clinical cards for EPPP
Terms
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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
- 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