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Theories Exam #1
Term | Definition |
---|---|
What is a theory | explains/ predicts behavior |
Theory attempts to | - explain the process of therapy/ how it works - offer prescription to both counselor/ client - explain development - define healthy/ unhealthy |
Who is a Therapist (in the CA) | Master’s level therapist (MFT program) LPCTC Psychologists (counseling, clinical, sometimes school psychologist) |
Acts of counseling | Counseling , psychotherapy, therapy, mental health services, mental health counseling therapy, psychological services |
Education (doctoral) | PhD (doctor of philosophy) Doctor of Psychology (practice/ scholarship) ED (doctor of education) |
Why theory? | Its fun It works → framework that gives a roadmap to treat mental illness, what does dysfunction look like Is essential to human life → need to arrange info/ easily refer to |
Theory is a structure/ schema | is a strong road map/ guides practice |
Downsides | - Stereotypes, labeling, biases - Ignore/ forget what fits into the theories schema |
Counselors Who Don't Use Theory | Having no theory is like being without directions or having no compass / it is NOT abt giving advice/ NEED A THEORY |
Guidelines for Theory | 1. Flexible/ Adaptable 2. NOT absolute 3. Alternative routes 4. Follow ethical guidelines |
Identifying a Personal Theory | - process of choosing a theory is a journey - start w/ one good theory w/ room to grow/ learn it inside out - be intentional --> avoid theory hopping -flexibility w/ sensitivity |
What is a Good Theory | 1. Precision/ Testable 2. Empirical support 3. Parsimony 4. Stimulation 5. Practicality |
Precision/ Testability | - Define constructs/ relationships - Generates predictions abt behavior that are testable - Refutability (can u test the theory to see if its wrong) |
Empirical support (research) | - 1 study “proves” nothing → it is preliminary support - Meta-analysis: pulling together several studies (more power/ significant difference between treated/ untreated) - Efficacy studies/ expensive to run |
Common factor | not specific techniques mainly determine therapeutic outcome generally → dodo bird effect (which theory u choose doesn’t matter in the end) → setting goals w/ therapist/ how will u know when ur down w/ therapy |
Common Factors in Psychotherapy Outcomes (1-5) | 1. Catharsis --> advice --> behavioral regulation 2. Identitfcation w/ therapist 3. Mitigation/ isolation 4. Positive relationship 5. Reassurance |
Common Factors in Psychotherapy Outcomes (6-11) | 6. Release of Tension 7. Structure sessions 8. Therapeutic alliance 9. Trust 10. Therapist expertise 11. Therapist warmth, respect, empathy, acceptance |
Research on Psychotherapy Outcomes | research: the therapist (person)/ therapeutic relationship are key factors in successful therapy generally - specific diagnosis/ issue= EBTs/ ESTs can be more effective than therapy as usual |
Continuation of a Good Theory | - parsimony= client has a right to ask what theory is being used - stimulation= something that stems from research - practically= is it practical/ can it be practiced |
Corey says (chap 1) | NO single model can explain all facets of human experience |
Categories of Theories | 1. Psychodynamic approaches= created psychodynamic theory (Freud) 2. Experiential/ relationship-oriented therapies 3. Cognitive behavioral (action-oriented) apporaches 4. Systems/ postmodern apporaches (narrative, feminist) |
Existential approach | not prescribe a set of techniques/ procedures, mainly draws techniques from the other models of therapy |
Psychoanalytic | early psychosexual/ psychosocial development → past plays crucial role in shaping our current personality/ behavior |
Cognitive behavioral focus | how thinking affects the way we feel/ behave → emphasize current behavior |
Collboration | teaching clients ways to use what they learn in therapy in their everyday lives/ empowers client to take an active stance in their world |
Reality therapy | focus on clients’ current behavior/ stresses developing clear plans for new behaviors |
Behavior therapy | doing/taking steps to make concrete changes |
Rational emotive behavior therapy/ cognitive therapy | necessity of learning how to challenge inaccurate beliefs/ automatic thoughts that lead to behavioral problems |
Feminist therapy | contributed an awareness of how environmental/ social conditions contribute to the problems of women/ men + how gender-role socialization leads to a lack of gender equality |
Psychotherapy | involves both therapist/ the client in co-constructing solutions regarding life’s tasks |
Adlerian therapy | focus on meaning, goals, purposeful behavior, conscious action, belonging, social interest |
Person-centered approach | humanistic philosophy places emphasis on basic attitudes of the therapist → maintains quality of client-therapist relationship is prime determinant of the outcomes of the therapeutic process |
Gestalt therapy | offers a range of experiments to help clients gain awareness of what they are experiencing in the here/ now |
Postmodern approaches | focus on how people produce their own lives in the context of systems, interactions, social conditioning, discourse |
Ethic Codes | 1. guidelines 2. codes/ decision-making 3. outline professional standards of behavior 4. NOT make decisions for counselors |
Aspirational ethics | general principles suppose to follow, but dont have to (benefit others, do no harm, responsibility |
Mandatory ethics | have to follow the codes/ basically loose career if don’t follow the codes someone complains |
Purpose of Mandatory ethics | Educate abt responsibilities Basis for accountability/ improving professional pracitce Protect clients How psychologists are allowed to advertise/ can't w/ no license |
Ethical Decision Making Process | 1. identify the problem 2. review codes/ laws 3. seek consultation 4. brainstorm, list consequences, decide 5. document the reasons for your actions |
Informed consent | Inform clients what they can expect w/ therapy w/ the counselor/ what they expect from the study/ mandatory ethics |
Purpose of informed consent | - clients need enough info abt the counseling process to make choices - educate clients abt their rights/ responsibilities/ practice policies - helps client build trust w/ counselor |
Includes info such as | - communication methods/ rules - crisis procedures - the right to withdraw from treatment - cost/ fees - counselors use of consultation - limits of confidentiality |
Limits of Confidentiality | Confidentiality is NOT absolute (keeping client info private/ not sharing it) |
Expectations (limits of confidentiality) | 1. Client is a danger to self or others 2. Clients who are children/ minors, dependent adults, older adults/ are victims (or PAST victims) of abuse 3. Subpoena (court case, tell them what they want) 4. Client requests a release of records |
Technology + Privacy | Confidentiality/ privacy= complicated when technology is involved --> keep everything private/ things on separate device |
Ethics & Culture | - Past/ current theories need to be expanded to account for sociocultural factors/ multicultural diversity - Do no Harm= aware of expectations/ culturally sensitive |
Value imposition | not imposing values on clients (cultural competence/ unethical) |
Clinical Assessment | ongoing princess that helps the counselor evaluate a client’s psychological functioning/ constantly assessing how client is doing |
Factors of Clinical Assessment | Guided by theory Requires cultural sensitivity Helpful in treatment planning --> have client improved |
Diagnosis | identifying a patterns of symptoms which fit criteria for a specific mental disorder defined in the DSM-5 |
Factors of Diagnosis | → Requires cultural sensitiity → Helpful in treatment planning → Required by inurance (this can create ehtical issues) |
EBT/ Evidence-based Practice (EBP) | refers to a manipulaized treatment (structured) for a particuar disorder or problem |
Strengths of EBT/ EBP | Validated by research (empirical) Cost-effective Usually brief/ standardized (valued by research) Preferred by Insurnace companies Increase accountability amongst therapists |
Disadvantages of EBT/ EBP | Mechanistic (robotic like) ill-fitted for extisenistal concerns (not for life transition) Difficult to measure both relation/ technical aspects of a psychological treatment Miss-used as a cost saving feature for insurance companies |
Multiple or Dual Relationships | either sexual or nonsexual occur when counselors assume two (or more) roles simultaneously w/ a client |
Factors of Multiple/ Dual Relationships | Not inherently unethical Must be managed ethically to protect client’s well-being Sexual relationships are always EXPLOITATIVE |
Contextual factors | alliance, the relationship, the personal/ interpersonal skills of the therapist, client agency, extra-therpeutic factors- are the primary determinants of therapeutic outcome |
Therapy relationship/ therapy models | used influence the outcomes of treatment, but it essential that the methods used support the therapeutic relationship being formed w/ the client |
Effective Counselor | 1. Authentic 2. Willing to tolerate ambiguity 3. Empathic 4. Interpersonally skilled 5. Self-awarness 6. Open/ flexible 7. Culturally aware 8. Sets good boundaries |
Counter transference | you have reaction to a client |
Counselor's Values | 1. Avoid value imposition 2. Develop self-awarness of own values/ their effects 3. Assist clients within their value framework |
Value Conflicts | Corey says= No bc you have these values, but need to set them aside when working w/ the clients - Seek consultation, compartmentalize values/ roles |
Multiculturally competent | -Develop awareness of own biases, values, cultural norms - Understand world from client’s view - Learn abt oppression, racism, discrimination, stereotyping - Study the historical background/ traditions - Develop awareness of acculturation strategies |
Intergration | maintain a sense of ancestral culture/ adopt dominant culture |
Assimilation | fully identity w/ the U.S. dominant culture |
Marginalization | don’t identify w/ either your ancestral culture or w/ the dominant culture |
Separation | highly identify w/ ancestral culture and don’t want to integrate into the new culture (isolation) |
Issues Faced Beginning Therapists (1-6) | Dealing w/ anxieties Being oneself/ self-disclosing Avoiding perfectionism Being honest abt limitations Understanding silence Dealing w/ demands from clients Dealing w/ clients who lack commitment Tolerating ambiguity |
Issues Faced Beginning Therapists (7-14) | Avoiding losing oneself in clients Developing a sense of humor Sharing responsibility w/ the client Declining to give advice Defining one’s role as a counselor Learning to use techniques appropriately Developing one’s own counseling style |
Staying Alive as a Therapist | 1. Know what causes burnout 2. Recognize / remedy burnout → overworking/ lack of self-care |
Active/ Directive | therapist will do fair amount of talking/ teaching/ have control within the session |
Nondirective | let client bring in their issue/ be more reactive what client bring to you |
Bracketing | managing your personal values so that they do not contaminate the counseling process |
Ethical obligation | counselors to develop sensitivity to cultural differences if they hope to make interventions that are consistent w/ the values of their clients |
Diversity | counselor brings own heritage to work/ need to recognize the ways in which cultural conditioning has influenced the directions you take w/ clients |
Culture | values/ behaviors shared by a group of individuals/ important to realize that culture refers to more than ethnic or racial heritage |
Framework of Multicultural Counseling | 1. Beliefs/ attitudes 2. Knowledge 3. Skills/ intervention strategies |
Concern-based ethics | think about how you can become the best practitioner possible |
Positive ethics | approach taken by practitioners who want to do their best for clients rather than simply meet minimum standards to stay out of trouble |
Professional maturity | implies that you are open to questioning/ discussing your quandaries w/ colleagues |
Confidentiality | ethical concept/ most states it is legal duty of therapists not to disclose info abt client |
Privileged communication | legal concept that protects clients from having their confidential communications revealed in court without their permission |
DSM-5 | emphasizes the importance of being aware of unintentional bias/ keeping an open mind to presence of distinctive ethic/ cultural patterns that could influence the diagnostic process |
Boundary crossing | departure from a commonly accepted practice that could potentially benefit a client |
Boundary violation | serious breach that harms the client/ its therefore unethical |
Unconscious | reservoir of unacceptable thoughts, wishes, feelings, memories, what lies deep, below the surface (drives instincts) |
Conscious | whats on the surface (logic/ reality) → what we are aware of in the moment |
Preconcious | info that can be made conscious easily, but not thinking abt it (pulling a memory or preference into conscious awareness) |
Id | instincts → pleasure principle/ satisfying its needs in the moment (seeks immediate gratification) (devil on ur shoulder) |
Ego | reality → can’t get needs met right away, but set some goals to eventually meet that need/ develops after born (mediator)/ rationalization |
Superego | morality → conscious/ fell guilty when something happens (angle on ur shoulder) → too dominant gonna feel perfectionist/ high anxiety/ depression |
Evidence for the unconscious | 1. in clinical practice --> ego defensive mechanisms 2. in scientific reasearch --> implicit bias/ slips of tongue |
Health | Don't repress unacceptable thoughts/ impulses; resolve inner turmoil/ balanced personality |
Dysfunction | Personality unbalanced; unresolved conflicts that have not been dealt w/ repress unwatned thoughts/ impulses |
Neurotic anxiety | Feeling of dread resulting from repressed feelings, memories, desires - ego lets anxiety surface rather than the id’s impulses (unacceptable thoughts) |
Ego-Defense Mechanisms | Unconscious behaviors that deny or distort reality - helps us cope w/ anixety |
Defense Mechanisms | Repression Denial Reaction formation projection displacement rationalization sublimiation regression introjection identifcation compension |
Repression | threatening thoughts or feelings are excluded from awareness |
Denial | refusing to accept or believe painful realities (reaction to grief) (refusing to admit to the reality) |
Reaction Formation | acting the opposite of how you feel |
Projection | project own unacceptable impulses to others |
Displacement | shifting aggressive or threatening impulses to a less threatening object/ person (ex: punching a wall) |
Rationalization | making excuses for your behaviors |
Sublimiation | diverting sexual or aggressive energy into other channels (ex: poetry or art) |
Regression | reverting more infantile development behavior under stress |
Introjection | take in values/ standards of others without questioning those values/ don’t think abt it |
Identification | identifying w/ successful causes, organizations, people in hope to be perceived as worth-while |
Compension | masking perceived weakness or developing certain traits to make-up for limitations |
Parapraxes | leakages from the unconscious (memory lapses/ omissions) |
Slips | unintended actions caused by leakage of suppressed thoughts or impulses |
Freudian slips | miss-statements or slip of the tongue - (more likely to happen when tired/ stressed out)/ don’t have to be sexual) |
Psychosexual Development | Oral Anal Phallic Latency Genital |
Psychoanalytical Theory Goal | to make the unconscious conscious |
Oral Stage | First 18 months of life (exploring world through mouth as an infant/ soruce of pleasure) |
Anal Stage | 18 months- 3 (toddler gains pleasure through the anus) → learning indpendence/ exert control |
anal retentive | very rigid/control, anxious, experience a lot of negative emotions |
anal explusive | choatic/ messy person |
Phallic Stage | 3-7 figure out they have gentiles and they can bring pleasure crisis of attractive to parents of diff sex (sexually) |
Latency | 7-12 learning social rules/ not alot of sexual |
Genital Stage | Ages 12-60 learn to have healthy realtionships/ satisfy sexual relationships/ how maturity is reached |
Blank-screen approach | fosters transference (don’t share anything abt yourself w/ client) |
Transference | client reacts to therapist as he or she did to an earlier significant partner or person |
Countertransference | reaction of the therapist towards the client |
Countertransference Type (1) | Subjective= experience something in the past and projected onto the client |
Countertransference Type (2) | Objective= multiple reactions to the same client |
Resistance | anything that works against progress in therapy Prevents unconscious matieral from becoming conscious Late mutlple times Defelcts when asking a question Avoidance |
Psychoanalytic technique (1) | Maintaining the analytic framework (the structure of therapy) |
Psychoanalytic technique (2) | Analysis of the resistance: process of the resistant/ the client’s resistance in general/ help client become aware of their resistance to combat it |
Psychoanalytic technique (3) | Analysis of transference: process the reasons of transference/ help client work through their transference |
Psychoanalytic technique (4) | Free association: ask to say any word without censoring whatever it is/ use whatever words come to mind → coming from ur unconscious |
Psychoanalytic technique (5) | Interpretation: therapist point out, explain, teach the meaning of whatever is revealed → sharing causes/ explain why someone is doing something they are doing |
Psychoanalytic technique (6) | Dream analysis: used a lot of symbols → Freud’s symbols was sexual |
Contemporary Psychodynamic Therapy | Object relations + Self-psychology - Both empathize how we use interpersonal relationships (self objects) to develop out sense of self |
Attachment Theory (Bowlby/ Ainsworth) | how infants temperament/ responsivness of the caregiver set the stage for sense of security in relationships |
Interpersonal psychotherapy (IPT) | EBP for depression that has robust research support - Brief psychodynamic therapy --> time limited |
Diversity Strengths (psychoanalytic) | promotes therpay for therapists, which gives them insight into countertransference (more aware of our feeling towards clients) |
Diversity Limitations (psychoanalytic) | Based on upper/ middle class values/ income Clients from some cultures may find it too nondirective/ passive Focus on long-term personality reconstruction Fails to address oppression of any type |
Psychoanalytic Contributions (1-2) | - Human behavior from a psychosexual/ psychosocial perspective - Unfinished business can be resolved |
Psychoanalytic Contributions (3-4) | - The value of unconscious motivation, influence of early development, transference, countertransference, resistance - How overuse of ego defenses limit clients’ lives |
Limitations of Approach (1-3) | Not appropriate for al cultures or socioeconomic groups → narrow framework of experience Determinsitic focus does NOT emphasize current maladaptive behaviors Minimizes role of the environment |
Limitations of Approach (4) | Requires subjective interpretation → how therapist want to interpret what client brings into therapy |
Limitations of Approach (5-6) | Relies heavily on client fantasy → as indicative from unconscious mind Lengthy, intensive treatment → work on the person’s personality and very expensive |
Contemporary approaches | A lot more research support → manualized treatment Therapy style → more active/ collaborative w/ the client Focus in therapy → present relationships/ current functioning Length of treatment → much shorter Freud, Jung, Adler NOT contemporary |
Traditional approaches | Freud is the only one |
Individual Psych | Adlers more on the culture/ environment of a person / Largest contribution is social interest and social interactions |
Holistic | consider entire person/ idea that we are not able to be broken up into parts |
Phenomenological (somewhat) | means it’s subjective/ individual experience in present moment - Stresses social interest, birth order, family relationships - more active/directive |
Phenomenological Approach | world is seen from the client’s subjective frame of reference - Focus on the present moment/ current state, but does go into the past |
Human Nature– Striving (Neutral to Optimistic) | Start w/ inferiority feelings, then strive for superiority → purely adler |
Inferiority feelings | sense of having a personal weakness compared to others/ feel limited in someway |
Superiority feelings | feeling confident and able to face challenges/ promote mastery over obstacles/ not abt being superior towards others |
Social interest | community feeling & capacity to cooperate/ contribute to something bigger than oneself |
3 Universal Life Tasks | 1. Building friendships 2. Establishing intimacy 3. contributing to society |
Building friendships | social task= everyone needs friendships/ be able to connect w/ others |
Establishing intimacy | marriage task= romantic relationships w/ romantic partners |
Contributing to society | occupational task= contribute to common good and provide service to ppl |
Healthy | Well-developed social interest Courage to meet problems head-on → believed in client’s courage/ abilities to master own problems w/ a bit of support |
Dysfunction (unhealthy) | Lack of social interest Unable to master a life task |
Safeguarding (unhealthy) | (protecting one’s fragile self-esteem- not taking any risks)/ lacking courage |
Birth Order | 1. Oldest child 2. Second of only 2 3. Middle 4. Youngest 5. Only child |
Oldest child | take on responsibility/ being second parent for young kids, hardworking, control of the house, don’t like to loose attention |
Second to only 2 | competition w/ the first/ opposite to the first child |
Middle | forgotten, lost, squeezed out, problem child, overlooked, independent |
Youngest | paving own way, get away w/ anything they want, spoiled, privileged, seen as helpless |
Only child | get alot of attention, develop more adult language quickly, get along w/ adults better, may not cooperate w/ other children, isolated/ passive |
Therapy Process | Goal: client becomes aware of their fears/ basic mistakes mistakes in thinking/ evaluating that lead to symptoms (leads to feel mistrusting/ lack of confidence) |
Relationship is egalitarian/ collaborative | going to be seen as equal/ going to be collaborative w/ client/ help client understanding family processes/ provide some encouragement |
4 Phases of Therapy | Establish the Proper Therapeutic Relationship Explore the Individual’s Psychological Dynamics Encouraging Self-understanding/ Insight Reorientation & Re-education |
Alderian Techniques | humor Paradoxical intention early recollection analysis lifestyle assessment encouraging use stories/ fables |
Paradoxical intention | encourgae client to intensify the symptom or problem behavior (tanturm, avoidance, procrasination) |
Early recollection analysis | sharing a early childhood memory/ interpret things from/ projective technique/ what they think is important |
Lifestyle assessment | long questionaire (actual assessment)/ assesses one’s family, social interactions, info gathering |
Encouraging | expressing trust/ faith in client to overcome a challenge/ express a strength that is seen |
Encouragement is Critical | An attitude more than a technique Expecting clients to assume responsibility for their lives build self-confidence/ courage |
Diversity Strengths (1-3) | Focus on socially-oriented values Adler → equality for women Investiage culture in therapy → clients are able to explore their culture of their experience |
Diversity Strengths (4-5) | Easily put this into society Felxibility in techniques to help clients explore problems in their cultural contexts → adapt technique to client |
Diversity Limitations (1-2) | Focuses on the self as the locus of change/ responsbility Exploring past childhood experiences, early memories, family experiences, dreams may not appeal to some → not interested in exploring the past |
Diversity Limitations (3) | If clients expect the therapist to be the “expert” they may be disappointed |
Limitations of the Approach (1-2) | Adler spent most of his time teaching his theory as opposed to systematically documenting it Ideas are vague/ general; low precision/ testability → very difficult to test/ fading theories |
Limitations of the Approach (3-4) | Not a lot of ppl practice this → other theories after this incorporate something from the this theory Not a lot of research for this theory |
Victor Frankl (psychiatrist) | survived holocaust and treated better bc of his education → man search for meaning (big book in existential) |
Irvin Yalom | used existential therapy in groups (group therapy) |
Existenialism | A philosophical approach that influence therapeutic pratice Asks deep questions about life → what is the point of life? Death anxiety + despair → resolving death anxiety in life → deals centrally w/ questons of meaning, creativity, love |
Common Questions | Why am I here? What do I want from life? What gives my life purpose? |
Basic Dimensions of Human Condition | Capacity for self-awarness Freedom vs. responsibility Search for meaning in life Accepting anxiety as a condition of life The awarness of death & nonbeing |
Freedom & Responsbility | Freedom implies that we are responsible for our lives, for our actions, for the failures to act Empower us to find our meaning in life |
Identity & Relationship | Identity is the courage to be → courage to face ourselves Out greatest fear that there is no self → we do have a self but we have to own it |
The awareness of death/ nonbeing | longer you live, think abt it more bc ppl are |
View of Human Nature- Neutral | Free will includes capacity for cruetly but also love, creativity Strive for meaning key in life but not seen as positive or negative → just seen as neutral VARIES BY PHILOSOPHER |
Capacity for Self-Awarness | The greater our awareness → the greater our possibilities for freedom feel loneliness, meaninglessness, emptiness, guilt, isolation Have choice to act or not act |
The Search for Meaning | A distinctly human characteristic is the struggle for a sense of significance/ purpose in life |
Logotherapy | provides the framework for helping clients find meaning in their lives |
Meaningless in life can leads to an... | existential vacuum |
existential vacuum | (hollowness in life- no purpose of meaning in anything) |
Angst | existential anxiety Unpleasant feeling caused by contemplating the meaning of life |
Anxiety + Angst: A Condition of Living | Angst is normal Healthy view of anxiety → anxiety can be a stimulus for growth or catalyst for change |