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EPPP Clinical - Dec2005


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Psychoanalytic theory says defenses are... and anxiety is due to...
Defenses are to keep impulses unconscious Anxiety occurs when defenses break down
What is reaction formation?
Reaction formation is a defense mechanism - show feeling opposite to what you're feeling.
Which personality disorder tends to use reaction formation most often as a defense?
Tends to be used most often by obsessive compulsives.
What did Freud's theorioes focus on?
Internal, unconscious drives
What are the stages of his theory?
Oral Anne is a Pretty Little Girl
According to Freud, what is the basic defense?
According to Freud, who tends to use projection as a defense?
Paranoid individuals
What did Carl Jung state happens as we age?
move from introversion to extroversion
What common crisis did Jung define?
midlife crisis
What did Sullivan focus on?
The cognitive experiences of infants.
What is parataxic as defined by Sullivan?
Parataxic is like transference. Individuals relate to others based upon experiences w/family members
What did the Neo-Freudians focus on?
1. social and cultural influences on personality
What did the object relations theory focus on?
1. development of introjects based upon early interactions
What disorders does Object Relations theory attempt to explain?
Borderline & Narcistic PD
What defenses does Object Relations define?
Alloplastic (think others should change, e.g., narcissist) and autoplastic(think you should change - e.g., neurotic person)
What was Adler's theory? What was its focus?
1. Individual Psych 2. overcoming inferiority and need for power & attention
What was Beck's theory? What does a automatic thought mean to Beck?
1. CT 2. an interpretation of a situation
Give an example of a type of automatic thinking & define it
Arbitrary inference, overgeneralization, dichotomous thinking, or personalization
How do distorted percentions lead to behavior?
distortion -> schemata ->automatic thought->behavior
According to cognitive theory, when are irrational thoughts maladaptive?
When they interfere w/functioning
What is the cognitive triad of depression?
1. negative thoughts about self, future, & world 4.
Is CT or medication better for depression?
CT equal to or better than meds
What is the initial focus of therapy w/severe depression?
Negotiate behavioral tasks to increase activity level
What's 1st thing to do if client severly depressed?
refer for medical eval
What did Seligman contribute?
1. Concept of learned helplessness
What did Michenbaum contribute?
The use of self-talk or self-instruction
What is IPT? What is its primary application?
1. Interpersonal Therapy 2. short term therapy for depression
According to Interpersonal Therapy, what contributes to depression?
According to IPT depression is due to early attachment disturbances
What theory did Ellis create? What is its focus?
1. REBT 2. irrational beliefs
What diagram best describes it?
ABC model (Activating event, Beliefs, Consequences of beliefs)
According to Ellis and REBT, when are irrational thoughts maladaptive?
Which Biofeedback technique good for tension headaches?
EMG biofeedback is good for tension related problems
Which Biofeedback technique good for bloodflow issues like a migrane?
Thermal biofeedback is good for bloodflow issues.
How effective is Biofeedback?
Biofeedback is not necessarily better than simple relaxation
What do Existential/Humanist focus on?
Existential/humanist focus on the subjective experience in the here and now
How do existential/humanist view psychopathology?
According to existential/humanist psychopathology is a well intentioned defense that never the less interferes with personal growth.
What did Maslow contribute to psychology?
Hierarchy of needs
What is the overall goal of life according to Maslow?
Maslow viewed the primary goal of life as self- acutalization
According to Maslow, in what order are needs met?
Basic primary needs are met before relationship needs and before self-actualization.
What did Kohler contribute? What did his theory lead to?
1. focus on Insight learning (ah-ha experience) 2. development of gestalt theory
What did F.Perl contribute? According to Perl, what is fantasy?
1. Gestalt theory 2. Fantasy is anything outside of here and now.
What is the primary goal of Gestalt theory?
Awareness of a greater whole
What is the focus of Gestalt theory?
Integrating selves into the greater whole
What is Roger's theory?
What is the goal of Roger's client-centered theory?
Reconcile discrepancy between ideal & real self
What does client centered therapy discourage?
Client centered therapists discourage emphasis on a diagnosis
What is Glasser's theory?
1. Reality
What is the goal of Glasser's Reality Theory?
Reality therapy strives to create a successful identity.
What is the focus of Reality Therapy?
Power, affiliation, & fun
According to the communication's theory of psychopathology, what two types of communication are possible between individuals?
Symmetrical & complementary
Which communication style involves people of 2 different roles?
According to communication's theorists, what is a double-bind?
When 2 aspects of the same message conflict (e.g., spoken communication does not match non-verbal communication).
What is Milton Erikson greatest contribution to therapy?
Milton Erikson pioneered the paradoxical directive (I.e., prescribing the symptom, or asking client to increase the behavior they want to stop).
The paradoxical directive likey reduces what associated with the problem behavior?
The paradoxical directive likely decreases the anticipatory anxiety of the behavior through exposure.
What does Existential therapy focus on?
The ultimate concerns of existence
What is TA? What does it focus on?
1. Transactional Analysis 2. Life scripts and the choices we tend to repeat in our lives.
What are 3 benefits of group therapy?
1. interpersonal learning, catharsis, cohesiveness
When should co-leaders resolve their conflict in front of the group?
Co-leaders should resolve their conflict in front of the group in the later stages of the process.
What is a downside of doing group and individual therapy together?
Concomittant individual therapy may detract from that individual's contribution during group sessions.
What is the focus of Bowen's Family therapy?
1. Bowen believed it was best to work w/ the most differentiated family member
Bowenian theory was one of the first to introduce the idea of triangulation. What is triangulation?
Triangulation occurs when two family members attempt to form a coalition with a third to disempower the other family members. In the classic Bowenian example, each parent attempts to get the child to side w/them.
MMPI-2 uses what type of scoring? What is difference between MMPI-A & MMPI-2?
The MMPI is a criterion keyed measure. That is, items distinguish different groups of psychiatric patients. 2. MMPI-A is the adolescent version. MMPI-2 best used on those 18 years old and older.
What population is the MMPI-2 designed for?
psychiatric population
How are MMPI-2 results analyzed?
MMPI results are analyzed through a process of pattern analysis. Certain code types capture reliable behavior patterns.
What are the MMPI-2 validity scales?
The MMPI-2 uses three validity scales: L scale (faking good), F scale (faking bad), K scale (consistency of responding)
Other personality scales: SCL-90 MCMI-III
1. self report inventory 2. labeled as DSM categories
What is the Kuder Vocational? What is the Kuder good for?
The Kuder also assesses interest, but it assesses interest in specific occupational areas. Typically, these are more trade related occupations (e.g., plumber, eletrician, etc).
How do Strong & Kuder differ?
The Kuder assesses areas outside of traditional academia focus.
What is the Strong Interest inventory? What is the Strong good for?
1. assesses occupational interests 2. predicting job satisfaction Scales like realistic, artistic, etc.
Projectives What are the steps of Rorschach administration?
1. introduction, instructions, responses, & inquiry (which helps with scoring)
What does recent research say about the Rorschach?
Recent advances in Rorschach scoring systems have led to an increase in validity of results.
What is the biggest suicide risk factor?
A feeling of hopelessness.
What is the goal of family therapy? What is the focus of family therapy?
The goal of family therapy is to solve the presenting problem. 2. The focus is to disrupt family homeostasis which has maintained the problem, but maintain a balance between stability and change so new solutions can emerge.
What is a basic tenet of family therapy in terms of changing the identified patient?
Changing the family system will lead to change in the identified patient.
What did Minuchin add to family therapy literature?
Minuchen's theory focused on the structural hierarchy of the family. His theory focuses on boundaries (enmeshment vs. disengagement) between family members.
What did Haley contribute to family therapy literature?
Haley is the father of strategic therapy.
What is the focus of strategic therapy?
Strategic therapy focuses on the communication patterns and power conflicts that maintain the problem behavior. Strategic disruption of these processes leads to problem resolution.
What 2 things does pain therapy involve?
1. relaxation & coping skills training
What does stress inoculation focus on? What is it good for?
1. Modifying maladaptive cognitions about the problem or situation 2. Worry, aggression & impulsiveness
According to Minuchin, what is mimesis?
Mimesis is Minuchen's view of joining with the family
Hypnotherapy induces what state of consciousness?
Relaxed (and focused) wakefulness
What types of problems (name two) is it good for and what is it not good for?
Hypnotherapy is good for PTSD symptoms, anxiety, and habits (I.e., those disorders that respond to exposure based interventions). It is not good with severe disorders like psychosis.
Is psychotherapy efffective?
Yes. Most people (75%) who receive therapy improve.
Is any particular therapy better than any other?
No. All therapies appear to be similarly effective.
Who responds best to therapy?
Females, particularly adolescent females, respond best to psychotherapy.
Which factor influences outcome of therapy most?
Client/problem variables impact therapy the most.
The most important therapist variables are?
Competence and the similarity between the therapy beliefs held by client & therapist.
What is cognitive behavioral therapy most effective for?
Depression, anxiety, phobia, aggression
Most important client variables are?
The client's level of misery/distress and their expectations of therapy
What is the impact of client/therapist ethnicity matching?
Ethnicity influences duration in counseling (higher ethnicity matching = longer course of therapy)
What is relationship between #sessions & improvement?
Negatively accelerated curve - most change occurs early on but improvement seen up to 26 sessions.
What are the three types of prevention? What do they work on? (define them)
1. primary seconday tertiary
What is brief psychotherapy?
Short term therapy that attempts to reduce symptoms.
What is the goal of brief psychotherapy?
Change behavior, perhaps through flash of insight or new way of viewing situation.
How does brief psychotherapy view symptoms?
Symptoms are viewed as maladjustment. They are the result of previously attempted solutions or a failure to adapt old strategies for a new situation.
What is crisis intervention?
Psychological and physical "first aid" to reduce symptoms.
What is the focus and goal?
The focus is to stabilize current functioning with the goal of returning the person to previous (I.e., precrisis) functioning.
How does crisis intervention view symptoms?
Symptoms are viewed as a normal reaction to an abnormal situation.
What was Prochaska & DiClemente's major contribution to the literature?
Stages of readiness for change (precontemplation, contemplation, preparation, action)
What is the difference between preparation & action?
Those in the preparation stage are taking small "baby" steps, but those in action are consistently and actively engaged in changing.
What is the difference between contemplation & preparation?
Those in contemplation will act within 6 months, but preparation will act within 1 month.
What is the Halstead-Reitan? What kind of score does it provide? How long to administer?
1. neuro psych assmt 2. impairment index= below criterion subtest scores 3. 4-5 hours
What is the Stroop Color-Word?
A test frequently utilized as a screener for frontal lobe damage. Describe test.
What effect would be seen on the Stroop Task for people with left frontal lobe lesions?
The person would read the word instead of naming the color of the ink.
Multicultural competency requires ASK. What does ASK stand for?
1. Awareness, skills, & knowledge
What is a culturally encapsulated therapist?
A culturally encapsulated therapist is someone who is unaware of his/her own biases.
emic vs. etic high context vs. low context
What does research reveal about minority utilization of therapy?
Utilization of therapy varies across (and presumably within?) minorities.
Which minority has the highest drop out rate for therapy?
Which minority has the lowest drop out rate for therapy?
Minorities experience what type of locus of control and locus of responsibility in TODAY'S times?
Internal locus of control, and external locus of responsibility
What is a commonly held stereotype about elderly and intelligence?
Intelligence declines with age
Who developed a healthy identity model of homosexuality?
"Cass. Cass proposed that individuals go through six non-age-specific stages: (1) identity awareness--the individual is conscious of being different; (2) identity comparison--the individual believes that he or she may be homosexual, but tries to act heterosexual; (3) identity tolerance--the individual realizes that he or she is homosexual; (4) identity acceptance--the individual begins to explore the gay community; (5) identity pride--the individual becomes active in the gay community; and (6) synthesis--the individual fully accepts himself or herself and others.
According to Cass, who develops a healthy homosexual identify sooner?
Boys develop a healthy homosexual identify sooner than girls.
What are the two basic tenets of feminist theory?
A woman is the expert of her problems. Therapy should empower women.
What is the percentage of children diagnosed with Tourette's that are also diagnosed with ADHD?
60% of those children with Tourette's will also meet criteria for ADHD.
Which medication may cause an increase tics?
Stimulant treatment (e.g., methylphenidate), particularly high doses, may cause an increase in motor and vocal tics.
Name two popular neuropsych tests.
1. Luria-Nebraska 2. Bender-Gestalt

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