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Clinical therapies 2
Family sys, CBT, brief, psychdymamic
| Question | Answer |
|---|---|
| When is EFT for couples contraindicated? | EFT for couples is contraindicated when the partners have different agendas for their relationship or therapy, when the therapist believes that emotional vulnerability is not safe or advisable (e.g., when there is ongoing physical abuse in the relationshi |
| Practitioners of EFT assume what? | helping partners express their emotions is the fastest/effective way to solve problems, goal of therapy is to expand/restructure the emotional experiences partners (new interactional patterns), experience attachment security in the relationship |
| What are EFT's three stages: | assessment and cycle de-escalation, changing interactional positions and creating new bonding events, and consolidation and integration. |
| Functional family therapy (FFT) says problematic behaviors within a family serve important relationship functions; what population is it for? | an evidence-based treatment for at-risk adolescents (conduct disorder and/or a substance use) and their families. It incorporates bits of structural, strategic, and behavioral family therapy. |
| What is the primary goal of FFT? How many sessions? | primary goal of FFT is to replace problematic behaviors with nonproblematic behaviors that fulfill the same relationship functions. Therapy ordinarily involves 8 to 30 sessions over a 3- to 6-month period |
| Functional family therapy stage one? what techniques in this stages? | engagement and motivation stage, emphasis is on forming a therapeutic alliance with family members and helping family members reduce feelings of hopelessness and negativity. Use joining and reframing |
| Functional family therapy stage two? what techniques in this stages? | immediate and long-term behavioral goals are identified and an individualized treatment plan for the family is implemented. Techniques used during this stage include training in parenting, communication, problem-solving, and coping skills |
| Functional family therapy stage three? what techniques in this stages? | generalization stage, the focus is on linking family members to community resources and helping them generalize their acquired skills to new problems and situations and identify ways to avoid relapse. |
| Multisystemic therapy (MST) is an evidence-based treatment that was originally developed for adolescent offenders at risk for out-of-home placement | adapted for adolescents with other serious clinical problems including psychiatric disturbances, substance abuse, and childhood maltreatment. MST is based on Bronfenbrenner’s (2004) ecological model |
| The MST model includes 9 treatment principles that are applied using an analytic process (the “MST Do-Loop”) that structures the development, implementation, and evaluation of the treatment plan. What are the 9? | fit between id problems/broader systemic; focus positives/strengths; increasing respons; present-focus, action-oriented-defined; targeting behx seqs; develop appropriate interventions; encourage effort; stressing evaluation/accounty; generalization. |
| MST is delivered by a multidisciplinary team that is tailored to the adolescent’s and family’s target behaviors. What is an example? | adolescent w academic/conduct problems, use marijuana/cocaine, recent arrest for cocaine possession, the team will likely include a caseworker, family therapist, substance abuse counselor, and other individual at adolescent’s school and neighborhood. |
| Because low fidelity causes poorer outcomes MST implements what to ensure fidelity? | quality assurance system is used to promote treatment fidelity. System components include initial and booster training of therapists; ongoing supervision and consultation; 6 month reviews |
| group therapy is contraindicated for what individuals? | actively experiencing suicidal ideation, delusional and likely to incorporate the group into their delusions, orpose a threat -unable to control aggression. antisocial person dis do well in homogeneous not be included in heterogeneous groups |
| recommended size for an adult outpatient group ranges from? Why? | from 7 to 10 members. When a group has less than 7 members, interactions are limited; when it has 11+ members, it’s hard to involve everyone . Rsh:larger the size of a therapy group, the lower its cohesiveness and the higher the dropout rate. |
| Closed groups begin with the desired number of members and, if any members drop out, they’re not replaced. What are the benefits? | Advantages of closed groups are that they’re associated with greater group cohesiveness |
| What are the advantages of open groups? | They usually have broader goals than closed groups do and meet indefinitely. An advantage of open groups is that they benefit from the energy and new input provided by new members. |
| In the final GROUP therapy phase,development of cohesiveness stage looks like | conflict decreases/cohesiveness increases as members trust others/ therapist. Members may reveal the real reason why they have come to therapy and show concern absent or drops outs. The development of cohesiveness marks the beginning of a mature group |
| conflict, dominance, and rebellion stage of GROUPS | members compete for power and control and attempt to establish a pecking order. Members tend to be critical of each other, and some may become hostile and resentful toward the therapis |
| Yalom and Leszcz (2005) describe 11 therapeutic factors that are responsible for the effects of group therapy | group cohesiveness, instillation of hope, universality, altruism, imparting information, development of socializing techniques, corrective recapitulation of the primary family group, interpersonal learning, imitative beh, catharsis, existential factors |
| General systems theory predicts? | all systems consist of interacting components, are governed by the same general rules, and have homeostatic mechanisms that help them maintain a state of stability and equilibrium. |
| Cybernetic theory is concerned with the mechanisms that regulate a system’s functioning and distinguishes between negative and positive feedback loops. What is a negative feedback loop? | Negative feedback loops resist change and help a system maintain the status quo, while positive feedback loops amplify change and disrupt the status quo. |
| In Bateson Communication Theory, what is double bind communication? what population did he study it in? | linked the development of schizophrenia to double-bind communication, which occurs when a person receives two contradictory messages from a family member and is not allowed to comment on the contradiction. |
| Bateson also distinguished between symmetrical and complementary interactions; what are the differences? | Symmetrical interactions reflect equality;one person elicits a similar type of behavior from the other person. escalate= “one-upmanship game.” complementary interact. reflect inequality; behavior of 1 person complements the other. 1 dominant/subordinate |
| postmodernism therapies are under what two approaches? | These approaches adopt a constructivist or social constructionist perspective and assume that there are multiple viewpoints and realities. They view family therapy as a shared process in which the therapist forms a collaborative relationship |
| Bowen’s extended family systems therapy is also known as intergenerational and transgenerational family therapy. Bowen derived his approach from ? | work with children with schizophrenia and their families, which led to his conclusion that the transmission of certain emotional processes from one generation to the next is responsible for the development of schizophrenia in a family member. |
| Name 2 Bowen extended family system therapy terms ? | Differentiation: Differentiation is both intra- and interpersonal. The intrapersonal aspect is a person’s ability to distinguish between own feelings and thoughts.Emotional Triangles, Family Proj Process (immature),Multigenerational Transmission Process |
| Bowen The primary goal of therapy is to increase each family member’s differentiation, and several strategies are used to achieve this goal. Name 3? | genogram questions are designed to defuse emotions and help family members identify how they contribute to family problems. teach family members how to interact to alter triangulated relationships. Neutral role of coach |
| Minuchin’s structural family therapy says what things are important part of the family structure? | identifies subsystems and boundaries as important aspects of a family’s structure: overly diffuse and lead to enmeshed relationships; at the other end are boundaries that are overly rigid and lead to disengaged relationships |
| Minuchin identified four rigid family triads, which are boundary problems that help parents obscure or deny their conflicts, what are they? | stable coalition;1 parent and a child form an inflexible alliance against other. unstable coalition aka triangulation;each parent demands child side. (c) A detouring-attack parents blame child. detouring-support coverprotect the child. |
| Minuchin’s structural family therapy, primary goal | primary goals of therapy are to alleviate current symptoms and change the family structure by altering coalitions and creating clear boundaries. |
| What are the three overlapping phases of Minuchin's structural family? as well as 1 technique? | joining (mimesis/affective), evaluating (family map) , and intervening. reframing, unbalancing, boundary making, enactment, |
| What is mimesis in the joining phase of Minuchin;s family therapy? | Mimesis involves adopting the family’s affective, behavioral, and communication style; tracking involves adopting the content of the family’s communications; and maintenance entails providing family members with support. |
| Haley’s strategic family therapy makes what assumptions? | struggles for power and control in relationships are core features of family functioning and that “a symptom is a strategy that is adaptive to a current social situation for controlling a relationship when all other strategies have failed |
| Haley’s strategic family therapy what is the therapist role? | strategic family therapists assume an active role and use a variety of strategies that are aimed at changing behavior rather than instilling insight. |
| Haley’s strategic family therapy what are the four stages of the INITIAL session? | initial session is highly structured and consists of four stages: brief social stage;welcomes/ observes. problem stage, in which the therapist elicits each family member’s view. interactional stage, discuss different views.final goal-setting stage, |
| King Haley's strategic family therapy uses what two directives? | straightforward and paradoxical directives. Straightforward directives are instructions to engage in specific behaviors. Paradoxical directives; prescribing the symptom, restraining, and ordeals. |
| Milan(5 part olympics) systemic family therapy assumes what? | the family as a whole protects itself from change through homeostatic rules and patterns of communication”. family games, and family games associated with problematic behaviors are rigid, involve power struggles between family members,aka “dirty games.” |
| Milan(5 part olympics) systemic family therapy has how many parts? and how long? | use of a therapeutic team and five-part therapy sessions (pre-session, session, intersession, intervention, and post-session) and gaps between therapy sessions of four to six weeks. |
| Milan(5 part olympics) systemic family therapy uses what strategies? | hypothesizing, neutrality, circular questioning, positive connotation, and family rituals: Hypothesizing is “a continual interactive process of speculating and making assumptions about the family situation” Family rituals are activities to alter games |
| Milan(5 part olympics) systemic family therapy - what are family rituals? | Family rituals are activities to alter games |
| Satir’s conjoint family therapy is also known as the human validation process model and was influenced by humanistic psychology and communication and experiential approaches to family therapy. what assumptions does it make? | family systems seek a state of balance, with family problems arising when balance is maintained by unrealistic expectations, inappropriate rules and roles, and dysfunctional communication |
| Satir distinguished between four dysfunctional communication styles in conjoint fam therapy, name 2? | Placating; agreeing w others due to fear. Blaming involves accusing. Computing overly intellectual. Distracting involves changing the subject/ inappropriate jokes. Satir also identified a congruent (or leveling) style- verbal and nonverbal messages |
| The primary goal of conjoint family therapy is? | is to enhance the growth potential of family members by increasing their self-esteem, strengthening their problem-solving skills, communicate congruent. “use of the self” most important therapeutic tool and thp have multiple roles educator, |
| What are the strategies of conjoint family therapy from Satir? | including family sculpting (which involves having each family member take a turn positioning other family members in ways that depict thr view). family reconstruction (psychodrama that involves role-playing) |
| They also assume that the problem – not the person – is the problem- what family therapy? | narrative family therapy consider a person’s problems “as arising from, and being maintained by, oppressive stories which dominate the person’s life”. they view these stories as being socially constructed |
| A narrative family therapist assumes the role of collaborator and uses questions and other techniques to help family members identify current stories and construct alternative, name 2 techniques? | externalizing questions are used to help clients view their problems as being outside themselves, while opening space questions. therapeutic letters, therapeutic certificates, and definitional ceremonies |
| What is EFT, what is influenced by? | brief evidence-based treatment that integrates principles of attachment theory, humanistic-experiential approaches, and systems theory. |
| In narrative family therapy, what are unique outcomes? | Listening involves paying attention to what family members say to identify dominant discourses and unique outcomes, which are also known as “sparkling moments” and are experiences that are not consistent with problem-saturated stories |
| CBT assumes what about mental health concerns? | psychological disturbance is due largely to maladaptive cognitive schemas, automatic thoughts, and cognitive distortions: |
| According to Beck, the cognitive profile for depression consists of ? | negative beliefs about oneself, the world, and the future. |
| Automatic thoughts in Beck's CBT are? | self-statements or mental images that “come to mind spontaneously when triggered by circumstances … [and] intercede between an event or stimulus and the individual’s emotional and behavioral reactions” |
| Cognitive distortions are triggered by? | Cognitive distortions are systematic errors in reasoning that often affect thinking when a stressful situation triggers a dysfunctional schema that, in turn, affects the content of automatic thoughts |
| In CBT whats the difference btwn the cog. distortion of Dichotomous thinking and Arbitrary Interference? | Arbitrary inference involves drawing negative conclusions without any supporting evidence. while, Dichotomous thinking is the tendency to classify events as representing one of two extremes |
| In CBT whats the difference btwn the cog. distortion of Emotional reasoning and Selective Abstraction? | Selective abstraction involves paying attention to and exaggerating a minor negative detail of a situation while ignoring other aspects. emotional reasoning-rely on one’s emotional state to draw conclusions about self, others, and situations. |
| Common CBT distortions include arbitrary inference, selective abstraction, dichotomous thinking, personalization, and emotional reasoning- What is personalization? | Personalization involves concluding that one’s actions caused an external event without evidence for that conclusion |
| Name some cognitive and behavioral techniques in CBT? | Cognitive techniques include redefine problem, reattribution, decatastrophizing. Behavioral include activity scheduling, behavioral rehearsal, exposure therapy, and guided imagery (which is used to facilitate relaxation and decrease anxiety and pain). |
| An essential feature of CBT is its reliance on collaborative empiricism, what is it? | a collaborative therapeutic alliance between the therapist and client in which they become coinvestigators as they examine the evidence to accept, support, reevaluate, or reject the client’s thoughts, assumptions, intentions, and beliefs” |
| Another feature is the use of Socratic dialogue, which involves ? | asking the client questions that are designed to clarify and define the client’s problems, identify the thoughts and assumptions that underlie those problems, and evaluate the consequences of maintaining maladaptive thoughts and assumptions. |
| Ellis’s rational emotive behavior therapy (REBT) attributes psychological disturbances to ? | irrational beliefs, which tend to be “absolute (or dogmatic) and are expressed in the form of ‘must’s,’ ‘should’s,’ ‘ought’s,’ ‘have to’s,’ etc. … and lead to negative emotions that largely interfere with goal pursuit and attainment” |
| Ellis uses an A-B-C-D-E model to explain psychological disturbance and the process of change in therapy: A is an activating event, B is the client’s irrational belief about that event, C emotional or behavioral consequence of that belief. What is D and E? | D is the therapist’s use of techniques that dispute the client’s irrational belief, and E is the effect of these techniques, which is the replacement of the irrational belief with a more rational one. |
| Practitioners of REBT use a variety of cognitive, behavioral, and emotive techniques, including | active disputation of irrational beliefs, rational-emotive imagery, systematic desensitization, and skills training. Research :REBT is an effective treatment for depression, anxiety, conduct problems, anger, and several other disorders and conditions |
| Self-instructional training (Meichenbaum, 1977) was initially developed to? | teach problem-solving skills to children with high levels of impulsivity but has since been applied to other populations and problems. It consists of five stages |
| Self-instructional training, what are te 5 stages? | cognitive modeling: child observes model. overt external guidance:child perform-model verbal. overt self-guidance:child perform task while verbalizing. faded overt guidance:child perform whispering. covert self-instruction-perform the task -subvocally. |
| The instructions used by the model and children while performing the task address what 4 skills in Self instructional training? | identifying the nature of the task, focusing attention on the task and the behaviors needed to complete it, providing self-reinforcement that sustains appropriate behavior, and evaluating performance and correcting errors. |
| Stress inoculation training focuses on improving the ability of clients to deal better with ongoing and future stressful situations by teaching them effective coping skills. what are the three phases? | conceptualization/education phase, clients are provided with info stress/effects- view stressful “problems-to-be-solved”. skills acquisition /consolidation phase, clients learn CB coping skills. application/follow-through- clients skills; imagined/real. |
| ACT distinguishes between clean and dirty pain: Clean pain is also known as clean discomfort and refers to natural levels of physical and psychological discomfort. What is dirty pain? | Dirty pain is also known as dirty discomfort and refers to the emotional suffering that’s caused by attempts to control or resist clean pain. |
| main goal of ACT is to increase psychological flexibility, which involves addressing six core processes that foster acceptance, mindfulness, commitment, behavior change. What are the 6? | Experiential acceptance,Cognitive defusion to distance oneself. Being present counters attentional rigidity. self-as-context counters attachment to the conceptualized self. Values-based action,committed action. |
| What interventions are used in ACT? | Interventions target the six processes in ACT and include metaphors, mindfulness strategies, and experiential exercises. |
| ACT is considered to be an evidence-based treatment for a number of conditions including | ACT is considered to be an evidence-based treatment for a number of conditions including chronic pain, psychosis, depression, anxiety disorders, and obsessive-compulsive disorder. |
| MBSR was originally developed “to make mindfulness meditation available and accessible in a Western medical setting while remaining true to the essence of Buddhist teachings” What does it help with? | It’s used to help people cope with stress, pain, and illness and consists of an 8-session group prog. focuses on teaching participants several mindfulness meditation practices including awareness of breathing, yoga, and sitting and walking meditation. |
| MBCT combines elements of MBSR and CBT. It was originally developed as a method for treating recurrent depression. What is the primary goal? | “enable clients to become self-aware, so they can learn to de-centre from distressing thoughts, feelings, bodily sensations and behaviours”.includes psychoeducation, mindfulness meditation practices, and cognitive-behavioral tech. 8-session group program. |
| mechanisms that are responsible for the effectiveness of mindfulness-based interventions, researched include? | primary: attention and emotion regulation, body awareness;awareness of one’s internal states. decentering aka reperceiving and is the ability to separate oneself from one’s thoughts and emotions and view them objectively as transient mental events. |
| cognitive therapy for suicide prevention (CT-SP) was designed to prevent repeat suicide attempts by ?.brief cognitive-behavioral therapy for suicide prevent.was developed for ? and incorporates many of the elements of CT-SP. | Adult active-duty members |
| CT-SP and BCBT consist of three phases that focus on, in order, what items? | emotion regulation, cognitive flexibility, and relapse prevention |
| CB for suicide prevention (CBT-SP) was developed for adolescents who recently attempted suicide and combines elements of cognitive-behavioral therapy and dialectical behavior therapy. what are the phases? | individual /fam: acute phase consists of chain analysis (events that led), safety planning, psychoeducation, reasons for living, case conceptualization.continuation phase: generalizing/consolidating behavioral/cognitive skills/relapse prevention. |
| safety planning intervention (SPI) w./cognitive-behavioral therapy or stand-alone intervention in ER or other emergency situations or any other time. The SPI consists of what six steps? | (1) recognizing the warning signs suicidal crisis, internal coping strategies, utilizing social contacts, (4) contacting others, (5) contacting mental health professionals or agencies, (6) reducing access to lethal means |
| What has research found about safety plans versus contracts? | While research has found the SPI and other safety plans to be useful for reducing suicidality, there is no empirical evidence supporting the use of no-suicide contracts. |
| regard to effectiveness, there is evidence that cognitive-behavioral therapies for suicide prevention reduce suicidal ideation and suicide attempts, feelings of hopelessness, and depression. | research; benefits occur regardless of a person’s gender, severity of suicidal ideation, and number of suicide attempts |
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