question

emotional component; - treatment for emotional problems - affect changes in the individual (e.g. reduce symptoms) - professionally established relationship

answer

psychotherapy

question

- inducing change (or acceptance) via professional relationship - solve or prevent probs - achieve latent potential

answer

intervention

question

- person receiving treatment must show significant reduction in the levels of dysfunction -- is it psychotherapy that's causing the reduction/change? - focus on internal validity - does it work? is treatment responsible for change?

answer

efficacy

question

- treatment option must be representative - emphasize external validity -- can we use this treatment on other ppl-- older/younger/diff pops? - effective beyond target population?

answer

effectiveness

question

change relative to a comparison group that does not receive the treatment - amount of change matters in comparison to control group

answer

effect size

question

- standardized studies - selected, more homogenous participants to control for more extraneous variables

answer

efficacy studies

question

- more "real-world" testing - may or may not include a control group

answer

effectiveness studies

question

What did the 1995 study done by Consumer Reports magazine say about ppl seeking psychotherapy?

answer

- surveyed 4000 readers who had sought treatment for a psychological problem and summarized - most respondents were well-educated - median age was 46 - half were women - a wide variety of psychological probs reported

question

What were the results of 1995 Consumer Reports study?

answer

- majority reported SOME improvement - those who felt the worst before treatment reported the MOST improvement - all types of mental health professionals appeared to be EQUALLY effective - respondents who received psychotherapy alone improved as much as those who received psychotherapy plus MEDICATION - longer treatment (MORE sessions) was related to more improvement

question

- question of efficacy vs other treatments - THESE have produced significant change in trials - APA established criteria for THESE in 1995 - combined trials of THESE through use of meta-analysis

answer

Evidence Based Treatments (EBTs)

question

- broader, contains non-controlled trials (i.e. no control/comparison group) - question of whether one can scientifically measure effect without a comparison group - rise in use w/ healthcare reforms - not a direct match w/ research literature

answer

Evidence Based Practice (EBP)

question

What should be included in evidence-based practice approach?

answer

1. evidence based treatment knowledge 2. clinical expertise 3. patient characteristics, values, preferences

question

What are 3 common factors/features common to many therapies?

answer

supportive, learning, action - involved in all effective psychotherapies

question

- relation b/w client/therapist - unique in importance - not necessarily curative - must be: non-judgmental, objective, insightful, professional

answer

therapeutic alliance

question

- expert knowledge about psychological probs - competency/training - maintaining equal respect

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expert role

question

How do you build competency?

answer

become a therapist - educates, promotes self-efficacy, facilitate mastery experiences non-specific factors - influence of immeasureables: hope, belief - placebo effect of therapist?

question

What are different therapeutic variables of the patient/client?

answer

- degree of distrass - intelligence - age - motivation - openness - gender - race, ethnicity, social class - reactions to patient

question

What are some therapeautic variables of a therapist?

answer

- age, sex, ethnicity - personality - empathy, warmness, genuineness - emotional well-being - experience -- professionals vs paraprofessionals

question

What is the course of clinical intervention?

answer

1. initial contact 2. assessment 3. goals of treatment established (negotiated) 4. implementing treatment 5. termination, evaluation, follow-up

question

no intention to alter behavior, outside pressure to change

answer

pre-contemplation

question

ware of problem, but not committed to changing

answer

contemplation

question

intention to change present

answer

preparation

question

actively changing bad behaviors

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action

question

prevent relapses, further gains

answer

maintenance

question

necessary changes made, relapse not a threat

answer

termination

question

What are the 6 stages of change?

answer

- pre-contemplation - contemplation - preparation - action - maintenance - termination

question

What are 2 issues w/ psychotherapy research?

answer

1. groups - some receive treatment and some do not - waiting list control - attention only control 2. assessment of patient functioning - conducted in parallel fashion for experimental and control groups - before and after study

question

when the treatment is delayed until after study

answer

waiting list control

question

when someone meets with a clinician, but no "active" treatment is given

answer

attention only control

question

What are 4 other considerations about psychotherapy research?

answer

- sample: is it representative? - patient variables may influence outcome - outcome measures: are they identical for every patient? - nature of the study?

question

Describe the Temple University study.

answer

studied behavior therapy vs psychdynamic therapy vs waiting list control FOUND: BT and PT groups are better at termination and follow-up

question

Who did the meta-analysis on 475 studies, 25,000 patients, 78 therapies, and an average of 16 sessions?

answer

Smith, Glass, Miller (1977)

question

What had the 2 biggest effect sizes of the meta-analysis of 1977?

answer

Non-RET cogntive therapies cog-behavioral therapy

question

What 3 events occur during therapy?

answer

1. competence and adherence tied to positive outcomes 2. client emotionally processing session material tied to outcome 3. degree of cooperative and positive affect in session positively tied to outcome

question

What does psychotherapy research focus on?

answer

- efficacy and effectiveness - factors related to higher efficacy and effectiveness

question

recommend specific form of treatment for specific problems common goal to achieve effective treatment

answer

practice guidelines

question

involves a prescribed treatment method, encourages innovation, a therapeutic alliance, and managed care

answer

manualized treatment

question

- clinical work that aligns itself with the study of human behavior - highly diversified field - scientific emphasis - de-emphasis of inferred variables

answer

behavioral approach

question

origins of the behavioral approach

answer

- classical conditioning - learning theory - systematic desensitization - operant tradition (antecendents, triggering) kind of mechanistic-- breaking down for methodically oriented therapists

question

important techniques of behavior therapy

answer

- relationship b/w therapist and client - use of multiple techniques -- broad spectrum behavioral therapy - detailed analysis -- SORC

question

Name 3 relaxation techniques for systematic desensitization.

answer

muscle tensing then release possible use of hypnosis breathing exercises

question

procedure of systematic desensitization?

answer

History of problem Determining treatment Assessing appropriateness Briefing the patient Relaxation training Development of anxiety hierarchy (measured by SUDS)

question

List the 4 steps of the anxiety hierarchy.

answer

1. difficulties identified 2. ordered by anxiety level 3. low to moderate to extreme 4. relaxation practiced at each level of hierarchy

question

the substitution of relaxation for anxiety

answer

counterconditioning

question

when the patient repeatedly visualizes anxiety-generating situations but without ensuing bad experiences, the anxiety responses are eventually extinguished

answer

extinction of behaviors

question

Name 4 of the rationale behind systematic desensitization

answer

- counterconditioning - extinction of behaviors-- don't allow them to run away, wears down - habituation - positive reinforcements

question

when the client is placed into anxiety causing situations - external cues - interoceptive cues for panic - exposure and response prevention

answer

exposure therapy

question

Requirements for exposure therapy

answer

- long durations (90-120 min) - repetition to extinction - graduated process - interaction w/ stimuli - exposure MUST provoke anxiety

question

a technique to expand a patient's repertoire of coping behaviors - practice the behavior for eventual integration into real life - origins in psychodrama - fixed role playing -- therapeutic emotional release -- altering cog structuresah

answer

behavioral rehearsal

question

What are the 4 stages of behavioral rehearsal?

answer

1. prepare the patient 2. target specific situations 3. actual rehearsal 4. patient's utilization of skills in real-life situation

question

part of behavioral rehearsal - One application of behavioral rehearsal - Stems from anxiety due to timid coping - Sexual issues, depression, marital conflicts - Cognitive self statements enhance effects of training - Aim is not to teach aggression, but rather how to express one's feelings without trampling on the rights of others

answer

assertiveness training

question

- changing behavior by manipulating consequence - common w/ children and adolescents - forms -- shaping/successive approximation -- time out -- contingency contracting -- premack principle/Grandma's rule -- token economies - works best if you tell them what you're doing

answer

contingency management

question

attempts at a desired behavior are rewarded until it is achieved

answer

shaping/successive approximation

question

removal of patient from environment/reinforcement in which unwanted behavior is reinforced; i.e. kid has to want to be back in the family room, kitchen, etc. a reinforcing environment they want to return to TO somewhere not where they want to go; removed from genuinely reinforcing environment

answer

time out

question

agreement b/w patient and therapist specifying consequences of behavior

answer

contingency contracting

question

desired activity reinforced by allowing the individual to engage in a more desireable activity i.e. homework done before you play outside

answer

premack principle/Grandma's rule

question

- children and residential care patients - considerations: -- clear and specific definition of expected behavior -- clearly established reinforcer -- back up reinforcer - requires: -- committed supervision -- detailed record keeping

answer

token economy

question

- controversial/ethical concerns - series of treatments - negative stimuli applied to cause change -- electroshock -- emetic drugs - covert sensitization

answer

aversion therapy

question

- modification of thought pattersn - empirically supported - social learning theory - sense of self-efficacy - active process - general approach to therapy *bandura

answer

cog-behavioral therapy

question

the higher your self-efficacy, the less likely you are to become ____________; strength of your belief to emit a certain behavior

answer

depressed

question

keep going when first obstacle hit you can do it and keep going realistic sense of what they can do

answer

self-efficacy

question

- observational learning - used often to eliminate unwarranted fears - videotape modeling - written instructions

answer

modeling

question

When is modeling best and most efficient?

answer

when: - subject attends/pays attention to model - if patient retains the info provided by the model - patient performs modeled behavior - motivation to use behavior

question

- relabeling of situations, more realistically - modification of the internal "self-talk" - rational emotive therapy (RET) --> REBT (rational emotive behavior therapy) -- B- beliefs -- A- activating events -- C- consequences -- therapist as a teacher; corrects illogical thinking

answer

rational restructuring

question

- exposure to a little bit of stress but how to deal w/ it - prevents probs by inoculating clients to ongoing and future stressors usages: - rape/assault traumas - PTSD - anger issues stages: 1. conceptualizations 2. skill acquisition and rehearsal 3. application

answer

stress inoculation testing (SIT)

question

What are the 3 stages of SIT?

answer

1. conceptualiztion 2. skill acquisition and rehearsal 3. application

question

- utilizes cog and behavioral methodology - modify dysfunctional patterns (of thoughts and behavior) - cog therapy - some techniques: -- increasing pleasurable activities -- cog rehearsal (practice certain kinds of thoughts) -- assertiveness training/role playing -- identify maladaptive, automatic thoughts -- challenge these -- search for alternative solutions of ways of coping

answer

Beck's Cog. Theory

question

big since 2000 - used primarily w/ Borderline Personality Disorder (and those self-harm-ers) but can be applied in a lot - 4 skills training models 1. mindfulness 2. emotional regulation 3. distress tolerance 4. interpersonal effectiveness

answer

dialectical behavior therapy (DBT)

question

What are the 4 training modules of DBT?

answer

1. mindfulness 2. emotional regulation 3. distress tolerance 4. interpersonal effectiveness

question

to be aware of the moment, focused, nonjudgmental

answer

mindfulness

question

identifying and dealing with emotions

answer

emotional regulation

question

learning to cope with stress

answer

distress tolerance

question

how to deal with conflict, get needs met, say no to unwanted demands

answer

interpersonal effectiveness

question

What are 6 strengths of CBT?

answer

- efficacy - efficiency - evidence-based - no evidence for symptom substitution - breadth of application - scientist practitioner/clinical scientist model

question

What are 6 limitations to CBT?

answer

- hard to link practice to science sometimes when don't have research base - dehumanizing-- to say change can be fixed that simply - inner growth - manipulation and control (exposure based stuff-- but informed consent) - do these effects generalize to real-world clients? - lacks a unifying theory

question

a control group whose members meet regularly with a clinician but receive no "active" treatment

answer

attention only control group

question

the release of emotions

answer

catharsis

question

a set of features that characterize many therapy orientations and that may be the source of positive changes effected by psychological treatment

answer

common factors

question

in psychotherapy research, the group that does not receive the treatment under investigation

answer

control group

question

the changeability of a condition or behavior - the deeper the condition, the less changeable it is perceived to be

answer

depth of a problem

question

the size of the treatment effect - determined statistically

answer

effect size

question

studies that emphasize external validty and the representativeness of the treatment that is administered; it is considered effective to the extend that clients report clinically sig benefit from the treatment

answer

effectiveness studies

question

studies that place a premium on internal validity by controlling the types of clients in the study, by standardizing the treatments, and by randomly assigning patients to treatment or no treatment groups; a treatment is considered ___________ to the extend that the average person receiving the treatment in clinical trials is demonstrated to be significantly less dysfunctional than the average person not receiving any treatment

answer

efficacy studies

question

treatments for various psychological conditions taht have been shown through careful empirical study to be either "well established" or "probably efficacious"; a list of these is updated and published periodically by the APA's Division of Clinical Psych

answer

empirically supported treatments (ESTs)

question

those interventions or techniques that have produced sig change in clients and patients in controlled trials

answer

evidence-based treatments (EBTs)

question

those interventions or techniques that have produced sig change in clients and patients in controlled trials

answer

evidence-based practice (EBP)

question

the therapist's demonstration of competence (knowledge and experience)

answer

expert role

question

the achievement of understanding the nature and origins of one's problems

answer

insight

question

the therapist's conceptualization of the meaning behind the patient's experiences or behaviors

answer

interpretation

question

psychotherapeutic treatment that is presented and described in a standardized, manual format (outlining the rationales, goals, and techniques that correspond to each phase of the treatment)

answer

manualized treatment

question

the acquisition of a high level of knowledge or skill; one goal of psychotherapy may be for a patient to develop competence or THIS in a particular area

answer

mastery

question

a method of research in which one compiles all studies relevant to a topic or question and combines the results statistically

answer

meta-analysis

question

factors that are not specific to any particular therapy orientation yet contribute to a positive treatment outcome (the expectation that you will improve)

answer

nonspecific factors

question

indicators of patient functioning following treatment, used to gauge the treatment effectiveness

answer

outcome measures

question

individuals without advanced education in psychology who have been trained to assist professional mental health workers

answer

paraprofessionals

question

how well a patient is getting along across a number of domains (psychological, social/interpersonal, occupational)

answer

patient functioning

question

research that investigates the specific events that occur in the same course of the interaction b/w therapist and patient; some therapy processes have been shown to relate to treatment outcome

answer

process research

question

a method of inducing changes in a person's behavior, thoughts, or feelings

answer

psychological intervention

question

a series of stages that represent a given client's readiness for change in psychotherapy; including: precontemplation, contemplation, preparation, action, maintenance, and termination

answer

stages of change

question

the group that receives the treatment under investigation

answer

treatment group

question

a control group whose members receive treatment only after the study is completed

answer

waiting list control group

question

in systematic desensitization, a list of situations that precipitate anxiety rxns, ordered from lowest to highest severity. often, items may be organized according to their spatial or temporal distance from the feared stimulus

answer

anxiety hierarchy

question

using behavioral rehearsal and other techniques to train ppl and to express their needs effectively without infringing on the rights of others

answer

assertiveness training

question

a controversial type of treatment in which an undesired behavior is followed consistently by an unpleasant consequence, thus decreasing the strength of the behavior over time

answer

aversion therapy

question

a general technique for expanding the patient's repertoire of coping behaviors; successful THIS involves explaining to the patient the necessity of acquiring the new behaviors, selecting the target situations, conducting the rehearsal and providing feedback, and having the patient apply the newly acquired skills in real-life situations

answer

behavioral rehearsal

question

a framework for treating disorders that is based on the principles of conditioning or learning; this approach is scientific in nature and deemphasizes the role of inferred (unobservable) variables on behavior

answer

behavior therapy

question

a model of therapy pioneered by Aaron Beck that focuses on the connection b/w thinking patterns, emotions, and behavior that uses both cog and behavioral techniques to modify the dysfunctional thinking patterns that characterize a disorder. THIS is active, structured, and time limited and has been adapted for the treatment of several disorders

answer

cognitive therapy

question

a contingency management technique in which the therapist and patient draw up a contract that specifies the behaviors that are desired and undesired as well as the consequences of engaging or failing to engage in these behaviors

answer

contingency contracting

question

any one of a variety of operant conditioning techniques that attempts to control a behavior by manipulating its consequences

answer

contingency management

question

the principle of substituting relaxation for an anxiety response

answer

counterconditioning

question

a form of aversion therapy in which patients are directed to imagine themselves engaging in an undesired behavior and then are instructed to imagine extremely aversive events occurring once they have the undesired behavior clearly in mind

answer

covert sensitization

question

a behavioral technique often used for the treatment of OCD. in this technique, the patient is exposed to the situation that spurs his/her obsession (touching a doorknob) and is prevented from engaging in the compulsive behavior that relieves the obsession; ultimately, the patient will habituate to his/her obsession and the compulsive behavior will be extinguished

answer

exposure plus response prevention

question

a behavioral technique for reducing anxiety in which patients expose themselves (in real life or fantasy) to stimuli or situations that are feared or avoided; to be effective, this exposure must provoke anxiety, must be of sufficient duration, and must be repeated until all anxiety is eliminated

answer

exposure therapy

question

the elimination of an undesired response

answer

extinction

question

the elimination of a response that comes from the repeated and/or prolonged presentation of the provoking stimulus

answer

habituation

question

internal physiological stimuli (dizziness, nausea)

answer

interoceptive cues

question

aka observational learning; the learning of a new skill or set of behaviors by ovserving another person perform these skills/behaviors

answer

modeling

question

a form of aversion therapy in which the client is made to "overcorrect" for the consequences of his/her undesired behavior

answer

overcorrection

question

"grandma's rule"; the contingency management technique in which a behavior is reinforced by allowing the individual to engage in a more attractive activity once the target behavior is completed

answer

Premack principle

question

a therapy pioneered by Albert Ellis in which patients are forced to confront and correct their own illogical thinking. in this system, a person's beliefs about events, rather than the events themselves, determine the problematic emotional or behavioral consequences

answer

rational-emotive therapy (RET)

question

an excectic set of techniques that teaches individuals to examine their assumptions about situations or the world in general and alter their ideas to be more realistic/rational

answer

rational restructuring

question

a state of lowered anxiety, stress, and physiological arousal; this may be induced by tensing and then relaxing various muscle groups or via breathing exercises, imagery exercises, or hypnosis

answer

relaxation

question

a form of aversion therapy in which positive reinforcers are removed following an undesired behavior

answer

response cost

question

a contingency management technique in which a behavior is developed by first rewarding any behavior that approximates it and then by selectively reinforcing behaviors that more and more resemble the target behavior

answer

shaping

question

a technique developed by Donald Meichenbaum that attempts to prevent problems by inoculating patients to ongoing and future stressors; this involves educating patients about how certain appraisal patterns lead to stress, teaching them to identify and cope w/ potential stressors, rehearsing these coping skills in the therapy setting, and consolidating these skills by applying them across a range of real-life stressful situations

answer

stress inoculation training (SIT)

question

another term for shaping

answer

successive approximation

question

the notion that if a symptom is removed without attending to the underlying pathology of an illness, another symptom will emerge to take its place

answer

symptom substitution

question

a behavioral technique for reducing anxiety in which patients practice relaxation while visualizing anxiety-provoking situaitons of increasing intensity; patient becomes used to the feared stimulus

answer

systematic desensitization

question

a contingency management technique in which a person is removed temporarily from the situation that is reinforcing the undesired behavior

answer

time-out

question

a system in which desired behaviors are promoted through the strict control of reinforcements; establishing such a system requires specifying the immediate reinforcers for each behavior as well as the backup reinforcers for which patients can exchange their immediate reinforcers

answer

token economy

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