Treatment-Intervention Flashcards
Reciprocal inhibition
Two incompatible responses can’t be experienced at hte same time, but the stronger response will inhibit the other. Weaken maladaptive conditioned response (fear of whales) by strengthening incompatible response (relaxation).
Ex: Fear will inhibit pleasure.
Systematic desensitization
Effective for PHOBIAS.
master relaxation –> anxiety hierarchy –> gradually expose from lowest to highest.
Assertiveness training
Practicing assertive responses, initially by role-playing, then to real-life situations. Gradual reductions in social anxiety.
Aversive conditioning
Pairing a bad behavior with something negative.
Flooding
Presenting the conditioned/feared stimulus w/o the unconditioned stimulus.
EX: Presenting a spider without a mother screaming; presenting a dog without getting bit.
Primary vs Secondary reinforcers
Primary: Reinforce everyone at all ages and cultures (food)
Secondary: Acquire their reinforcing value through training/experience (praise)
Shaping
Person reinforced every step taken toward achieving the target behavior.
Premack Principle
Using a high frequency behavior (something someone does without any coercion) to reinforce low frequency behavior (something a person doesn’t do often unless forced).
Grandma principle
Desert after broccoli.
Positive Punishment
Introducing an aversive stimulus after an undesirable behavior occurs. Rarely used in clincal work. Doesn’t really work.
Escape learning
Aversive stimuli emits but goes away when the desired behavior happens.
Shocking a mouse until it presses the lever.
Avoidance learning
Avoding the aversive stimuli by emitting the desired behavior in time.
Social learning theory
Modeling adaptive behaviors to replace maladaptive ones.
Symbolic modeling
Observing a film in which a model enjoys progressively more intimate interaction with a feared object or anxiety-producing setting.
In-vivo modeling
Having the person observe a live model engage in graduated interactions with a feared object/situation
Participant modeling
Live modeling plus contact with a model; model gradually guides the person in activities.
Rational emotive behavior therapy (REBT)
first CBT approach. Approaches problems by convincing clients of their irrationality.
Beck’s CT
Similar to REBT, but different because it emphasizes collaborative empirical hypothesis testing to change beliefs.
Beck believed that cognitive distortions are gradually made.
Cognitive Behavior Modification
Self-instructional training and stress inoculation training.
Self-instruction therapy
Combines modeling and graduated practice with elements of REBT to help people with task completion.
involves: repetition, graded practice, and cognitive restructuring.
Stress inoculation training (SIT)
Guidelines for treating stressed individuals and PTSD. Main idea is bolstering a client’s set of coping skills to milder stressors.
Rehm self-control model of depression
Posits that reinforcement can be self-generated rather than derived from external sources; views depression as a result of negative self-evaluations, lack of self-reinforcement, and high rates of self-punishments.
Marlatt’s Relapse Prevention
View’s addiction as a learned behavior, and attempts to minimize effects of relapses by teaching recovering addicts to view relapses as inevitable experiences. Removes the idea of relapse === failure.
Includes identifying triggers and developing skills to deal with triggers.
DBT
For BPD. Acceptance on the one hand and change on the other. Behavioral mostly.
Classic Psychoanalysis
Freud posited that behavior is determined by irrational forces, conscious motivations, biological and instinctual drives, and psychosexual events. YIKES.
Id
Primitive part of the psyche. Ruled by instincts and basic biological drives (libido and aggression). Pleasure principle. Present at birth.
Ego
Operates on reality principle (awareness of real world/consequences of behavior) and is able to defer immediate gratification in order to obtain greater long-term gratification.
Superego
Conscience, moral code, and internalized parental/social standards. It forces the ego to satisfy the id in a manner that is moral and ethical. “The weapon of the superego is guilt”.
Primary process
Dreams and hallucinations.
Secondary mental process
Thinking and speaking.
Psychoanalysis - anxiety and defense mechanisms
Neurotic anxiety results when the unacceptable urges of the id become too strong to be controlled by the ego.
Defense mechanisms prevent the id’s forbidden impulses from entering.
Psychoanalysis - repression
Most basic and commonly used one, underlies all defenses. Involves forcing disturbing impulses out of consciousness.
Psychoanalysis - regression
Guarding against anxiety by retreating to behaviors of an earlier, less demanding and safer stage of development.
BPD
Psychoanalysis - projection
Seeing one’s unconscious urges in another person’s behavior; results in suspicion and paranoia.
Psychoanalysis - displacement
Involves transference of emotions from the original object to some substitute. Phobias.
EX: fear of sex displaces fear onto snakes, develops snake phobia.
Psychoanalysis - reaction formation
Engaging in behaviors that are the exact opposite of id’s true urges.
Psychoanalysis - intellectualization
Distancing self from feelings.
Schizoid
Psychoanalysis -rationalization
Coming up with satisfying, yet incorrect reasons for one’s behavior.
Narcissistic
Psychoanalysis - sublimation
Finding socially acceptable ways of discharging energy from unconscious forbidden drives.
Alloplastic reactions
Trying to change the external environment or blaming the external environment.
Used by people with personality disorders.
Autoplastic reactions
Trying to change oneself or blaming oneself.
Used by neurotic ppl.
Psychoanalysis - treatment/techniques
Making the unconscious conscious, specifically bringing to light conflicts between id’s impulses and effort of the ego.
Free association is used as is analysis of dreams. Interpretation of transference and countertransference.
Heinz Hartmann
Ego did not arise out of the id, but in parallel with it; humans are driven by their thoughts and impulses in concert.
Anna Freud
Ego is a medium through which we get a fuller picture of the id and superego. Capacities for integration and adaptation and what is interfering with these processes.
Erik Erikson
Premise is that the ego matures in epigenetic sequences, in which development occurs in a series of stages built on mastery of prior stages.
Object-Relations Theory
We are born with an inherent drive for satisfying object relationships that are as fundamental to humans as the need for food.
Kohut Self Psychology
Kohut suggested that narcissism guides development. Suggested that primary narcissism is healthy and helps get needs met.
Neo-Freudians
Focused on impact of social/cultural factors in determining prsonality. Believed psychological disturbance results from faulty learning, and involves a maladaptive style of interacting with environment.
Neo-Freudian clinicians help client examine difficulties in relating to people. Treatment is used to facilitate the process of indeitfying and correcting clients’ tendencies to misperceive or misinterpret the behavior of others.
Sullivan Interpersonal Theory of Personality
Personality exists ony in an emotional exchange between people; a person doesn’t possess a personality as much as reflect one in responding to the perception of others.
Karen Horney theory of neurosis
Neurosis is a culturally defined construct, indicating a deviation from societal behavioral norms.
Fromm’s behavioral approach
Man’s behavior stems from sociocultural and economic conditions.
Adlerian psychology
each person strives for superiority or personal competence. Feelings of inferiority either motivate or cause further neurosis.
Maladaptive behavior results from people’s attempts to make up for perceived or real disabilities.
Jungian psychology
The psyche includes the ego, the personal unconscious, and collective unconscious.
Collective Unconscious
Impersonal/transpersonal. Within are archetypes, which are primordial images and images that have been inherited, and that are common to all members of hte race from the beginning of life.
Humanist psychology
Emphasize client’s subjective experience. When nurtured, people move towards actualization.
Rogers: Client-centered therapy
Rests on premise that all ppl have inborn capacities for purposive, goal-directed behavior, and, if free of adverse conditions, will develop into self-accepting, kind, socialized people.
Therapist creates accepting, non-threatening atmosphere for client to reconsider their ways of thinking/acting.
Three characteristics of client centered therapy
Empathy, warmth, genuineness.
Gestalt Therapy
People structure experiences as whole, integrated organisms, not in fragments. Focus of therapy is becoming aware of the whole personality by discovering those aspects of the self that are blocked from awareness.
Introjection results in unexamined values/beliefs
Model of Behavior Change (PCPAM)
People progress through a series of stages in making changes in their behavior.
- Precontemplation: Don’t believe I have a problem.
- Contemplation: Begin to acknowledge having a problem and may increase awareness and knowledge related to the problem.
- Preparation: Developed a commitment to change and begin to construct a detailed plan for change.
- Action: Behavior change is initiated.
- Maintenance: Steps taken toward preventing relapse.
Big 5 model of personality
OCEAN.
Family therapies - General Systems Theory
System is an interaction of component parts, which seeks to attain homeostasis.
Family therapies - Psychodynamic
Focus is on facilitating individual maturation in the context of the family system, and on freeing family members from unconscious patterns of anxiety. Clarify communication and admit feelings.
Object-relations family therapy
Family problems are caused when member unconsciously project unwanted elements of themselves onto other members of the family. Therapy focuses on helping each family member become aware of what is being projected, and then to address these unwanted elements.
Gaol: Reorganize the family’s structure in such a way that dysfunctional elements are removed.
Communications family therapy
Addresses communication problems by implementing direct and indirect techniques.
Direct: Teaching, pointing out problematic communication.
Indirect: Paradoxical interventions, like prescribing the symptom. EX: fight 3 hrs per day.
Primary prevention
Preventing disease before it ever occurs
Secondary prevention
Reduce impact of the disease that has already occurred
Tertiary prevention
Soften the impact of an ongoing issue.
Parallel processes
When the client is acting one way and the provider acts a similar way. E.g., a patient not responding to Tx and then wanting to refer the pt out.
Feminist Psychotherapy
Centered on social structures and gender. Goal is to understand the individual within the larger social/political aspects of a society. Includes self-disclosure more frequently.
Solution-focused family therapy emphasizes:
The miracle question, the exception question, and the scaling question.
According to psychoanalytic theory, mania:
Is a defense against depression.
In kirkpatrick’s training evaluation model there are 4 levels of evaluation, including:
Reaction of student, behavior, and results.
Elavil (amitryptyline)
Can cause difficulties with concentration, attention, and memory.
If projection is the most frequently exhibited defense mechanism, what else may they exhibit
Paranoia
MAO requires you to avoid the following foods:
Chianti, fava beans, smoked meats.
According to Nancy Boyd-Franklin, working with african american families should:
Consider meetings outside of traditional office setting to include members of clients’ support systems
Psychoanalytic perspective on borderline adolescents focuses most on;
Abandonment rage
DRO
Entails delivering reinforcement whenever the problem behavior does not occur during a predetermined amount of time.
What is the most effective ingredient for group therapy?
Cohesiveness
Systemic family therapy
Involves circular questions to clarify members’ attributions of presenting problems.
Treatment options for enuresis
Bell and pad approach or tricyclic antidepressants.
Bell and pad is preferred because there is a higher rate of relapse associated with tricyclics.
In family therapy, if 2 family members are talking about another one negatively, what is that called?
A coalition
Yalom Group Stages
Stage 1. Forming; the orientation phase. The leader is most active in this stage. Universal norms are discussed such as confidentiality, attendance, and rules of communication and participation are addressed.
Stage 2. Storming; the transition phase. Anxiety, ambiguity, and conflict become prevalent as group members test and act-out behaviors to define themselves and the group norms. This stage creates an interpersonal climate where members should feel free to disagree with each other.
Stage 3. Norming; the cohesiveness phase. Members develop group-specific standards (cohesiveness) and a therapeutic alliance forms
Stage 4. Working; the performing phase. During this stage, individual growth and team productivity and effectiveness occur.
Stage 5. Adjourning; the termination phase. The closure for the group as a whole or the individual that left. T
The underlying principle hypothesized to be at work in the clinical intervention of flooding is that:
the subject is repeatedly exposed to the stimulus that elicits the problematic response while at the same time the subject is not permitted to emit the problematic response, thus leading to extinction.
Recent research on the effectiveness of antidepressant medications (ADMs) and cognitive therapy (CT) in the treatment of moderate to severe major depressive disorder has found all of the following except:
patients that received antidepressant medications and those that received cognitive therapy had comparable rates of change of both cognitive and vegetative symptoms of depression.
Which age group has the lowest rates of utilization of MH services.
Older adults (65+)
Treating child phobia
Follow live/symbolic modeling with guided participation
Overcorrection includes
Physical guidance and reparation
Prozac can be used to treat
Obsessions in OCD, eating disorders, depression.
Defense mechanism that is thought to underlie all others
Repression
Transference (Jung)
When the personal and collective unconscious is projected outward
Antisocial individuals are most influenced by what?
MONEY
According to Gestalt therapists, what are dreams reflections of?
Aspects of the client
