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Clinical Flashcards

1
Q

What are the main assumptions of psychodynamic therapies?

A
  1. Behavior is motivated mainly by unconscious processes.
  2. Early development has a significant impact on adult functioning.
  3. Universal principles explain personality development and behavior.
  4. Main focus of therapy is insight into unconscious processes.
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2
Q

Name three psychodynamic therapies?

A

Freud’s psychoanalysis
Adler’s individual psychology
Jung’s analytical psychotherapy

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3
Q

In Freud’s structural theory, what are the three aspects identified?

A

I’d, ego, and superego

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4
Q

When does the id develop?

A

It is present at birth.

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5
Q

What does the id consists of?

A

The person’s life and death instincts, which is the source of all the psychic energy.

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6
Q

What principle does the id operate under?

A

The pleasure principle - seeks immediate gratification of its instinctual drives and needs to avoid tension.

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7
Q

When does the ego develop?

A

About six months

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8
Q

Why does the ego develop?

A

It develops in response to the id’s inability to satisfy all of its needs.

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9
Q

What principle does the ego operate under?

A

The reality principle - defers gratification of the id’s instincts until an appropriate object is available in reality.

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10
Q

What are some of the characteristics of the ego?

A

It employs secondary process thinking which is realistic, rational thinking and planning.

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11
Q

What is the main role of the ego?

A

To mediate the conflicting demands of the id and reality and between the id and superego.

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12
Q

When does the superego develop?

A

About 4-5 years old

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13
Q

What does the superego represent?

A

Internalization of society’s values and standards.

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14
Q

What is the main difference between the ego and superego?

A

The ego postpones gratifying the id’s instincts, but the superego attempts to permanently block the id’s socially unacceptable impulses.

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15
Q

How does Freud describe how personality developments?

A

He noted that it develops during childhood as a result of certain experiences that occur in his five psychosexual stages.

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16
Q

What are Freud’s psychosexual stages?

A

Oral, anal, phallic, latency, and genital

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17
Q

According to Freud, what is anxiety?

A

It is an unpleasant feeling that is linked with the excitement of the autonomic nervous system (sympathetic nervous system)

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18
Q

According to Freud, what role does anxiety play?

A

Alerts the ego to impending internal or external threat - conflict between id’s impulses and superego and/or reality.

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19
Q

What happens when the ego is unable to cope with the anxiety through rational realistic means?

A

It may use defense mechanisms.

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20
Q

What level do defense mechanisms operate on?

A

The unconscious level.

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21
Q

How does defense mechanisms assist with managing anxiety?

A

Either denying the anxiety or distorting reality.

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22
Q

What is the most basic defense mechanism?

A

Repression - it excludes the id’s drives and needs from conscious awareness by keeping them in the unconscious level.

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23
Q

How does Freud’s psychoanalysis view psychopathology?

A

It stems from unconscious unresolved conflict that occurred during childhood.

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24
Q

What is the main goal of psychoanalytic psychotherapy?

A

Reduce or eliminate pathological symptoms by bringing the unconscious into conscious awareness.

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25
Q

What are the main technique and targets in psychoanalysis?

A

Analysis is the main technique and it is used on the client’s free associations, dreams, resistances, and transferences.

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26
Q

Analysis is based on psychic determinism. What is it?

A

It is the belief that all behaviors are meaningful and serve some psychological function.

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27
Q

Analysis consists of what?

A

Confrontation - help client view behavior in a new way
Clarification - restating client’s statements in clearer terms
Interpretation - connecting behavior to unconscious processes
Working through - client assimilate new insights into personality

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28
Q

What are some characteristics of brief psychodynamic therapies?

A

Time limited
Target specific interpersonal problem - usually in first session
Uses interpretation early
Emphasize development of strong working alliance

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29
Q

What approach did Adler take toward personality development?

A

A teleological approach - behavior was mainly motivated by a person’s future goals and not by past events as stated by Freud.

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30
Q

What is Adler’s theory name?

A

Individual psychology

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31
Q

What is the premise of Adler’s individual psychology?

A

People develop feelings of inferiority during childhood based on real or perceived biological, psychological, or social weaknesses. As a result, people will strive for superiority or perfect completion.

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32
Q

According to Adler’s theory, what does style of life mean?

A

The way people choose to compensate for their inferiority, which will unify their personality components.

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33
Q

What are Adler’s two types of styles of life?

A

Healthy and mistaken (unhealthy) styles of life. They differ primarily on social interests.

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34
Q

What are some characteristics of a healthy style of life?

A

Healthy style of life main characteristics include optimism, confidence, and concern about the welfare of others.

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35
Q

What are some characteristics of a mistaken (unhealthy) style of life?

A

Mistaken (unhealthy) style of life main characteristics include self centeredness, competitiveness, and striving for personal power.

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36
Q

When is a person’s style of life developed significantly?

A

By four or five

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37
Q

What plays a major role in the development of a person’s style of life?

A

Parents response to the child - whether pampered (don’t develop social feelings) or neglected (dominated by a need for revenge)

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38
Q

How does Adler’s individual psychology view maladaptive behavior?

A

Mental disorders are mistaken style of life - maladaptive ways to compensate for feelings of inferiority, a preoccupation with achieving personal power, and lack of social interest.

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39
Q

What are the therapy goals for Adler’s individual psychology?

A

Establish a collaborative relationship with client, help client identify and understand his/her style of life and its consequences, change client’s beliefs and goals that are more adaptive and support a healthy style of life.

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40
Q

According to Adler, what is a lifestyle investigation?

A

Helps to identify aspects of the client’s style of life such as family constellation, goals (fictional/hidden), and basic mistakes (distorted beliefs and attitudes).

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41
Q

What areas has Adler’s techniques been used in?

A

Individual psychotherapy, group therapy, family and marriage counseling, parent education, and teacher student relationships (systematic training for effective teaching - STET)

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42
Q

What is the name of Jung’s theory of psychotherapy?

A

Analytical psychotherapy

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43
Q

What did Jung believe about personality development?

A

He believed that behavior is determined by past events, but also the person’s future goals and aspirations.

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44
Q

Jung stated that personality development also included what?

A

Conscious and unconscious factors

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45
Q

How did Jung describe the conscious?

A

It stated that the conscious is externally oriented, ruled by the ego, and represents the person’s thoughts, ideas, feelings, sensory perceptions, and memories.

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46
Q

Jung noted that the unconscious has two parts. What are they?

A

The personal unconscious and the collective unconscious.

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47
Q

What is the personal unconscious?

A

It is all the experiences that were unconsciously perceived or were once conscious but are now repressed or forgotten.

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48
Q

What is the collective unconscious?

A

It is latent memory traces that have been passed down from one generation to the next.

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49
Q

What are archetypes?

A

They are primordinal images that are apart of the collective unconscious.

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50
Q

How does archetypes impact people?

A

They cause people to experience and understand certain phenomena in a universal way.

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51
Q

What is one archetype identified by Jung?

A

The self which represents a striving for a unity of the different parts of the personality.

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52
Q

What are the four parts of the personality described by Jung?

A

The persona or public mask
The shadow - dark side of the personality
The anima and animus - feminine and masculine aspects of the personality

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53
Q

What are the two main attitudes of the personality described by Jung?

A

Extraversion and introversion

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54
Q

What are the four main psychological functions of the two attitudes of the personality?

A

Thinking, feeling, sensing, and intuiting which all function in the unconscious with one dominating in the conscious.

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55
Q

How did Jung view the personality development?

A

Personality developed throughout the lifespan.

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56
Q

What was Jung mainly concerned about in personality development?

A

Individuation - integration of the conscious and unconscious aspects of the psyche which leads to unique identity.

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57
Q

What did Jung believe was an important outcome of individuation?

A

The development of wisdom - occurs later in life when a person’s interests turn to spiritual and philosophical issues.

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58
Q

How does Jung view maladaptive behavior?

A

Symptoms are unconscious messages that something is wrong and requires the person to seek out fulfillment of the demands.

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59
Q

What is Jung’s analytical psychotherapy goal?

A

To bridge the gap between the conscious and the unconscious (personal and collective)

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60
Q

How is Jung’s analytical psychotherapy goal achieved?

A

Mainly through interpretations that help the client become aware of inner world.

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61
Q

Are dreams important in Jung’s analytical psychotherapy?

A

Yes, because they represent an unconscious message to the person that is revealed in a symbolic form.

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62
Q

Are transference important in Jung’s analytical psychotherapy?

A

Yes, they are believed to be a projection of the personal and collective unconscious

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63
Q

Why is countertransference important in Jung’s analytical psychotherapy?

A

It is useful information about what is happening during the course of therapy.

64
Q

What is the emphasis of Jung’s analytical psychotherapy?

A

Optimistic view that emphasis the healthy aspects of personality. It has a present focus with the past explored only when needed to help client understand the present.

65
Q

Name four object relations theorists?

A

Ronald Fairbairn
Otto Kernberg
Melanie Klein
Margaret Mahler

66
Q

What are the developmental stages of Mahler’s object relations theory?

A
  1. Infantile Autism - child is self absorbed and usually oblivious to the external environment, which occurs during the first month.
  2. Normal Symbiotic - child becomes aware of the mother, but can’t differentiate between me and not me.
  3. Separation Individuation - begins about 4-5 months and thought to be when object relations occurs.
67
Q

What are the stages of the separation individuation phase?

A

Differentiation, practicing, reapproachement, and object constancy. Child explores the environment through senses first then by physical through locomotor ability which is usually followed by a conflict between independence and dependence (separation anxiety).

68
Q

How does object relations theorists view maladaptive behavior?

A

It is the result of abnormalities in early object relations. Also, that the natural tendency we have to split mental representations of self and others into good and bad is not resolved appropriately.

69
Q

What are the object relations therapy main goals?

A

To bring problematic unconscious relationship dynamics into conscious so the internalized object representations can be replaced by more appropriate ones.

70
Q

How does object relations therapist achieve therapy goals?

A

By providing the client with support, acceptance, and other conditions that help the client relate to others in meaningful realistic ways.

71
Q

What are the main assumptions of humanistic therapies?

A
  1. Has a phenomenological approach - to understand a people one must understand their subjective experience.
  2. Focus on current behaviors.
  3. People have inherent potential for self determination and self actualization.
  4. Therapy involves authentic, collaborative, and egalitarian relationship between the client and therapist.
  5. Rejection of traditional assessment techniques and diagnostic labels.
72
Q

What are four humanistic therapies?

A

Person centered (aka client centered, rogerian therapy)
Gestalt therapy
Existential therapy
Reality therapy

73
Q

Who created client centered therapy?

A

Carl Rogers

74
Q

What is the main basis for client centered therapy?

A

People have an innate self actualizing tendency that is a major source of motivation and guides them toward positive healthy growth.

75
Q

According to Roger, what is required for a person to self actualized?

A

The self must remain unified organized and whole.

76
Q

What does Roger believe about the self?

A

He believed that the self is composed of gestalts which are perceptions of the characteristics of the I and me and how they relate to others and various aspects of the person’s life.

77
Q

How does client centered therapy view maladaptive behavior?

A

It is the result of a disorganized self which occurs when there is incongruity between the self and experience.

78
Q

According to Roger, what causes anxiety?

A

When there is incongruence between the self and experience. For example, when a child believes that parents love is unconditional, but experiences conditions of worth from parents.

79
Q

According to Roger, anxiety is a signal for what?

A

The unified self is being threatened.

80
Q

What are the goal for client centered therapy?

A

Help the client achieve congruence between self and experience.

81
Q

How is the goal of client centered therapy achieved?

A

By providing the right environment which includes unconditional positive regard, genuineness, and accurate empathic understanding.

82
Q

What is unconditional positive regard?

A

It is respect for the client. It usually involves genuinely caring about the client, affirming client’s worth as a person, and accepting the client without judgment (any judgments represents a condition of worth).

83
Q

What is genuineness?

A

It is congruence. It typically involves the therapist being genuine and authentic.

84
Q

What is empathic understanding?

A

It is the therapist ability to see the world as the client does and to relay that to the client. This can be shown by nodding, maintaining eye contact, and reflection of feeling.

85
Q

What does client centered therapist tend to avoid?

A

Directive techniques such as assigning a diagnosis. The also do not encourage or interpret client’s transference as the don’t see it as a necessary component of therapy.

86
Q

Who created gestalt therapy?

A

Fritz Perl’s

87
Q

What is the premise for gestalt therapy?

A

That each people can take responsibility for their own thoughts, feelings, and actions. Also, people can live as integrated whole.

88
Q

Gestalt therapy uses principles from what areas of psychology?

A

It incorporates principles from psychoanalysis, phenomenology, existentialism and gestalt psychology.

89
Q

What does gestalt psychology focus on?

A

It focuses on perception

90
Q

What are the five concepts of gestalt psychology?

A
  1. People tend to seek closure .
  2. People gestalts (perceptions of parts as wholes) reflect their needs.
  3. People’s behavior represents a whole that is greater than the sum of its parts.
  4. Behavior needs to be understood in its context.
  5. People experience the world based on the principle of figure/ground.
91
Q

How does Perls, the founder of gestalt therapy, view personality?

A

Personality consists of the self and self image.

92
Q

According to Perls the self is what?

A

The self is the creative aspect of the personality that promotes the individual’s tendency for self actualization (ability to live as a fully integrated person).

93
Q

What is the self image according to Perls?

A

The self image is the darker side of personality and hinders growth and self actualization by imposing external standards.

94
Q

Whether the self or self image dominates depends on what?

A

The person’s early interactions with the environment.

95
Q

How does gestalt therapists view maladaptive behavior?

A

They see it has a growth disorder that involves the abandonment of the self for the self image. Therefore, the person lacks integration.

96
Q

How does maladaptive behavior develop?

A

Usually from a disturbance in the boundary between the self and the external environment which prevents the people’s ability to satisfy their needs and maintain a state of homeostasis.

97
Q

What are the four major boundary disturbances noted by Perls?

A
  1. Introjection: person psychologically accepts whole concepts from environment without completely understanding them or assimilating them.
  2. Projection: disowning aspects of the self by assigning them to other people.
  3. Retroflection: doing to oneself what one wants to do to others.
  4. Confluence: the absence of a boundary between the self and the environment.
98
Q

What problem does introjectors have?

A

They struggle with distinguishing between me and not me and tend to be overly compliant.

99
Q

What problem does projectors have?

A

Extreme cases can result in paranoia.

100
Q

What is an example of retroflection?

A

Person turning his/her anger toward another person inward.

101
Q

What problem does confluence lead to?

A

It causes intolerance between oneself and others and often underlies feelings of guilt and resentment.

102
Q

What is the major goal of gestalt therapy?

A

Help the client become a unified whole by integrating the various aspects of the self.

103
Q

What are some things that is unique to gestalt therapy?

A
  1. Avoid diagnostic labels
  2. Focus on the present, but will incorporate past only when it directly impacts the client’s current situation.
  3. Transference is seen as counterproductive
104
Q

How does gestalt therapy use transference?

A

Therapist help the client to recognize the difference between transference fantasy and reality.

105
Q

What is the curative factor in gestalt therapy?

A

Awareness

106
Q

What are some techniques used in gestalt therapy?

A

Empty chair, role playing (e.g. top dog/underdog, guided fantasy, dream work.

107
Q

What does dream work include?

A

Having the person role play elements of the dream in order to integrate the parts of the personality they represent.

108
Q

What type of therapy is logotherapy?

A

Existential therapy

109
Q

What is the premise of existential therapy?

A

People are consistently changing and they have choices and the responsibility to develop a meaningful life.

110
Q

How does existential therapy view maladaptive behavior?

A

It is the result of not dealing authentically with the concerns of existence like death, freedom, isolation, and meaninglessness.

111
Q

What is the difference between existential anxiety and neurotic anxiety?

A

Existential anxiety is typical response to concerns of existence and motivates change and growth. Whereas, neurotic anxiety is due to the avoidance of existential anxiety and usually outside of the conscious.

112
Q

What is the main goal of existential therapy?

A

To help the client live a more committed, self aware, authentic and meaningful ways.

113
Q

How does the existential therapist achieve therapy goals?

A

By helping the clients recognize their ability to choose their own destinies and help them accept responsibility for changing their own lives.

114
Q

What is seen as the most important therapeutic tool?

A

The therapist-client relationship

115
Q

What is the paradoxical intention?

A

It is used in existential therapy to reduce a client’s fear. It helps the client to focus in an exaggerated and humorous way on the feared situation.

116
Q

Who created reality therapy?

A

William Glasser

117
Q

What is reality therapy based on?

A

Choice theory or control theory

118
Q

What does choice theory assumptions?

A

People are responsible for their choices and focus on how they make those choices that affect their lives.

119
Q

What are the five basic innate needs stated by Glasser that are the primary source of motivation?

A

Survival, love and belonging, power, freedom, and fun.

120
Q

What is the most important of the five needs according to reality therapy?

A

The need for love and belonging

121
Q

What does success identity mean in reality therapy?

A

Person fulfills needs in a responsible way - realistic manner that doesn’t impinge on others’ rights.

122
Q

What does failure identity mean in reality therapy?

A

Person is unable to satisfy needs or does so in irresponsible ways - reason for mental and emotional disturbances.

123
Q

How does reality therapy view maladaptive behavior?

A

Reality therapy view mental illness as the result of the person’s choices. The person chooses to be…

124
Q

What are the five major principles of reality therapy?

A
  1. Reject medical reasoning for mental illness
  2. Focus on the present behavior and beliefs
  3. See transference as detrimental
  4. Stress conscious processes
  5. Emphasize value judgments
125
Q

What is the main goal for reality therapy?

A

Help clients identify responsible and effective ways to satisfy needs and therefore develop a success identity.

126
Q

What therapy did George Kelly create?

A

Personal construct therapy

127
Q

What does personal construct therapy believe?

A

People choose how they deal with the world

There are always alternative ways to cope with the world

128
Q

How does George Kelly, created of personal construct therapy, view personality development?

A

People’s psychological processes are determined by their construes (perceives, interprets, and predicts) events using personal constructs.

129
Q

What are personal constructs?

A

Bipolar dimensions of meaning (e.g. happy/sad) that develop in infancy and can be conscious or unconscious.

130
Q

Why did Kelly believe that people act like scientists?

A

Because he thought that people continually test their personal constructs by their predictive accuracy and revising them if necessary.

131
Q

How does George Kelly, created of personal construct therapy, view maladaptive behavior?

A

Maladaptive behavior is the result of inadequate personal constructs.

132
Q

What is the therapeutic relationship between the client and therapist in personal construct therapy?

A

The client and therapist are seen as mutual experts and co-experimenters.

133
Q

What is the main goal for personal construct therapy?

A

Help the client identify and revise or replace maladaptive personal constructs in order to have a better understanding of experiences.

134
Q

What is the goal of the personal construct therapy assessment?

A

Identify the content and process of the client’s construing.

135
Q

What is the repertory grid?

A

It is a personal construct assessment technique that involves having the clients identify people who have various roles in their lives and the ways they are similar and different.

136
Q

What is self characterization sketch?

A

It is a personal construct assessment technique that involves clients describing themselves from the perceptive of someone who knows them well.

137
Q

What is fixed role therapy?

A

It is a type of therapy created by Kelly which allows clients to try on and adopt alternative personal constructs through acting out the fictional characters in their daily lives.

138
Q

What are the main principles of brief therapies?

A
  1. Time limited - between 6 to 30 sessions.
  2. Focus is on the present.
  3. Therapist is active and encourages the client to be active in the change process.
139
Q

Name four brief therapies?

A

Interpersonal therapy, solution focused therapy, transtheoretical therapy, and motivational interviewing.

140
Q

Who developed interpersonal therapy?

A

Klerman and Weissman

141
Q

What was interpersonal therapy (IPT) developed for?

A

To treat depression, but has been successful in treating bipolar disorder, bulimia, and drug addiction.

142
Q

Interpersonal therapy is a combination of which theories?

A

Psychobiological, interpersonal, attachment, psychodynamic, and cognitive behavioral therapies.

143
Q

How does interpersonal therapy (IPT) view maladaptive behavior?

A

It is the result of problems in social roles and interpersonal relationships which developed by lack of strong attachments early in life.

144
Q

What are the main goals of interpersonal therapy (IPT)?

A

Symptom reduction and improved interpersonal functioning

145
Q

How does IPT achieve symptom reduction?

A

Through education, instilling hope, and by medication if applicable.

146
Q

What are the four major areas that IPT addresses to improve the client’s interpersonal functioning?

A

Unresolved grief
Interpersonal role disputes
Role transitions
Interpersonal deficits

147
Q

What is the premise of solution focused therapy?

A

Focus is on solutions to the client’s problems and not of the problems themselves.

148
Q

What is the therapeutic relationship between the client and therapist in solution focused therapy?

A

The client is the expert and the therapist is seen as the consultant/collaborator

149
Q

How does the therapist help in solution focused therapy?

A

The therapist asks the client different questions to help clients recognize and use their strengths and resources to achieve specific goals.

150
Q

What are three typical questions a solution focused therapist may ask the client?

A
  1. Miracle question - a miracle happens and your problem is solved.
  2. Exception question - when the client did not have the problem.
  3. Scaling question - on a scale….
151
Q

Who created the transtheoretical model?

A

Prochaska and DiClemente

152
Q

What is the premise for the transtheoretical model?

A

Change entails a progression through predictable stages.

153
Q

What are the ten interventions that support change according to the transtheoretical model?

A

Consciousness raising, self liberation, social liberation, dramatic relief, self reevaluation, counterconditioning, environmental re-evaluation,reinforcement management, stimulus control, and helping/supportive relationships

154
Q

What is the transtheoretical model used for?

A

Addictive behaviors, but also weight control, compliance, partner violence, and financial management

155
Q

What are the stages of the transtheoretical model?

A
  1. Precontemplation stage
  2. Contemplation stage
  3. Preparation stage
  4. Action stage
  5. Maintenance stage
  6. Termination stage
156
Q

What is the characteristics of the precontemplation stage?

A

Client has little insight and does not intend to change

157
Q

What is the characteristics of the contemplation stage?

A

Client is aware of the need for change

Psych (8 decks)

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