelings of isolation, anxiety, hostility, and helplessness in the face of all-powerful adults
-basic anxiety –> rigid pursuit of safety, familiarity, security
-neurotic trends:
1. moving compliantly toward others
2. moving aggressively against others
3. moving detachedly away from others
Erich Fromm
-neo-freudian
-incorporated concepts from Marx and existentialists
-bx results from sociocultural and economic conditions
-experience of freedom frightens most ppl
-“having” vs. “being” (healthier) modes of living
Individual Psychology
-aka Adlerian psych
-ppl strive for personal competence; are influenced by first 6 yrs of life, but motivated primarily by SOCIAL rather than sexual urges
-happiness/success related to social connectedness
-every child has feelings of inferiority –> either mastery or neurosis (maladaptive effort to compensate for these feelings)
-Adlerians encourage the client; focus on mistaken goals, faulty assumption; focus on present + future (rather than past) –> form more positive attitudes toward self and others, more adaptive patterns of living
-pragmatic, problem-solving
STEP program (systematic training in effective parenting)
-Adlerian intervention applied to parenting
-democratic parenting approach, respects the child’s contribution
-natural and logical consequences for misbx
-misbx reflects 1 mistaken goal (attention, power, revenge, or giving up)
Analytic Psychology
-aka Jungian psych
-psyche includes the conscious ego, the personal unconscious, and the collective unconscious (includes archetypes)
-neurosis represents one’s struggle to free themselves from archetypes in the process of personality integration and fulfillment of potential
-individuation: psychological maturity
-goal is to help client gain awareness of the unconscious –> develop a productive relationship w/ these elements
-more directive than Freud, more of a real therapeutic relationship
teleological
bx seen as determined by the future, rather than the past
Humanist psychologists
-believe ppl move in direction of self-actualization if nurtured
Existentialist psychologists
-believe we have no internal nature, the world lacks meaning –> ppl are faced w/ what to make of this
-e.g., Victor Frankl
commonalities of humanist and existentialist psych…
-emphasize client’s subjective experience
-emphasis on freedom, choice, autonomy, purpose, meaning
-present-focused
-trust client capacity to make positive choices
Rogers
Client/Person-Centered Therapy
Client/Person-Centered Therapy
-Rogers; humanist/existentialist approach
-all ppl have natural capacity for purpose, goal-directed bx; if nurtured, will develop into self-accepting, kind, socialized ppl
-faulty learning –> maladaptive, hateful, self-centered bx
-FOCUS OF THERAPY: correcting faulty learning, allowing for clients to develop liking for themselves
-therapy does not offer direct suggestions or make interpretations; instead, therapist creates an accepting, non-threatening atmosphere for exploration of one’s thoughts and feelings
-therapist allows the client to grow through the empathic relationship, form a more positive view of themselves
-KEY CHARACTERISTICS: warmth, empathy, genuineness
Gestalt Therapy
-by Perls; humanist/existentialist approach
-Gestalt theory: whole > sum of its parts; people structure experiences as integrated wholes
-gestalts = figure (what is attended to) + ground (what is ignored)
-healthy fx results from maintaining flexible, adaptive contact w/ one’s own needs and environment
-FOCUS OF THERAPY: client becoming aware of their whole personality, discovering aspects of the self blocked from awareness
-KEY CHARACTERISTICS: active; focus on awareness, experience, affective expression (rather than cognitive analysis); facilitation of experiencing and self-expression (e.g., empty chair, “becoming” parts of a dream)
Gestalt therapy’s resistances to contact w/ the whole include…
1) introjection - taking info in whole –> gullible, overly compliant
2) projection - results in paranoia
3) retroflection - turning back on oneself what you’d like to do to others –> self-destructive
4) deflection - thru distraction, humor, asking Qs, etc.
5) confluence - lack of differentiating self from others in order to avoid conflict
Reality Therapy
-by Glasser; humanist/existentialist approach, also influenced by REBT
-KEY feature: RESPONSIBILITY - clarifying values, examining current bx/plans related to those values, accepting responsibility
-Choice Theory: we create an inner world that satisfies our needs but doesn’t necessarily reflect reality; ppl have choice in what they do
-help the client assess consequences of possible actions and decide on realistic solutions, goals
-associated w/ use in juvenile delinquent and prison populations
