| Terms |
Definitions |
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Congruence
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Genuineness
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Defense Mechanisms
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Repression
Denial
Regression
Projection
Rationalization
Reaction-Formation
Displacement – onto a safe target
Sublimation – into a constructive activity
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Conscious
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Ego, Superego
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Preconscious
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Id, Ego, Superego
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Bowen
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Family Systems Therapy
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Reflection of feeling
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repeat emotion
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Authenticity
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Recognizing one’s uniqueness, remaining true to self
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"Total Behavior"
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Reality Therapy-Doing-Thinking (includes subconscious and dreams)-Feeling-Physiology
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Bowenian Concepts/Approaches
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TriangulationDifferentiation of Self
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Paradoxical Interventions
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Strategic Family Therapy-DEF?
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Adlerian Therapists are...
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educators, role-models, diagnosticians
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Etic
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Assumes universal laws and behaviors
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Cultural Empathy
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incorporates the learned ability of the counselor to accurately understand the C’s cultural experience, but also communicate understanding effectively and with an attitude of concern
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confluence
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resistance to contact (GESTALT)-The feelings and wishes of a significant other easily overwhelm the confluent person, who responds as if they were his own feelings and desires. Often becomes extremely anxious when separation occurs or is threatened.-when a person can't tell "...where I end and you begin" due to an inability to distinguish the interpersonal boundary.
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Empowerment Techniques/Principles
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Feminist Therapy– Skills Development• Address client’s limitaQons and external barriers• Can be “Technically EclecQc”– CommunicaQon skills: AsserQveness Training– RelaQonship building: Empty Chair Technique– Negative self‐talk: Socratic Questioning– Social Justice: Feminist therapists are expected to use their power and privilege to create positive change in society
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Group Techniques
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Group Therapygroup leader/therapist interventions aimed at facilitating movement within a group– Examples: pre-group interview, suggesting a new behavior, offering feedback, presenting interpretations
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Social Construction
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Narrative TherapyReality is constructed through conversation: monologically (by oneself) or dialogically (with others).Wittgenstein: problem of “is” Thin conclusions support problem saturated storiesLook at family, gender, culture, ethnicity, sexuality, SES, religion, etc. (importance of multi-cultural interview).
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Contact
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GESTALTinteracting with nature and with other people without losing one’s individuality
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BASIC ID
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Technical Eclectisism Behavior Affect Sensation Imagery Cognition Interpersonal relationships Drugs (or biological functioning)
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focusing
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Gestalt Therapy Technique-Depth of detail in specific-What do you feel like right now? Where? What's it like?-Example
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Gestalt
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configurationour entire field of awareness = figure/ground configuration
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Positivism/Post-Positivism
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Quantitative, Etic, Uses a priori knowledge
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Neurotic Anxiety
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Exceeds or minimizes the situation
It is repressed
Destructive
Neurotic anxiety is a blocking of normal anxiety which interferes with self-awareness. Rather than facing and dealing with the threat causing the normal anxiety, the individual cuts him or herself off from it
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Adlerian Therapeutic Techniques
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1) Assessment
• Family Constellation
• Dreams
• Priorities
• Earliest Recollections
2) Catching oneself - In this technique, patients learn to notice that they are performing behaviors which they wish to change,. When they catch themselves, they may have an "Aha" response.
3) Acting “As If” - requests the client to presume the successful result of a not yet attempted action
4) Paradoxical Intention - clients are instructed to engage and exaggerate behaviors that they seek to change. By prescribing the symptom, therapists make clients more aware of their situation and help them seek to change.
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Experimental Analogue
(and Advantages/Disadvantages)
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simulation of real counseling situations in an experimental methodology
Advantages
– Specific variables can be
Controlled
Isolated
Manipulated
– Allows for strong causal inferences
Disadvantages
– Risks oversimplification of counseling phenomena
– Are the results generalizable to real life counseling?
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Common assessment methods
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Paperwork
Clinical interviews: e.g., Intake interview; gather general data, presenting issues
Psychological testing
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Ethical dilemma
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Situations that present conflict amongst any of the following: ethical principles, professional ethical codes, legal requirements, personal conscience/values
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Attending Behavior
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Shoveler:
S: Face the other Squarely
H: Head nods
O: Adopt an Open Posture
V: Verbal Following
E: SpEech
L: Lean toward the other
E: Make Eye Contact
R: Be Relatively Relaxed
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Emic
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Constructs and behaviors that are specific to an individual socio-cultural context, not generalizable
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Interpersonal learning
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Group Therapyfinding out about themselves & others from the group
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Extratherapeutic factors
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COMMON FACTORSStuff that is independent of therapy Severity of Disturbance *Motivation for Therapy Social Skills “Ego Strength” “Psychological Mindedness” Miscellaneous Life Events Client’s Personality
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enactment
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Gestalt Therapy Technique-Put words to things AND/OR the use of Exaggerating
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reversal technique
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Gestalt Therapy Technique-act opposite of normal-say out loud what you say in your head-act the opposite of your symptoms
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rehearsal technique
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Gestalt Therapy Technique-role playing a planned for new behavior with a person or people in for new behavior with a person or people in client’s environment client’s environment
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Contemplation
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Aware, seriously thinking about overcoming but not yet made commitment to action Seriously considering changing withinthe next 6 months Example: New Year’s resolutions Therapist role: Socratic teacher (like in CT)
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Power Analysis Intervention
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FEMINIST THERAPYPower Analysis GridAssess: Situation, client strengths, client resources, and client and societal limitations and boundaries.
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Differentiation
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The process of distinguishing one’s thoughts from one’s emotions and oneself from others
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SAMIC
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Good plans are SAMIC (Reality Therapy)SimpleAttainableMeasurableImmediateControllable (success depends on YOUR actions, not the actions of others)
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Who is behind Structural Family Therapy?
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Minuchin
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Termination
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Completed change process Total confidence or self-efficacyacross all high risk situations Zero temptation to relapse If there is relapse: Recycle throughstages
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Ravens Progressive Matrices test
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Intelligence test
Low cultural bias
Good for detecting Aspies
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Frank Parsons
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Vocational Counselor – came up with Parsons’ Model of Career Counseling (Match knowledge of self to knowledge of work)
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Qualities of Good Tests
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Validity
Reliability
Standardization
Usability
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Existential Therapeutic Techniques
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Deemphasis of techniques
The therapeutic relationship is the most effective and powerful technique
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In feminist therapy, what is the therapeutic relationship is based on?
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EgalitarianRole-modelingTransparencySelf-Disclosure (help normalize the client's experience and provide hope things will be better)
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What is Postmodern theory’s understanding of reality?
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Constructivist, phenomenological, individal-in-context
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overgeneralization (Behavioral)
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Taking a localized or specific negative event and applying it globallyExample: “Because I did poorly on my first test, I would never make a good ______.”
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Automatic thoughts
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Thoughts those that appear without apparent cause; "instinctive" or immediate thoughts; often from stereotypes/biases/etcmay become such a habit that you no longer notice them (like driving a stick-shift car).
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Externalizing the Problem
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Narrative TherapySeparate person from problem.He is depressed:He is a person struggling againstdepression.
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Equifinality
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FAMILY THERAPYThe ability of a system to arrive at the same destination from different paths or conditions
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Specific Techniques
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COMMON FACTORSEffects in outcome that are particular to each kind of therapy. Techniques (e.g., exposure in behavior therapy) Model (e.g., the conceptualization of client in terms unique to a particular theory might lead to special insights for the therapist
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Experimental Field Study
(plus advantages and disadvantages)
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Manipulation of IVs, random assignment
Intervention
– Involves real-life activity
– Occurs in natural setting
Advantages
– Empirical rigor
– Clinical relevance
Disadvantages
– Difficult to accomplish
– Often not possible to examine specific
variables
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Correlational Analogue
(example + advantages + disadvantages)
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Simulation
No manipulation of IVs or random assignment
Example: Latts & Gelso (1995)
– Participants were counselors who self-rated their
awareness of their own personal conflicts/issues (i.e.,
Countertransference awareness) and use of
counseling theory. They then were asked to respond
to a videotaped session of “client” who survived a
date rape; dependent variable was involvement in
session
Advantages
– Allows for greater control than the field study
– More realistic than the experimental analogue
– Offers greater convenience
Disadvantages
– Artificiality
– Generalizability
– Causal inferences cannot be drawn
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Potential problems of Multi-Role Relationships (i.e Teacher-Therapist, Boss-therapist)
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Erosion/distortion of therapy
Conflicts of interest
Adverse effects on client rights
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Basic mistakes (According to Adler)
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• Overgeneralization
• False sense of security/insecurity
• Misperception of life and life’s demands
• Minimization or denial of one’s basic worth
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Vocational Guidance
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Choose a career – began during Industrial Revolution – gained in importance AGAIN after WWII to deal with returning vets
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Person-Environment Interaction
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How a person and their environment affect each other – possibly best demonstrated by Frank Parsons (fitting the work to the person and vice-versa)
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the internal dialogue experiment
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Gestalt Therapy TechniqueHaving a conversation with themselves or with perceived others-Top dog (critical parent) and underdog (victim)-Empty-chair (two sides of themselves)-Example
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Interviewing the Problem
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Narrative TherapyHave the client take the role of their problem (Alcoholism, depression, etc.) and answer questions (What do you do to the _Client's Name_? What purpose do you serve? When will you leave? Etc.)
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personalization (Behavioral)
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Seeing external events as being caused by you w/out evidence that you had anything to do with them
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What are the major principles behind social learning?
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Modeling
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Preparation
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Intending to take action in the nextmonth, unsuccessfully taken action inthe past year Small behavioral changes: “Baby steps” Score high on both contemplation and action scales of measure Therapist role: experienced coach
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staying with the feeling
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Gestalt Therapy Technique-exploring an emotional response in depth (how is it affecting you physically? how does it feel? etc.)-Example?
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According to reality therapy, all human behavior is geared toward fulfilling five basic needs. Be able to name and identify each of these needs.
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BelongingPowerFreedom (existential definition)FunSurvival
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Common Types of Counseling Groups
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Group Therapy– Support– Psychoeducational– Interpersonal Process/Therapy
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Contemporary methods of psychodynamic therapy
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Utilize principles from classical psychoanalysis
1. Focus on affect and expression of emotion
2. Exploration of attempts to avoid disturbing thoughts and feelings
3. Identification of recurring themes and patterns
4. Discussion of past experiences (developmental influence)
5. Interpersonal relationships
6. Focus on the therapy relationship
7. Exploration of fantasy life
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Limits to Confidentiality
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Client request for release of information
Court orders for confidential information
Not the same as a subpoena
Illicit substance use while pregnant
Knowledge of abuse or exploitation by another health professional
Child abuse or abuse of a vulnerable adult
Danger to oneself
Danger to others
-“Duty to warn”
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What theory was the MBTI based on?
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Jung's Typological Theory
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Psychodynamic Therapist’s Role
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To understand the client’s motives
To interpret to the client his/her thoughts, feelings, and behaviors
To help clients work through unresolved conflicts and gain insight
Function= expert
Stance= Neutral, Anonymous
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Ultimate Concerns (in Existentialist Theory) – conflicts?
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Freedom (and responsibility) - Conflict is between groundlessness and desire for ground/structure – the more you choose, the more responsible you are for what happens
Death - Conflict between awareness of death and desire to live - Psychopathology in part is due to failure to deal with the inevitability of death
Meaninglessness - Conflict stems from “How does a being who requires meaning find meaning in a universe that has no meaning?”
Isolation - Each of us enters existence alone and must depart from it alone
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What components of Adler’s theory have received empirical support?
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need for belongingness, social interest, etc
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The “Dodo bird effect”
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Everybody wins!Most of what determines success of therapy is independent of the type of therapy - just being in therapy and motivated can be enough - only 15% of outcome effect based on type of therapy
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name and describe the main operant techniques used
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Positive ReinforcementNegative ReinforcementPositive PunishmentNegative Punishment
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Group Process
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Group TherapyNot WHAT is said, but how it is said and how the individuals respond to each otherall elements basic to groups unfolding from beginning to termination– Examples: norms, level of cohesion, resistance, conflict resolution, group stages
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Modeling (Behavior)
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Acting or showing an example of acting as you want the client to actthe client learns by imitation
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What are some of the psychoanalytic themes/concepts that Dr. Hanna Levenson touched upon in the video viewed in class?
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Unconscious motives, transference (e.g.,
the coffee)
Early childhood experiences
Interpersonal issues
Stance= Neutral, Anonymous
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Criticisms and Cautionary Factors of Assessment Methods
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Appropriate norm groups and use
Classifications and labels have potentially harmful effects
Construction of tests and diagnostic systems is an imperfect science
There are potential gender and racial biases in many tests
Test results and diagnoses may limit client’s potential, goals, and vision
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For the existentialist, how are freedom and responsibility related? What implications do freedom and responsibility have for counseling?
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Freedom and Responsibility are directly related. Freedom = Responsibility. When you do something, you are responsible for the outcomes.
Implications: train them to be more self-aware of what their actions do. Get them to be less afraid of that responsibility. If they cannot take responsibility for what they've done to contribute to where they now find themselves, they will have little ability to work for change.
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What are the differences between Ellis’s REBT and Beck’s Cognitive Therapy approaches to cognitive-behavioral therapy?
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REBT: Dysfunctional beliefs are WRONGCT: Dysfunctional beliefs are problematicREBT: Highly directive, persuasive, confrontationalCT: Client self-direction, self-discovery through reflective questioning, collaborative empiricism, therapist is teacher/guide to empirical methods, client-centered
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Drawbacks of Eclecticism
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Therapists can do more harm than good if they have little or no understanding about what is helping the client Sometimes atheoretical; trial-and-error approach; “technician”
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Three Components of Disputing (ABCDEF model)
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Detecting - identify irrational behaviors Discriminating - discriminate rational from irrational Debating - "Why?" "Is that reasonable?"
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General Principles of Motivational Interviewing
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1. Expression of empathy2. Development of discrepancy3. Rolling with resistance4. Support for self-efficacy
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Main Driving Forces of Empirically-Supported Treatments
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Managed Health Care (MHC) Paid little attention to treatment effectiveness Psychotherapy approaches were viewed as homogeneous and psychotherapists asinterchangeableCourts and legislative bodies Standards for assessing treatment effectiveness: Principle of community standard Doctrine of respectable minorityThe Medical Model Preference of psychopharmacology overpsychotherapy
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Role of the Therapist in Existential Therapy
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There are no uniform roles
To understand the subjective world of the client (phenomenology)
The therapeutic relationship is key
The core of the therapeutic relationship
-Authenticity
-Confront clients
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Freud thought all issues were related to crises that occurred at different stages of psychosexual development (mostly childhood)
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Freud thought all issues were related to crises that occurred at different stages of psychosexual development (mostly childhood)
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Psychological Assessment came into prominence ____________ and was used for ____________
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came into prominence during WWII for dealing with personnel selection and their mental health
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What is the main logic behind systematic desensitization?
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Habituation leads to desensitization (i.e. if they are allowed to gradually be exposed to a stimulus and nothing bad happens, they'll get used to it)
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How is Narrative Therapy similar to other therapies?
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Adlerian - phenomenological, early recollectionFeminist- dominant culture is designed to perpetuate viewpoints or stories that serve to work against the individualCognitive- deconstructing problematic stories similar to challenging black/white thinking, focusing thoughts on problems. Therapeutic relationship as a collaborationGestalt- increase client’s personal agency or power (similar to Feminist)
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What are some contributions of identity stage models (either sexual orientation or racial identity) in counseling? Disadvantages or caveats?
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• Helpful for assessment, background knowledge, but may be some limitations.• Stage Model - Assumptions???• Bisexuality, queer identity, asexuality• Multicultural perspectives on identity:– For example: “Two Spirit” notion in Native American culture– Multiple identities intersecting (e.g., Female process; Person of Color / LGBTQ identity; Spiritual identity)
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To what does reality therapy attribute the root of psychological problems?
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Unfulfilled basic needsContinuation of short-term strategies (that aren't getting us what we need)
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What does psycholingustic research find in the area of motivational interviewing intervention? What types of statements are found to be related to positive outcomes?
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More "change-talk" = more change, less resistance"Self-Talk" (e.g. I believe I can change) related to positive outcomes
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Why do psychological problems occur according to Gestalt therapy?
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Lack of Awareness (understanding of relationship of figure and ground)Having too much focus on past or future
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the stages in the Cass identity development model
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1. Identity Confusion2. Identity Comparison3. Identity Tolerance4. Identity Acceptance5. Identity Pride6. Identity Synthesis
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Surgeon General's Report on Ethnicity and Mental Health
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Minorities have less access to, and availability of, mental health services.
Minorities are less likely to receive needed mental health services.
Minorities in treatment often receive a poorer quality of mental health care.
Minorities are underrepresented in mental health research.
Staff assignment and treatment modality
Assessment and diagnosis: may be misdiagnosed due to cultural differences
Drop out, underutilization, and over-representation
Attitudes: distrust of services by racial/ethnic clients, and the perspective that therapy “can be used as an oppressive instrument by those in power to . . . mistreat large groups of people”
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What are Narrative therapists’ ideas about stories and their use in therapy?
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Stories are situated within a broad social contextClients' lives are multiple stories happening at same timeDominant vs. Alternative Stories
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On what dimensions can treatments be culturally adapted?
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- Language• Values and attitudes about health/mental health, coping, skills, etc.• Discrimination• Interdependence• Spirituality• Indigenous cultural practices
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What are the key concepts that define reality therapy?
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Needs manifest through wants"Total Behavior" - everythingChoice Theory - We have choices, those bring responsibility
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How do psychological issues arise in the Person-Centered view?
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– When you give into conditions of worth (i.e. what other people think you should be) rather than being who you really are
– Gap between the ideal self and the real self
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How are the stages of change related to the research on Common Factors?
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Approximately 70% of variance from Lambert & Barley (2002) is related to the client (Motivation and perception of the therapy/goals/problem)WHICH MEANS that changes in motivation and perception (say from precontemplative to contemplative) correlate with better long-term outcomes
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What are the goals of behavior therapy?
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substitute in a good behaviorUnlearn a bad behavior
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How do 2nd wave CBT approaches differ from 3rd wave / mindfulness-based approaches to CBT?
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3rd wave adds mindfulness and acceptance to CBT3rd wave adds:- Just noting (not judging) private events- self-as-context- Mindfulness skills
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the rationale underlying the techniques of Gestalt therapy
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Whole is more than the sum of the partsintegrate the pieces into a wholeFocus on being what you are, not on "becoming"
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