Week 8 - Intervention Part A (Adults) Flashcards
C sad
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Psychoanalysis can be “______ ________”
Time intensive
Up to 4 sessions a week for 3-6 years
What are some terms used in psychodynamic therapy?
(5 terms)
Free association: saying whatever comes to MIND
Transference: displaced attitudes and feelings originally experienced in relationships with person from the PAST to the ANALYST
Interpretation: therapist provides MEANINGFUL statements of current conflicts and historical factors that influenced them
Countertransference: therapist’s feelings that are thought to be RELATED to what the patient is projecting onto the therapist
Resistance: when UNCONCIOUS ideas or impulses are REPRESSED and PREVENTED from reaching awareness because they are unacceptable to consciousness for some reason
What are some indications that psychoanalysis would work well?
Significant suffering so that patients are MOTIVATED to make the sacrifices of time and financial resources
Have a genuine wish to UNDERSTAND themselves, not simply looking for symptom relief
They must be able to withstand STRONG EMOTIONS, such as frustration and anxiety without fleeing or acting out
Have a reasonable, mature superego that allows them to be HONEST
At least AVERAGE intelligence
Be psychologically minded
What 3 things do short-term psychodynamic therapies contain?
- DEVELOPING a (+) transference relationship
(Identifying themes) - ANALYZING the transference relationship
(Exploring themes) - TERMINATING therapy
(Dealing w/ loss, expectable challenges)
Short-term dynamic psychotherapy last usually how long?
What differs in these sessions?
Targets cluster “___&___” personality disorders (anxiety, depression etc…)
Strongest for treatment of “___________”
Occur once/twice a week b/w 16 and 30 sessions
——————————————————————————
Therapists more ACTIVE and CHALLENGING
——————————————————————————-
A&C
——————————————————————————
Depression
What is interpersonal theory?
Created by Harry Stack Sullivan
Believed that a person could NOT be understood outside of their relationships
The way one RELATES to others DEFINES who they are
Emphasizes interpersonal elements (development, maintenance & alteration) of psychological problems
What are the 3 phases of interpersonal psychotherapy?
- Initial phase:
- sessions 1-3
- assessment & case formulation
- sick role (illness “isn’t clients fault” helps to externalize individual illness)
- link to one of 4 problem areas… - Intermediate phase:
- addressing interpersonal themes
- 1. grief (promote healthy mourning), 2. role disputes, 3. role transitions, 4. interpersonal deficits - Termination phase:
- acknowledge feelings about termination
- practice skills
- anticipate challenges
Interpersonal therapy usually lasts how long?
Therapists are “_________&________”
Strongest evidence for support is “___________”
Growing evidence for “_________&________” disorders
Adapted for use in different “___________”
Over 3 to 4 months
———————————-
Relaxed & supportive
———————————-
Depression
———————————-
Eating & anxiety
———————————
Cultures
What is cognitive therapy?
It goes by the “__________ ________”
Developed by Aaron Beck in the 1960’s
STRUCTURED, SHORT-TERM, PRESENT-ORIENTED psychotherapy for depression
——————————————————————————————
Cognitive model:
- distorted/dysfunctional thinking is common to psych disturbances
————————————————————————————-
Adapted to treat several psych disorders
What are the 3 aspects of the cognitive triad?
Negative thoughts about ONESELF——-> negative thoughts about the WORLD ——-> negative thoughts about the FUTURE
What are the principles of cognitive therapy?
- cognitive terms
- therapeutic alliance
- collab and active participation
- goal & problem focused
- initially empahsizes present
- time-limited
- sessions are structured
- teaches paitents to identify their dysfunctional thoughts/beliefs
- variety techniques to change mood/thinking/behaviour
What are some terms used in cognitive therapy?
(3 terms)
- Automatic thoughts:
- quick thoughts, no deliberation/reasoning
- actual words/images in mind
- situation specific
- superficial level - Intermediate beliefs:
- rules, attitudes and assumptions - Core beliefs:
- beliefs about oneself, others and world
- understandings are deep
- absolute truths
- global, rigid and over generalized
What is involved in the assessment phase in cognitive therapy?
- Assessment
- diagnosis and comorbidity
- life circumstances: relationships & social functioning
- resources and strengths
- recent precipitating events and stressors
- integrate data from interview, direct observation, rating scales, and self-monitoring - Case formulation
- Psychoeducation on depression
- Treatment options
- establish concrete, collaboratively agreed-upon treatment goals
What is the structure of sessions in cognitive therapy?
1.Brief update
and CHECK
on mood
- Bridge from
PREVIOUS
session - Set the
AGENDA - Review of
HOMEWORK - Discussion
of issues on
the agenda,
set new
homework,
and periodic
summaries - Final
summary
and
feedback
What are 3 skills that are looking to come out of cognitive therapy?
- Behavioral activation (self-monitoring, schedule pleasant activities, thought logs)
- Altering automatic thoughts & beliefs (cognitive restructuring, developing strategies, thought stopping)
- Interpersonal skills (develop problem-solving/stress-management skills)
***WANT TO INCREASE AWARENESS (—->BEHAVIOUR——>THOUGHTS—->FEELINGS—->PHYSICAL SENSATION—->)
What are 5 sections that a thought log can contain?
Situation (what happened?)
Thoughts (what did I think?)
Feelings (how did I feel?)
Physical sensations (how did I feel it in my body?)
Behaviour (what did I do?)
What are some cognitive distortions?
(8 types)
- Black or white thinking:
- ignoring the GRAY area: all or nothing, good or bad, right or wrong, win or lose. - Catastrophizing:
- blowing things out of proportion; you think of the WORST possible outcome - Shoulds/Coulds
- placing DEMANDS onself or others, often unrealistic demands which set yourself and others up for FAILURE. - Mind-reading
- when you assume that you know what someone ELSE is thinking or feeling instead of asking. - Personalizing
- you believe OTHERS are behaving in a certain way because of YOU. - Blaming/Making excuses
- you focus on the other person as the source of your NEGATIVE
feelings. - Negative thinking
- focusing on only the NEGATIVES of a situation and ignoring any
positives. - Minimization
- taking a MOUNTAIN and pretending it was only
a molehill.
CBT is often used for “________” disorders?
Anxiety
Often uses combo of CBT, self-monitoring, relaxation training, exposure, and problem-solving
Includes GAD, panic disorder, social anxiety disorder, OCD & PTSD
How is exposure used as a technique?
(4 types)
- Graduated:
- least to most difficult - Intense (flooding):
- starts w/ higher anxiety stimulus - Guided mastery:
- building self-efficacy over stimulus exposure - In-vivo exposure:
- repeated, systematic, real-life exposure
- continues until anxiety reduced
What is dialectical behaviour therapy (DBT)?
What are the 3 theoretical positions?
Developed by Marsha Linehan
- Behavioral science (behavioral strategies)
- Dialectal philosophy (promotes wholeness, interrelatedness etc…)
- Zen practice (mindfulness = acceptance & self-validation)
What does DBT treatment include?
Group
Individual
24 hour on-call telephone consultation
Therapist consultation
What are some dialectics in DBT?
Emotional vulnerability
Unrelenting crisis
Apparent compentence
Active passivity
Self- invalidation
Inhibited grieving
= GO BACK TO BIOLOGICAL SOCIAL
What do DBT modules include?
Mindfulness
Distress tolerance
Emotional regulation
Interpersonal effectiveness
What is trauma informed care in DBT?
DO NOT have to necessarily discuss trauma
Focus on SAFETY & ENGAGEMENT
Services are provided for physical and emotional safety
Focuses on OVERALL ESSENCE OF APPROACH (rather than specific method)
What are the 3 phases of treatment in DBT?
- Treatment:
- safety and stabilization
- longest phase
- informed consent, intro to therapy, theraputic alliance
- modulate emotional arousal
- approach and master triggers - Processing the Trauma:
- SAFE self-reflective disclosure of traumatic memories (progresssive/coherent narrative)
Ex) present-centered therapy
Ex) exposure therapy - EDMR - Reintegration:
- unresolved work that presented itself during the therapy
- CONTINUE emotional regulation skills
- interpersonal relationship = generalize skills
