Basics of addiction counseling -Theoretical approaches – Flashcards

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Adlerian psychology
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-Developed by Alfred Adler -AKA Individual psychology -Humanistic
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Basic premise of Adlerian psychology
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-Individuals are moving towards goals -Feelings and beliefs of discouragement and inferiority might result in self-defeating patterns -Belief that all behavior is goal-directed
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Fictional Finalism
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-"Central goal" of a individual's life. -All behavior is directed towards this goal. -Can be positive or negative
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Lifestyle
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-How client moves through life -Includes client's views, filters, skills -It is the way the client goes about pursuing his/her fictional finalism
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Phenomenology
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Process where the counselor attempts to view the world from the same frame of reference as the client, in order to better understand the behavior of the client
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Private logic
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Subjective reality, as perceived by individual. Can best be understood by engaging into phenomenology.
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Social Interest
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Component of Adlerian therapy that is the awareness of being part of the human community, and how one interacts with others. Associated with sense of acceptance and identification with a group, and empathy for others.
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Behavioral Therapy founders
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-Pavlov's "Classical conditioning" (Early 20th century) -B.F. Skinner's "Operant conditioning" (1938) -Albert Bandura's "Social learning approach" (1974)
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Classical conditioning
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Model where a response to a stimulus can be elicited overtime by association with a related stimulus. Basically, pairing.
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Operant conditioning
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Model where behavior is learned and reinforced based on consequences and outcomes of behavior.
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Social learning model
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Model where behavior is learned by observing outcomes of someone else's experience.
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Similarities and differences in behavior models
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Behavioral analysts believe that most human behavior is learned, and can be unlearned is it is maladaptive. All agree that there are certain laws or processes that govern initiation, maintenance, and cessation of behavior, but disagree in how those behaviors are learned and reinforced.
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Unconditioned stimulus (UCS)
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Event that produces unconditioned response (smell of dinner for Pavlov's dogs)
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Unconditioned response (UCR)
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Natural reaction to UCS (Salivation of dogs)
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Conditioned stimulus (CS)
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Related person or action to UCS, that ultimately results and shapes a conditioned response (CR) (Sound of bell for pavlov's dogs)
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Conditioned response (CR)
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Response that it identical to unconditioned response, but is elicited by the CS (Salivation of dogs when bell is heard in absence of smell of food)
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Contingency management or behavioral contracting
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System where tokens or rewards or punishments are given for periods of abstinence, or pro-social, recovery-oriented behaviors.
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Community reinforcement
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Where client's vocation, social ties, recreational activities, and family play a role in reinforcing healthy behavior.
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Assertion training
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Where client learns skills necessary to resists negative influences and behaviors in his or her life
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Cue exposure training
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Where client is constantly exposed to triggers and cues that are known to result in addictive behavior
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Covert sensistization
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Where client imagines himself abusing substances, then immediately visualizes a horrible consequence
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Aversion therapy
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Form of therapy where a unconditioned aversive stimulus, such as an electric shock, is paired with addictive behavior, resulting in a CR of an unpleasant feeling when thinking of using/drinking
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Brief Therapy
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Not a specific discipline, but rather a relative set of therapies that include a shorter time period than traditional therapy.
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Phases of brief therapy
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1. Induction Phase -Client seeks treatment, is assessed for SOC, and "feels out" what SOC clinician's interventions should match. 2. Alliance (pretreatment): Formation of alliance. Assessment of impediments to change, tx planning, and goal setting. 3. Refocus/Change: Working phase. Every session is an "on-task" session. 4. Termination/Homework: Long-term goal setting, and plans for relapse prevention. 5. Continuation/Follow-up: Appointments scheduled in relationship with homework. Plan for emergencies and relapse is set in place. Client internalizes treatment aspects.
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CBT (Cognitive-behavioral therapy)
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-Developed by Aaron Beck in 1960s -Originally developed to treat depression -Focus on thoughts, feelings, and behaviors, especially when those patterns lead to dysfunction -Reshape core beliefs, automatic thoughts, and learning new behaviors
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Things to know about CBT
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-Directed and focused -Requires client participation to be effective -Based on collecting data, evaluating date, developing hypotheses, and testing such hypotheses - Not so much about the "why" of behavior, but more about the "how".
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Gestalt
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-Developed by Fritz Perls -About gaining "awareness" of what one is currently experiencing, and learning to take personal responsibility for what he/she is currently is feeling, thinking, and doing. - Meant to be different from psychoanalysis -Means "meaningful whole" in German -Encompasses "existentialism"
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Main principles of Gestalt
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-"How" focused, not "why" -People are ultimately responsible for their own lives and behavior -Utilizes empty chair technique Unfinished business: Emotions from the past that interfere with healthy functioning Contact: Process of truly seeing, hearing, touching, and experiencing his/her concerns. According to Gestalt, successful contact will inevitably result in change.
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MET (Motivational Enhancement Therapy)
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-Based on principles of Prochaska and DiClemente's SOC -Non-directive, evocative approach of using client's own internal motivation for change -Similar to MI -Similar to Roger's person-centered therapy
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Main principles of MET
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-Assumes client has capacity and responsibility to change -Client's own motivation is driving force -Non-linear, and non-directive -Non-confrontational -> Uses client resistance and an opportunity for reflection, rather than argumentation -Change will come as a result of client's own intrinsic motivation, in a timeframe set by client himself
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F.R.A.M.E.S. Guide for counselor feedback during MET
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F= Feedback of personal risk of impairment R= Emphasis on personal responsibility A=Advice to change M=Menu of alternative change options E=Empathy S=Self-efficacy is promoted
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Stages of Change
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1. Pre-contemplation 2. Contemplation 3. Preparation 4. Action 5. Maintenance 6. Relapse
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Person-Centered Therapy
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-AKA Rogerian or Client-centered therapy -Non-directive -Humanistic and existential
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Main principles of person-centered therapy
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-Not a complete method of therapy, but rather a "spirit" -Assumes people are trustworthy, resourceful, and capable of self-direction -Utilizes phenomenology (perspective taking) -Trusts client to create own change -Counselor is there to provide encouragement, reflect positive changes, and provide empathy
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3 characteristics necessary for counselor in PST
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1. Congruence: The ability to match external behavior and expression with internal feelings and thoughts 2. Unconditional positive regard: Constant acceptance and caring in all therapeutic situations 3. Empathy: Ability to truly understand the subjective world of the client.
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Psychoanalytical Therapy
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-Developed by Freud -AKA Freudian therapy -Deterministic approach (human behavior is driven by internal, unconscious drives) -Unpopular amongst many psychologists, but core ideas are still used with other therapies
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Analysis of resitance
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-Technique from psychoanalysis where client surfaces repressed material from unconscious mind up to conscious mind -If client can identify and express what they are feeling, it becomes more bearable, and less maladaptive
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Main principles of psychoanalytic therapy
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1. One function of unconscious mind is to store and repress painful emotions or memories 2. Human bx is strongly influenced by unconscious drives
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Structure of mind from psychoanalytic theory
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Id: Animal brain (brain stem and limbic system). Source of strong sexual and aggressive drives. Superego: The conscience. Morally driven. Makes sure bx is aligned with social and moral expectations. Ego: Source of mediation between id and superego. Logic and rational, and able to balance needs of different parts of brain and social expectation.
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Defense mechanisms
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Tactics used by the ego to "calm the storm" when superego and id are in battle. Allows for reduction of anxiety and other painful emotions. Examples: Denial, Displacement, projection, rationalization, repression, and sublimation.
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Rational-emotive-behavioral therapy
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-Developed by Albert Ellis -AKA Rational emotive therapy -Cognitive-oriented counseling approach that focuses on changing attitudes, beliefs, and negative self-statements that drive and maintain problematic bx -ABCs = Activating events, beliefs, and consequences
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Main principles of REBT
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-It is the individual's reaction to events, not the event itself that disturbs people -Present-focused -By correcting irrational thoughts, and thought patterns, the individual can correct maladaptive bx -Cognition is most important element of human disturbance -Directive approach where counselor challenges and replaces client's irrational thoughts and beliefs with more logical and healthy ones
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ABC model of REBT
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Activating events: Negative or disturbing events that set off chain Beliefs: How one thinks and feels about the event Consequences: Resulting actions and feelings
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Reality Therapy/Control Theory
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-Developed by William Glasser -Individual's interpretation of the world, not the world itself, determine their reality -Similar to Adlerian Individual therapy
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Eight basic principles of Reality therapy
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1. Develop therapeutic relationship 2. Focus on client's current behavior 3. Ask the client to evaluate current behavior 4. Develop plans for change 5. Get a commitment from client 6. Do not accept excuses 7. Do not punish client 8. Never give up on client
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Reality therapy's Four components that guide functioning
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1. Doing 2. Thinking 3. Feeling 4. Physiology
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Rational Recovery
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-Developed by Jack Trimpey, a former AA member -Based on REBT -Has only one step "We made a fearless evaluation of our most personal beliefs and chose the recovery program that made the most sense" -Lead by trained REBT therapist who volunteers their time -Looks more like group counseling than self-help
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Solution-focused therapy
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-Developed by Steve de Shazer and Insoo Kim Berg -Focuses on problem, not person -Utilization: Uses client strengths and past successes as source of possible solution to problem -Optimistic and positivity-oriented -Does not delve into past, or analysis of client
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Behavioral family therapy
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-Draws from social learning theory -Problematic bx is learned and reinforced by the consequences of family bx -Maladaptive behavior is identified, and replacement adaptive behaviors are introduced and practiced
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Bowenian Family therapy
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-Based on theory that there is a multi-generational transmission of problems -Family can become "fused", where emotions and intellect of individuals become entangled -Fusion is alleviated via "differentiation", where the individuals remain relatively autonomous and separate -Counselor is direct, by non-confrontational
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Family disease model
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-Believes that addiction is family disease -Dependence is disease of identified patient -Codependence and enabling is disease of rest of family
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Group counseling
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-Most popular form of therapy used for addiction tx -All members suffer from similar affliction -Shared experiences serve as source of healing for members
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Stages of Group Counseling
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Stage 1: Developing (Storming and Norming) -Acquaintance Stage: Intros, socializing, and norms for group -Groundwork substage: Conflict Stage 2: Potency -Working substage: Most productive and smooth -Closing substage: Closure and goodbyes
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