Treatment & Intervention Flashcards
Two techniques in classical conditioning
Counterconditioning & classical extinction
What do behaviourists believe psychopathology comes from?
problematic learned patterns
What approach is the term reciprocal inhibition from?
Counterconditioning in classical conditioning
What is covert sensitization
it’s aversive counterconditioning in imagination
Aversive counterconditioning is used for what?
eliminating “bad behaviours” like drinking, smoking & fetishes
What happens to the conditioned stimulus in aversive counterconditioning?
The conditioned stimulus is paired with a new & stronger stimulus (like antabuse with alcohol)
What’s the downfall of aversive conditioning?
it is not effective in the long-run/high rates of relapse/recidivism
What was systematic desensitization designed for and who designed it?
specific phobias & it was designed by Wolpe
What does systematic desensitization involve?
Training clients to relax deeply & using anxiety hierarchies to expose them gradually using either in-vivo or imagination
What recent research has found that’s more effective than systematic desensitization?
Prolonged & flooding is most efficacious, while systematic desensitization is second most effective
What category of interventions does sensate focus come from & who was it developed by?
Counterconditioning & Masters and Johnson
What are the 4 stages of Master & Johnson’s sexual response cycle?
- Excitement
- Plateau
- Orgasm
- Resolution
What category of interventions does Assertiveness Training come from, and what is it used for?
Counterconditioning & social anxiety
What’s the treatment involved with Assertiveness Training?
practicing assertive responses antagonist to social anxiety
What is classical conditioning in relation to the conditioned stimulus/unconditioned stimulus, and how does it affect the UR (e.g., spider phobia)
Presenting the conditioned stimulus without the unconditioned stimulus with the goal of exposure making conditioned stimulus not elicit the conditioned response
E.g., spider (CS) elicits screaming from someone (US), so person is exposed to the spider while preventing them from running away until they no longer are screaming (US) or running away (UR)
What is implosive therapy by Stampl
Imaginal exposure while the therapist interprets possible psychosexual themes (did not add to treatment effectiveness)
What type of treatment approach involves a functional assessment & what is a functional assessment?
- Operant conditioning
- Defining target behaviour, determining antecedents & consequences & contingencies (reinforcers & punishments)
3 types of reinforcers & what do they mean?
- Primary: reinforcers that reinforce everyone (food)
- Secondary: training or experience help acquire their reinforcing value (praise)
- Generalized Conditioned: they give access to other reinforcers (money or tokens)
Shaping (reinforcement intervention strategy)
reinforced every step taken toward the target behaviour
Token Economies (reinforcement intervention strategy)
When tokens (a generalized conditioned reinforcer) are used in a system like jail, they are given for appropriate behaviours and can be exchanged for reinforcers like goods or privileges; on the other hand, tokens can be taken away for undesirable behaviours.
Contingency Contracting (reinforcement intervention strategy)
Negotiating a contract when there’s problematic interactions between people to identify the behaviours they want from one another
Premack Principle with example (reinforcement intervention strategy)
using a high-frequency behaviour to reinforce a low-frequency behaviour (e.g., eat peas before playing)
Differential Reinforcement of Other Behaviours or DRO or DRA or DRI (reinforcement intervention strategy)
combining operant extinction (stop reinforcement) with positive reinforcement (e.g., ignored if speaking without raising hand (extinction) & reinforced for desirable behaviours like raising hanf or waiting turn (positive reinforcement)
Self-reinforcement (reinforcement intervention strategy)
administering reinforcement to oneself - eating a candy after reading a textbook chapter or page
Positive punishment (Aversive control of behaviour - operant conditioning) & example of it’s use with an elastic band
applying aversive stimulus after an undesirable behaviour
e.g., thought stopping - hitting arm with an elastic band with undesirable thought
Difference between escape learning & avoidance learning (Aversive control of behaviour - operant conditioning)
Escape learning: stopping the aversive stimulus while it’s happening through a desirable behaviour (lady giving wallet when at gunpoint)
Avoidance learning: engaging in a desirable behaviour to fully avoid an aversive stimulus before it happens (paying credit card on time before late penalty)
Overcorrection (Aversive control of behaviour - operant conditioning)
involves reparation from what they’ve done with the addition of repairs beyond the initial thing they’ve needed to repair & may include with physical guidance (e.g., kid cleaning up the living room they messed up plus also cleaning a bathroom)
Three approaches based on Social Learning Theory
- Symbolic modelling: watching a film of a model engaging/enjoying interactions with a feared object or anxiety-producing setting
- Live or in-vivo modelling: showing it live through a model
- Participant modelling: live modelling plus contact with/guidance from the model (best for kids with phobias)
Kohler’s studies contributed to what aspect of cognitive-behaviourism?
found that chimps have insight/”aha” moments where their cognitive processes influence their behaviours to solve problems
Ellis’ ABC-DEF model
A- activating event
B - belief
C - consequence
D - disputing intervention
E - effective philosophy/belief
F - new feelings
Two terms for Ellis’ therapy
REBT (rational emotive behaviour therapy) or RET (rational-emotive therapy)
What did Ellis’ therapy involve, and how was it approached?
Convincing clients they are being irrational & using argumentative/confrontational approaches
Who/what therapy uses empirical hypothesis testing
Beck’s cognitive therapy
Beck’s cognitive therapy approach involves what two key elements?
- Testing the validity of beliefs
- Socratic questioning
Beck’s maladaptive cognitive triad of depression
- Negative view of self
- Negative view of world
- Negative view of future
What’s Meichenbaum’s approach called?
Cognitive behavioural modification (CBM)
Meichenbaum’s two treatment approaches are as follows: What are they for & what are they effective for?
- Self-instruction therapy - helping clients master problem-solving independently (effective for kids with ADHD)
- Stress-inoculation training - mastering stress gradually by helping coping with milder stressors to decrease susceptibility to more severe stress (effective for PTSD)
Relapse prevention is associated with what treatment approach from Meichenbaum’s cognitive behavioural modification?
Meichenbaum’s stress inoculation training
How Rehm’s Self-Control Model of Depression understands what 3 things contribute to depression
He understands depression as a combination of negative self-evaluations, lack of self-reinforcement & high rates of self-punishment
Marlatt’s relapse prevention - how it understands addiction & relapse
understands addiction as an overlearned habit and that relapse is unavoidable
Marlatt’s relapse prevention - what does it understand as the most common relapse trigger?
A client’s internal state/negative emotional state
Freud’s 3 parts of personality (no definitions)
- Id
- Ego
- Superego
The ID (Freud):
- what it’s ruled by
- principle
- perception of gratification/long-term consequences
- two instincts within it
Ruled by instincts & biological drives
Pleasure principle
Doesn’t think of the long-term consequences
1. Libido is the life instinct/Eros
2. Aggression is the death instinct/Thanatos
The Ego (Freud):
- principle
- perception of gratification/long-term gratification
- it’s main task
- Reality principle
- Defers immediate gratification to obtain greater long-term gratification
- It’s main task is to suspend/control Id impulses
Superego (Freud):
- what it involves
- what is its weapon?
- evolves as the child passes through which stage?
- moral codes/internalized parental & societal standards
- guilt
- Oedipal stage
Alloplastic defence & connected to what disorders?
reacts to stress by trying to change or blame the environment (borderline or narcissistic)
Autoplastic defence & connected to what disorders
reacts to stress by trying to change oneself or blaming oneself (depression or anxiety)
3 Ego Psychologists
- Hartmann: ego & id co-develop in parallel
- Anna Freud: ego is a medium for id & superego - interpretation of kids’ words instead of play & strong positive bond development
- Erikson: epigenetic sequences where development happens in stages
What’s Hartmann’s term that’s opposite of defensive ego functions?
“ego autonomous functions,” which is a conflict-free sphere for functions developing outside of conflict like perception, learning, memory & locomotion
What is object constancy of Object Relations Theory/Therapy?
The experience of the other in an integrated way, the good & the bad together - the opposite of this is splitting (borderline’s do this in how they see therapists - good one week & bad the other week)
Major object relations theorists
Klein, Winnicott & Mahler
What did Klein see as a major defense mechanism?
Splitting - seeing something as only good or only bad (which prevents object constancy: seeing the breast as an object with both good & bad capacities)
How did Klein understand children’s play?
She saw it as the child’s free association
Winnicott’s understanding of what results in pathology?
Abandoning one’s true self & adopting a false sense
Mahler’s theory describes what two processes?
The processes of separation (physically separating themselves from their mom) & individuation (psychologically independent people, which involves maturation)
Kohut’s primary narcissism
It’s a healthy kind of narcissism that happens when a baby naturally focuses on getting its own needs met
Kohut’s term of “selfobject” needs include
Mirroring (approval/admiration of the baby), idealizing (presence of adults worth idealization) and twinship (ability to imitate adults)
The key difference between neo-Freudians and Freudians/classical psychoanalysts
Neo-Freudians focus on social & cultural factors in determining personality instead of internally driven impulses
Major neo-Freudians include:
Sullivan, Horney & Fromm
Sullivan’s 3 modes of existence
- Prototaxic - when things are in a series of sensory experiences & nothing seems related
- Parataxic-temporal sequence serves as the only conception of causality (saw transference in therapy as parataxic distortion)
- Syntaxic - logical & analytical thinking/ability to predict causes from knowledge of their effects
Sullivan’s developed therapy
Interpersonal Therapy (IPT)
Therapy that focuses on the here-and-now, on current interpersonal relationships & targets problem areas of grief, role dispute, role transition & interpersonal deficits
Interpersonal Therapy
Alfred Adler’s 3 key ideas
- strive for superiority or competence
- people are motivated by social urges & needs instead of sexual needs
- happiness is our capacity to connect socially
Adler’s belief about experiences with family & birth order
Experiences with family & birth order have a significant impact on our lifestyles
Adler’s work has significant applications in what settings?
- Education
- Parenting
Yung’s collective unconscious - what’s within the collective unconscious?
Archetypes
Types of archetypes in Yung’s idea of the collective unconscious
- the persona (social mask)
- the shadow (one’s hidden aspects)
- the anima (female aspect)
- the animus (male aspect)
The goal of Jungian therapist is:
Help client’s gain awareness of the unconscious, focusing on dreams, myths and folklore, to liberate growth-promoting forces within the personality
How Jungians see transference
as a projection of the personal and/or collective unconscious
Humanist vs existentialist psychologists
Humananist: people move in self-actualization if nurtured
Existentialist: we have no internal nature, the world lacks intrinsic meaning & people are faced with what to make of this meaninglessness
Roger’s 3 key characteristics of treatment
Empathy, warmth & genuineness
Introjection (boundary disturbance)
People taking information as whole, without critically examining it which results in over-compliance or being gullible (car salesman’s dream)
Projection (boundary disturbance)
When people project their feelings onto others which can result in paranoia
Retroflection (boundary disturbance)
Process in which people turn back onto the self, what they would like to do to others (can result in self-destructive behaviour)
Deflection (boundary disturbance)
Process in which people distance themselves from their feelings through distraction, humour, generalization and asking questions rather than statements
Confluence (boundary disturbance)
involves a lack of self-awareness of differentiation between the self and others in an attempt to avoid conflicts
Glasser’s therapy
Reality therapy
Key concept of reality therapy
Responsibility
The aim of Berne’s Transactional Analysis
to understand the intent behind communication
Big 5 or five factor model of personality by Costa & McCrae
- Openness to experience
- Conscientiousness
- Extraversion
- Agreeableness
- Neurotocism
What two theoretical models have influenced family therapy?
General systems theory and Cybernetics (negative & positive feedback loops)
Negative feedback loop
decreases deviation/change - keeps it the same/homeostatic
Positive feedback loop
increases deviation/change within a system
Psychodynamic family therapy: Marital Schism vs Marital Skew
Schism: chronic/severe discord with threats of separation are common
Skew: The relationship is skewed to meeting the needs of one member at the expense of the needs of other members
The 2 main concepts in object relations family therapy
transferences & projections
Minunchin’s family therapy
Structural Family Therapy
minUnchin & strUctural
Structural family therapy’s beliefs on what results in relationships from too rigid boundaries vs diffuse/loose boundaries
rigid boundaries = disengaged or emotionally distant relationships
diffuse boundaries = enmeshed relationships
Minunchin’s 3 chronic boundary problems & what are they?
- Triangulation: child is caught in the middle of the parents’ conflict
- Detouring: the child becomes the source of the family’s problem & parents express their distress through one child
- Stable Coalition: one parent uniting with the child against the other parent
What’s a paradoxical intervention in communications family therapy?
It’s when a therapist, for example, tells a couple who fights at least one hour a day to now try and fight for 3+ hours a day
What’s Haley’s family therapy called & what’s it a combination of?
hAley = strAtegic family therapy
combination of Minunchin’s structural approach & family communication/interactions
Milan group is what type of family therapy?
Systemic Family Therapy
What’s Milan’s circular questioning?
a technique to gather information & to give the family information about themselves
What’s the purpose of Milan’s prescription of rituals?
The purpose is to alter the family’s direction from its current course
What’s the essential goal of Bowen’s family systems therapy
personal differentiation from the family of origin
What’s pathology look like in a family according to Bowen’s family systems therapy? & what’s multi-generational transmission process
- when the family is one single undifferentiated unit
- when the pathology gets transmitted across generations
What’s Bowen’s term “emotional triangle” mean?
It means two members’ closeness ends up excluding a third member
What family therapy does the genogram?
Bowen’s family system therapy
What therapy includes the exception/scaling questions & the miracle question?
Solution-focused therapy
Which family therapy are the names Liberman, Patterson and Alexander, associated with?
Behavioural family therapy model
What’s the most important component of successful group therapy?
Cohesiveness
Yalom’s three stages of process groups (group therapy) & what happens in each stage
initial stage: everyone is friendly to each other
2nd stage: conflict among group members
3rd stage: where there’s closeness, intimacy & cohesion with group members
People who do poorly in group therapy
psychotic, anti-social, significant brain damage or anyone actively using drugs or alcohol
People who drop out more of group therapy
lower SES, lower IQ, lower likability, significant denial, lower motivation & severe pathology
What’s the honour system in group therapy?
How confidentiality is enforced
The difference between crisis intervention vs short term therapy?
crisis intervention: get them back to their pre-crisis functioning
short-term: helping people attain a higher level of functioning
What is the difference between case consultation & administrative consultation?
Case = clinically oriented
Administrative = administrative issues or programmatic changes
What’s the difference between client-centered vs consultee-centered consultation
client-centered: one case or one client
consultee-centrered: group of clients
Primary vs secondary vs tertiary prevention
primary: preventing the onset from occurring (vaccinations)
secondary: catch the problem (that’s already happened) early so you can get rid of it (HIV testing)
tertiary: reducing the residual effects of a chronic, well-established disorder (day treatment program for schizophrenics)
What’s the most common precursor to violence in a relationship
emotional/verbal abuse & controlling behaviours
What two elements create change in the perpetrator of abuse?
- when the victim refuses to tolerate the situation further
- following the arrest of the perpetrator
Instrumental vs expressive abuse?
Instrumental: using violence as a means of control
Expressive: less deliberate & comes from difficulty managing emotions
Children’s responses to divorce at
- 3-6 y.o
- 7-12 y.o
- adolescents
- 3-6 y.o: feel responsible
- 7-12 y.o: decreases in school performance
- adolescents: could have prevented the divorce but they also feel hurt and critical of their parents
What’s the average effect size/number in comparing treated & untreated individuals?
average effect size of 0.85
Difference between efficacy research vs effectiveness research
Efficacy research: volunteers are easily diagnosed/uncomplicated & treatment is effective even if it fails to help 30% of the people
Effectiveness research: look at overall effectiveness of a variety of approaches like the consumer reports study
Total quality management (TQM)
improving the quality of the organization
Quality assurance
monitoring & evaluating the availability, adequacy and appropriateness of a health care services plan
Utilization review
conserving costs & resources
Risk management
reducing the risks for inappropriate practices & limiting the potential for liability or malpractice
Avoidance vs escape paradigm
avoidance: you can avoid punishment altogether
escape: punishment will happen, but you can get it to stop
The fundamental rule of psychoanalysis is…
free association
Formative evaluation
when you evaluate the program periodically during the program and make modifications
Summative evaluations
wait until after the program and then you evaluate it’s effectiveness
Ipsative evaluation
A form of measurement that compares your scores in different categories relative to yourself
Behavioural criterion
specific measurable outcome criterion = set up a certain criterion - reducing head banging to 50%
What’s introjection
taking things as whole without questions which causes naivité
One of the primary uses of treatment manuals is:
to compare outcomes of different types of therapies
Getting a client to accept responsibility is from what therapy?
reality therapy
The use of circular questioning is used in
Milan’s group - systemic family therapy
Freud’s defense mechanism of repression
forcing disturbing impulses out of consciousness
Freud’s defense mechanism of regresssion
guarding against anxiety by retreating to younger age behaviours
Freud’s defense mechanism of projection & what’s the outcome of it?
Seeing one’s unconscious urges in another person’s behaviour. The outcome is suspicion & paranoia
Freud’s defense mechanism of displacement
transference of emotions from original object to something else like afraid of sex (penis) turns into a snake phobia
Freud’s defense mechanism of reaction formation
engaging in behaviours that are the exact opposite of the id’s real urges like a mother who has aggressive feelings becomes an overprotective & adoring mother
Freud’s defense mechanism of intellectualization
distancing oneself from their feelings
Freud’s defense mechanism of rationalization
coming up with self-satisfying yet incorrect reasons for one’s behaviour
Freud’s defense mechanism of sublimation
finding acceptable ways of discharging energy from unconscious forbidden desires like someone with a desire to smear feces becoming a painter
Howard’s meta study found that __% of patients improved after the 8th session and ___% of patients improved at the end of 6 months
50%
75%
Does psychological debriefing help the likelihood of PTSD?
It has NOT been shown to decrease the likelihood of PTSD
Emic vs Etic (Maslow)
Emic: culture-specific approach
Etic: non-culture specific that looks for universal principles (Maslow)
Which therapy is most likely to use guided imagery?
Cognitive behavioural therapy
What’s most essential to Beck’s cognitive behavioural therapy? Is it
a. Hypothesis testing
b. modifying behavioural contingencies
c. collaborative empiricism
d. the ABC model
Collaborative empiricism
Lewinsohn conceptualized depression as the result of
low rates of behaviour
