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Glossary of clinical cards for EPPP

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core assumption for Freudian theroy
psychic structure split into 3 main components - id, ego , superego
id
unrganized energy resevoir; all instincts and bioogcial drives; dom,inated by pleasure prin ciple; unconscious
how do you test for id impulses?
dreams, slips of the tongue, daydreams, neurotic symptoms formation
ego devlops through what mechanism?
devlops from id's unteractions with the world
ego dominated by what princilpe? What is its function?
reality principle who function is to suspend the pleasure principle; the ego is organizing, critical, and synthesizing to lead to reason
superego devlops through what process?
successful passing throught eOedipla complex; internalization of parental rstricitons
ego is conflict with…
the id, superego, and reality
what are defense mecahnisms?
used by the ego to relieve presure from the drives
repression
rejection from consciosness of painful or shameful expeirences
denial
disavowal
reaction formation
replace urges that are unacceptable to the ego by the opposite (e.g. OCD)
rationalization
giving socially acceptable reason to exmaplin unaccepatalbe behavior or thoughts
projection
atttirbute own unaccepatable wishes to another
displacement
transfer emotion from original to more acceptable (e.g. phobias)
fixation
stuck at stage of devlopment that has been attained successfully when problmes too difficult to deal with
sublimation
transform libidinal desires to socially accptable interests/actions; most mature of the defenses
projective identificaiton
deposit unwanted aspects of the self into another so that theperson feels one with the object; modified, then retrieve
projective identificaiton has what affect on others
pressures them to feel as you do
splitting
divide external objects into "all good" or "all bad"
intellectualization
control of affect and imp;luses by way of thinking v. experiencing them,
undoing
symbolic acting out in reverse of unacceptalbe thing thathas already been done (e.g. driving slowly after accident)
anxiety occurs when (a/t Freud)
defenses fail and impulse starts to break down --> signal anxiety
primary process thinking
governed by the id and pp; unconscious
secondary process thinking
logical, sequntial; reality principle
transference
pt projects own feelgins, wishes, etc. about person in the past onto the therapist = projection plus repetition compulsion
positive and negative transference
postive - love, longing, desire for health; negative - aggressive drives from parent
therepeutci alliance is fomred from what a/t Frued
postive transference
coutnertransference (postive and negative)
own desires, thoughts, etc. from the past onto patient --> gratify own needs but can lead to better understanding of transference
4 steps in psychoanalysis
1. Confrontation (points out sx of neurosis); 2. Clarification why/what/how pt. Is resiting 3. Interpretation once motivated, pt must be ready to hear; over and over; 4. Working htrough assimilation of insight into the personlaity
interpetation should lead to what?
cahtarsis and insight (connect behavior to unconscious material)
Jung's version of unconscious
2 levels: individual/personal unc. (arises from repression) and collective unconsicous (inherited neural patterns)
archetypes
predisposiont to perception and emotions hsared by all
extraversion
pleasure in external things
introversion
turning inward of the libido; devlops at midlife crisis (@40)
Adler is known for
inferiority complex, masculine protest, compentsatory patterns, style of life,
masculine protest
whne inferiority complex turned into a desire to dominate or be superior =
compensatroy patterns
defense mechanism to overcome inferiorirty feelings =style of life
maladaptive style of life leads to
neurosis, psychosis, ot delinquency (unproductive life styles)
goal of Adlerian therapy
replace unhealthy styles of life with healthy ones
STEP and STET (systematic training for efective parenting and teaching) is based on who's work?
adler
neofreudians
horney, stack-sullivan, fromm
Horney main theory
parents' behavior--> basic anxiety (helplessness and isolation in a hostile world)
defense mechanism defined by honey
using style of relating to others (moving towards, away, or against)
health a/t honey
integrating styles of relating
Harry stack Sullivan basic theory
role of cognitive experience in personality development
3 modes developing infant (modes and theorist)
Harry stack Sullivan 3 modes are protaxic, prataxic, syntaxic
protaxic
discrete, unconnected momentary states that refer to experiences prior to language (1st months of life and schizophrenia)
prataxic
private or autistic symbols and see causal connections between unrelated events - serves developing self and reduces anxiety or related to neurosis
syntaxic
symbols that have shared meaning (by end of 1st year) sequential, consistent --> lang. acquisition
Eric Fromm main theory
society prevents people from realizing their true nature (creative, loving)
5 chs styles of rx to demands of society a/t Fromm
5 chs styles of rx to demands of society a/t Fromm receptive, hoarding, exploitive, marketing, productive (allows reach potential)
ego analysis
emphasizes the ego's role in personality development; more focus on current exp vs. transference
2 fx of ego a/t ego psych
ego defensive fx (resolution of conflict) and ego-autonomous (adaptive non-conflict, learning, memory, speech)
object/introject
a mental representation of an ind. (self or other); by 3rd year, maintained by ego as stable
poorly developed introjects occur b/c
disturbed parents
Kernberg is associated with which theory
object relations - esp. in BPD
Kohut is associated with which theory?
self-psychology and the fact that natural self-love is thwarted by unempathic parenting --> grandiosity
Self-psychology methods of tx
re-parenting to protect ego and reduce grandiosity
3rd force psychology
humanism and existentialism; individuality and inherent ability to grow/change stressed
client centered therapy
Rogers;
self-actualizing tendency
goal of treatment is to realize this
incongruence
when not a unified whole - conflict btwn the self concept and experience
what causes anxiety a/t Rogers
when we deny or minimize incongruence to maintain pos. self image
what leads to a constructive client response a/t Rogers
accurate empathetic understanding; unconditional pos. regard, congruence in therapist
existential therapy theory of personality
struggle btwn individual and ultimate concerns of existence
existential theory of pathology
neurotic anxiety - when try to avoid normal anxiety (which is proportionate to cause) leads to subjective sense of loss of free will
goals and tech of existential
eliminate neurotic anxiety by identifying instances when pt avoids responsibility for own life
gestalt theory
each person is capable of assuming responsibility and living life as a whole integrated person
gestalt theory of personality
self-image imposes external standards and impairs actualization and growth of the self
boundary disturbance a/t gestalt theory
interactions with the env. That result in an ind. Controlled more by self-image than self
gestalt theory of pathology
awareness of the needs and incorporating wants (self) and should (s-I) and modulating boundaries
goals of gestalt tx
awareness of environment, self, and boundaries through focus on here-and-now
reality therapy
GLASER; focus on present; be realistic about fulfilling own needs w/out harm; encourages resp.
5 basic needs of Glasser
survival, power, belonging, freedom, and fun
meet 5 basic needs of reality leads to
success identity
transactional analysis theory of pers.
ego state; scripts; strokes; ;life positions
ego states (ta)
CHILD, PARENT, ADULT
strokes
pos or neg recognition from others that facilitate transactions
scripts
life plan from an in reaction of parents and society; chs. Pattern of giving or receiving strokes
life positions
I'm OK - you're ok (only healthy one) and its variations
3 TYPES OF transactions
complementary, crossed, ulterior
goal of at
integrate ego states and alter maladaptive scripts etc.
feminist therapy goals
emphasizes seeing alt roles and empowerment; equal power is fundamental tenent
non-sexist therapy
focus on equal power, validating non-stereotypical gender roles; doesn't focus on political change
feminist object relations theory
change will only occur with change in parenting of equality btwn da and sons
automatic thoughts
appraisal of a situation
schema
core beliefs - internal models of self and world
cognitive distortions a/t Beck
link dysfunctional schemas and automatic thoughts - info is distorted to fit schema
arbitrary reference
draw conclusions without evidence or contradictory evidence
selective abstraction
focus on detail taken out of context
overgeneralization
general rules from isolated instances and apply to other situation broadly
personalization
attributing external events to oneself without evidence
dichotomous thinking
extremes
cognitive triad
negative thoughts about the self, the future, and world -linked to depression
tech of CBT
monitor neg. at, examine evidence, substitute more reality based interpretations for biased cog, identify and alter schema that predispose distortions
cog techniques of CBT
decatasrophizing, eliciting at's through journaling, reattribution, redefining problem as concrete/sp
beh techniques of CBT
homework, activity scheduling, graded task assignments toward goal, hyp. Testing, beh. Rehearsal, diversion tech for reducing strong emotions
RET
people have rational and irrational beliefs about negative events
rational beliefs lead to
appropriate emotional and beh rx
tech of RET
direct confrontation, contingency contracting, in-vivo
goal of RET
modify irrational beliefs, specifically must statements
ways CBT differs from RET
CT holds dysf. Thoughts are so b/c they interfere with normal cog processing of info not b/c they are irrational and RET is more behavioral b/c more directive
self-control techniques
stimulus control and stimulus monitoring only have minor short-term effects
stress inoculation training
cognitive prep (why faulty prevent coping); skills acquisition, practice in-vivo
stress inoculation training works well for
useful for reducing aggression
hypnotherapy involves 3 factors
absorption, dissociation; suggestibility
hypnotherapy useful for
phobias, habit cessation, dissociative disorders, PTSD
hypnotherapy contraindicated for
psychosis, paranoia, cod, depression, mania
who is easiest to hypnotize, hardest?
anxious versus manic/dep
paradoxical intervention
prescribe sx for which wants relief; used to circumvent anticipatory anxiety
transtheoretical model of change (theorist)
Prochaska and DiClemente
transtheoretical model of change
5 stages people pass through - precontemplation, contemplation, preparation, action, maintenance
precontemplation
low insight
contemplation
considering but not committed (6 mo)
preparation
clear intent of action, small steps poss. at this point (1mo)
action
time & energy - others notice
maintenance
lasted at least 6 mo --> consolidation
Motivational Interviewing (theorists and goal)
Miller and Rollnick; resolve ambivalence and build commitment; based on TM
Motivational Interviewing (5 principles)
express empathy through reflective listening; develop discrepancy btwn goal and beh.; avoid argument; roll w/ resistance; support self-efficacy
properties of family systems theory
wholeness, non-summativity, equifinality, equipotentiality, homeostasis, negative feedback, positive fdbk
wholeness -
interrelatedness, change one change all
non-summativity
whole is greater than sum of its parts
equifinality
pattern of behavior is more imp. than individual topics
equipotentiality,
one cause can lead to different results on different members of family
homeostasis
family tends towards keeping status quo
negative feedback (in family system)
maintains homeostasis
pos. fdbk (in family system)
disruption of homeostasis
communication/interaction therapy concepts
double-bind comm, metacomm (implicit nonverbal comm), symmetrical comm (when 2 equals --> conflict), complementary comm (inequality and reciprocal e.g. th and pt)
extended family systems theorist
Bowen
extended family systems theory - how is it transmitted
intergenerational dysfunction
extended family systems theory - 8 interlocking constructs
differentiation of self, triangulation, nuclear family emotional system, family projective process, emotional cutoff, multigen transmission process, sibling position, societal regression
differentiation of self
separation v. fusion
triangulation
2 conflicting members involve a 3rd
nuclear family emotional system
mechanisms used to deal with tension and instability
family projective process
projection of parental conflict onto children
emotional cutoff
method of children to distance from parents (lack of self-diff)
multigenerational transmission process
escalation over gen. -- severe dysf.
sibling position
older children tend to care for younger
societal regression
stress on family system
goal of Bowen extended family therapy
encourage differentiation of self
tech of Bowen EFT
genograms and triangualtion by therapist
Structural Family therapy - theorist
Minuchin
Methods of SFT (Minuchin)
directive, here and now framework that created crises to jar out of homeostasis
Minuchin theory
family is a system with implicit structure and subsystems with boundaries that maint. Homeo.
boundaries (SFT)
rules about how much and w/ whom ind. Can communicate
boundaries (SFT) (types)
rigid --> disengagement diffuse--> dependence
parent reinforces bad beh to refocus
detouring
triangulation (Minuchin)
each parent demands child side with them
stable coalition
one parent and child against other parent
goals of SFT
restructure family
techniques of SFT
joining, tracking, creating family maps, restructuring
joining (SFT)
thx blends into family system
tracking (SFT)
identify with values and history
family map (SFT)
tracks transactional patterns
enactment (SFT)
role plays
reframing (SFT)
re-label family behavior
blocking
block usual beh to lead to new and healthy beh.
Strategic Family Therapy (theorist)
Haley
main theory of Strategic Family Therapy
power struggle to disrupt
Strategic Family Therapy (goals)
effect immediate change by focusing on current problem
Strategic Family Therapy (techniques)
directives (straightforward or paradoxical), reframing, circular questioning (see diff accounts)
operant interpersonal therapy
increase positive and decrease negative exchanges
object relations family therapy is different from others how?
not based on systems approach
group therapy (main theorist)
Yalom
composition of groups imp.
gender only imp with kids, devt level (not >2yrs w/ kids), IQ (very imp), stability--> cohesive, 7-10members
stages of group tx
hesitancy, establish power and participation (more hostile), trust (> support and cohesion)
role of the group leader a/t Yalom
knowledgeable of group dynamics so can manage, handle muti-trans/countertrans, encourage part from all, avoid presenting sx directly
co therapists (+/-)
broader transference, complement and support, m/f; competition and disagreement
disagreement in session
not openly in beg., later ok if tactful resolution
benefits
installation of hope, belongingness, universality, express flgns, interpersonal learning (*), catharsis
most imp benefit of group tx for lower fx
installation of hope
advantages/dis of both ind and group part
adv: explore issues more and insight complements group cohesion dis: < discussion in group
crisis intervention goals
immediate sx redux, strengthening of coping mechs, restoration of fx, prevention of further dysf.
crisis therapy
short term, supportive v analytic, active, use supports, limited in scope
assumptions of crisis interv. (Saposnek)
people are healthy, focus on present and future, not due to MI, increase coping, small tx --> big gain, assess is ongoing
brief psychotherapy (goals)
remove or reduce most severe sx. ASAP, restore cl to previous emotional state, acquire understnading and skills to cope better in future
best cl for STT
acute onset, satisfactory adjustment, high motivation, good IP skills
Solution Focused Tx (theorists)
DeShazer and Insoo Kim Berg
Sltn Focused Tx
problems and goal should be client-chosen, cl has resources, change is desired, rejection of tech is lesson
tech of Sltn Focus. Tx
exception q,, formula tasks, miracle Q, skeleton keys, narratives
narrative in SFT
narratives derives from transactions of shared meanings
binocular vision
when cl and thx meaning intermingle to crease deeper meaning
progressive narrative
reflects how cl is progressing
digressive
moving away from goal
stability narrative
life is static for client
language games in SFT
creatively misunderstanding call's confusion
MMPI-2 (T-scores)
mean 50, SD 10, 65 deviant
MMPI-2 (Age)
18 and older
MMPI-A (age)
14-18
MCMI-III (chs)
175 T/F q, 21 scales, DSMIII theory
MACI
adolescent version of MCMI-III
SCL-90
self-report, DSM-III, 5pt Likert Scale, 0=not at all
Rorchach (chs)
10 cards, 5 b/w, 2 red, 3 pastels
4 steps of Exner Admin
allay anxiety, instruction "what might this be", free ass, query
location
W - IQ to org. env, Dd - usual detail avoidance
determinants
chs of the blot, Form (shape features), F. Quality (degree blot conforms to response)
content
many A (children), few H (detachment)
populars
many (conventionality or defense) few (rebelliousness, thought disorder)
special scores
many (psychosis)
Draw a Person test
expression of self or body image, draw man, woman, self
Strong Campbell Interest Inventory (SCII) valid at...
more valid at predicting choice than success
Strong Campbell Interest Inventory (SCII) whose theory
general occupational themes derived from Holland's theory
Strong Campbell Interest Inventory (SCII) scales
Basic Interest (realistic, artistic, social, enterprising, conventional, investigative) and Occupational Scales (124) empirically keyed
Kuder Vocational Preference Record (KVP-R)
interest in 10 broad areas (outdoor, computational, scientific, musical, persuasive, artistic, literary, musical social service, clerical)
Kuder Vocational Preference Record (KVP-R) validity?
based on content validity
Kuder General Interest Survey (ages)
kids 6-12 grade
neuropsych testing (goals)
identify impairments, residual strengths, differentiate brain damage from not, degree of deficits on everyday fx, specific rec for rehab, localizing lesions
Halstead Reitan measures what different areas?
lateral dominance, psychomotor f., sensory perceptual fx, speech and lang, visuospatial, abstract reasoning, mental flex, attn/concentr.
how is the Reitan used?
often supplemented with WAIS-III or WISC-III
how long to admin Reitan?
4-5 hours
Luria Nebraska - how many items and scales?
239 items on 11 scales plus supp scales
Luria Nebraska - what does it measure?
motor, rhythm, tactile, visual, receptive speech, expressive sp, writing, reading, arithmetic, memory, intellprocess
what are the supplemental scales of the Luria-Nebraska used for?
severity, acuteness, localization of dysfunction
Bender Visual Motor Gestalt Test is used for what?
as a screening device for brain damage and indication of poss. Psych disorders such as mania, seizures, dep, obs, etc
Bender Gestalt is made up of
9 designs to re-create and often used with other tests
Bender Gestalt rel/val
highly rel/valid in predicting brain damage, emotional problems, school perf
Illinois test of Psycholinguistic Abilities (ITPA) age
kids 2-10 yrs old
Illinois test of Psycholinguistic Abilities (ITPA)used for
assess channels (auditory/vocal, visuomotor), processes (org, expressing, understanding) & levels (representation, automatic)
Stroop Color Word Test used to assess for
frontal lobe damage, try to inhibit color
Eysenck found what in what year?
tx=no tx; 1952; 19 studies; only BT > placebo
Smith and Glass found what when?
1978; ave. cl at the end of tx is better off than 80% w/out
Smith and Glass found what ES?
tx ES .85 >placebo on average; placebo better than nothing
Rosenthal when and what
1983 and found 66% of tx show improvement v. 34% of controls
Smith and Glass found what about BT ?
not significantly better, just more studies
client variables that increase effectiveness of tx
IQ, openness, understanding goals, anxiety tolerance, moderate expectations
client variables that decrease effectiveness of tx
low or high expectations, low IQ, lower SES
client variables with no effect
gender (wo seek more), age, motivation (inconsistent)
therapist variables - age
modest effect for young cl w/ mild disorders - similarity helps
therapist variables - ethnicity
not a factor a/t Sue but some rch suggests AA more disclosing to AA
therapist variables - emotional well-being
modest rel.
therapist variables - expectations
when matches pt, increases outcome
therapist variables - professional background
paragraph = proff; cl view of this imp, > exp imp when difficult and measured early
therapist var - self-disclosure
inconsistent
therapist var - gender
no diff
therapist var - orientation
no real diff
therapist var - competence
difficult to operationalize, but in some situations, the most important
treatment variables - therapeutic alliance
most important, more than sp. Interv.
treatment variables - duration
ambiguous, STT favored, 26 seems to be ceiling
treatment variables - type
BT and combo of psychothx and pharm for some disorders
outcome for adolescents
girls more effect, ES > for BT
outcome for geriatrics
effective - no better type
3 phases of effective tx (Howard, 96)
remobilization, remediation, rehabilitation (reduce hopeless, reduce sx over 16 sess, then gradual inc. in fx) respectively
emic
studying a culture from the inside to see as they do
etic
studying culture from the outside through one's own lens
why are ethnic minorities underserved?
1. language diffs; 2 class boundaries; 3. culture bound values
similarity of cl and pt (ethnicity)
depends on study, but probably decreases drop-out
factors that effect ThAlliance
racial/cultural identification, attitude similarity (> imp than race), thx sensitivity, possibly presenting issues

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