EPPP-Clinical Psychology

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Ackerman, Nathan: A psychoanalyst/child psychiatrist, is sometimes referred to as the "grandfather of family therapy" and is usually credited with adapting psychoanalytic theory to family therapy. Ackerman emphasized the dynamic between the biologically-driven individual and the social environment. For Ackerman, a FAILURE OF
COMPLEMENTARITY in social roles underlies maladaptive behavior in an individual and family. A failure of complementarity limits a family's ability to adapt to change and thereby
maintain homeostasis.
ANXIETY (PSYCHOANALYSIS), BASIC ANXIETY & NEUROTIC ANXIETY: 1. ANXIETY (PSYCHOANALYSIS): To Freud, a key concept in normal personality
development and functioning and in the development of pathological conditions. Freud distinguished between three types of anxiety: reality (objective) anxiety, neurotic anxiety and moral anxiety. All serve to alert the person to the presence of internal or external threats, which involve conflicts between the different structures of the personality or between the structures of the personality and reality. Underlying moral anxiety, for
example, is a conflict between the ego and the superego.
2. BASIC ANXIETY (HORNEY): A feeling of dread or impending disaster that is attributable to the child rearing practices of one's parents. Parenting behaviors associated with basic
anxiety include indifference and coldness, exceedingly high standards and constant criticism. For Horney, a person's personality reflects his/her strategies for coping with
basic anxiety.
3. NEUROTIC ANXIETY (EXISTENTIAL THERAPY): In existential psychology, the anxiety that results when an individual attempts to evade facing certain "existential issues" and
the existential anxiety that accompanies them; it is considered the cause of maladaptive behaviors.
Bowen: Bowen, a key figure in the development of family therapy, views the family as an "emotional relationship system" that consists of eight interlocking components (e.g.,
differentiation of the self, triangles, multigenerational transmission process). His version of
family therapy is sometimes referred to as the extended family systems approach, since he
attributes maladaptive behavior patterns to the operation of a family's emotional system
over several generations.
1. DIFFERENTIATION: The separation of the intellect and emotion that allows an
individual family member to resist being overwhelmed by the emotional states of other
family members.
2. EMOTIONAL TRIANGLES: Systems in which a third person has been recruited by a
two-person system in order to reduce conflict and restore stability.
3. MULTIGENERATIONAL TRANSMISSION SYSTEM: The notion that severe mental
disorders require several generations to develop.
4. GENOGRAM: A schematic diagram of a family's multigenerational relationship system.
Brief Psychotherapy: A recent development in psychodynamic therapy is the introduction of a number of brief psychotherapies that are used commonly in crisis-oriented situations, but that retain, to
varying degrees, elements of traditional psychoanalysis. While transference, insight and
working through are retained in many of the brief psychotherapies, they are accelerated,
and the ultimate goal of therapy is not the reconstruction of the personality, but the ability
to adapt to and cope with day-to-day living in a more functional way.
Child Abuse: 1. CHARACTERISTICS OF ABUSIVE PARENTS: Poor impulse control, low frustration
tolerance, low self-esteem, emotional immaturity, emotional overreactivity, chronic
suspiciousness, high dependency, authoritarianism and drug and alcohol abuse; relatively
young age; social isolation; a history of childhood abuse; misperceptions about their
children (e.g., unrealistically high expectations) and inaccurate perceptions of the child's
needs and normal development; and a strong belief in the value of physical punishment as
a method for controlling behavior.
2. CHARACTERISTICS OF THE ABUSED CHILD: Display higher rates of medical illness,
mental retardation, physical deformities and handicaps, developmental delays,
hyperactivity, oppositionalism, delinquency, low self-esteem, impaired ability to enjoy life
and withdrawal (however, these may be effects of maltreatment rather than causes);
among young children, boys are usually the more common victims of physical abuse, while
in adolescence, girls are more frequently abused; premature and difficult births are linked
with higher rates of physical abuse.
Client-centered and facilitative counseling: Client-centered therapy (Rogers) is based on the assumption that the individual possesses
inherent capabilities for growth (self-actualization). Rogers views maladaptive behaviors
as the result of an "incongruence between self and experience." He defines such
INCONGRUENCE as the inconsistency that an individual feels between his/her sense of
self and experience in the world. The therapist's role in client-centered therapy is to help
the client achieve his/her own destiny by promoting the client's free expression of feelings
through the provision of three facilitative conditions:
1. CONGRUENCE (GENUINENESS): Occurs when the therapist is "real," when he/she is
genuine, integrated and authentic during the therapy session.
2. EMPATHY: A therapist is exhibiting empathy when he/she accurately and sensitively
enters the client's private, inner experiences; i.e., when the therapist is able to "walk in
the client's shoes."
3. UNCONDITIONAL POSITIVE REGARD: An attitude of concern, acceptance and
warmth. The experience of unconditional positive regard is a necessary precondition for
self-actualization.
Collaboration, consultation, and supervision: 1. COLLABORATION: collaboration is often distinguished from consultation. In the former
only is there an implication that the consultant will participate with the consultee in the
implementation of any plans.
2. CONSULTATION: A form of indirect service to the population in which the consultant interacts directly with consultees (e.g., therapists, teachers) who then interact directly
with the target population. The primary goal of a consultant is to "have a positive but indirect effect on a client population by improving the work skills of the consultee who works directly with that population" (B.L. Bloom, Community Mental Health, 1977).
3. SUPERVISION: The clinical guidance and direction of a trainee in the field of
psychotherapy by an experienced psychotherapist. Supervision must be distinguished from consultation and collaboration.
Community Psychology: The branch of psychology that deals with problems related to mental health, education, crime, delinquency, drug abuse, family planning, etc. Community psychology interventions
often involve attempts to alter social systems and social environments. The emphasis of
community psychology is on prevention, rather than treatment, especially primary
prevention. See also "Prevention."
Community Psychology Treatment Techniques: 1. CONSULTATION: A knowledgeable professional (consultant) trains or advises others (consultees) who are in closer contact with members of the target population so that they
can provide the desired services to the population. Characteristics include: (a) The consultee-consultant relationship is always voluntary; (b) the consultant is not a member
of the consultee's organization; (c) the consulting relationship is time-limited; and (d) the
consultation is always problem-focused.
2. USE OF PARAPROFESSIONALS: See "Paraprofessionals."
3. DEINSTITUTIONALIZATION: Some studies suggest that deinstitutionalization (plus the introduction of antipsychotic drugs) caused a large drop in the number of hospitalized mental patients in the 1960s and 1970s but others have found that it actually produced a
"revolving door" effect in which hospital readmission rates have increased along with discharge rates. Readmission rates tend to be lower when appropriate programs prior and subsequent to release from the hospital are provided and the most successful aftercare programs are those that emphasize psychosocial skills.
4. MENTAL HEALTH EDUCATION PROGRAMS: Goals are to reduce the incidence of
mental health problems by increasing preventative activities and to improve the care of the mentally ill by educating the public about the nature of mental disorders and their treatment. Some studies suggest that such programs are more useful for increasing information than for actually changing health-related practices but others indicate that mass media campaigns are effective both for increasing information and changing behavior.
Counseling Minority Groups: Experts in the field have suggested the following with regard to counseling minority
groups clients:
1. AFRICAN-AMERICAN: (a) Culture and Values: Greater emphasis on nonverbal
communication; greater emotional expressiveness; more likely to turn to family, neighbors
and church during a crisis. (b) Therapy: Respond best to time-limited, problem-solving and child-focused approaches and to expect active therapist participation and direction.
2. ASIAN-AMERICAN: (a) Culture and Values: Shame may be used to control the behavior of family members; roles are often determined by age and gender; emphasize conformity, dependency, obedience to elders, duty to family, achievement, privacy and restraint of strong feelings. (b) Therapy: Cultural conflicts may be reflected in therapy; e.g., by the client's lack of active participation, dislike for the ambiguous, unstructured nature of the
therapeutic process, suppression of emotional expression, difficulty discussing emotional
problems and preference for talking about educational/vocational or somatic complaints.
3. LATINO-AMERICAN: (a) Culture and Values: The family is usually patriarchal and
emphasizes loyalty and love for the mother who unifies the family and loyalty to the family first; favor personal and professional relationships that emphasize personal contact and
individualized attention. (b) Therapy: Therapist should acknowledge the importance of personalismo, be active so that a swift, concrete solution for the identified problem can be
found, use family-oriented therapy and modify counseling techniques to fit the client's degree of acculturation.
Crisis Intervention: 1. CRISIS: A situation or event that causes unusual stress and marked disorganization in affect and behavior. A crisis usually involves three stages: shock (denial), realization and integration.
2. CRISIS INTERVENTION: Brief and directive therapy that focuses on the present and is provided to help the person cope with psychological emergency situations. The primary
goal in crisis intervention is to restore the client to at least his/her pre-crisis level of functioning.
Crisis Intervention vs. Brief Psychotherapy: 1. CRISIS INTERVENTION: (a) Lasts 1-8 sessions. (b) Indicators include acute emotional
pain and danger. (c) The problem is considered a normal reaction to a stressful event. (d) The therapist is an active participant. (e) The goal is to resolve the immediate crisis. (f) The focus is on the present.
2. BRIEF PSYCHOTHERAPY: (a) Lasts 1-20 sessions. (b) Indicator is a sudden loss of
ability to cope with a life situation. (c) The problem is viewed as pathological. (d) The therapist is a participant observer. (e) The goal is to remove specific symptoms. (f) The focus is on the past as it relates to the present.
Curative Factors in Group Therapy: All therapy groups provide their members with certain therapeutic experiences, or curative factors. For Yalom (1985), these factors include: Information, hope, universality, altruism,
interpersonal learning, imitation, socializing techniques, corrective recapitulation of the
primary family, catharsis, group cohesiveness and existential learning. Of these factors, interpersonal learning and catharsis are usually ranked, respectively, as the first and second most important factors by out-patient therapy groups members. In-patient group therapy members are more likely to rate instillation of hope, existential learning and other factors as most important.
Defense Mechanisms: According to psychoanalytic theory, "defense mechanisms" are mental strategies that
operate unconsciously and are used by the ego to reduce emotional conflict and anxiety
arising from the discrepant demands of the id, superego and reality. Examples include:
1. DISPLACEMENT: Unacceptable impulses are discharged by expressing them toward a
neutral or nonthreatening target rather than the original target.
2. PROJECTION: One's own unacceptable id impulses are attributed to others.
3. REACTION FORMATION: An anxiety-arousing impulse is replaced with its direct
opposite.
4. REPRESSION: Unacceptable id impulses are kept out of conscious awareness by
maintaining them in the unconscious. Repression is the most "basic" defense mechanism.
5. SUBLIMATION: Undesirable impulses are directed into socially-desirable goals.
Leonardo da Vinci's urge to paint Madonnas can be viewed as a sublimated expression of
his longing for reunion with his mother, from whom he had been separated at an early age.
Double-Bind Communication: A "double-bind communication" is a set of contradictory communications from the same person. For example, a parent says "I love you" to his child while pushing the child off his
lap. According to communications family therapists, double-bind communication is a
contributing factor to Schizophrenia.
Milton Erikson: Erickson, a psychiatrist, is attributed with influencing both family therapy (especially
strategic family therapy) and hypnotherapy. He is associated with the use of hypnotic
techniques and paradoxical instructions designed to manipulate a client's resistance so
that the client, by resisting, actually performs the desired behavior.
Expressed Emotion: High levels of expressed emotion (EE) by family members have been associated with high relapse rates and rehospitalization of schizophrenic patients. High-EE families are characterized by emotional overinvolvement, high levels of criticism and open expressions of hostility.
Psychotherapy Research: 1. EYSENCK, HANS: A British psychologist known for his factor analysis of personality, contributions to behavior therapy and now-classic 1952 review of the therapy outcome literature. His review suggested that 72% of hospitalized neurotics improved without
treatment, a figure higher than that for patients receiving either psychoanalytic or eclectic
therapy.
2. SMITH, GLASS AND MILLER: Researchers who, in response to Eysenck's criticism of
psychotherapy, used meta-analysis to review therapy outcome research studies. Their meta-analysis concluded that the typical therapy client is better off than about 80% of untreated individuals (1980).
Family Therapy Approaches: 1.COMMUNICATION/INTERACTION: Focuses on the role of communication and other
interaction patterns in individual and family functioning and, thus, views human problems as being primarily interactional and situational. Associated with this approach are Gregory
Bateson, Don Jackson, Jay Haley and Virginia Satir.
2. EXTENDED FAMILY SYSTEMS: The name given to the version of family therapy
associated with Bowen. Therapy combines various strategies in a context that involves all the significant people in the client's life, and can be conducted with any or all members of
the family. The therapist is a "coach," his/her approach is directive and cognitive and the goal is to maximize the self-differentiation of family members.
3. STRUCTURAL: Emphasizes altering the family organization, or structure, in order to change the behavior patterns of family members. Of particular concern are boundaries,
which can be either enmeshed or disengaged. The structural model is associated with Minuchin.
4. STRATEGIC: Emphasizes the use of specific strategies or plans (e.g., paradoxical
interventions and ordeals) to solve the family's presenting problem. Strategic therapy is
associated with Jay Haley and Cloe Madanes.
Group Therapy Considerations: Requires consideration of the following issues:
1. GROUP COMPOSITION: In general, therapy groups are more effective when they are
heterogeneous in terms of client characteristics; such groups promote greater group
interaction and longer-lasting personality change. Homogeneous groups are sometimes preferred, however, since they may lead to quicker mutual understanding and
acceptance. Homogeneous groups are most effective for certain problems; e.g.,
alcoholism, substance abuse, obesity, depression, delinquency, marital problems.
2. GROUP ENTRY: Closed groups (those that begin and end with the same members) are most useful for short-term, task oriented groups and groups conducted in in-patient settings. Open groups (those that allow new members to join and replace departing members) are best suited for outpatient groups that are long-term and that have broad goals.
3. GROUP SIZE: Therapy groups are generally most effective when they consist of between five and ten members.
4. CONFIDENTIALITY: In most jurisdictions, statutory privilege does not extend to
information revealed to other group members and a therapist cannot guarantee that confidentiality will always be respected by all members of the group. To help ensure that confidentiality is maintained, the issue of confidentiality should be discussed during screening interviews with potential members, in the first therapy session, periodically
during subsequent sessions and at termination.
Systems Theory, Open/Closed Systems: 1. GENERAL SYSTEMS THEORY: The theory that the "whole" can be understood only in
terms of the organization and interactions of its components. General systems theory is the theoretical framework underlying family therapy.
2. OPEN SYSTEM: An open system accepts input from the outside and is amenable to change. In an open family system, honest self-expression is allowed, open negotiation is used to resolve differences and differences are viewed as natural.
3. CLOSED SYSTEM: A closed system is self-contained and organized to resist change.
In a closed family system, the members are relatively uninvolved with individuals outside the family, honest self-expression is discouraged, members must have the same desires,
opinions and feelings and differences are considered as dangerous.
Gesalt Therapy: Gestalt therapy is based on the concepts of gestalt psychology (the whole is greater than the sum of its parts). Its goal is to increase a client's AWARENESS of all parts of
him/herself. It emphasizes the here-and-now and views maladaptive behavior as a growth disorder involving the abandonment of the "self" for the "self-image." Maladaptive
behavior is often the result of one or more BOUNDARY DISTURBANCES, which all reflect identification with the self-image
Boundary Disturbances: 1) Introjection: Psychological "swallowing" of whole concepts, facts, etc. without true assimilation, which prohibits the person from developing a unique personality.
(2) Projection: Making someone or something else responsible for what originates in oneself. Extreme projection results in paranoia.
(3) Retroflection: Doing
to oneself what one would like to do to others. Retroflected feelings reduce the amount of energy available for positive, spontaneous growth.
(4) Confluence: An absence of a boundary between the self and environment, which causes an intolerance of differences between self and others and often underlies guilt and resentment.
Heterogeneous vs. Homogeneous groups: 1. HETEROGENEOUS GROUPS: Groups that consist of individuals who differ with regard to important characteristics such as diagnosis, age, gender and/or socioeconomic status.
In general, therapy groups are most effective when they are heterogeneous: As long as
they do not include members who are too "deviant," heterogeneous groups promote
greater group interaction and longer-lasting personality change.
2. HOMOGENEOUS GROUPS: Groups that consist of individuals who are similar with regard to certain important characteristics such as diagnosis, age or gender. Homogeneous groups are sometimes preferred because they may lead to quicker mutual understanding and acceptance than heterogeneous groups. Homogeneous groups seem
to be especially effective for certain problems including alcoholism, substance abuse, obesity, smoking, depression, delinquency and marital problems.
Homeostasis and Feedback Loops: 1. HOMEOSTASIS: Refers to the self-maintenance of a system (e.g., a family) in a state of equilibrium, or balance, by reducing deviation so that the system maintains status quo.
Homeostasis is maintained by "negative feedback."
2. FEEDBACK LOOPS: In systems theory, describes the flow of information back into a system. NEGATIVE FEEDBACK LOOPS tend to reduce change and maintain homeostasis, and POSITIVE FEEDBACK LOOPS tend to disrupt the system's normal homeostasis.
Humanistic Psychotherapies: Insight-oriented therapies that emphasize the individual's subjective experiences, free-will
and positive qualities. The focus of humanistic psychotherapies is on present behaviors
and conscious experience. The primary goals of the humanistic approaches include the following:
1. CLIENT-CENTERED: Help the client achieve congruence between self and experience
so that he/she can become a more fully-functioning, self-actualizing person.
2. GESTALT: Help the client achieve maturity (self-responsibility and self-support) and integration (the ability to function as a systematic whole).
3. REALITY THERAPY: Help the client become responsible and thereby develop a
success identity.
4. EXISTENTIAL THERAPY: Help the client achieve an authentic existence, or mode of being-in-the-world, in which he/she can confront the threat of non-being, take
responsibility for decisions in the face of existential doubt and acknowledge his/her
fundamental existential isolation.
5. TRANSACTIONAL ANALYSIS: Help the client integrate his/her three ego states, adopt an "I'm OK - You're OK" life position and alter his/her maladaptive life script.
ID, EGO, and SUPEREGO: 1. ID: In psychoanalysis, the structure of the personality that is biological and unconscious and that operates via the "pleasure principle" to gratify its instinctual needs.
2. EGO: In psychoanalysis, the structure of the personality that deals with reality in a practical, rational way (e.g., through problem-solving, judgment, perception) and that
mediates the conflicting demands of the id, superego and reality. The ego is the
"executive function" of the personality.
3. SUPEREGO: In psychoanalysis, this is the structure of the personality that represents society's standards of right and wrong (the conscience) and the individual's own aims and
aspirations (ego ideal). The superego develops primarily through identification with one's parents.
Individual (Adlerian) Psychotherapy: The form of psychotherapy and personality theory developed by Adler, which stresses the unity of the individual. Adlerian psychotherapy involves identifying and fusing an
individual's traits in order "to form a composite portrait that is, in turn, individualized" (Adler, 1924). Key concepts in Adler's personality theory are inferiority feelings, striving for superiority and style of life. A STYLE OF LIFE is an individual's pattern of behavior, as
manifested by his/her goals, attitudes, manner of coping, etc. According to Adler, a
"mistaken" style of life is characterized by a lack of social interest and is the cause of maladaptive behaviors.
Jung's Analytic Therapy: Views the psyche as consisting of three structures: consciousness, personal unconscious
and collective unconscious. For Jung, the ultimate life goal (and a primary goal of his therapy) is to achieve a state of individuation, the state in which the various parts of the personality are integrated to form a fully realized self. Achievement of individuation involves the incorporation of unconscious aspects of personality into the conscious aspects and the achievement of unity among the four psychological "functions" (thinking, feeling, sensing, intuiting). Jung relied on many of the same techniques as Freud (e.g., free associations, interpretation of transference) to provide the client with insight into
unconscious mental content; however, he disagreed with Freud about the nature and role of the unconscious.
Meta-analysis and Effect Size: 1. META-ANALYSIS: A method used to combine data from a number of different outcome
studies. Meta-analysis involves selecting studies on the basis of predetermined criteria,
quantitatively coding relevant variables (e.g., calculating "effect sizes") and statistically
comparing the coded variables.
2. EFFECT SIZE: In meta-analysis, a method of quantifying and comparing outcome data. Calculating effect size involves subtracting the control (or other comparison) group
posttest mean from the experimental posttest mean and dividing the result by the standard deviation of the control group.
Minuchin: Minuchin is the founder of structural family therapy, which emphasizes the structure, or organization, of a family.
1. BOUNDARIES: The delineations between systems or parts of a system. Boundaries are of particular concern to structural family therapists, who view family dysfunction as the
result of boundaries that are too diffuse (enmeshed) or too rigid (disengaged).
2. JOINING: The therapist links with the family as a group and with each family member by showing that he/she understands their unique experiences. Joining involves adopting a
family's typical behaviors and patterns of communication.
Neo-Freudians & Paratoxic Distortions: The "neo-Freudians" are a group of psychologists and psychiatrists who broke away from Freud. Most importantly, the neo-Freudians reject Freud's biological (instinctual) position and adopt an approach that emphasizes the role of social and cultural factors in personality development. Individuals in this category include Horney, Fromm and Sullivan.
According to Sullivan, PARATAXIC DISTORTIONS (cognitive distortions that result from early (experiences) are the primary cause of maladaptive behavior. An example is
misinterpreting the attitudes of others toward oneself as being negative (when they are not) because of negative experiences with one's parents during childhood.
Object Relations Therapy: Psychologists and psychiatrists who have adopted many concepts of traditional psychoanalysis, but who emphasize the role of early relationships with other ("objects") in personality development. Maladaptive behavior is viewed by these theorists as the result of abnormalities in early object relations.
Paraprofessionals: A "paraprofessional" is a noncredentialed worker who performs many of the same duties as a professional; e.g., teacher's aides, nurses's aides, trained volunteers. Research on
the effectiveness of paraprofessionals in the mental health field has suggested that, at
Ieast for certain disorders and clients, paraprofessionals can be as or more effective than
professionals.
Pleasure Principle and Reality Principle: 1. PLEASURE PRINCIPLE: In psychoanalytic theory, the mode of operation of the id. The pleasure principle involves the immediate gratification of the id's needs.
2. REALITY PRINCIPLE: In psychoanalytic theory, the mode of operation of the ego. The reality principle involves delaying gratification of the id's needs until they can be satisfied in a realistic, rational manner.
Premature Termination: Premature termination from therapy is associated with conventional views, lack of anxiety, lower education levels, high need for approval, minority group membership and an
expectation that the therapist will give specific advice.
Prevention (Primary, Secondary, Tertiary): In community psychology, methods of prevention are classified as primary, secondary or tertiary:
1. PRIMARY PREVENTION: Preventions aimed at the promotion of mental health so that mental disorders will not develop. Examples: Reducing environmental stresses that usually
Iead to personality disorders; providing preventative medical care to low-income families.
2. SECONDARY PREVENTION: Preventions aimed at reducing the development or
worsening of mental disorders through early detection and treatment. Example: Administering screening tests to high-risk individuals.
3. TERTIARY PREVENTION: Preventions aimed at returning the patient to his/her previous level of functioning and/or preventing relapse. Example: Vocational rehabilitation programs.
Primary and Secondary Processes: 1. PRIMARY PROCESS: In psychoanalytic theory, the mental functioning of the id.
Primary process thinking is unconscious, irrational, ignorant of time and space and governed by the pleasure principle.
2. SECONDARY PROCESS: In psychoanalytic theory, the mental functioning of the ego. Secondary process thinking is conscious, rational, logical and governed by the reality principle.
Program Evaluation (Formative and Summative): "Program evaluation" is applied research conducted to evaluate the effectiveness of a
social program. It aids in decision-making regarding programs. The steps in program evaluation ordinarily involve (1) identifying the program's objectives; (2) specifying the
techniques for achieving those objectives; and (3) collecting and analyzing the relevant data.
1. FORMATIVE EVALUATION: Conducted during the planning and development of a
program for the purpose of determining what modifications are needed to make the program more effective.
2. SUMMATIVE EVALUATION: A systematic evaluation of a program after it has been
administered to determine if its objectives have been met.
Psychic Determinism: "Psychic determinism" is the doctrine that all psychic events obey the law of cause and effect.
Psychoanalysis (Freud): According to Freud, unconscious processes underlie current behavior. Psychoanalysis involves bringing unconscious material into consciousness through an analysis of free associations, resistances, transference and dreams.
1. TRANSFERENCE: The client's experience of feelings, etc. toward the analyst, which represent a displacement or projection and repetition of reactions to a significant person in the client's past.
2. COUNTERTRANSFERENCE: The analyst's unconscious emotional responses toward a
client.
3. FREE ASSOCIATION: The client expresses whatever comes to mind. This permits the identification and exploration of unconscious conflicts.
4. RESISTANCE: The client's reluctance to bring into conscious awareness repressed, threatening unconscious material.
5. CATHARSIS: The release of repressed material into consciousness.
6. INSIGHT: The client's awareness of the unconscious conflicts that underlie his/her dysfunctional behavior.
7. WORKING THROUGH: "Recognition and assimilation of newly learned truths ...alteration of balance among the defenses, neutralization of resistance, formation of new identifications ..." (Campbell, 1981). Catharsis, insight and working through are the key processes of psychoanalysis.
Psychosexual Stages of Development: The stages of development during childhood and adolescence proposed by Freud. According to Freud, the human is "polymorphous" since an individual's sexuality takes many forms as he/she passes through five stages of psychosexual development: oral,anal, phallic, latency and genital. During each stage, the id's libidinal (sexual) energy is focused on a different area of the body and frustration during a particular stage,
consequently, has specific consequences for the adult personality.
Reality Therapy: Glasser's therapeutic technique, which focuses on developing the client's ability to cope with the stresses of reality and assume responsibility for fulfilling his/her own needs,
especially the need for identity. In reality therapy, RESPONSIBILITY is the willingness to work toward fulfilling one's basic needs in a way that does not interfere with the ability of others to fulfill their needs. Irresponsibility is the primary cause of maladaptive behaviors.
Spousal Abuse: 1. CHARACTERISTICS OF BATTERERS: Possessive, insecure; lack self control; abuse alcohol or drugs; have severe reactions to stress (e.g. to financial stress, pregnancy, isolation, medical problems); afraid of losing their wives and attempt to control them through physical violence; have unrealistic expectations about their wives and marriage; adhere to the doctrine of male supremacy; blame others for their actions; and have a
lower educational and occupational status than their wives.
2. CHARACTERISTICS OF BATTERED WIVES: (a) Type I: Stable relationship with her
assailant, infrequent occurrence of abuse, more likely to rationalize the abuse and to return to her partner after staying in a shelter. (b) Type II: Unstable, explosive relationship with her assailant, experiences the most severe abuse, is unlikely to return to her partner. (c) Type III: Most chronic and severe violence, lives in fear, is least likely to have a history of abuse by others, has the lowest tolerance for abuse, is least likely to return to her partner. (d) Type IV: Lowest frequency and severity of abuse, is most likely to report an intent to return to her partner but is among the least likely to actually return. (e) Type V: Extensive history of violence in her family of origin, accepts violence as part of her life, is unlikely to return to her assailant (Snyder and Fruchtman, 1981).
3. PHASES (CYCLE) OF VIOLENCE: (a) I: Tranquility and calmness. (b) II: Tension begins to build as a variety of stressors impinge on the relationship. (c) III: Communication has
broken down and violence erupts. (d) IV: A time of crisis. Either the abuser becomes remorseful and Phase I is restored; the abuser is not remorseful but the victim gives in and Phase I is restored; or the victim takes new action, which the abuser either accepts or rejects. It is when he rejects her action that she is most likely to seek help (Barnett, et al.
(1980).
Stages in Group Therapy: According to Yalom, the initial group sessions are characterized by three stages: (1) orientation, participation, search for meaning and dependency; (2) conflict, dominance and rebellion; and (3) development of cohesiveness.
Suicide Prevention Centers: Suicide prevention centers are one of the original applications of crisis intervention.
Research on suicide prevention centers is inconclusive, although there is some evidence
that their effectiveness is increased when they include follow-up.
Teleological Approach: An approach to human behavior and motivation that claims that everything in nature is
explained in terms of purpose or future goals. Adler's emphasis on goals chosen by the
individual to fulfill herself (i.e., "fictional goals") reflects a teleological approach.
Therapeutic Double Blind and Paradoxical Intervention: 1. THERAPEUTIC DOUBLE-BIND: A general term encompassing a range of paradoxical
techniques (see below) used by family therapists, especially those associated with the
communication/interaction approach. Paradoxical techniques involve instructing the client
to continue manifesting his/her symptoms, which places the client in a "double-bind": The
client must either give up the symptom or admit that he/she has control over it.
2. PARADOXICAL INTERVENTIONS: Therapeutic interventions in which the therapist
deliberately gives the individual or family a directive that the therapist wants the individual
or family to resist. The resulting change in the individual or family is then a result of
defiance of the therapist's directive. For example, when the therapist PRESCRIBES THE
SYMPTOM, the client in put in the position of abandoning the symptom or admitting that it
is under voluntary control.
Therapy Outcome: 1. CLIENT CHARACTERISTICS: Research suggests that, overall, client characteristics are the best predictors of therapy outcome. Positive outcome is associated with higher
evels of intelligence, higher SES, initially high levels of anxiety and greater participation
in the therapeutic process.
2. THERAPIST CHARACTERISTICS: Research suggests that these are not particularly good predictors of therapy outcome. However, greater therapist experience is somewhat related to lower dropout rates and therapist competence seems to be more important than the treatment modality used.
3. CLIENT-THERAPIST INTERACTION FACTORS: In general, interaction factors are less predictive of therapy outcome than client factors alone. Positive outcome in therapy is,
however, somewhat related to client-therapist attraction, client-therapist congruence
about therapy goals and expectations about the nature of therapy and a good therapeutic alliance.
4. TREATMENT FACTORS: Overall, the research suggests that no one form of treatment is consistently superior to any other form (although behavioral therapies have been found
to be more effective for certain phobic reactions and other specific disorders).
Therapy Outcome (Miscellaneous): 1. CONTINUATION: In the client, continuation is associated with high levels of perseverance, social integration, suggestibility and anxiety, low impulsivity and an absence of antisocial or authoritarian attitudes. Therapist factors include greater experience, liking for the client and being judged as competent by the client.
PREMATURE TERMINATION is associated with lower SES and education level,
conventional, uncompromising views, low level of psychological sophistication, high need
for approval, authoritarianism, lack of anxiety, minority group membership and an
expectation that the therapist will provide specific advice.
2. DETERIORATION IN THERAPY: Associated with therapist pathology and deficits in
training, therapist failure to structure therapy properly or deal with the client's negative
attitudes toward him/her, poor motivation or ego strength in the client, a diagnosis of a psychotic disorder or borderline personality disorder and a low-quality therapist-client
relationship.
3. DURABILITY OF THERAPY OUTCOMES: The positive effects of therapy are most likely to be maintained when clients view change and maintenance as due to their own efforts and when clients receive training in self-management techniques.
4. MEDICAL UTILIZATION: Short-term psychotherapy can significantly decrease the use of medical services, especially by overutilizers who have high levels of distress.
5. ECLECTICISM: There is a trend toward eclecticism; however, there is some evidence that the less eclectic and the more "pure" a therapist's techniques, the better the therapy
outcome.
Transactional Analysis (Berne): Berne's transactional analysis (TA) focuses on interactions between people.
1. EGO STATES: For Berne, the personality includes three ego states: the Parent is an introject of one's parents, the Child consists of feelings, impulses and spontaneous acts and the Adult is the processor of information. Behavior patterns involve interactions
between these states. An ego-state imbalance is responsible for maladaptive transactions and behaviors.
2. LIFE POSITION: As the result of experiences with his/her parents, a child adopts one of four life positions: I'm OK - You're OK; I'm OK - You're Not OK; I'm Not OK - You're OK;
or I'm Not OK - You're Not OK. Only the first is healthy. It is maintained only if a child's
parents meet his/her emotional and physical needs in a loving accepting way.
3. GAMES: Recurrent ploys played out in the interactions of people; i.e., the exchanges
of strokes that lead to bad feelings and to advancing one another's scripts.
4. SCR PT: A life plan developed early, which indicates how one will live and how one will die.
5. STROKES: The unit of attention that provides optimal stimulation. "Stroke hunger" is a primary source of motivation. Positive strokes are more desirable, but negative strokes are
better than no strokes at all.
COMPLIANCE: DOOR-IN-FACE AND FOOT-IN-DOOR: "Compliance" occurs when a person agrees to behave in a particular way at the request
of another person. A number of methods have been found useful for inducing compliance:
1. DOOR-IN-THE-FACE-TECHNIQUE: A technique for gaining compliance based on the
assumption that refusal of a large request will increase compliance with a subsequent
smaller request.
2. FOOT-IN-THE-DOOR-TECHNIQUE: A technique for gaining compliance based on the
assumption that compliance with a small request will increase the probability that an
individual will subsequently comply with a much larger request.
CONFORMITY (ASCH AND SHERIF) AND AUTOKINETIC EFFECT: 1. CONFORMITY (ASCH AND SHERIF): A change in behavior or attitude that occurs as the result of real or imagined indirect social pressure. An individual is more willing to conform when: he/she feels deviant in some way and wants to avoid social disapproval; the group to which he/she belongs is unanimous in its judgment; and he/she has
particular characteristics, such as low self-esteem, low intelligence, a high need for
affiliation and/or approval and/or an authoritarian personality. A person is less likely to conform if he/she can express his/her opinion anonymously.
2. AUTOKINETIC EFFECT: The effect used by Sherif and others to assess conformity to group norms. The autokinetic effect involves an illusion of movement of a stationary point of light when viewed in a dark environment.
COOPERATION (SHERIF'S ROBBER CAVE STUDY/SUPERORDINATE GOALS/INTERGROUP CONTACT): 1. SHERIF'S ROBBER CAVE STUDY: Sherif's research at a boy's camp, which
demonstrated that the most effective way to reduce intergroup hostility is have the
members of the groups cooperate to achieve a mutual (superordinate) goal.
2. SUPERORDINATE GOALS: Goals that can be achieved only when individuals or
members of different groups work together cooperatively. Superordinate goals have been
found useful for reducing intergroup conflict.
3. INTERGROUP CONTACT: Research shows that intergroup contact can help reduce
intergroup hostility when certain conditions are met. Most important, groups must be of
equal status or power and must be provided with opportunities to negate negative
stereotypes of members of the opposing group. Of course, the effects of intergroup
contact are maximized when members of the groups are working together on a
superordinate goal.

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Number of cards 54