Week 6 - Therapy Flashcards
Although definitions of the therapeutic alliance vary, its key elements are (3)
(1) a sense of working collaboratively on the problem,
(2) agreement between patient and therapist about the goals and tasks of therapy, and (3) an affective bond between patient and therapist
Measurements of success in clinical settings:
(1) a client’s reports of change in their symptoms or functioning,
(2) a clinician’s ratings of changes that have occurred,
(3) reports from the client’s family or friends,
(4) comparison of pretreatment and posttreatment scores on instruments designed to measure relevant facets of psychological functioning, and
(5) measures of change in selected overt behaviors.
Research suggests that about ___ percent of patients show clinically significant change after X therapy sessions. After X sessions, about ___ percent of patients have improved
50
21
40
75
It has been estimated that between ___ and ___ percent of clients deteriorate during treatment
5 and 10
boundary violations
This is when the therapist behaves in ways that exploit the trust of the patient or engages in behavior that is highly inappropriate (e.g., taking the patient to dinner, giving the patient gifts)
A major assumption of behavior therapy is that….
abnormal behavior is acquired in the same way as normal behavior—that is, by learning.
Examples of BT include…
Exposure Therapy:
(guided exposure to anxiety-provoking stimuli, e.g. systematic desensitization, or flooding; imaginal exposure, or in vivo (real) exposure)
Aversion Therapy:
(modifying undesirable behavior by the method of punishment)
Modeling:
(the client learns new skills by imitating another person, such as a parent or therapist, who performs the behavior to be acquired)
Systematic Reinforcement: (token or response shaping)
Therapists have sought to use ___ ____ exposure whenever practical, encouraging clients to confront anxiety-provoking situations directly.
in vivo
Systematic Reinforcement:
- Removing positive enforcement for negative behaviour
- Response shaping, positive reinforcement is used to establish, by gradual approximation, a response that is actively resisted or is not initially in an individual’s behavioral repertoire. (e.g. child with mutism rewarded for any sound at first, but later only for whole words, and then sentences).
- Token economies (rewards or priveleges)
No single set of techniques defines cognitively oriented treatment approaches. However, two main themes are important: (2)
(1) the conviction that cognitive processes influence emotion, motivation, and behaviour; and
(2) the use of cognitive and behaviour-change techniques in a pragmatic (hypothesis-testing) manner
rational emotive behavior therapy (REBT)
The first form of behaviorally oriented cognitive therapy was developed by Albert Ellis
Cognitive model - a fundamental assumption…
A fudamental assumption of the cognitive model is that problems result from biased processing of external events or internal stimuli.
These biases distort the way that a person makes sense of the experiences that she or he has in the world, leading to cognitive errors
The errors in the logic behind their thinking lead them (CT; 4)
(1) to perceive the world selectively as harmful while ignoring evidence to the contrary; (2) to overgeneralize based on limited examples—for example, seeing themselves as totally worthless because they were laid off from work;
(3) to magnify the significance of undesirable events—for example, seeing the job loss as the end of the world for them; and
(4) to engage in absolutistic thinking—for example, exaggerating the importance of someone’s mildly critical comment and perceiving it as proof of their instant descent from goodness to worthlessness.
A recent meta-analysis that examined nearly 40 years of data on the use of CBT to treat depression also yielded several very interesting findings….(4)
(1) CBT has been an effective treat-ment for depression since the 1970s
(2) female patients ben-efit more from treatment than do men
(3) more experienced clinicians have better treatment effects than less experi-enced ones, and
(4) most alarmingly, the effectiveness of CBT seems to be decreasing over time.
Humanistic-experiential therapists feel that a client must….
take most of the responsibility for the direction and success of therapy, with the therapist serving merely as counselor, guide, and facilitator
