EPPP: Clinical Psychology Flashcards

Terms Definitions
Clarification
Restating remarks.
script
Transactional Analysis
-characteristic pattern of giving and receiving strokes.
-unhealthy scripts lead to maladaptive behavior
Freud's Psychoanalysis
Anxiety and ego
Pessimistic
Deterministic
Driven by irrational forces, unconscious motivations, instinctual needs, and psychosexual events that occured early in life.
Milan Techniques
Therapeutic Team
"Strategy Conference"
Hypothesizing - made @ intake
Neutrality - Therapist stays obj
Paradox
Circular Questions - Made to see diff in family opinions.
id
pleasure principle
basic biological drives
unconscious, unorganized
processes deduced from dreams, "slips", free assoc., etc.
Narrowing
stimulus control technique
restricting target beh to limited set of stimuli (ex. obese: eat only at dinner table at certain time)
Jung's two attitudes
Extraversion and Introversion
Cultural Competence
Credibility & Giving
Awareness, Knowledge, & Skills
Interpretation
Connecting current behavior w/ unconscious processes.
etic
studying culture as an observer/outsider
etic
tourist
isolation
non-existent boundary between self & environment
-all understanding of importance of others for hte self is lost
projection
placing unacceptable wishes on another
includes severe prejudice, hypervigilance to external danger
emic
-studying culture from within it
-approached advised for therapists
emic
member
Weight loss, increased appetite, intolerance to heat, tremors, and rapid heart rate are indicative of:a. alcohol withdrawalb. caffeine intoxicationc. cocaine intoxicationd. hyperthyroidism
d. hyperthyroidism
Freud: Sublimation
Transformation of libidinal urges into socially acceptable interests and activities. Mature DM.
Key concepts: Biofeedback
Used for psychophysiological disorders (e.g., hypertension, headaches, ulcers).For many problems, not much more effective than relaxation training.However, it's the treatment of choice for fecal incontinence and Raynaud's disease.EMG biofeedback for tension headaches.Skin Temperature biofeedback for migraines.
Feminist Therapy Techniques
1. Egalitarian Relationships
2. Avoiding Psych Labels
3. Avoiding Revictimization
4. Involvement in Social Action
Working Through
Assimilates new insights into personality
Parallel Process
When a therapist recapitulates client/therapist issues in supervision.
Mahler's O-R Theory
Normal autism (oblivious)
Normal symbiosis (fuse w/ mother)
Separation-Individuation
IPT Therapy
Focuses on current SOCIAL RELATIONSHIPS and SYMPTOM REDUCTION.
Education about depression
Instillation of hope
Pharm
Minuchin's Boundaries
"Barriers" or rules that determine contact.
DISENGAGED vs ENMESHED
Developmental Theory
Personality is formed during childhood.
Object Relations Theory
Object-seeking (relationships w/ others) is a basic inborn drive. Emphasis is on early relationships and "INTROJECTS" (Child's perception) of objects.
Elevations on MMPI K Scale
defensiveness/guardedness
deny problems
low score=low self-image
high score=high defenses/armor
low-context communication
-many words to convey meaning
-Anglo-American communication
catharsis
emotional release from recall of unconscious material
Cross' Black Racial Identity Developement Model is directly linked to racial oppression and consists of four stages. Name the acronym and the names of the four stages.
Patients: PreencounterElect: EncounterI/M injections: Immersion/EmersionI/C in court: Internalization/Commitment
Secondary prevention:
attempts to decrease the prevalence of disorders by reducing their duration through early detection and intervention --screening is done.
STEP training based on whose theoretical approach?
Alfred Adler
Carl Jung: Archetypes
Predispositions to perception and emotion shared by all people
One of Freud’s central beliefs was that ideas could be dissociated from consciousness. Who was the source for this belief?
Charcot
Jung's Personal Unconscious
Repressed or forgotten experiences that were once conscious.
Reality Therapy's Needs
1. Belonging (Psychological)
2. Power
3. Freedom
4. Fun
5. Survival (Physical)
Suicide Hotlines
Can reduce suicide rates, especially for young white females who are the most frequent callers.
Double-Blind Communication
Do/Don't and you'll be punished. CONTRADICTORY INJUNCTIONS lead to SCHIZO.
Gestalt Personality
SELF (creative) and SELF-IMAGE (dark side).
Childhood development affects images.
circular questioning
-method of strategic FT
-ask family members about relationships of each
Feminist object-relations theory
focus on mother-child attachment differences bt genders. Changes in gender relations will occur with equality in responsibility for child-rearing.
McLaughlin's Homosexuality Identity Formation
1. Isolation
2. Alienation/Shame
3. Rejection of self
4. Passing as straight
5. Consolidating self identity
6. Acculturation
7. Integrating self/public identity
8. Pride and synthesis
object introject
mental representation of a person, either the self or another.
Jung's extroversion & introversion, when switch?
developmentally-determined, we all turn from extroversion of youth to introversion in adulthood.
Mid-point of life cycle, around 40 y.o.
resistance
reluctance of px to recall traumatic memories (Freud)
Name and identify the 5 stages of Prochaska and DiClemente's Transtheoretical model of behavior change.(name the acronym and title of each stage)
precontemplationcontemplationpreparationactionmaintenance
confluence
refers to the abscence of a boundary between the self and the environment and causes an intolerace of any differences between self and other.
Communication/Interaction Therapy
All behavior is a form of communication1960s research at Mental Research Institute in Palo AltoDouble-Bind Communication: two aspects of the same communication contradict each other.Metacommunication: two levels of communication: "report" (intended verbal statement) and "command" (implicit non-verbal message; metacommunication)Symmetrical communications: equality between communicatorsComplementary communications: inequality in communicators; reciprocal nature; parent/child or therapist/client
Focus of object relations theory
Development of introjects (internalized representations) based upon early interactions.
View object-seeking (relationships with others) as basic inborn drive.
Strategic Techniques
1st session in 4 sections:
1. Social stage - obs family
2. Problem stage
3. Interaction stage - obs of family dis
4. Goal-setting - contract that defines goals
Reality Therapy Goals
ID responsible ways to meet needs.
Rejects medical model
Focus on current behaviors
Transference is bad
Stress is conscious
Client can judge oneself
Teaches clients how to be responsible.
Motivational Interviewing
For pts who are ambivalent about changing and combines transtheoretical stages with client-centered therapy and self-efficacy.
Homosexual ID Model (Troiden)
1. Sensitization; Feeling Diff
2. Self-Recognition; Identity Conf
3. Identity Assumption -
4. Commitment; Identity Integration - out of closet
Behavior Family Therapy
Operant Cond, Social Learning, and Social Exchange Theory
Jung's Analytical Psychotherapy
Conscious is oriented toward the external world (Ego)
Unconscious (Personal & Collective)
Paradoxical Interventions
Clients maladaptive beh allows them to be constructive.
Ex: Ordeals - give mother in law an expensive gift
Restrainig - encouraging family not to change
Positioning - exaggerating sev of sympton
Reframing
Prescribing the symptom - del do maladaptive beh
Kuder vs. Strong
1. Kuder assesses general interests while Strong relates interest to specific occupations
2. Kuder uses content validity vs. empirical criterion keying
high context communication
-few words but high meaning
-relies heavily on codes, non-verbal, culturally-defined meanings
-most minority communication
-AA, His, NA
biofeedback effectiveness
-found no more effective then less costly tx like relaxation
-tx of choice for fecal incontinence and Raynaud's disease
Atkinson, Morten, and Sue's Racial/Cultural Identity Developement Model Stage I: Conformity
Conformity: positive attitude toward dominent culture, depreciates own culture, preference for therapist from majority group
There is some evidence that stimulus exposure and antidepressants that increase serotonin levels both alleviate the symptoms of OCD by reducing activity in the:a. locus coeruleusb. caudate nucleusc. reticular activating systemd. i
b. caudate nucleus
An etic approacha:
studies a culture from outside of that culture and is not culture-specific.
Key concepts: Beck's Cognitive Therapy
Collaborative process of empirical investigation, reality testing, and problem-solving between therapist and patient. Patient's maladaptive interpretations and conclusions are treated as testable hypotheses.Automatic thoughts: individual's appraisals that arise spontaneously in response to specific stimuli or situations.Schemas (or Core Beliefs, Underlying Assumptions): internal models of self and world that develop through experience; facilitate information processingCognitive Distortions: Systematic errors in reasoning that link dysfunctional schemas and automatic thoughts; information often distorted to fit relevant schema, resulting in dysfunctional automatic thoughts.Cognitive Triad: negative views of the self, the future, and the world
Psychoanalytic psychotherapy: Goal? Techniques?
Goal: bring unconscious into conscious awareness & integrate previously repressed info

Techniques: free association, dreams, resistances, transferences (confrontation, clarification, interpretation, working through)
Extended Family Systems Therapy: Founder, Theory, Goal, Technique
FOUNDER: Bowen
THEORY: Probelms result of multigenerational transmission.
GOAL:­ intellectual & emotional differentiation
TECHNIQUE: Focus on spouses or 2 most mature people; do genogram; be coach and educate them

**From a large crowd of all the family members, he used a BOW to strike an arrow into family member that stuck out most. This differentiated the individual singled out to work with.**
Group Therapy is best for...
Individuals w/ interpersonal issues, who are motivated, positive, and verbally sophisticated.
Jung's Therapy
Bridge the gap b/t the CONSCIOUS & the PERSONAL and COLLECTIVE UNCONSCIOUS.
Interested in DREAMS, TRANSFERENCE (projection of coll unc)
Here-and-now
Optimistic
Unique aspects of therapy with Asian Americans
-direct, structured, short-term
-couched w/i academic/vocational issue
-helpful to discuss what to expect from therapy, roles, and need for verbal disclosure
"psychological birth": who, when, what?
-Mahler
-3rd year of life
-infant ego develop stable self identity and ability to maintain representation of another (healthy development)
Motivational interviewing, who & what?
-Miller and Rollnick ("roll w/it")
-help move ppl through change stages
Name 6 general occupational themes in SCII derived from Holland's work.
RICE AS
Realistic
Investigative
Conventional
Enterprising
Artistic
Social
Which of the following was responsible for the genesis of Gerald Caplan's developement of mental health consultation:a. recognition that traditional psychoanalysis was not helpful for many of his clientsb. recognition that an internal consult
c. Caplan's conslutation approach grew out of his experiences at residential institutions. He recognized that it was not feasible to provide direct services to patient's due to their large number and, consequently, developed an indirect approach that increased his ability to ensure that patients received adequate treatment.
Stages in Prochaska and DeClemente's Transtheoretical Model of Change
1) Precontemplation: little insight of need for change2) Contemplation: considering change (in the next 6 months) but not committed to it.3) Preparation: clear intent to take action within the next month; may have begun taking small steps.4) Action: considerable time and energy devoted to change; obvious to others5) Maintenance: change has lasted 6 months, person consolidating change and taking steps to prevent relapse. May last as long as a lifetime.
Group therapist's primary tasks (according to Yalom)
1. Creation and maintenance of group
2. Culture building (establish norms)
3. Activation and illumination of here-and-now (process work)
Object Relations View of Maladaptive Behavior
Abnormalities in early object relations
Spliting b/t good and bad.
3 modes of cognitive experience in infant
-Sullivan
Prototaxic: 1st months, unconnected moments
Parataxic: see causal connections not actually related = developing self
Syntaxic: End of 1st yr, symbols w/shared meaning, logical & sequential. Underlies language acquisition
Operant Interpersonal Therapy, who and what?
Stuart
-marital therapy based on operant conditioning and social exchange theory
-increasing positive reinforcements and exhanges
positive vs. negative feedback in systems theory
positive: disruption of family's homeostasis
negative: restores comfortable equilibrium
(counterintuitive!)
"Joining" in Structural Family Therapy involves what?
mimesis - adopting family's style and language
tracking - identifying family's values and history
"Change through therapy, is accompanied by stress, and the therapeutic system must be capable of dealing with it." This statement was made by:a. Glasserb. Bowenc. Adlerd. Minuchin
d. Minuchin: for Minuchin, change is often precipitated by stress. Consequently, in therapy, to effect appropriate structural changes, the therapist induces stress.
According to the Racial/Cultural Identity Development Model, the resistance and immersion stage is characterized by:a. a preference for the dominent group and resistance to being considered a member of the minority group.b. conflicting attitu
c. during this stage, the individual actively resists the dominent cultural group and becomes immersed in his/her own culturea. incorrect - this is the conformity stageb. incorrect - this is dissonance staged. incorrect - this is internalization /commitment stage of Cross' Nigrescense Model
Self-in-relation therapy is an approach to:a. family therapy that emphasizes the multiple transferences that affect current relationships among family membersb. group therapy that focuses on interpersonal interpretations and misinterpretation
c. Object relations theory was an important influence on self-in-relation theory. However, self-in-relation theory extends the objects relations approach by considering the impact of same versus opposite gender in caregiver-infant relationships on development, especially on development of the relational self.
Name and describe Stage 2 of Helms' White Racial Identity Development
Disintegration: Increasing contact with AA increases the person's awareness of being white, which leads to confusion and ambivalence. To reduce conflicts, the person may overidentify with AA or acti in a paternalistic way, or retreat into white society.
Name and describe Stage 3 of Helms' White Racial Identity Development
Reintegration: The individual attempts to resolve the conflicts of the Disintegration stage by accepting racist views of white superiority and AA inferiority.
5 stages of change in the Transtheoretical Model
1. Precontemplation- denial, little insight
2. Contemplation- aware of need to change
3. Preparation- realistic plan
4. Action
5. Maintenance- change of 6+ mo., prevent relapse

**PCP in the AM**
Id is to ego as ______ is to ______.
Pleasure principle
Reality principle
Black Racial ID Model (Cross)
1. Pre-encounter - whites are ideal, African Americans are denigrated.
2. Encounter - exposure to event; interest in developing an African-American identity and a preference for a therapist of one's own race.
3. Immersion/Emersion - a struggle b/t old and emerging ideas about race. There is an initial idealization of African-Americans and a denigrating of whites. Toward the end of this stage the person becomes less emotionally immersed and moves toward internalization of a new identity.
4. Internalization/Commitment - the individual adopts an African-American worldview.
Strategic Family Therapy, who and what?
-Haley
-therapy is power struggle bt family and therapist
-focus on current problem, correct problem will improve family system
Evaluation of Cognitive Therapy
Research show CT equal or superior to antidepressant drugs (yet, combined tx most effective)
What is most important group composition factor?
intelligence level - should be same
Name and define the 1st stage of Prochaska and DiClemente's transtheoretical model of behavior change.
precontemplation: the individual has little insight into the need for change and does not intent to change.
What makes a person a good candidate for group therapy?
What factors are contraindicated?
GOOD CANDIDATE: interpersonal issues are primary problem; motivated to change; positive view of group tx; verbal; slow to engage in therapy; appreciates peer support/feedback.
CONTRAINDICATIONS: can't follow group norms; can't tolerate group setting; severe sx (extreme depression, paranoia, psychosis, TBI); sociopathy
Ego-Analysts: Anna Freud, Rappaport, Hartmann
-Focus on role of ego in personality dev.
-healthy beh is under conscious control
-pathology ensues when ego loses autonomy from id
-"re-parenting"
Name and define the 4th stage of Prochaska and DiClemente's transtheoretical model of behavior change.
action: the individual actually takes steps to bring about action.
Define stage 1 of Cross' Black Racial Identity Development Model
Preencounter: whites are seen as ideal, AA are denigrated --AA in this stage would prefer white counselor
The 3 parts of Freud’s structural (drive) model of the psyche are:
1. Id--> birth; life & death instincts (in direct opposition of the superego, dominated by pleasure principle)
2. Ego--> 6 mo.; reality principle (mediates amongst the id, superego and external world)
3. Superego--> 4-5 yrs; internalizes society’s values (acts as conscious and ego-ideal)
composition of groups with regard to children
-avoid age differences of more than two years
-same gender
Sue describes "worldview" in terms of two independent dimensions --locus of control and locus of responsibility. From this perspective, an Anglo-American therapist with an internal locus of control and an internal locus of responsibility is mos
c. IC-ER worldview is likely to pose the most difficult problems for the IC-IR white therapist because the client is likely to challenge the therapist's authority, view the therapist as part of the establishment that has oppressed the minorities.
Howard et al (1986) & Length of Treatment
26 sessions (75% of pts)
52 session (85% of pts)
"Level off"
Dose-Dependent Effect
A man with a history of chronic back pain loses his job. He tells you that his pain has beenmuch worse since he stopped working. A possible explanation for this phenomenon is:a. chronic back pain syndromeb. masked depressionc. Conversio
b. masked depression: the clue is the man's loss of his job, which is certainly a potential precipitant of depression. The research has shown that depression can magnify pre-existing pain.
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