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MFT Clinical Review > Treatment Planning > Flashcards

Treatment Planning Flashcards

1
Q

Theory: Psychodynamic:

Assumptions

A
  • Humans have a powerful unconscious mind
  • Behavior is mostly driven unconsciously
  • Awareness will bring change
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2
Q

Theory: Psychodynamic:

Defining the Problem

A
  • Unresolved childhood conflict

- Typically unconscious

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3
Q

Theory: Psychodynamic:

Goals of Therapy

A
  • Resolve childhood conflict

- Bring unconscious material into conscious awareness (make the unconscious conscious)

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4
Q

Theory: Psychodynamic:

Interventions

A
  • Explore - open ended questions
  • Also free association techniques
  • Offering insight - therapist observations - used sparingly
  • Interpretation - applying meaning to behavior, dreams, decisions, or anything else
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5
Q

Theory: Psychodynamic:

Role of Therapist

A
  • Expert

- Blank slate - so that a client can project unconscious material onto you

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6
Q

Theory: Psychodynamic:

Key Concepts

A
  • Id, Ego, Superego
  • Superego keeps the Id in check
  • Ego is the mediator
  • Defense mechanisms
  • Transference
  • Countertransference
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7
Q

Theory: Psychodynamic:

Defense Mechanisms

A
  • Repression - removing troubling thoughts or memories from conscious awareness
  • Denial - blocking immediate events from entering conscious awareness
  • Projection - attributing your own traits, thoughts, or feelings to someone else
  • Regression - in times of stress, falling back to earlier behavior patterns
  • Displacement - acting out against a safer target
  • Rationalization - distorting facts to make them less threatening (ex. I had no choice)
  • Reaction formation - behaving in direct opposition to one’s true (and threatening) beliefs
  • Sublimation - generally considered the healthiest defense mechanism, this involves satisfying an urge or drive in a socially acceptable way
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8
Q

Specific models: Psychoanalytic:

Attachment Theory

A

-A model for understanding childhood behavior

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9
Q

Attachment Theory:

Key concepts

A
  • Early childhood bonding events set attachment style
  • Caregiver responses set child’s interval working models of thought, emotion, social behavior
  • A good amount of childhood behavior is designed to maintain proximity to attachment figure
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10
Q

Attachment Theory:

Tx Models and Techniques

A
  • Several models of therapy for children rely on attachment theory concepts (child parent therapy, circle of security)
  • Focus on facilitating appropriate parental responses
  • Examination of parent and child history
  • Parent training
  • Joint play, facilitated by therapist
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11
Q

Object Relations:

Key Concepts

A
  • “Objects” are internal representations
  • “Object relations” are mental representations of:
    • Object as perceived by self
    • Self in relation to object
    • Relationship between self and object
  • As infants, we split objects into good and bad
  • As we grow and mature, integrate to cohesive whole
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12
Q

Object Relations:

Techniques

A
  • Insight-oriented therapy - awareness of split or repressed objects and efforts to integrate
  • Psychoanalytic techniques
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13
Q

Specific models: Psychoanalytic:

Self Psychology

A

All 3 are:

Attachment Theory
Object Relations
Self Psychology

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14
Q

Self Psychology:

Key Concepts

A
  • Self
  • Selfobject
  • Selfobject-function
  • Optimal frustation
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15
Q

Self Psychology:

Techniques

A
  • Empathy (“vicarious introspection”)


- Typical psychoanalytic techniques; differences are in underlying philosophy

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16
Q

Theory: CBT

Key Concepts

A
  • Classical conditioning

- Operant conditioning

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17
Q

Theory: CBT

Assumptions

A
  • The cognitive triangle:
    • Faulty thinking leads people to feel a certain way, impacting their behavior
  • Thoughts can be changed, behavior can be unlearned
  • Dysfunctional patterns are caused by prior experience
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18
Q

Theory: CBT

Role of the Therapist

A

-Expert

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19
Q

Theory: CBT

Key Concepts

A

-Schema - Global constructions of one’s character

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20
Q

Theory: CBT

Interventions

A
  • Cognitive Restructuring
    • Charting (thought record, log, or journal)
    • Disputing irrational beliefs
    • Thought-stopping/though replacement
    • Psychoeducation
  • Logical Fallacies
    • Overgeneralization
    • Catastrophizing
    • Black and white thinking
    • Fortune telling
    • Pst hoc propter hoc (bc one thing happened, after another, it happened bc of that thing)
      • There are many more
  • Behavior modification
    • Shaping
    • Desensitization/exposure
    • Mindfulness
    • Token economy
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21
Q

Specific models: CBT Based

-DBT-Dialectical Behavioral Therapy

A
  • Aims to create stability by helping people hold together dialectics, or conflicting ideas that coexist
  • Therapeutic relationship is a key driver of change
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22
Q

DBT-Dialectical Behavioral Therapy:

Goals

A
  • Functionality
  • Acceptance
  • Motivation
  • Skills
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23
Q

DBT-Dialectical Behavioral Therapy:

Methods

A
  • Individual therapy
  • Group skills training
  • Phone sessions for crisis
  • Consultation for care providers
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24
Q

DBT-Dialectical Behavioral Therapy:

Skills being taught and practiced

A
  • Mindfulness
  • Interpersonal effectiveness
  • Distress tolerance
  • Emotional regulation
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25
Q

Specific models: CBT Based

-Rational-Emotive Behavior Therapy (REBT)


A
  • Philosophically holds that events aren’t good or bad

- How we think about events causes emotional difficulty

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26
Q

Rational-Emotive Behavior Therapy (REBT)


A
  • Core philosophies that lead to disturbance:
    • Self- I must always perform well
    • Others - Other people must always treat me well
    • Conditions under which I live must always be easy
  • A-B-C-D-E-F Model of disturbance and change
    • Therapy helps clients identify, dispute irrational beliefs
    • Examples include demands, awfulizing, low frustration tolerance, depreciation
    • Avoid shoulds, musts, oughts when absolute or rigid
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27
Q

Rational-Emotive Behavior Therapy (REBT)
:

Interventions

A
  • Identify target problems, values, and goals
  • Examine problems for irrational beliefs
  • Work actively and forcefully against irrational beliefs
  • Ultimately achieve self-acceptance, other-acceptance, life-acceptance
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28
Q

Theory: Humanistic:

Assumptions

A
  • People are inherently good
  • People inherently want themselves and the world to be better
  • People determine the course of their own lives
  • Therapist as collaborator, not expert
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29
Q

Theory: Humanistic:

Interventions

A

-Primary Intervention: Therapist style/way of being

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30
Q

Theory: Humanistic:

Key Concepts

A
  • Warmth
  • Empathy
  • Genuineness
  • Acceptance
  • Unconditional positive regard
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31
Q

Theory: Humanistic:
Interventions:
Gestalt

A
  • Empty chair

- Active confrontation

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32
Q

Theory: Humanistic:
Interventions:
Existential

A

-Here and now

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33
Q

Theory: Humanistic:

Intervention (All 3):

A

-Modeling authenticity

34
Q

Theory: Humanistic:

Role of the Therapist (All 3):

A

-Collaborator: The client is the expert on their own life

35
Q

Specific models: Humanistic

A
  • Client Centered Therapy
  • Gestalt Therapy
  • EFT (Emotionally Focused Therapy)
36
Q

Client Centered Therapy(Also known as person centered therapy):
Key Concepts

A
  • Humans are naturally self-actualizing
  • Clients have the answers within themselves
  • Therapist’s job is to create conditions for change
37
Q

Client Centered Therapy(Also known as person centered therapy):
Conditions for change

A
  • Accurate empathy
  • Unconditional positive regard
  • Self-congruence
  • Therapist-client psychological contact
  • Client incongruence
  • Client perception of therapist UPR(Unconditional positive regard) and AE(Accurate empathy)
38
Q

Gestalt Therapy:

Key Concepts

A
  • Gestalt (whole)
  • Unfinished business
  • Paradox of change
39
Q

Gestalt Therapy:

Techniques

A
  • Empty chair
  • Role play
  • Fantasy
  • Experiments (safe emergencies)
40
Q

EFT (Emotionally Focused Therapy)

A

-Developed as a couple therapy model, expanded to families

41
Q

EFT (Emotionally Focused Therapy):

Key Concepts

A
  • Attachment as a lifelong process and need
  • Many relationship problems are efforts to meet attachment needs safely
  • Attachment injuries
  • Primary and secondary emotions
42
Q

EFT (Emotionally Focused Therapy):

Therapeutic process

A
  • 9 steps in 3 stages
  • De-escalation
  • Changing interaction cycles
  • Consolidation
43
Q

EFT (Emotionally Focused Therapy):

Key Change Events

A

-Blamer softening, withdrawer re-engagement

44
Q

EFT (Emotionally Focused Therapy):

Techniques

A
  • Heightening
  • Empathetic conjecture
  • Evocative responding
  • Validation
45
Q

Theory: Systems

Primary Systemic Therapies

A
  • Bowen
  • Structural
  • Experiential
  • Strategic
46
Q

Traditional Psychotherapy

A
  • Psychodynamic
  • CBT
  • Humanistic/Existential/Gestalt
47
Q

Departure in Systems

A
  • Contextual
  • The individual cannot be understood outside of their context
  • De-emphasis on childhood, unconscious
  • Less concern with examining an individual’s internal world
48
Q

Systemic Therapy’s Origins

A
  • Cybernetics
  • Communication constantly influences both sides
  • General Systems Theory
  • How biological systems thrive in an environment
49
Q

Key Systemic Assumptions

A
  • Individuals are members of complex systems
  • Complex systems are governed by rules
    • Behavior can be understood as the product of those rules
  • Human suffering is either necessary for systemic functioning, or a result of too
50
Q

Key Concepts in Family Systems Theory

A
  • Identified Patient: Symptom holder for pathology is the system
  • Homeostasis
  • Boundaries and subsystems
    • Common subsystems: parental, partner, sibling
    • Rigid/diffuse boundaries
      • Open versus closed systems
  • Overt and covert rules
  • Roles
  • Power and hierarchy
  • Feedback loops
    • Positive loops move away from stability (change a homeostasis that isn’t working anymore)
    • Negative loops move toward stability (get back to homeostasis that is working)
51
Q

Systemic models:
Structural:
Key Concepts

A
  • Power
  • Enmeshment
  • Alignments (+) and coalitions (-)
  • Rules, roles, and hierarchy
  • Boundaries and subsystems
52
Q

Systemic models:
Structural:
Goal of Therapy

A
  • Fix the family structure
  • Organize subsystems
  • Redistribute power
  • Repeal outdated rules
53
Q

Systemic models:
Structural:
Role of the Therapist

A
  • Coach

- Disruptor

54
Q

Systemic models:
Structural:
Goals by Stage

A
  • Early stage goals: Joining and accommodating
    • Join w family
    • Accommodate to rules, patterns, structure
    • Assess family structure and boundaries
  • Assessment Process
    • Family map
    • Observation
  • Middle stage goals
    • Re-establish parental subsystem and generational hierarchy
    • Strengthen spousal subsystem
    • Develop clear boundaries among all subsystems
55
Q

Systemic models:
Structural:
Interventions

A
  • Enactment
    • Acting out a family interaction in session
  • Unbalancing
  • Tracking
  • Reframing
  • Circular questioning
  • Boundary demarcation (boundary making)
56
Q

Systemic models:
Strategic:
Key Concepts

A
  • Informed by communications theory
  • Everything in communication
  • Circular causality
  • Black box
  • Double bind
57
Q

Systemic models:
Strategic:
Role of Therapist

A
  • Expert

- Focus on outsmarting a resistant system

58
Q

Systemic models:
Strategic:
Defining the Problem

A
  • The problem is the problem

- Take family definition of the problem at face value

59
Q

Systemic models:
Strategic:
Interventions

A
  • Paradoxical injunction
  • Directives
  • Prescribing the symptom
  • Ordeal
  • Ritual
60
Q

Systemic models:

Experiential

A

-Experiential therapies believe that the experience of therapy itself will serve as the agent of change

61
Q

Systemic models:
Experiential:
Key Concepts

A
  • Largely rooted in Humanistic and Existential ideas

- Assumption: Human beings are fundamentally good

62
Q

Systemic models:
Experiential:
Defining the Problem

A
  • The problem is suppression of the true and natural person
    • Inauthentic communication
  • Satir’s model has been named in a number of ways, including as a “Communications Approach”, the “Human Validation Process Model,” and the “Satir Growth Model.” She also used the simpler title “Peoplemaking” in one of her books.
63
Q

Systemic models:
Experiential:
Role of the Therapist

A
  • Consultant

- Caring, accepting, validating of any form of honest expression

64
Q

Systemic models:
Experiential:
Goals of Therapy

A
  • Improve self-esteem
  • Become choiceful and intentional
  • Become responsible and accountable
  • Become congruent
65
Q

Systemic models:
Experiential:
Communication Stances

A
  • Stances sometimes labeled “survival stances” because they are ways of protecting self-worth
    • Blamer
    • Placater
    • Super-reasonable
    • Irrelevant
  • Normal and healthy: congruence
66
Q

Systemic models:
Experiential:
Goals by Stage

A
  • Early stage goals: Making contact
    • Establish rapport and hope
    • Assess communication stances and patterns
    • Identify treatment focus and goals
  • Middle stage goals: Chaos
    • Increase congruent communication
    • Strengthen each individual’s self-esteem
  • Late stage goals: Integration
    • Practice, use, and integrate changes
    • Increase knowledge of problem issue and family patterns
    • Solidify a new way of functioning including openness to possibility
67
Q

Systemic models:
Experiential:
Interventions

A
  • Family sculpting
  • Parts party
  • Family drawing
68
Q

Systemic models:

Emotionally Focused Therapy

A
  • Susan Johnson’s model, initially developed for couples
  • Focus on attachment injuries and attachment science
  • Goal is to alter a couple’s interaction pattern
  • Resolve attachment injuries
  • Establish secure attachment bond
69
Q

Systemic models:
Emotionally Focused Therapy:
Stages

A
  1. De-escalation
  2. Changing interactional patterns
  3. Consolidation and integration
70
Q

Systemic models:
Emotionally Focused Therapy:
Interventions

A
  • Reflection and validation
  • Evocative responding
  • Heightening
  • Empathetic conjecture
71
Q

Systemic models:
Emotionally Focused Therapy:
Key Change Events

A
  • Blamer softening

- Withdrawer re-engagement

72
Q

Systemic models: Multigenerational (Bowen):

Key Concepts

A
  • Emphasis on family of origin
  • Differentiation and fusion
  • Chronic anxiety
73
Q

Systemic models: Multigenerational (Bowen):

Eight Core Concepts

A
  • Differentiation/fusion
    • Differentiation: I can be fully myself in the presence of others
    • Fusion: My ability to be okay depends on the well-being of others
    • Undifferentiated family ego mass
  • Triangles
  • Nuclear family emotional process
  • Family projection process
  • Multigenerational transmission process
  • Cutoff
  • Sibling position (birth order)
  • Societal emotional process
74
Q

Systemic models: Multigenerational (Bowen):

Role of Therapist

A
  • Expert: Educator and coach

- Should be a non-anxious presence (in other words, the therapist needs to be well differentiated)

75
Q

Systemic models: Multigenerational (Bowen):

Interventions

A
  • Genogram
  • Psychoeducation
  • Communication skills - “I” statements
  • Detriangulation
  • Family of origin work: going home again
76
Q

Theory and models: Multigenerational:

Postmodern Approaches

A
  • Label for several theories w common philosophy
    • Narrative Therapy
    • Solution Focused Therapy
    • Collaborative Language Systems
77
Q

Theory and models: Multigenerational:
Postmodern Approaches:
Concepts

A
  • Reality cannot exist independently of observation process
    • Problem exist when people say that a problem needs to be addressed
  • Social constructionism - focus on meaning-making
  • Problem saturated story
78
Q

Theory and models: Multigenerational:
Postmodern Approaches:
Methods

A
  • Changing client meanings through dialogue
  • Deconstruct common beliefs, examine their value. Look for times when existing language doesn’t fit
  • Externalization (Narrative) - Through language, separate person from dx
  • Deconstruction(Narrative, CLS)
  • Moving problem talk to solution talk (Solution Focused)
  • Creation of new, more accurate language around the problem
79
Q

Theory and models: Multigenerational:
Postmodern Approaches:
Role of Therapist

A
  • Philosophical position less defined by function, more by way of being
  • Source of optimism and hope
  • Collaborator
  • Non-expert as to clients’ experience; expert on the process of change
80
Q

Theory and models: Multigenerational:
Postmodern Approaches:
Interventions: Narrative Therapy

A
  • Locating unique outcomes
  • Externalization
  • Mapping influence/statement of position map
  • Situating comments
  • Reflecting teams
  • Letters, certificates, definitional ceremony
81
Q

Theory and models: Multigenerational:
Postmodern Approaches:
Interventions: Solution Focused Therapy

A
  • Formula first session task: Notice what happens with your (relationship, family, whatever brought you to therapy) that you would like to continue
  • Miracle question (one kind of solution generating question; time machine, magic wand)
  • Scaling questions
  • Exception questions
  • Coping questions
82
Q

Theory and models: Multigenerational:
Postmodern Approaches:
Interventions: Collaborative Language Systems

A
  • “Appropriately unusual” comments
  • Experimenting w possible new meanings
  • Share inner dialogue
  • Reflecting teams

MFT Clinical Review (6 decks)

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