Quiz 1 Study Guide
Quiz 1 Study Guide CLP 6169
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This 7 page Study Guide was uploaded by Jadenole on Sunday January 10, 2016. The Study Guide belongs to CLP 6169 at Florida State University taught by Dr. E in Spring 2016. Since its upload, it has received 39 views. For similar materials see Adult Development and Psychopathology in Language at Florida State University.
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Date Created: 01/10/16
Quiz 1 Study Guide ** This guide includes comprehensive lecture notes, but does not repeat PowerPoint information. Please use in conjunction with PowerPoints 1-3 posted on Blackboard. Lecture 1 Theories in (slide 2): The transition between stages can significantly impact an individual’s mental health in a positive or negative way Freud’s Psychosexual Stages (slides 4-6): Freud called failure to make progress to the next stage “fixation.” In Latency there is not much activity, this stage is considered to be the downtime between phallic and genital stages where children are consumed by school Freud’s theory is pessimistic, there is either progress or fixation (no remediation) The anal stage involves having a need for control (Ex: toilet training) o Once could develop control issues if fixated in this stage (Ex: OCD) Deprivation or too much of something (pampering) can lead to psychological issues o Ex: Feeding in the oral stage If an individual becomes fixated in one of the 4 stages, when they encounter problems later in life, they will revert back to behavior from the stage in which they were fixated Erickson’s Psychosocial Stages (slide 7): We never stop growing – Erikson expanded his theory from childhood stages into adulthood (e.g., over the lifespan) Erickson had a more optimistic view of human nature than Freud Maslow’s Hierarchy of Needs (slide 8): Seen as more cross-cultural than other theories Maslow agreed with Freud in that too much or too little of something can lead to mental health problems Two categories of needs: Basic and Growth (reference slide 8) It is estimates that very few people actually reach self-actualization There may be some issue with self-actualization being trans-cultural; there are some cultures in which basic needs are not fulfilled, so it would be difficult for these people to reach higher levels of the Maslow’s pyramid (in theory) Sheehy’s 10 Stages of Adult Development (slide 11): The proposed stages seem to be changing with time; people are living longer lives and some of the people in various categories do not fit in Sheehy’s stages o Ex: A 70 year-old may still work full-time The results of the adult happiness study (1981) have been supported by more recent studies Men experience more “volatile” happiness patterns than women as they age. It is thought that women may feel more satisfied with who they are and their place in life by the time they reach their 70s. Aging Well (slides 14-15): Lifestyle choices are by far the strongest predictor of happiness as we age Subjective health (e.g., how we feel) is just as important as objective, measurable health Emotional intelligence (EI) is essential to adaptation and successful coping later in life Those who experience early onset of a disability have a higher quality of life and report more happiness than those with late onset disabilities o These individuals have often learned to be “great copers” Lecture 2 Diagnosis: Although diagnoses are often required for treatment and research, practitioners should avoid putting clients “in a box” based on a diagnostic label. o Example: Thinking that all bipolar women exhibit similar behavior Certain disorders become “popular” due to attention in the media. Examples of this include ADHD and Autism Spectrum Disorder. o This could lead to over-diagnosis of these disorders – the practitioner must be aware of the impact of social phenomenon It is necessary to categorize mental disorders to conduct research, this is part of what makes psychology a science. Evidence-based practice: more research is needed on treatments of various disorders, and the studies should include diverse populations. The effectiveness of therapy is more often based on the therapeutic alliance/relationship, rather than the techniques or interventions used. Client motivation is essential – should be assessed prior to treatment in order to get a baseline level. The therapist should tailor the approach being used to the client. Consolidating gains: find out what is going right and emphasize the positive with the client. o Example: The client’s strengths as observed by the therapist. There is a general lack of mental health services in the US – not enough to meet the needs. Treatment Objectives: It is often easier and more effective to create treatment objectives with a client, rather than the therapist deciding on the goals alone. The client will only put in “work” towards the goals they want to accomplish (relates to motivation). As therapy sessions progress, the therapist may be able to add to adjust the objectives. Checking in with clients throughout the process is recommended. Hawthorne Effect: being present and interested in what the client says can be enough to be helpful for the client. 5 Stages of Change Model: In the Precontemplation stage, there is a high dropout rate in therapy. The client may resist making changes because they are not ready. Facilitating insight is important in Precontemplaion. The therapist provides a safe, peaceful place (relief from chaos). The practitioner can also help the client to become more stable and think about next steps to take, or better evaluate the problem. Environmental evaluations involve going to the client’s home and seeing where they live (e.g., the conditions of their environment). The practitioner should ask about the social and physical environments. It easy to be judgmental when we do not see the whole picture. Therapist variables Impacting Treatment (slide 10): Cultural background may impact the first impression, but has not been shown to be a significant factor in treatment overall. Location of Treatment: Options: residential treatment, inpatient hospitalization, partial hospitalization, and outpatient treatment. In regards to inpatient treatment, it is rare to keep a patient longer than three weeks. Partial hospitalization is more popular today because it is cost effective (e.g., less that residential or inpatient). Clients in this treatment type can live at home and go to treatment during the day. Good results are being reported. General Note: Attitudes in the public are changing regarding therapy – people are becoming more accepting than in the past. CBT: Behavioral techniques work better for people who don’t want to know “why”; clients who do not wish to engage in abstract thinking. Emphasis of Treatment: Some clients may get bogged down by the past, and can be resistant to coming into the present. It is important that clients be in the present for treatment, not living in the past or the future. Certain techniques simply will not work for certain clients. Types of Therapy: Individual, group, or couples/family therapy. Group therapy may be preferred for insurance providers – cheaper per client that individual. Couples and family therapy: tensions can run high. People may fall into roles from their family upbringing (e.g., the caretaker, the rebel, etc.). In certain cases, family members may need to participate in the treatment plan of one individual (Ex: severe mental illness). Frequency of Therapy: Clients in severe distress may need to be seen multiple times per week. The frequency can be reduced as session progress, and the client’s sense of independence and autonomy is supported. Adjunct Services: Adjunct services should reinforce and follow the goals of therapy so that they do not become counter-effective. Example: Support groups for people that are not in treatment, such as parents or caregivers. When formulating prognosis, the DO A CLIENT MAP exercise may be helpful Lecture 3 Using the DSM-5: Symptoms are what the client reports or complains about Signs are what the therapist observes Diagnosis - Is it Necessary? Insurance often requires diagnosis o However, if diagnosis does not impact treatment, it may not be necessary Clinical significance: symptoms or dysfunction that warrant diagnosis What is Abnormal? Pay attention to the client’s affect: emotions, moods, facial expressions, and nonverbals Ask yourself, what is the client getting with these thoughts, feelings, or behaviors? o Maladaptive: Not doing what you should to get what you want or need Social expectations: may not be a good measure of normal vs. abnormal. Social expectation are culturally exclusive o It was not until the late 1960’s that homosexuality was removed from the DSM Be aware of distress or discomfort towards self or others in the environment Additions and Revisions to the DSM-5: The DSM-IVTR did not include the advanced research we have now – more empirical evidence, assessments, and genetic test information was added ICD-10-CM: coding used for medical and mental diagnoses across various fields o The DSM-5 aligns with these because we don’t want competing diagnostic tools o Facilitates communication between different professions and is necessary for research The DSM-5 was almost not released because the American Psychiatric Association couldn’t come to a vote Consider the impact of pressure from major pharmaceutical companies (big $) o Example: wanting certain symptoms to be added to fit their medication Two codes listed for each disorder: one in bold font and one in parentheses o Parentheses code is the ICD-10-CM code Categorical: you either have a diagnosis or not (presence or absence) o Better for research purposes – easier to analyze data Dimensional: classify on quantitative continuum; diagnosing on a spectrum or range o Example: mild, moderate, or severe o Example 2: Pain scale 1-10 It was discovered that about 30% of diagnoses were NOS (not otherwise specified) – from the DSM-IV o Meeting some, but not all of criteria – enough to give a diagnosis Neurodevelopmental disorders used to be known as childhood disorders because they manifest early in life o The organization of the DSM-5 starts with disorders that develop early Definition of a Mental Disorder: “Usually associated with significant distress or disability in social, occupational, or other important activities.” (PowerPoint) o This is not always the case - some clients flourish with diagnosis Social deviance: engaging in criminal activity does not mean you have a mental disorder If the deviance or conflict results from the dysfunction caused by a disorder, the diagnosis is necessary (Ex: A client with a substance abuse disorder constantly gets into fights) Recording a Diagnosis: Example: F33.2 (pg 162) Major Depressive Disorder, recurrent episode (PowerPoint) Subtypes: you can’t be in more than one – must be in a type. Mutually exclusive and jointly exhaustive subgroupings within a diagnosis Specifiers – including features, giving more specific information about the diagnosis Provisional diagnoses: used in place of “rule out” system. Use when you are pretty sure that a client will meet the criteria for a certain disorder Other specified and unspecified disorders used in place of “Not Otherwise Specified” o Other Specified: Insufficient symptoms to meet full criteria, but mostly fit within that category o Unspecified: more vague, not explaining symptoms as much Cultural Factors: Example of cultural phenomenon: “roots” or being “rooted”: form of southern voodoo bringing on mental illness o Treatment was not effective when “roots” were not incorporated or acknowledged Certain behaviors may be seen as acceptable in the individual’s culture, but the practitioner may see it as requiring diagnosis o Ex: Having visions, enduring a certain amount of suffering, etc. Culture impacts what is extreme and what is not, and could be the reason behind what we cannot seem to understand (why someone did what they did, or behaves a certain way) DSM-V Disorders: Not empirically proven: DMDD, PDD, Asperger’s Disorder, and Substance Abuse o Not enough evidence to add the disorders o Asperger’s Disorder and Substance Abuse were retired after the DSM- IV o Substance Abuse is now broken into several “substance use” categories The number of diagnostic categories and the number of disorders have increased over the different versions of the DSM o There are now 20 categories and 365 disorders in the DSM-V (PowerPoint) The NIMH voted not to include the DSM-V in their research – may be a sign that we could be moving away from the DSM in the future Differential Diagnosis: Eliminate alternative disorders, do a complete case history and medical history o Rule out substance use, which could be causing the symptoms Malingering: client is trying to manipulate practitioner into giving them a certain diagnosis to get something from it (Example: obtaining medication, or getting out of criminal charges) o Using language that is overly clinical, saying they have all symptoms There are cases where drug use (even one time) can trigger mental illness – these individuals may have a genetic predisposition for mental illness and substance use brings it out o The drug wears off (out of the person’s system), but the abnormal behavior and/or cognitions are still present and stick with the individual Substance use and other forms of mental illness can be comorbid – dual diagnoses. These clients are often the hardest to treat Before Diagnostic Interview: Read the case files – any background information that you already have Brush up on the DSM criteria, so you know what to look for However, you want to avoid asking questions that will confirm diagnosis (Confirmatory Bias Effect) and using your first impressions of the client (Halo Effect) Preparing for an Interview: Maintain professional distance when conducting interview – not appearing to be a friend or like you are on a “first date.” Know your needs, problems, biases, and blind spots as a counselor. Also be sure not to work with family or loved ones (cannot be objective) Be aware of environmental factors that could be dangerous or distracting when working with inpatient clients People with psychiatric issues can be hypersensitive to nonverbal behavior Be aware of abrupt changes in a person’s demeanor
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