Psychotherapy Exam 3 Review
Psychotherapy Exam 3 Review
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Psychotherapy Exam 3 review Behavior therapy 1 What are the assumptions of behavior therapy Behavior therapy is based on principles and procedures of the scienti c method Behavioral concepts and procedures are stated explicitly tested inherently within a conceptual framework and revised continually Behavior can be operationally de ned includes overt actions as well as internal processes like cognitions images beliefs and emotions Client is the producer and product of their environment Focuses on client39s current problems and on assessing behavior through observation or selfmonitoring Emphasis on speci c factors that in uence present functioning and what can be used to modify performance through quotbehavior analysisquot Action oriented and educational approach therapist teaches clients self management Change can take place without insioht into underlying dynamics and without understanding the origins of a psychological problem Treatment interventions are individually tailored to speci c problems experienced by the client 2 What is the main goal of behavior therapy To increase personal choice and to create new conditions for learning Increase range of freedom and skills so that they have more options for responding The clients with the help of the therapist de ne speci c treatment goals and continual assessments throughout therapy determines the degree to which identi ed goals are being met 3 What intervention models are known as quotthird wavequot behaviorism New facets of cognitive behavior therapy are labeled quotthird wavequot of behavior therapy including mindfulness acceptance the therapeutic relationship spirituality values mediation being in the present moment and emotional expression These are centered around ve core themes Expanded view of psychological health view of acceptable outcomes acceptance mindfulness and creating life worth living 4 What is systematic desensitization Be able to describe it A basic behavioral procedure developed by Joseph Wolpe that is based on the principle of classical conditioning It is an effective treatment in the reduction of maladaptive anxiety and the treatment of anxiety related disorders particularly speci c phobias Clients imagine anxiety arousing situations while also engaging in relaxation training Gradually clients become less sensitive to the anxiety arousing situation It can be considered a form of exposure therapy Very empirically supported 5 What is a functional assessment A functional assessment or behavioral analysis thoroughly identi es the maintaining conditions by systematically gathering information about situational antecedents things that happen before the behavior The goal is to understand the capital ABC sequence A antecedents cueelicit a certain behavior B behavior in uenced by antecedent C consequences certain events following behavior that either decrease or increase it This model suggests that behavior B is in uenced by some particular event that preceded it A and by certain events that followed it C therapists try to understand the function of client39s behavior 6 What is the ABC theorymodel in behavior therapy What is the capital ABC framework in cognitive behavioral therapy Know both of them and the difference between them ABC model in behavior therapv A antecedents prior to behavior that in uence it B behaviors in uenced by antecedent and consequences C consequences after behavior that in uence it Examplel client who has trouble going to sleep the sinks you in relaxations he may serve as a cue for sleep induction Example2 drinking coffee lead to consequences of staying awake ABC framework theorv of personalitv for coonitive behavioral therapv Speci cally use for REBT theory this model provides useful tools for understanding the clients feelings thoughts events and behavior A activating B belief C consequence of emotion and behavior A is the existence of a fact or an activating event or interference about an event of an individual B person39s belief about A which creates C emotional and behavioral consequences or reaction of the individual which can either be healthy or unhea hy After ABC comes D disputing It comes in at the belief stage Helps clients challenge irrational beliefs Three components detecting debating discriminating E Effective philosophy replacing unhealthy thoughts with healthy ones F New set of feelings in marriage instead of feeling depressed or anxious we feel disappointed according to the situation which is healthier 7 What is the difference between operant conditioning and classical conditioning What sets them apart Classical conditioning respondent refers to what happens prior to learning that creates a response through pairing Key gure Pavlov Certain respondent behaviors such as kneejerk39s and salivation are elicited from a passive organism A neutral stimulus becomes conditioned Ex Systematic desensitization Operant conditioning Skinner focuses on what happens after behavior It focuses on actions that operate on the environment to produce consequences Includes both positivenegative reinforcement and positivenegative punishment 8 Be familiar with the different 5 steps of selfdirected change programs In selfmanagement programs people make decisions concerning speci c behaviors they want to control or change Strategies include selfmonitoring selfreward self contracting and stimulus control Steps include selecting goals translating goals into target behaviors self monitoring working out a plan for change and evaluating an action plan 1 Selecting goals should be measurable attainable positive realistic etc 2 Translating goals into target behavior Identify behavior and anticipate obstacles 3 Selfmonitoring observe own behavior and record it with antecedent cues and consequences included in diary 4 Plan for change reinforcement devise action program to bring change 5 Evaluating plan determine goal achievement and adjustmentrevise to t Ongoing process 9 What are the seven major areas of personality functioning according to Lazarus The BASIC ID or the seven major areas of functioning are part of the essence of his multimodal approach which is a holistic approach that encourages technical eclecticism it applies diverse behavioral and techniques to a wide range of problems It is grounded and social cognitive theory It also encourages breadth over depth Using the right technique for the right client BASIC ID B behaviors overt behaviorscan be observablemeasurable A effective responses emotions S sensations basic ve senses imagery picture ourselves C cognitions insights unions believes etc I interpersonal relationships interact with others D drugsbiology drugs nutrition exercise The therapist emphasizes one issue from each of these as a target for change These 7 need to be in sync to be a healthy individual 10 What is the difference between positive and negative reinforcement and positivenegative punishment Operant conditioning techniques The goal of reinforcement is to increase the target behavior positive added negative removed Positive reinforcement addition of something of value to the individual Example get A on test mom gives you 5 Negative reinforcement the escape from or avoidance of an unpleasant stimulus Example train yourself to wake up earlier then alarm so you can avoid it Extinction withholding reinforcements from a previously reinforced response This then leads to quotextinction burstquot or spiking behavior right before it disappears Example child has tantrum and parent ignores it The goal of punishment is to decrease undesirable behavior Positive punishment stimulus added to decrease behavior Example timeout for child Negative punishment reinforcing stimulus is removed as a consequence to decrease target behavior Example deducting money from workers salary 11 How does REBT rational emotive behavioral therapy view emotional distress REBT is based on assumption that human beings are born with a potential for both rational and irrational thinking It encourages people to except themselves even though they will make mistakes A major goal is to encourage clients to be less emotionally reactive Example feeling disappointment rather than to depression Ellis says we have a tendency to use blame and use the quotshould39s or must39squot 12 What is REBT and what are the techniques used REBT stresses thinking judging deciding analyzing and doing conduit and behavioral aspects It assumes that thoughts affect behaviors and is reciprocal behavior affects thoughts It is a highly didactic or teaching style It39s an educational process Believes our emotions stem mainly from our beliefs interpretations and reactions to life situations REBT uses cognitive emotive and behavioral techniques 5 coonitive techniques demonstrate in directed manner what client is continually telling them self and teach how to deal with them Disputing irrational beliefs therapist disputes these beliefs and teaches how to do this on your own Doing cognitive homework client must be able to so the task successfully Bibliotherapy reading selfhelp books Changing ones language from absolutes to preferences D not I should but I prefer etc Psycho educational methods teach client about the nature of the problem and treatment possibilities 5 emotive techniques main purpose is to dispute irrational beliefs Rational emotive imagery clients imagine worst thing that can happen The idea is the more practice the more they will see positively not negatively Humor both cognitive amp emotional bene ts Role playing practice experience emotions so they learn how to work w them Shame attacking exercises engage in exercise to stop shame Standard behavior therapy procedures conditioning selfmanagement etc Goal Evaluate behavior wout evaluating yourself or being overly emotional about it 13 What is the role of the client in REBT Clients learn to Focus on present Identify interplay of their thoughts feelings and behaviors Dispute irrational beliefs maintained by what you repeatedly tell yourself Replace ineffective ways of thinking w effective and rational cognitions Stop absolutistic thinking blaming amp repeating false beliefs Carry out behavioral HW 14 Identify what Beck39s cognitive therapy principles are This therapy is active directive timelimited present centered problemoriented collaborative structured and empirically supported It makes its own HW collaboratively It perceives psychological problems as stemming from commonplace processes like faulty thinking making incorrect inferences and failing to distinguish bw fantasy and reality Based on the rationale that the way pp feel amp behave is in uenced by how they perceive amp structure their experiences Main focus on quotautomatic thoughtsquot and assisting the client in examining amp restructuring their core beliefs or schema looks for evidence in support of clients beliefs Client centered they can discover meanings on their own Focuses on Socratic dialogue and teaching 15 What are the 7 different types of cognitive distortions according to Beck similar to the egodefense mechanisms Beck believed pp w emotional dif culties tend to commit characteristic quotlogical errorsquot that distort objective reality These errors are also called quotcognitive distortionsquot which include Arbitrary inferences making conclusions wout supportingrelevant evidence Example quotcatastrophizingquot thinking absolute worst scenario wout evidence Selective abstraction forming conclusions based on isolated detail of an event Some small part you draw conclusions based on that alone Overgeneralization holding extreme beliefs based on a single incident amp applying them to events that aren39t even similar Magni cation and minimization looking at situation in either better light or worse than what it actually is Personalization tendency to relate external event to yourself Ex you hear pp in the room talking loud and when you go walk in everyone just stops talking and you assume it is bc they were talking about you Labeling amp mislabeling portraying identity on basis of imperfections in the past and allowing them to de ne you Dichotomous or polarized thinking thinking in black and white Ex either I get a man or I am a terrible person 16 Be familiar w the 3 phases of Meichenbaum39s stress inoculation training Individuals are given opportunities to deal w relatively mild stress stimuli in successful ways which gradually help develop tolerance Training assumes we can affect our ability to cope w stress by modifying our beliefs amp selfstatements about our performance in situations They are assigned for both present and future gt The Conceptual Phase educational phase essential focus is on creating a working relationship amp therapeutic alliance w clients gt The Skills Acquisition amp Consolidation Phase focus is on giving clients a variety of behavioral and cognitive coping skills to apply to stressful situations Application and Follow Through Phase focus is on carefully arranging for transfer and maintenance of change from therapeutic situation to everyday life plan of action That includes relapse prevention which creates plan for client w procedures in dealing w the inevitable setbacks likely to experience in daily life 17 How does Beck explain depression Beck s observations of depressed clients39 reveal that they had a negative bias in their interpretation of certain life events which contributed to their cognitive distortions He focuses on the content of negative thinking amp biased interpretations of events He created a quotcognitive triadquot as a pattern that triggers depression Cognitive Triad 3 patterns gt gt Client holds negative view of themselves Ex quotI am a lousy personquot Selective abstraction negative lter of life and tendency to interpret personal world in a negative manner Ex quotthe world is a bad place where bad things are bound to happen to mequot Client holds gloomy vision of the future they anticipate only failure in the future Ex quotthe world is unwelcoming amp isn39t going to improvequot Reality Therapy 18 What is the primary focus of reality therapy Getting needs met in a realistic way while focusing on the present Underlying problem of most clients is that they are either involved in a present unsatisfying relationship or lack what could be called a relationship Therapist guides client toward a satisfying relationship amp effective behavior Symptoms are results of quotchoicesquot we39ve made and it avoids focusing on symptoms Transference is rejected Emphasis on choice and personal responsibility Reality therapy is based on Choice Theory explains why amp how we function amp helps clients take more effective control of their lives Believes we are born w 5 needs based on this choice theory survival love amp belonging power freedom and fun 19 Does reality therapy focus on the past present or future and why Therapists function to keep it focused on the quotpresentquot not symptoms To function effectively pp need to live amp plan in the present amp take steps to create a better future We can only satisfy our needs in the present But they do not totally ignore or reject the past 20 What are some of the techniques or strategies used in reality therapy 2 major components Creating counseling environment supportive challenging avoids behaviors such as arguing blaming excuses etc If this relationship is lacking then there is little hope Implementing speci c procedures that lead to changes in behavior need to be convinced that our present behavior is not meeting our needs amp we believe we can choose other behaviors We can use the quotWDEPquot system which helps explore the clients W wants needs perceptions D direction and doing E Selfevaluation P panning plan must be SAMIC simple attainable measurable immediate amp involved amp controlled Main goal explore tenets of choice theory w clients helping them identify their basic needs discovering their quality world and helping them understand that they are choosing their quottotal behaviorsquot which are their symptoms 21 In reality therapy what is an action plan and what is its purpose Once clients determine what they want to change they can explore other possible behaviors and formulate an quotaction planquot The process of creating a plan enables one to begin to gain effective control over their life The plan gives clients a starting point but plans can always be collaboratively modi ed as needed Throughout the planning phase the counselor continually urges the client to be willing to accept the consequences for choices amp actions Plans are discussed both in light of how it can help the client amp how likely they are to affect others in the client39s life This planning is effective only if the client has made a selfevaluation amp determined that they want to change their behavior 22 According to Glasser what is the cause of client39s problems Glasser believed that we are all responsible for what we choose to do We are internally motivated by current needs and wants and we control our present behavioral choices He rejected both transference and the Freudian model amp thought it best to talk to the quotsanequot part of pp not the quotdisturbedquot side Therapists believe the underlying problem is that clients are either involved in a present unsatisfying relationship or lack what could be called a relationship Their unhappiness results from the way they are choosing to behave Glasser challenges diagnosis amp believes mental illnesses are conditions associated w tangible brain damage which should be treated by neurologists not therapists 23 When it comes to Reality therapy what is the quality world amp how do we get clients to process it or identify it Our quality word consists of our visions of speci c pp activities beliefs and situations that will ful ll our needs It is like a quotpicture albumquot of our speci c wants amp precise ways of satisfying them The most important part of our quality world is the pp we most want to connect w Part of the process in therapy is helping clients prioritize their wants amp uncover what is most important to them It is from the therapeutic relationship that clients begin to learn how to get close to the pp they need 24 What are quottotal behaviorsquot in reality therapy Choice theory believes that all we ever do from birth is behave and with rare exceptions everything we do is chosen A total behavior is our best of attempt to get what we want to satisfy your needs It teaches that our behavior is made up of four inseparable but distinct components acting thinking feeling and physiology Actingdoing active behaviors Thinking thoughts self statements Feelings anger joy pain anxiety etc Physiology bodily reactions Example nauseous pit in stomach Main point we must own our feelings as we are causing them and instead of saying quotI am depressed you should say I am depressingquot 25 Strengths and weaknesses of reality therapy Strengths Much to offer multiculturally Respect culture values by helping clients explore satisfaction of current behavior Applicable to all people Focus on thinking and acting rather than feelings which can draw people away Timelimited Weaknesses limitations Doesn39t view psych disorders as behavioral choice Limited attention to helping people address socialenvironmental problems Danger of over stressing taking control of lives Not good for clients who can39t directly express their needs Doesn39t focus on insight unconscious or transference More empirical support needed 26 Who is BF Skinner Albert Bandura and Lazarus in behavior therapy Skinner famous for the Skinner box and operantclassical conditioning He believed in quotno free willquot and was a determinist He also believes that the environment is important not just the internal stuff Bandura famous for quotbobo dollquot explored social learning theory and role of observational learningsocial modeling The client is the agent of change Lazarus developed the multimodal therapy and had a more brief focus of therapy including the BASIC ID personality 27 Strengthsweaknesses of behavior therapy Strengths Appeals to diverse client populations because it39s speci c task oriented action oriented and has an emphasis on the present etc Focuses on environmental social and political conditions A lot of empirical evidence Weaknesseslimitations Narrowly approaches treating speci c behavior problems Therapist may not thoroughly assess Heavy focus on behavioral change not enough No emphasis on insight Focus on symptoms rather than underlying cause Potential manipulation and too directive imposing focuses on therapy managing 28 Strengthslimitations of cognitive behavioral therapy Strengths Culturally diverse uses individual beliefs systems Emphasis on cognitionaction is appreciated Makes integration possible Brief structured treatments costeffective and evidencebased practice Limitations Extensive training required and therapist may misuse power Strong confrontational style Can overlook values of past experience 29 What are the key assumptions of the feminist therapy Built on premise that is essential to consider the social cultural political context that contributes to a person39s problems lt acknowledges the psychological oppression imposed through sociopolitical status of women and minorities The client is the expert knows what works for them Emphasis on educating clients about therapy process Feels that diagnosisassessment is male oriented and women develop more symptoms because of societies views Individual change will best occur through social change equality focus Action oriented 30 According to feminist therapy how does socialization of women affect their development Believes that the role of both women and men have been socialized to except certain things It tends to result in women giving away their power in relationships often without being aware of it Because gender politics are embedded in the fabric of American society they in uence how we see ourselves as girls and boyswoman and men throughout life These gender role expectations tend to generate a false sense of self and force women to accept stereotype roles 31 What are the main principles of feminist therapy 6 The personal is political personal problems originate from political and social contexts stereotypes personal and social identities are interdependent Commitment to social change not only to help client but society Women and girls experiences and ways of knowing our honored brakes of forest silence of women The counseling relationship is egalitarian clients are experts of their own lives collaborative approach De nitions of distress and mental illness already formulated focus is not on problems rather distress Recognition and integrated analysis of oppression looks at different levels of past development 32 What are the different types of feminist groups and what are their main focuses 4 major quotsecond wavequot feminist groups Liberal feminism Focus healthy individual woman overcome the limits and constraints of their socialization patterns how they have been socialized Goals Personal empowerment of women Dignity Selfful llment Equality Cultural feminism Focus oppression stems from societies devaluation of menwomen39s strengths Emphasizes the difference between menwomen Goal infusion of society with values based on cooperation Radical feminism Focus oppression of women that is embedded in patriarchy Seeks to change society through activism Goal Transform gender relations and societal institutions Increase women sexualprocreative selfdetermination Socialist feminism Focus societal change Emphasis on multiple oppressions notjust gender Believes solutions include consideration of class race and other forms of discrimination Goal transforms the social relationships and institutions 4 contemporary quotthird wavequot approaches which embrace diversity of women of color lesbians postmodern and constructionist views Postmodern feminists more broad proposing multiple truths notjust one Women of color broaden theory and make inclusive emphasis on activism Lesbian feminists similar to radical feminism but includes analysis of intersections of peoples multiple identities and relationships to oppression Diversity lies within lesbians Global international feminists worldwide perspective in ways racism sexism economics and classism and affect women in different countries 33 How do you feminists feel about diagnosis and assessment They think diagnostic criteria were established through a system that views male gender role traits as quotnormativequot Thus women39s behaviors are more prone to becoming pathologized Feminists look at distress rather than psychopathology Goal is to reframe symptoms as resistance to oppression and coping skills or strategies for survival avoid blaming the victim Assessment is viewed as an ongoing process between client and therapist Diagnosis of distress becomes secondary to identi cation and assessment of strengths etc 34 What are some intervention strategies that feminist therapists use Gender role analysisintervention helps clients understand the impact of their gender role expectations in their lives Example as a woman lam expected to provides clients with insight into ways social issues affect their problems Power analysis intervention Focus on power difference between menwomen in society Helps clients recognize different kinds of power they possess and how to use it identifyingawareness Bibliothera py Reading assignments addressing issues like coping skills gender inequality stereotypes sexual assault etc Reframing Change frame of reference for looking at individual39s behavior change your perspective Selfdisclosu re Equalize therapeutic relationship and provide modeling for client by revealing to client some things you have done to change collaboration transparency Assertiveness training Awareness of interpersonal rights in change negative beliefs implement daily changes Relabeling Change the labels applied to clients behavior characteristics and focus on positive evaluation Social action main goal Embrace social activism 35 How does feminist therapy differ from traditional therapy Other models are Androcentric male oriented Gendercentric Heterosexist Deterministic lntrapsychic orientations only you are responsible While feminist therapy is gender fair has a exible multicultural perspective interactionistic employs a lifespan perspective focuses more on women and equality 36 Strengthslimitations of feminist therapy Multicultural and social justice perspective Openinclusive diverse Egalitarian relationshipscorroborative Doesn39t exist in our culture Emphasis on social change lead to society transformation Can be incorporated in many other models Limitations Some women do not share these beliefs culturally May impose values and out in danger if culture doesn39t accept more empirical support More focus on environment sociopolitical rather than intrapsychic experience
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