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Flashcards in Clinical Psychology Deck (128)
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1
Q

Freudian psychoanalysis is this type of theory;

human beings are determined by _____

A

pessimistic, deterministic, mechanistic, reductionistic

irrational forces, unconscious motivations

2
Q

Freud’s structural theory

A

id - pleasure (birth)
ego - reality - postpone gratification (6 mo)
superego - permanently block id’s impulses (4-5 yr)

3
Q

defense mechanisms

A

deny or distort reality

repression- underlies all other defense mechanisms- keep id’s drives from consciousness

reaction formation - avoid anxiety provoking response by expressing its opposite

projection - threatening impulse is attributed to another person

4
Q

goal of psychoanalytic therapy

A

reduce or eliminate pathological symptoms by bringing the unconscious into consciousness

5
Q

psychoanalysis includes ____ and is a combination of these 4 stages

A

free associations, dreams, resistances, transferences – combo of:
confrontation - see bx in a new way
clarification
interpretation
working through - final and longest stage - client assimilates new insights into personality

catharsis - emotional release resulting from recall of unconscious

6
Q

brief psychodynamic therapy

A

Prochaska & Norcross (2003)

time limited
target specific interpersonal problem
interpretation early on
strong working alliance
positive transference > neg transference
7
Q

Adler’s approach is _____ and states that behavior is motivated by:

A

teleological – future goals

8
Q

Adler’s individual psychology (4 concepts)

A

inferiority feelings - develop in childhood as result of weaknesses
striving for superiority - inherent tendency toward perfect completion
style of life - the way a person compensates for inferiority determines this, which unifies aspects of personality
social interest - differentiates bt healthy and unhealthy style of life (age 4-5)

9
Q

Systemic training for effective teaching (STET)

A

based on Adler’s approach - all behavior is goal directed and purposeful

10
Q

Jung says the libido is____; behavior is determined by____

and personality consists of these 6 things

A

libido = general psychic energy

behavior is determined by past and future goals

personality consists of:
extraversion and introversion
thinking, feeling, sensing, and intuiting

11
Q

Jung’s analytical psychotherapy says personality is consequence of____

A

conscious and unconscious

12
Q

collective unconscious

A

repository of latent memory traces that have been passes down from one generation to the next

13
Q

archetypes

A

in collective unconscious

primordial images- experience and understand certain phenomena in a universal way 
e.g.,:
 self- unity of personality
persona - pubic mask
shadow - dark side of personality
anima -feminine
animus - masculine
14
Q

Individuation

A

Jung
integration of conscious and unconscious - lead to development of unique identity

dvpt of wisdom

15
Q

Object Relations Theory

A

relationship with others is basic inborn drive
early relationships become part of the self

Melanie Klein, Ronald Fairbairn, Margaret Mahler, Otto Kernberg

16
Q

separation-individuation phase has these 4 steps and fully develops by what age?

A

Mahler’s theory

4-5 mo - development of object relations

differentiation
practicing
reapproachment
object constancy

taking steps toward separation through exploration

3 yo- child has permanent sense of self and object (object constancy)

17
Q

person-centered therapy says people are motivated by ____ and disorganization happens when ___

A

Carl Rogers

client-centered and Rogerian

all people have innate “self-actualizing tendency” - major source of motivation

self becomes disorganized when experience and self are incongruent

defense mechanisms of perceptual distortion or denial

18
Q

Roger’s three facilitative conditions

A

unconditional positive regard

genuineness

accurate empathic understanding

19
Q

Gestalt therapy says each person is capable of _____ and incorporates these 5 elements

A

Fritz Perls

each person is capable of assuming personal responsibility for his/her thoughts, feelings, actions and living as a “whole”

1) closure
2) gestalts = current needs
3) whole > sum of parts
4) context
5) figure/ground

20
Q

self and self-image

A

Gestalt
self = creative aspect of personality

self-image = darker side of personality that hinders growth

21
Q

boundary disturbances (4 major ones)

A

Gestalt
abandonment of self for self image

introjection- accepts facts from envt without understanding them (compliant)
projection - disowning aspects of self; assigning to others (paranoia)
retroflection - doing to oneself what you want to do to others
confluence - no boundary between self and environment (guilt and resentment)

22
Q

transference a la Gestalt

A

not productive

helping client recognize difference between transference fantasy and reality

23
Q

Most important part of gestalt therapy—— and therapy techniques

A

Awareness: full understanding of thoughts, feelings, actions in here and now

empty chair, other games used- role play, guided fantasy, dream work - dreams rep diff parts of the self

24
Q

Existential therapies

A

Frankl

emphasis on personal choice and responsibility for developing a meaningful life, satisfy needs

people are in constant state of evolving

25
Q

reality therapy

A

Glasser

based on choice theory (control theory)- people are responsible for choices they make

26
Q

successful identity/failure identity (reality therapy)

A

fulfills needs in responsible way

unable to satisfy needs in responsible way- underlies most psychopathology

27
Q

personal construct therapy

A

George Kelly

how client experiences the world - ppl. choose the ways they deal with the world and there are alternative ways for doing so

client and therapist are “mutual experts”
use assessment e.g., repertory grid
fixed role therapy - experiment with alt. constructs

28
Q

Interpersonal Therapy (IPT) is a combo of __

A

Klerman and Weissman; Adolph Meyer’s psychobiological approach to psychiatric disorders, Sullivan’s interpersonal theory, Bowlby

combines psychodynamic and CBT

29
Q

primary problem areas in IPT

A
interventions target:
unresolved grief
interpersonal role disputes
role transitions
interpersonal deficits
30
Q

Solution-focused therapy

A

de Shazar

“you get more of what you talk about”; focus on solutions to problems rather than problem themselves

31
Q

therapist posed questions - Solution focused therapy

A

client is “expert”

miracle question - everything is better- what does this look like?
exception question - when did you not have this problem?
scaling questions

32
Q

Transtheoretical model

A

Prochaska & DeClemente
originally - cigarette smoking and addictive bx - now for weight, compliance, IPV, $

change entails progress through a series of predictable stages
10 empirically supported change processes: consciousness raising, self liberation, social liberation, dramatic relief, self-reevaluation, counterconditioning, environmental reevaluation, reinforcement management, stimulus control, helping/supportive relationships

33
Q

six stages of change (transtheoretical model)

A

pre contemplation - little insight; no intention to change
contemplation - aware and intends to take action in 6 mo
preparation - take action in 1 mo
action - takes steps to change
maintenance -
termination - no risk for relapse

34
Q

decisional balance
self-efficacy
temptation (transtheoretical model)

A

db - strength of perceived pros and cons of problem (contemplation)

se - confidence to cope with high risk situations

temptation - intensity of urges

35
Q

Motivational Interviewing

A

Miller & Rollnick

clients who are ambivalent about changing their behavior
addiction, eating disorders, diabetes, pain

Roger’s client centered therapy and Bandura’s self efficacy

36
Q

OARS

A

open ended questions
affirmations
reflective listening
summaries - type of reflective listening for transitions

37
Q

General Systems Theory

A

system is an entity that is maintained by mutual interactions of its component; context is important

family = open system
homeostasis = family will try to maintain status quo
38
Q

Cybernetics

A

family communication process

negative feedback loop: reduces deviation and helps a system maintain status quo

positive feedback loop: amplifies deviation or change and disrupts the system

39
Q

family therapies

A

Kant; reciprocal view

focus on here and now, relational, freedom of choice, contextual, relativistic

Ackerman = grandfather of fam therapy

40
Q

double-bind communication

A

Bateson

dvpt of schizophrenia

conflicting negative injunctions “ do that - punish; don’t do that - punish”

41
Q

Communication/Interaction family therapy

A

Don Jackson, Virginia Satir, Jules Riskin, Jay Haley

all bx = communication
all comm has “report” (content) and “command” (nonverbal; statement about communicators) function
comm patterns = symmetrical or complementary

42
Q

symmetrical communications

A

equality bt communicators but may escalate into competitive “one upsmanship game”

43
Q

complementary communications

A

inequality and maximize diff bt communicators (dominant and submissive)

44
Q

primary goal of commnication/interaction family therapy

A

alter interactional patterns that are maintaining the presenting sx

45
Q

Extended Family Systems therapy

A

Murray Bowen

functioning across extended family:
differentiation of self
emotional triangle
family projection process

46
Q

differentiation (extended fam systems)

A

ability to separate intellectual and emo functioning

lower: more emotional (e.g., undifferentiated family ego mass = highly emotionally fused)

choose mates with similar differentiation

47
Q

emotional triangle

A

third person brought in to 2 person dynamic to diffuse stress

low level of differentiation - greater likelihood for emo triangle

48
Q

multigenerational transmission process

A

behavioral disorders result from this-

progressively lower levels of differentiation are transmitted from one generation to the next

49
Q

genogram

A

used in extended family systems

depict relationship between fam members

50
Q

therapist role in extended fam system

A

coach - achieve greater differentiation
questioning
clients talk to therapist not each other

51
Q

Structural family therapy

A

Minuchin- work with disorganized lower SES families

here-and-now, directive, concrete approach

all families have implicit structure that determines how family will relate to one another

power hierarchies
subsystems
boundaries

52
Q

boundaries

A

“barriers” or rules that determine the amount of contact that is allowed bt family members

53
Q

rigid triads

A

boundary problems

1) detouring - parent focus on child for problems
2) stable coalition - p and c form coalition and gang up on other parent
3) triangulation - each parent demand the child to side with him/her

54
Q

structural family therapy techniques

A

actions precedes understanding
changing behaviors rather than insight

joining
evaluating family structure
restructuring the family

55
Q

Strategic family therapy

A

Jay Haley

influenced by: communication/interaction, estrutural, and Milton Erickson’s hypnotic techniques

emphasize role of communication
symptom = interpersonal phenomena - strategy for controlling a relationship when other strategies have failed

56
Q

therapy goals - strategic fam therapy

A

altering transactions and organizations, esp hierarchies and generational boundaries

therapist = very directive

57
Q

stages of therapy - strategic fam therapy

A

first session- very structured:

1) social - therapist observes
2) problem - therapist gathers info
3) interaction - discuss problems
4) goal setting-

58
Q

paradoxical intervention

A

alters behavior of family members by helping them se a symptom in an alternative way (by resisting directive, fam member ends up abandoning maladaptive bx)
ordeals - unpleasant task when symptom occurs
restraining - encourage not to change
positioning - exaggerating severity of a symptom
reframing -
prescribing the symptom - deliberately engage in symptom

59
Q

Milan systemic family therapy

A

Mara Selvini-Palazzoli

circular patterns of action and reaction

goal: help fam members see their choices and in choosing

use of therapeutic team

60
Q

techniques used in Milan systemic family therapy

A

hypothesizing - test with fam and revise
neutrality -
paradox - not for resistance but for solutions
circular questions- each fam member asked a question

61
Q

Behavioral Family therapy

A

operant conditioning, social learning theory, social exchange theory

62
Q

Object relations family therapy

A

maladaptive bx = result of both intrapsychic and interpersonal factors

63
Q

projective identification

A

primary source of dysfunction in object relations family therapy

occurs when a fam member projects old introjects onto another family member and then reacts as though he has those characteristics

64
Q

multiple transferences

A

transferences of one family member to another, to the therapist

65
Q

Group therapy

A

every school of psychotherapy has been applied

66
Q

3 formative stages of group therapy

A

Yalom

first stage - orientation, hesitation participation, search for meaning, dependency ; search for similarities, advice seeking

second stage - conflict, dominance, rebellion - members try to establish dominance

third stage - development of cohesiveness - unity, intimacy, and closeness become chief concerns * critical

67
Q

therapists role in group therapy

A

creation and maintenance of the group

culture building -therapist is technical expert and participant/model

activation and illumination of the here-and-now-

68
Q

premature termination

A

10-35% drop out during first 12-20 sessions

prescreening can reduce
post-selection preparation to clarify misconceptions

69
Q

Feminist therapy

A

power differences bt men and women and impact on behavior

“personal is political”

goal: empowerment

70
Q

nonsexist therapy

A

different from feminist therapy:

feminist therapy - sociopolitical factors
nonsexist therapy - individual factors and modifying personal behavior

71
Q

self-in-relation theory

A

extends traditional object relations theory - many gender diff can be traced to diff in the mother-daughter and mother-son relationship

72
Q

Hypnosis

A

effective for treating acute stress disorder, anxiety, obesity, insomnia, chronic pain

compliance does not always occur

73
Q

hypnosis and repressed memories

A

1_ does not seem to enhance accuracy of memories - may produce pseudo memories

2) may exaggerate a person’s confidence in uncertain memories
3) often reflect issues that are relevant to treatment

74
Q

acupuncture

A

method for restoring health - involves stimulating specific anatomical points on the body with a thin needle

benefits may be dt release of endorphins
pain and chemo-nausea

75
Q

Primary preventions

A

reducing prevalence of mental and physical disorders

76
Q

secondary preventions

A

decrease prevalence of mental and physical disorders

early detection and intervention

77
Q

tertiary preventions

A

reduce duration and consequences of mental and physical disorders

e.g., rehab programs

78
Q

health education

A

more useful for increasing info than changing practices

mass media campaigns do both

peer norms to alter health behaviors is effective, esp for adolescents

79
Q

health belief model

A

health behaviors are influenced by

1) person’s readiness to take action
2) evaluation of benefits and costs
3) internal and external “cues to action” that trigger response e.g., health of family, advice, media

health bx can be modified by targeting knowledge/motivation

80
Q

consultation

A

organizational - systems approach - entire organization is consultee

advocacy- consultant must have explicit value orientation to foster goals of disenfranchised group

81
Q

Mental health consultation

A

client-centered case consultation - working with consulted to develop a plan that will help them work better with a client

consult centered - enhance consultee’s performance

program centered - working with administrators

consult centered administrative - help administrative level personnel improve professional functioning

82
Q

parallel process

A

extension of transference

when a supervisee replicates problems with the supervisor that are happening with the client

83
Q

Eyesenck

A

1952 article

effects of psychotherapy are “small or nonexistent”

72% of neurotic adults in no-therapy group showed improvement within 2 yrs
only 66% receiving eclectic therapy and 44% receiving psychoanalysis showed decrease in symptoms

84
Q

meta-analysis

A

smith and colleagues - statistical technique to psychotherapy outcome research

combine results of multiple studies and involves calculating an effect size - converts data from diff studies to a common metric to combine and compare

mean outcome for treatment - mean outcome for control / SD of control group = diff bt average patients in treatment and control groups in SD

85
Q

Smith, Glass, Miller (1980)

A

mean effect size of .85 - at the end of therapy, average therapy client is “better than 80% of those who need therapy but remain untreated”

86
Q

Lambert and Bergin (1994)

A

no one type of therapy is better than another - except CBT for panic, phobias, compulsions

positive change in therapy = general factors

87
Q

Howard and colleagues (1996)

A

relationship between tx length and outcome “levels off” after 26 sessions

75% of patients showed improvement at 26 sessions
85% showed improvement at 52 sessions = dose dependent effect

88
Q

phase model of therapy

A

predicts the benefits of treatment will vary depending on # of sessions. effects in3 stages:

remoralization - hopeless and desperation respond quickly (first few sessions)

remediation - focus on symptoms (relief in 16 sessions)

rehabilitation - unlearning poor patterns (time depends on type and severity)

89
Q

efficacy v effectiveness

A
efficacy = clinical trials
effectiveness = correlational/quasi-experimental; Seligman

Jacobson and Christensen support both

90
Q

utilization of MH services

A

AA - ER or psychiatric inpatient
Asians - underrepresented in outpatient and inpatient

Whites > AA and Hispanics for depression
AA> tx for illicit drug use

91
Q

premature termination rates

A

minority groups > Whites to terminate prematurely (e.g., 50% v 30% of Whites

AA > White dropout
White> Asians dropout
Whites = Hispanics dropout

92
Q

therapist-client matching

A

inconclusive

ethnic matching reduced premature termination for Asian, Hispanic and Whites but not AA

matching = better for Hispanics only
matching has a small, but not significant positive effect on # of sessions attended

preference dpends on: acculturation, client’s ethnic identity, gender, trust of Whites

similarity in values and worldview as well as education = more important in a therapist for many clients

93
Q

MH problems for older adults

A

most common: anxiety, severe cognitive impairment, depression

older adults are more heterogeneous

1) behavioral and environmental interventions best for dementia
2) memory and cognitive retraining = probably efficacious
3) cognitive, behavioral, and brief psychodynamic therapist = probably efficacious for depression

best when adapted to circumstances

94
Q

1 predictor of cessation of battering

A

family income

95
Q

couples therapy for spousal abuse

A

MAck
may be OK when abuse is expressive - mutual, followed by remorse

No good when instrumental

96
Q

factors affecting decision to remain in abusive relatioship

A

woman’s commitment to relationship

economic dependence, belief that the batterer will change, and fear that the batterer will retaliate

97
Q

Treatment manuals

A

originally developed to standardize so effects could be evaluated

  • oversimplify therapeutic process
    + help disseminate info
    + capitalize on empirically based approach
98
Q

placebo effect

A

average effect size of .67when compared to no treatment

.48 when compared to treatment group

useful? unclear

99
Q

diagnostic overshadowing

A

attribute all of clients problems to IQ

not related to theoretical orientation, expertise, experience and applies to other conditions, diagnoses, situations

100
Q

alloplastic v autoplastic intervention

A

allo - make changes in environment

auto - change individual

101
Q

psychiatric inpatients

A

marital status - highest for never married; lowest for widowed; intermediate for married or divorced/separated

race/ethnicity: Whites; but other races are overrepresented

age: 25-44
diagnosis: schizophrenia in 18-44 range; for 65+ organic disorder and then affective disorder

102
Q

Guidelines for AA clients

A

interconnectedness

family is extended kinship network- immediate and extended

Roles are flexible

“healthy cultural paranoia”

use of ecostructural or ecological systems approach

103
Q

multisystem model

A

for use with AA clients
type of ecological systems approach

addresses multiple systems, intervenes at multiple levels, empowers family by utilizing strengths

104
Q

American Indians and Alaskan Natives in therapy

A

spiritual and holistic orientation

extended family and tribe

cooperation and generosity

listening - more important than talking

incorporate elders, medicine people, etc. into tx process

105
Q

network therapy

A

for Indians, Alaskans

incorporates family and community members into the treatment process and situates problems within context of family, work, community

106
Q

Asian Americans in therapy

A

aware of country of origin and acculturation status

emphasis on group
hierarchical family structure, traditional gender roles
harmony, interdependence, mutual loyalty
value restraint of strong emotions that might otherwise disrupt peace and harmony

somatic and behavioral complaints rather than emo

directive, structured, goal-oriented, problem solving approach - CBT

107
Q

Hispanic/Latino Americans in therapy

A

family over individual welfare
interdependence and connectedness
discussing intimate details with strangers is unacceptable; problems should be handled in the family

active & directive - multimodal approach - behavior, affect, cognitions, relationships, biology

family therapy

somatic complaints

108
Q

Sexual minorities

A

LGBT have higher rates of certain psych problems : depression, anxiety, substance use, suicidality d/t prejudice and discrimination

109
Q

internalized homophobia

A

LGBT accept heterosexual society’s negative evals of them and incorporate these into self-concepts

low self esteem, self doubt, self hatred

therapy- id and correct cognitive distortions, assertiveness, coping skills, activating social support

110
Q

coming out

A

may have neg consequences

can be helpful: lesbians have higher self esteem, positive affectivity, lower levels of anxiety, reduced likelihood of engaging in anonymous socializing

111
Q

coming out diff for men and women

A

Savin-Williams and Diamond (2000) : first same sex attraction, self labeling, first same sex sexual contact, first disclosure

males had earlier onset except first disclosure was same

Grove, Bimbi, Nanin, Parsons (2006)- no gender diff; ppl age 18-24 coming out significantly younger than older generations

112
Q

cultural competence

A

awareness
knowledge
skills

credibility
giving - client has gotten something from therapy

113
Q

indigenous healing

A

curanderismo - holistic system practiced in latin american/hispanic countries - illness can arise from natural or supernatural forces; herbal medicine, massage

ho’oponopono “setting it right” - hawaiian - restoring harmony by senior family member

sweat lodge ceremony - Native American

114
Q

Acculturation

A

degree that someone accepts and adheres to values of their own group v dominant group

integration - maintains own culture but incorporates dominant culture
assimilation - accepts majority culture while letting go of own culture
separation - withdraws from dominant culture
marginalization - does not id with either culture

115
Q

worldview

A

how a person perceives relationship to nature, other people, institutions

locus of control
locus of responsibility

minority groups - IC-ER. big problem for IC-IR therapist

116
Q

cultural encapsulation

A

disregard cultural differences

117
Q

emic v etic orientation

A

emic - culture specific theories- see things through eyes of individual

etic - ppl from diff cultures as same

118
Q

high v low context communication

A

high- grounded in the situation, depends on group understanding, relies on nonverbal cues, slow to change (minorities)

low - explicit, verbal, less unifying, can change rapidly (white)

119
Q

oppression

A

internalized - system blaming, avoidance of whites, denial

conceptual incarceration - adopting a white worldview

split-self syndrome - polarizing oneself into “good” or “bad” (bad = AA)

playing it cool - concealing anger

uncle tom’s syndrome - adopting happy go lucky demeanor

120
Q

cultural v functional paranoia

A

cultural - healthy reaction to racism when nondisclosure is d/t fear of being misunderstood

functional - unhealthy - unwilling to disclose to therapist d/t general mistrust and suspicion

121
Q

sexual stigma

A

shared knowledge of society’s negative regard for non heterosexual behavior

creates power and status differential

122
Q

heterosexism

A

cultural ideologies- systems that promote and hostility against homosexuals

123
Q

sexual prejudice

A

negative attitudes based on sexual orientation

higher prejudice: heterosexual men, older, lower education, southern or midwestern, rural, limited contact with homosexuals

124
Q

Racial/cultural identity development model

A

conformity - pref for dominant culture
dissonance - confusion (pref for minority therapist)
resistance and immersion - reject dom group, immerse in own group
introspection - uncertainty about rigidity in above stage
integrative awareness - multicultural perspective

125
Q

Black racial (Nigrescence) identity development model

A

shift from black self hatred to black acceptance

pre-encounter - racial identity has little salience (assimilation - adopted mainstream identity; anti-Black- low-self esteem)

Encounter - exposure to race event leads to greater awareness and interest - prefer same race therapist

Immersion-Emersion - race has high salience - idealizes black culture; rage toward whites (emersion - reject white culture, internalize black identity

Internalization - race is imp; pro black, non-racist; biculturist orientation; multicultural identity

126
Q

White racial identity development model

A

abandoning racism (1-3); developing non-racist identity (4-6) through information processing strategy (IPS)

contact status - little awareness of racism

disintegration - increasing awareness leads to confusion, conflict; IPS - suppression, ambivalence

Reintegration - resolve moral dilemma; may blame minorities, see whites as victims; IPS - selective perception and negative out-group distortion

Pseudo-Independence Status - question racist views, intellectually interested in understanding racial differences; IPS - selective perception and reshaping reality

Immersion-Emersion - what does it mean to be White, biases, understand benefits of white privilege; IPS - hpervigilence and reshaping

Autonomy - internalizes nonracist White identity, appreciates other cultures ; IPS - flexibility and complexity — most effective as therapist working with minority clients

127
Q

progressive interaction

A

when therapists level of racial identity is at least one level more advanced than that of his client. this is most effective interaction in therapy

128
Q

Homosexual identity development model

A

sensitization/feeling different- middle childhood -

self-recognition/identity confusion - puberty- realizes attraction to same sex

identity assumption - more certain of homosexuality

commitment/identtity integration - homosexual way of life, out in public