This site is 100% ad supported. Please add an exception to adblock for this site.

EPPP Clinical


undefined, object
copy deck
Pros and cons of clozapine
An atypical antipsychotic

often effective when conventional antipsychotics are not
does not produce tardive dyskinesia

causes aganulocytosis
Diagnostic criteria for bulemia
binge eating
inappropriate compensatory behavior to lose weight

for at least 3 months
Therapy dropout rates by ethnic group
Highest for Afro-Americans
Lowest for Asian-Americans
Treatment for smoking cessation
Nicotine replacement therapy AND
Behavioral intervention
When do you use a DSM disgnosis of NOS
Not all critera are met
Symptoms meet criteria for diagnosis under study
Uncertainty about etiology
Incomplete information

(Provisional would be added to diagnosis)
What is the greatest risk factor for childhood depression?
Parental depression
Def: phenothiazines
Def: cognitive triad of depressive cognitions
Negative beliefs about the self, expectations of the world and the future
What is the most effective way for the police to deal with domestic violence?
Arresting the perpetrator results in the lowest rate of recidivism
Relationship of psychology to cancer onset and recovery
Unrelated to onset

Positively related to recovery and quality of life
Ethnic matching of client to therapist most effects...
Treatment length (not outcome)

Especially with Afro-Amer clients and non-Afro-Amer therapists

Ethnic matching most beneficial for Asian and Hispanic Americans
Stages of change
Precontemplation - no change considered

Contemplation - aware of need but not committed

Preparation - clear intent to take action


CBT approach to panic disorder
Indentifying and modifying interpretation of attacks and associated physical symptoms
Relationship between therapy and outcome
Moderate overall, but stronger when the symptoms are severe
Central development issue in BPD (Kernberg)
Defense against child's intrapsychic aggressive impulses
Difference between Freud and Jung
For Freud unconscious is personal

For Jung unconscious is both personal and collective
Adlerian explanation for childhood misbehavior
Child's effort to obtain

or to display deficiency
Adlerian intervention for childhood misbehavior
Identify real goals of the behavior and find better ways to obtain them
Use: CPI (California Psychological Inventory)
Broad personality test for non-pathologic individuals
Def: reaction formation *
Defense in which an anxiety provoking impulse is replaced by its opposite

Eg hatred by oversolicitude

Typical of obsessive disorders
Def: projection
Defense attributing unacceptable wishes to another

Includes prejudice and hypervigilance: the other person carries the guilt
Def: fixation
Defense: Return to an earlier stage of development under stress
Def: projective identification
Defense: projection of unwanted aspects of self onto another creating a sense of oneness
Adler's psychology
Psychopathology is a maladaptive attempt to compensate for inferiority
Neo-Freudian psychology
Horney, Sullivan, Fromm

Emphasis on cultural and social determinants of personality
Ego analysts
Anna Freud, Heinz Hartman

Focus on ego strength
Object-relations theory /self psychology
Mahler, Winnicott, Kernberg, Fairbairn, Melanie Klein, Kohut

Focus on internal representations of others or introjects from childhood

Psychopathology develops from damaged or weak introjects
Parataxic distortions (Sullivan)
Dealing w others as if they were significant persons from early life (transference?)
Kernberg's account of BPD
Results from failure to develop appropriate introjects

As a result of parental psychopathology or abuse

Characterized by splitting, aggression and unstable self-image
Def: introjection
Absorbing information without understanding or assimilation (Gestalt)

Incorporating aspects of other people in your self image (object relations theory)
Def: confluence (Gestalt)
Permeable self boundary, self merging with others
Gestalt (Fritz Perls) technique
Focus on here and now
I statements
Dream analysis
Empty chair technique
Stress innoculation training
Treatment of aggressive or impulsive behavior

1. education about maladaptions
2. rehearse new skills and thinking
3. apply skills to real life
Def: paradoxical intention
Instruction to do what you fear

Goal is to circumvent anticipatory anxiety
Def: stimulus control
Avoiding triggers for maladaptive behavior
Goal: Bowen's extended systems therapy
Differentiation of self
Goal: Minuchin's structural family therapy
Disrupt dysfunctional processes by modifying aspects of family structure (eg rules boundaries, coalitions)
Strategies associated with Haley's strategic family therapy
Paradoxical directives
Circular questioning
Def: negative feedback in family systems theory
Maintenance of homeostasis by attempting to correct deviations in status quo
Def: positive feedback in family systems theory
Disruption of homeostatsis by encouraging or creating deviations in the status quo
Def: joining in Minuchin's family therapy
Therapist blends with family using mimesis (adopting family's style and language) and tracking (identifying with family values and history)
Def: circular questioning in Haley's strategic family therapy
Therapist asks each family member to describe relationships and notes differences in accounts.

Eg who's the angriest?
Benefits of group therapy
Acquiring interpersonal skills
Expression of feeling
Instillation of hope
Sharing of information
Sense of belonging
Stages of crisis intervention
crisis identification

assessment of prior life
setting of short term goals
implementation of goals

progress assessment
discussion of termination and beyond
How was the MMPI developed?
empirical criterion keying

retention of items differentiating psychiatric from non-psychiatric populations
MMPI scores
Reported as T-scores
Mean 50, SD 10

Deviant clinical subscale T score 65

High validity scores invalidate test
MMPI Clinical scales
HS hypochondriasis
D depression
Hy physical symptoms with psychic origin
Pd Psychopathic deviant
Mf masculinity-femininity
Pa paranoia
Pt other neurotic, eg phobia, compulsions
Sc thought disorder, bizarre behavior
Ma manic style, inability to concentrate
Si introversion/extroversion
MMPI Validity scales *
? unanswered questions
L hyper socially correct answers
F rarely endorsed items - high F indicates real or attempted deviance
K defensiveness
TRIN consistent response patterns
Other personality inventories
Millon Clinical Multiaxial Inventory (MCMI-III) - DSM categories

Symptom Checklist 90 (SCL-90) - used in research
Rorschach administration steps
1. Introduction - allay anxiety
2. Instructions - say what you see
3. Response - free association, tracking verbatim, time, and unusual responses
4. Inquiry - after all cards presented; for clarification and collection of additional information
Rorschach scoring categories
Location - inkblot areas, including whole or detail

Determinants - form(F), movement, shading or color that determined the response

Content - human (expected), animal (children)

Populars - commonness of given responses
Stroop test
Name the color in which a different color word is printed

Left frontal lobe lesions impair performance, because response inhibition is impaired
Def: emic
Studying culture from within
Def: etic
Studying culture from the outside
Stages of the minority development model (MID)
Resistance and immersion
Synergistic articulation and awareness
Helms' White Racial Identity Development Model *
Contact (lack of)
Disintegration (confusing racial awareness)
Reintegration (prejudice)
Pseudo-independence (thoughtful revisiting of prejudice)
Immersion-emersion (separate and equal; racially proud but not racist)
Autonomy (integration; non-racist identity; seek interaction)

designed to help therapists understand inter-racial tensions
McLaughlin's stages of homosexual identity formation
Alienation and shame
Self rejection
Passing as straight
Consolidating a self identity
Integration of public and private self
Pride and synthesis
Berry's acculturation model
high on minority
high on mainstream culture

low on minority
high on mainstream culture

high on minority
rejection of mainstream culture

low on minority
rejection of mainstream culture
Considerations in treating Hispanic clients
Prefer an active goal-orientation

Stress personal contact and attention

Consider family
Considerations in treating Native American clients
Importance of tribe and family

Approach: non-directive,
history-oriented, accepting, cooperative

Goals: happiness, wisdom, peace with nature

Therapist attitude: reserved, open, accepting, listening
Considerations in treating Asian clients
Approach: direct, structured, short-term; address problem as academic or vocational

Education about therapy process
Purpose of defense mechanisms (Freudian)
Prevent unconscious drives and impulses from reaching awareness

Anxiety results from imperfect defense
MMPI 1990 revision
Updated norms
Addition of new content scales
Change of cutoff from 70 to 65

Clinical scales unchanged
Def: calibration
Return to homeostasis engineered by the family
Def: equifinality
Different causes producing the same result
Def: equipotentiality
Single cause may produce different results
Nigrescence theory stages (Cross) *
Pre-encounter - mainstream world view; problems are own

Encounter - event that precipitates search for A-A identity

Immersion/emersion - denegration of mainstream and idealization of A-A culture

Internalization - conflicts resolved; move toward non-racist view

Internalization/commitment - commitment to political activism
Def: multisystems / ecostructural approach to working with Afro-American families (Boyd-Franklin)
Target individual, immediate and extended family, nonblood relations and friends, church and other community services
Desc: SCL-90
Symptom CheckList is a self report measure of general psychicatric symptoms such as depression, anxiety, somatization, obsessive-compulsiveness and hostility

Question rated on a scale of 1-5
Risk factors for adolescent suicide
use of drugs and alcohol
anti-social behavior
Kohut's explanation and treatment for narcissim
Narcissim is caused by lack of empathy and is treated with empathy
Def: semantic paralexia
Dyslexic reading error in which the child responds with something semantically similar to the stimulus (eg dog in response to cat)
Reason for continued brain growth after birth
Increasing dendrites and mylination
Def: state dependence
Memory is maximized if we are in the same emotional state during learning and recall
% of clients profiting from psychotherapy
Relative efficacy of behavioral vs non-behavioral treatment for children and adolescents (Weisz)
Behavioral treatments significantly more effective
Desc Reality Therapy *
Premise is that people have innate, powerful needs:


goal of therapy is to discover what needs are not satisfied
Treatment of choice for agoraphobia
Flooding, with 75% long term improvement
For Beck, suicidal individuals are characterized by
poor problem solving skills
Terms associate with Bower
triangulation - means of reducing tension between 2 members in a family by focusing on a third

emotional divorce
Characteristics of disengaged families (Minuchin)
Rigid boundaries
Family members isolated from one another
Conflict avoidant
Parents inattentive to children's needs
Greenson's stages of psychoanalytic treatment
Working through
Minuchin's boundary disturbances *
Triangulation - parent demands child side with him/her

Detouring - parents either consistently attack or defend the child to avoid tensions between themselves

Stable coalition - child and one parent 'gang up' on other parent

Enmeshment - unclear boundaries that promote dependence
Afro-American use of mental health services
For solving practical rather than emotional problems
Therapy making most use of imagry techniques

Used to help identify automatic thoughts, increase self-control, distraction or to visualize life outcomes
Freud's explanation for specific phobias
Result of unresolved Oedipal conflict centered on the same sex parent
Techniques in structural family therapy (Minuchin)
Maps of family boundaries

Here and now focus
Central objectives of Gestalt therapy
Awareness of self, environment and the nature of the self-environment boundary
Terms associated with Bowen
Triangulation - means of reducing tension and conflict between two family members who refocus their attention on a third

Emotional divorce
Def: social skills training
A behavioral technique used to replace behavioral excesses and deficits with new behaviors
Efficacy of psychotherapy for children and adolescents compared to adults *
Characterize Skinner's theory
Focus is on environmental contingencies

Did not feel innate urges were very important
Freud's theory of personality
established by age 6
Horney's theory
Basic anxiety causes one to
move toward others
move away from others
move against others
Def: self control
For example, repeating affirmative statements to yourself

Effective in treating children afraid of the dark

Deck Info