Clinical Psych Final

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Flashcards on Clinical Psych Final, created by Hailie Marie Ile on 02/05/2016.
Hailie Marie Ile
Flashcards by Hailie Marie Ile, updated more than 1 year ago
Hailie Marie Ile
Created by Hailie Marie Ile over 8 years ago
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Manualized Treatment -treatment outlined in standardized format -rationales, goals, and techniques for each phase
Stages of Change 1. Pre-Contemplation 2. Contemplation 3. Preparation 4. Action 5. Maintenance 6. Termination
Therapeutic Alliance Relationship b/w therapist & patient *IMPORTANT 4 CHANGE
Skill Building/Competency -Therapist=Educator -Promote self-efficacy -Facilitate mastery experiences -Non specific like hope & belief
Expert Role -Expert knowledge about psychological problems -Competency/training -Maintaining equal respect
% of psychs who use EBTs 2/3 or 66.6%
Chambles & Hollon (1998) -Random groups -Control -Placebo -Alternative treatment option -Reliable/valid -Efficacious level
Criticisms of Meta-Analysis -garbage in, garbage out -apples and oranges -publication bias
Effect Size # value, or % of s.d. -indicates size between group differences
Meta-Analysis quantitatively combining several studies to measure the effect of the VARIABLE
Results of Consumer Reports Study -improvement in most -those who felt worse saw most improvement -equal imp. with psychotherapy alone vs. psychotherapy + meds -longer treatment more effective, all types
Efficacy -must show significant reduction in levels of DYSFUNCTION -INTERNAL validity (effi) -standardized -more homogeneous participants
Effectiveness -Treatment option -External validity (effe) -Real world testing -might have CONTROL group
Intervention -inducing change via producing RELATIONSHIP -achieve underlying POTENTIAL
Pros and Cons of Manualized Treatment Pros -Guideline -Research-based Cons -No leeway -Undermining of clinical judgment -No multiple diagnosis (comorbid)
Psychic Determinism a major assumption that holds that everything one does has meaning and is goal-directed (Freud, unconscious motivations)
ID (birth, unconscious, inaccessible) PLEASURE, attain gratification of needs, wants
Ego mediate demands of ID and Superego, cope with real world, REALITY
Superego MORALITY, develop conscience, block impulses
3 Types of Anxiety 1. Reality: anxiety springs from real danger in the outside world 2. Neurotic: fear that id’s impulses will be expressed unchecked and lead to trouble from environment 3. Moral: fear that one will not conform to the standards of conscience
Psychosexual Stages 1. Oral: mouth most important (birth-18 mos) 2. Anal: attention on urination and defecation (18 mos-3 yrs) 3. Phallic: sexual organs become source of gratification (ages 3-5) 4. Latency: lack of overt sexual activity (ages 5-12) 5. Genital: mature expression of sexuality (adolescence to adulthood)
Purpose of Defense Mechanisms To defend the ego
Repression banishment of highly threatening material from consciousness
Regression return to a stage that previously offered gratification
Reaction formation unconscious impulse consciously represented by its behavioral opposite
Projection unconscious feelings attributed to another person
Displacement redirecting unacceptable impulses to a non-threatening target
Denial insisting things are not the way they seem
Sublimation channeling unacceptable instincts into socially desirable activities
Free Association patient must say everything w/out censorship, believed to shed light on unconscious thoughts and urges
Dream Analysis reveal nature of the unconscious
Latent Content symbolic meaning of a dream, can be used to discover unconscious wishes
What are "Resistances?" behaviors that prevent unconscious material from reaching consciousness
List some resistances -less engagement -omitting/censoring information -cancelling or arriving to appointments late -acting out -intellectualization: patient strips experiences of their emotional content
Transference patient reacts as if therapist represents an important figure from childhood -positive or negative feelings
Counter-transference therapist transferring unconscious internal conflict onto the relationship with the client
Interpretation method by which the unconscious meaning of thoughts and behavior is revealed; most important technique
Purposes of Interpretation -designed to open up the patient to new ways of viewing things -interpretations offered over time by building upon patients own comments -less is more; don’t want to overwhelm patient, small dosages best
Central Concepts of Short Term Psychodynamic Theory 1. Past experiences influence current functioning 2. Affect and the expression of emotion 3. Therapeutic relationship 4. Facilitation of insight 5. Avoidance of uncomfortable topics (transference) 6. ID of core conflictual relationship themes
Interpersonal Therapy (IPT) 1. Brief, insight-oriented therapy 2. Focuses on the connection of clinical problems and interpersonal problems 3. Used with depressive disorder, substance abuse, bulimia 4. Alleviates symptoms by improving relations with others 5. 3 phases (see notes)
Carl Rogers -Originally a child clinician -Phenomenology -Client Centered Therapy
Phenomenology an individual’s behavior is completely determined by his or her phenomenal field, or everything that is experienced by the person at any given point in time
Phenomenal Field/Self =me o Subjective self-experience, self-concept o Probs occur when phenomenal self is threatened o Adjusted individuals incorporated threatening experiences into their self-concept
Principal Condition (of Client-Centered) -Complete absence of threat to self -Rationale for atmosphere of client-centered therapy -warm, accepting, non-judgmental
Basic assumptions and tenants of Client Centered Therapy -Self actualization -emphasis on uniqueness, on the self -experiences must be incorporated into self-concept -growth potential
Empathy (CCT) -understanding -genuine, deep regard -basis for therapeutic relationship
Unconditional Positive Regard (CCT) -respect as a human being -complete lack of judgment
Congruence (CCT) -expression of behavior, feelings, or attitudes stimulated by client -clients respond favorably to genuineness -open honesty
Attitude Vs. Technique (CCT) -State of mind, not a set of techniques -Non-directive, allow for client self-discovery -Self-fulfillment and health emphasized over destructive nature -Experience over empirical
Therapeutic process IS: acceptance, recognition, clarification
Therapeutic Process IS NOT: advice & info, reassurance & persuasion, questioning & interpreting
Diagnosis (CCT) -Deemphasized/avoided -Impedes autonomy and self-actualization -Focused on feelings themselves, not whether feelings are “correct”
Stages of CCT Stage 1 -Unwillingness to reveal self -Own feelings not recognized Stage 2 -Some description of feelings -Still remote from self Stage 3 -Free flow expression of self -Questioning of construct validity Stage 4 -Free description of feeling of self -Loosening of personal constructs -Beginnings of self responsibility Stage 5 -Free expression & acceptance -Desire to be what one is Stage 6 -Acceptance of feelings, no denial -Risking relationships & acceptance Stage 7 -Experiencing self fully -Little incongruence -Checking validity of experience
Pros of CCT Pros -Self determination over biological determination -Freedom of choice -Equal client/therapist standing -Less emphasis on the past -Shorter durations -81% of adult clients report reduction of symptoms and overall increase of well-being
Cons of CCT Cons -Therapists can’t affect change; client inner potential “released” -Too intuitive? -Influence of therapist’s personal framework -Lacking empirical proof of superiority -Effectiveness potentially limited for less verbal, lower intellect clients
Origins of Existential Therapy Search for a meaning, philosophically rooted, social context, inevitable choices, moving away from conformity
Goals of ET responsible decision making, self-awareness, accepting responsibility
Techniques of ET not emphasized, client not an object, therapy as an “encounter” or experience, questioning leading to realization, learning to focus on what is troubling and search for meaning
Fritz Perls (Gestalt) o Emphasis on immediate experience and the present o View person as a whole o Preoccupation with the past or future is deemed source of dysfunction, anxiety
Gestalt: Key aspects and techniques used o Therapist as a catalyst for change o Now=Experience=Awareness=Reality o Nonverbal clues o Defenses as layers o Emphasize the responsibility of the client
Rules for Gestalt always present tense, communication between equals, “I” not “it”, the immediate experiences, no gossip, discourages questions
Moral precepts of Gestalt live now, live here, stop imagining, stop unnecessary thinking, direct expression, aware of pleasant and unpleasant, rejection of others “should” and “oughts”, taking responsibility, surrendering to what you really are
Emotion Focused Therapy -Integration of Gestalt and client-centered therapy -Emotions are fundamentally adaptive and give our life experience its value, meaning, and direction -Emotional self-regulation necessary for personal growth -Dysfuntion=result of emotional impairment -Therapist provides supportive environment so patient can explore and transform emotional states
Pros of Humanistic-Existential Therapies -Experiences and awareness paramount -Choices and free will emphasized -Focus on the now -Positive growth -Emphasis on therapeutic relationship
Cons of Humanistic-Existential Therapies -Over emphasis on feelings -Phenomenal field is unique and hard to measure -Assessment de-emphasized -Techniques vague -Lack of comparative research
Origins of the Behavioral Approach -Clinical work with study of human behavior -Scientific emphasis -De-emphasis of inferred variables
Classical Conditioning the process by which an organism learns to associate two paired stimuli
Operant Conditioning the process of changing a behavior by following a response with reinforcement/punishment
Systematic Desensitization Reciprocal inhibition
SORC -S=Stimulus factors which occur before target behavior -O=Organismic variables relevant to target behavior (client background) -R=Response or target behavior -C=Consequences of target behavior
Procedures of Systematic Desensitization o History of problem o Determining treatment o Assessing appropriateness o Briefing o Relaxation training o Development of anxiety hierarchy
Relaxation Techniques o Muscle tensing then release o Possible use of hypnosis o Breathing exercises
Creating an Anxiety Hierarchy o Difficulties identified o Ordered by anxiety level o Low to moderate to extreme o Relaxation practiced at each level of hierarchy
Counterconditioning the substitution of relaxation for anxiety
Extinction of behaviors when the patient repeatedly visualizes anxiety-generating situations but without ensuing bad experiences, the anxiety responses are eventually extinguished
- In-vivo versus fantasy exposure therapy - Flooding versus gradual exposure lookup
Origins in Psychodrama -Therapeutic emotional release -ID root of patient problems
Shaping attempts at a desired behavior are rewarded until it is achieved
Time out removal of patient from environment in which unwanted behavior is reinforced
Contracting agreement between patient and therapist specifying consequences of behaviors
Grandma's Rule desired activity reinforced by allowing the individual to engage in a more desirable activity
Cognitive-Behavioral Approach -Modify thought patterns -Empirically supported -Social learning theory -Sense of self-efficacy -Active process
Types of Modeling o Observational learning o Used often to eliminate unwarranted fears o Videotape modeling o Written instructions
How to use modeling effectively o Subject attends to model o Patient retains the information provided by model o Patient performs modeled behavior o Motivation to use behavior
Rational Emotive Therapy -Beliefs (B), Activating events (A), Consequences (C), Therapists as a teacher; correct “illogical” thinking
Rational Restructuring / Cognitive Restructuring -Relabeling of situations, more realistically -Modifications of the internal “self-talk” -Rational Emotive Therapy (RET)
Cognitive Distortions -Identify Automatic Thoughts -Identify Cognitive Distortions -Arbitrary inference -Overgeneralization -Personalization -Absolutistic, Dichotomous Thinking -Awfulizing/Horribilizing -Low frustration tolerance -“Shoulding” and Musturbation -Dispute the automatic thoughts -Develop rational rebuttal to automatic thoughts
Beck's CBT -Utilizes cognitive & behavioral methodology -Modify dysfunctional patterns
Beck's Techniques -Increase pleasurable activities -Cognitive rehearsal -Assertiveness training/role playing -Identify maladaptive, auto thoughts -Challenge these -Search for alternative solutions or ways of coping
Dialectical Behavior Therapy (DBT) -Used primarily with borderline personality disorder (BPD)
Four Skills Training Modules (DBT) -Mindfulness-to be aware of the moment, focused, nonjudgmental -Emotional regulation-IDing and dealing with emotions -Distress tolerance-learning to cope with stress -Interpersonal effectiveness-how to deal with conflict, get needs met, say no to unwanted demands
Pros of DBT -Efficacy, efficiency, evidence based, breadth of application, scientist practitioner (clinical scientist model)
Cons of DBT -Linking practice to science, inner growth, manipulation and control, do these effects generalize to real-world clients?
Manifest Content what actually happens in a dream
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