Psychology Counseling Techniques – Flashcards
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Criticisms of Dx - Labels
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Labeling a human's behavior does not denote understanding the problem. The labels put a client into a "disease state". Poor reliability - slightly better with larger groupings. Labels carry a negative social stigma.
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We can make good treatment judgements about:
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Neurotic Disorders Psychotic Disorders Antixocial Personality Disorders
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An unattainable goal in diagnosing might be:
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to have a perfect treatment for a particular diagnosis.
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At the Intake interview (3 things):
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Information needs to be gathered to make a decision. The client should have a positive experience (especially if first impression). Inform client of purpose of interview and you may not be the therapist.
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Types/Purpose of Assessment (5):
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Screening Focused, problem-solving. Diagnostic. Counseling and Rehabilitation. Progress Evaluation.
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List 2 things to be aware of when utilizing test assessments.
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Use for diagnositc purposes but ensure that you work with the client and be candid. Tests are not perfect; should be interpreted cautiously.
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List 6 ways to avoid error in assessmetn and dx.
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Use comprehensive clinical interview with structure. Consider all data. Dx should be from the DSM-IV TR. Avoid relying on memory. Seek feedback. Be familiar with literature.
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This theory is hopeful and optimistic about humans.
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Humanistic and Experiential/Existential Therapies.
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This theory believes any person contains within him or herself the potentialities for healthy and creative growth.
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Humanistic and Experiential/Existential Therapies.
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Which theory believes the failure to realize these potential is due to the constricting and distorting influences of parental training, education, and other social pressures.
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Humanistic and Experiential/Existential Therapies.
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In this theory, the goal of therapy is to remove constrictions.
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Humanistic and Experiential/Existential Therapies.
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The goal of Humanistic and Experiential/Existential Therapies is:
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To remove restrictions.
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This therapy emphasized the inborn potential for positive healthy development.
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Humanistic and Experiential/Existential Therapies.
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What type of theory is utilized in Maslow's Hierarchy of Needs.
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Humanistic and Experiential/Existential Therapies.
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List the order from bottom to top in Maslow's Hierarchy.
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1. Physiological Needs. 2. Belongingness & Love Needs. 3. Esteem Needs. 4. Need to Know and Understand. 5. Aesthetic Needs. 6. Self-Actualization. 7. Transcendence.
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What theory is behind CCT.
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Humanistic.
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What is the mode of therapy in CCT?
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Between the client and the therapist.
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What characterizes incongruence in CCT therapy?
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Client state of vulnerability. Client may behave defensively. Client's thinking becomes constricted and rigid.
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In CCT, what aspects characterize congruence and genuineness in therapy?
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Client is able to think realistically. The therapist is open and self aware.
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True or False: Only ONE person in a relationship needs to feel congruence for changes to occur in the other person. (CCT)
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TRUE.
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What type of therapy will individuals have an innate drive for self actualization?
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CCT.
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What style of therapy has the single goal in life being to become a whole person?
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CCT.
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Name the therapist: "Don't solve problems, but help clients grow."
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Rogers; CCT; Humanism.
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Name the therapist. "Rely on individual's drive toward adjustment."
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Rogers; CCT; Humanism.
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Name the therapist. "Emphasize emotional rather than intellectual side of therapy."
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Rogers; CCT; Humanism.
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Name the therapist: "Focus on the immediate situation, not the past."
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Rogers; CCT; Humanism.
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Name the therapist. "Stress the therapeutic relationships itself as a growth experience."
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Rogers; CCT; Humanism.
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What style of therapy stress genuiness, unconditional positive regard, and empathy?
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Rogers; CCT; Humanism.
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What style fo therapy might state, "Value the human, reject the behavior (don't hate the sinner, hate the sin.)"?
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Rogers; CCT; Humanism.
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What aspect of CCT or Rogerian therapy has the highest priority?
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Empathy.
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What is one problem of Rogerian or CCT therapy?
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It is difficult to measure and study.
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What types of disorders is CCT useful for?
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ALL types.
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This "need" is developed in infancy as a consequence of the baby being loved and cared for.
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The need for positive regard.
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This "need" is established by virtue of the baby's receiving positive regard from others.
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The need for self regard.
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What stage of life are the needs for positive regard and self regard learned?
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Infancy (Rogers)
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(Humanism) Proper development might encourage:
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Evaluations only positive (unconditional positive regard) No distancing or incongruity between organism and self. No conditions of worth would develop. Unconditional self regard. Needs for positive regard and self regard would never be at odds with organismic evaluation.
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(Humanism) Improper development might:
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Cause negative evaluations and psychopathology. Individual learns to differentiate between worthy (approved) actions/feelings, and unworthy (disapproved) conditions of worth. Self concept out of line with organismic experience. Individual tries to be what others approve of instead of what he really is.
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Development exampl in positive and negative regard:
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Self picture - good boy, loved by his parents. However - also enjoys teasing sister, for which he is punished. Result - revise self concept: "I am a bad boy, my parents don't like me. I don't like to tease my sister." Each of these contains a distortion of the truth. The boy adopts the attitude, "I don't like to tease my sister." Denial of real feelings in organismic experience.
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What happens when the individual perceives and accepts all of his experiences into his self-structure?
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He becomes more understanding and accepting of others as separate individuals.
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This theroist believed all people have the same basic needs, their values will possess a high degree of commonality and so these subjective processes will not result in social anarchy?
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Rogers.
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In this state of being, there are no need for defenses, thus increasing openness to experience, ability to acknowledge and express feelings.
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Self Actualization.
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In this state of being, there is increased existential living, no rigidity, no preconceptions about "should", but lives fully in each moment (unconditional self-regard.)
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Self Actualization.
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In this state of being, one is able to make and rely on own decisions; doing what "feels right" proves to be a competent and trustworthy guide to behavior.
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Self Actualization.
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What are 5 qualities of an individual who is self-actualized?
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Openness to experience. Absense of defensiveness. Accurate awareness. Unconditional self regard. Harmonious relations with others.
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Which therapy seeks the meaning of human existence?
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Existential Therapy.
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This style of therapy was founded by Martin Heidegger.
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Existential Therapy.
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Who founded Existential Therapy?
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Martin Heidegger.
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This theorist felt that human existence is an evolving process for each individual.
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Martin Heidegger.
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What are some of the qualities of existential therapy?
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It seeks to understand the unique meaning of client's experiences. Emphasizes quality of therapeutic relationship.
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This style of therapy believes man is required to shoulder tasks set by life and has a chance to define the meaning of life.
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Existential Therapy.
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This style of therapy posits: Striving for freedome from instincts and environment, individually unpredictable, man free and responsible to himself.
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Existential Therapy.
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In this theory, behavior is mtoivated by attempts to find meaning.
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Existential Therapy.
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What are 3 aspects Existential Therapy is characterized by?
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Emphasis on experiences of the person. Emphasis on their feelings and values. Emphasis on their "inner life."
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What is the goal of therapy in existential therapy?
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Share the individual's experience of himself, and of the world, related on a person-to-person level.
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Which therapy is characterized by the goal: Share the individual's experience of himself, and of the world, related on a person-to-person level.
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Existential Therapy.
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What are the 4 ways of "Being in the World" in Existentialism?
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Umwelt Mitwelt Uberwelt Eigenwelt
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What characterizes Umwelt?
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Relating to the environment; and attending to the biological and physical.
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What characterizes Mitwelt?
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Relating to the world through relationships with others.
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What characterizes Uberwelt?
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Relgious or spirtual beliefs about the ideal world; how the individual wants the world to be.
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What characterizes Eigenwelt?
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Relating to one's "own world;" being aware of one's own self.
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What arrises from the nature of being human and dealing with unforeseen forces, lack of meaning in life or threat of nonbeing?
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Existential anxiety.
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What is self-transcendence?
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Understanding one's being and taking responsibility for it.
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What is authenticity?
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Being genuine and real, as well as aware of one's being.
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What therapy is characterzied by the theme of living and dying; freedom, responsibility and choice, isolation and loving, meaning and meaniglessness?
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Existentialism.
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Psychoanalysis, free association, interpretation, and transference are all techniques for...?
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Existential Therapy.
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What are 4 techniques of Existential therapy?
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Psychoanalysis. Free association. Interpretation. Transference.
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What style of therapy is seen as a partnership, with the therapist risking him/herself and client encouraged to be himself.
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Existential therapy.
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What is alienation in existential family therapy?
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Occurs when family members restrict their own awareness of their feelings which leads to restricted communication.
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What occurs when family members restrict their own awareness of their feelings which leads to restricted communication?
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Alienation.
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In this style of therapy, the therapist establishes a caring person-to-person relationship and models in honesty, openness and spontaneity.
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Existential family therapy.
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What are family myths?
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A set of beliefs based on a distortion of reality and shared by all family members that shape the "rules" that govern family functioning.
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What is mystification?
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The idea that many families will distort their children's experiences by relabeling or denying it.
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What are the goals of existential family therapy?
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Growth (family provides the push), demonstrated in: integrity, freedom, less dependency, experiencing.
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Name 4 techniques of existential family therapy.
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Role Play Sculpting Conjoin Drawing Imagery
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What are 2 techniques to be used by the therapist in Existential Family Therapy?
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Be provocative and supportive. Help family members take risks by yourself as a therapist being open, more active and genuine.
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Stimulus applied -> behavior increased or decreased.
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Operant conditioning.
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Reward a child with token for paying attention increases behavior. Scold a child to decrease interrupting decreases behavior.
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Operant conditioning.
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What is a schema (CBT)?
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Ways of thinking based on core beliefs and assumptions.
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Ways of thinking based on core beliefs and assumptions are...?
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Schemas.
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What are automatic thoughts?
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Ideas that occur without effort or choice.
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Ideas that occur without effort or choice are ?
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Authomatic thoughts.
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What are cognitive shifts?
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Biased interpretations of life experiences.
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Biased interpretations of life experiences are?
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Cognitive shifts.
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What cognitive distortions?
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Systematic errors in reasoning stemming from early childhood errors in reasoning.
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What are systematic errors in reasoning stemming from early childhood errors in reasoning?
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Cognitive Distortions.
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Name (5) Cognitive Distortions:
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Dichotomous thinking. Selective abstractiong. Arbitrary inference. Mind reading. Negative prediction. Labeling. Magnification. Minimization. Personalization. Catastrophizing. Overgeneralization.
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"What are all of the possible explanations for people talking softly in groups of 2 - 3?" is an example of:
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Reframing.
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"What are all of the possible explanations for conversation stopping when I walk up?" is an example of:
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Reframing.
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"What are all the possible explanations for not being invited to join small groups?" is an example of:
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Reframing.
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What are all the possible explanations for people smiling at me and being friendly?" is an example of:
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Reframing.
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What is the ABC model?
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Antecedent, Behavior, Consequence.
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This model answers the "Why?" of behaviors.
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ABC model.
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This model describes sequence of actions and consequences.
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ABC Model.
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True or False: Consequence can only influence the past occurence of behavior.
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False. Consequence can only influence the FUTURE occurence of behavior.
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True of False: Expectations are largely based on consequences for similar behaviors in the past.
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TRUE.
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True or False: Predictions about what is likely to happen is not a factor in repeating a behavior.
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FALSE. This is a factor.
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Ex: Dressing yourself is maintained by very different conditions today than when you were 2 years old, is an example of what?
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Present - Focused. According to the behavioral model, present conditions cause our present behavior.
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What 5 areas should be considered when understanding the problem (CBT)?
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Environmental changes/ life situations. Physical reactions. Moods. Behaviors. Thoughts.
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What style of therapy suggests to consider as many different angles on a problem as possible (positive, negative, and neutral)?
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CBT
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True or False: It should take you more than one word to describe a mood.
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FALSE. If it takes you more than 1 word to describe a mood, you might be describing a thought.
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IDing and rating moods involves:
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Rate moods on a scale of 1 - 100. Think about the worst time in your life. Rating of "100" worst you've ever experienced.
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Showing, teaching, and encouraging the client how to accomplish individual tasks on a thought chart is a technique used in what style of therapy?
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CBT.
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What are 5 questions that help ID automatic thoughts?
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What was going through your mind? What does that say about you if it is true? What does it mean about your life, your self, your future? What are you afraid might happen? What is the worst that can happen?
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What are hot thoughts?
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Automatic thoughts most connected to moods are caused by hot thoughts.
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These thoughts conduct an emotional charge and are associated with the most intense moods.
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Hot thoughts.
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How to change a hot thought?
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Target the hot thought. If starting with a thought that is not neccessarily tied to the problematic mood, the mood may not change. This is diagnostic - if it happens, keep searching, you have not ID'd the hot though yet, the thought is inaccurate, or it may be a core belief.
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What are some questions to help find evidence not supporting the hot thought?
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Is this true all of the time? If my friend had this thought, what would I tell them? When I am not feeling this way, do I think about this differently? Are there small things that discounts the thought that I might be discounting as not important? Am I jumping to conclusions that are not justified by evidence?
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True of false: When we have negative automatic thoughts, we tend to dwell on the data that confirms our convictions.
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TRUE.
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What is a negative filter?
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Mental filters may cause an individual to automatically discount or block all positive thoughts or compliments and only accept the negative.
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What is homeostasis?
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The body and mind seek balance in emotion and physical well being.
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Describe how to form an alternative thought.
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Summarize in 1 sentence column 4 of the thought record. Summarize in 1 sentence column 5 of the thought record. If appropriate, connect the 2 sentences with the word "and". "I've made some mistakes as a parent AND I've done some good things too."
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What are 4 advantages to completing thought records regularly.
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1. Can help broaden perspectives on troubling situations so that you react in ways that are inconsistent with the big picture rather than narrow and possibly distorted view. 2. Actually help you learn to think automatically. 3. After completing 20 - 50 thought records, many peopl report being able to think in balanced ways without writing it down. 4. At this point, fewer situations will be experienced as truly distressing.
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Who was a major contributer to Spritually Oriented CBT?
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Sperry & Shafranske.
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What is spiritual CBT?
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A personal experience related to transcendence and search for the sacred.
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What style of therapy is a personal experience related to transcendence and search for the sacred.
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Spritual CBT.
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Who staed that CBT is an "elegant" approach to treating religious clients with problems of a religious or spirtual nature.
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Albert Ellis.
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What are 3 interventions for Spiritual CBT?
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Cognitive disruptions utilizing scripture or religious evidence to combat or argue against irrational or self defeating thoughts. Use of religious imagery to decrease anxiety or heighten comfort (Relaxation techniques or calming exericeses.) Use of scripture reading or prayer in session or as adjuntive to other cognitive homework.
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This style of therapy emphasizes agape love and the need to develop empathetic genuine relationships with the client.
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Spritual CBT.
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Spritual CBT can assist with what aspect of therapy?
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Dealing with the past, especially unresolved childhood trauma and issues.
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What are some of the challenges of spritual CBT?
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Is it appropriate to challenge clients through scripture? God says that, "In this world you will have tribulation." Where does it say you will not?
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What is the difference between Implicit and Explicit integration in spirtuality CBT?
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Implicit - refers to a more covert approach that may not initiate the discussion of religious or spiritual issues and does not systematically use spiritual resources like prayer and Scripture or other sacred texts, in therapy. Explicit - Explicit integration regularly and systematically incorporates these resources
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What are some behaviors that would be unethical in spirtual CBT?
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Lack of informed consent. Done for or to meet spirtual needs of therapist vs. client. Forcing religious beliefs or spirtual practices on client (even your suggestion is powerful.) Practicing pastoral counseling, prayer ministry (Thophostic) or spiritual direction to exclusion of clinical psychology or regardless of fit with client's presenting problem.
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What are 5 characteristics a CBT therapist should have?
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Interpersonal warmth. Lack personal psychopathology. Motivated to learn CBT. Ability to tolerate negative client affect. Have abstract conceptual abilities.
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4 Qualities a SO-CBT therapist should have:
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Willing to accommodate and explicityly integrate religion into therapy. Well train in CBT theory, practice and interventions. Demonstrate competency in use of client religious and spiritual beliefs and practices to enhance health. Personal faith perspective may influence therapy - be aware and careful.
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What guidelines should the SO-CBT therapist follow when treating psycchotic disorders?
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Use so-cbt after control of psychotic symptoms with medication, prayer needs to be relatively controlled but can be comforting. Ex: If therpist refers to angels or God speaking to the client and the client state they're hearing voices - could be an issue.
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What guidelines should the SO-CBT therapist follow when treating personality disorders?
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Can have negative or harmful effects of applied indiscriminately to all clients with all types or problems. Ex: Clients from harsh, legalistic backgrounds asked to perform spiritual disciplines may not benefit until helped to experience love more deeply. May facilitate an active rebellion of God.
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What guidelines should the SO-CBT therapist follow when treating sexually abused clients?
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Inner healing evoking images of God as father or Jesus hugging client is insensitive and inappropriate with clients who have been sexually abused by their fathers.
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What percentage of Federal CO's endorsed punishment as a goal of corrections?
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76%.
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What percentage of CO's viewed rehabilitation as a goal?
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56%.
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What is the self-determination theory?
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This theory says that motivation is on a continuum.
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What is amotivation?
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The unwillingness to participate in normal social or community activities.
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What is autonomy in self-determination theory?
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The need to be in control of one's own life and self-motivated.
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What is intrinsic motivation?
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Intrinsic motivation refers to initiating an activity for its own sake because it is interesting and satisfying in itself.
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What is extrinsic motiviation?
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Doing an activity to obtain a certain goal.
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What are 3 Change Agents to motivation?
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Competence - believeing that one's behaviors can produce a desired outcome. Autonomy - Needs met by one's self and under one's own control. Relatedness - The need for believing that others value and respect you while feeling part of a group.
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Name 5 challenges with working with offenders.
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They are mandated for treatment. The idea they are imprisoned so collaborating with them is unnecessary. The temptation to "fix" offenders by telling them what they should do in certain environments. Some offenders deny that they committed any offense.
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True or False: Inpatient hospitals seem to have better treatment adherence and clients staying in outpatient treatment.
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TRUE.
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Why might MI be an effective technique for offenders?
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An humanistic approach they respond to well. MI can create a safe environment that can help sex offenders explore their issues.
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What are 2 strategies for increasing adherence in dual diagnosis clients?
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Raising awareness of nonadherence. Eliciting pros and cons of treatment nonadherence.
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What stage of change is characterized by little or no serious consideration or intent to change?
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Precontemplation.
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This stage of change often presents for treatment at the request of another party (e.g. courts).
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Precontemplation.
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This type of change may be exhibited when pressure is applied, but patient reverts to previous behavior when pressure is removed.
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Precontemplation.
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This type of change is characterized by an awareness of the problem and serious thoughts about working on it, but no commitment to begin work on it.
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Contemplation.
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In this stage, the patient may weight pros and cons of the problem and its solutions.
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Contemplation.
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In this stage, individuals are aware of the identified problem and intend to take action within 6 months.
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Contemplation.
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True or False: Many people are in the contemplation phase for a short period of time.
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FALSE: Many people remain in the contemplation phase for a long period of time.
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What is decisional balance?
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It is the weighing of positive and negative aspects of engaging in the process of change.
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In this stage, the client has intention to make change and takes it seriously.
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Preparation.
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In this stage, self-efficacy appears to be a main driving force.
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Preparation.
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Decision making is the hallmark of this stage.
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Preparation.
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In this stage, there is a continuation of change to prevent relapse and consolidate the gains made during the action stage.
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Preparation.
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In this stage, the client may overt modification of behavior, experiences, or environment in an effort to overcome the problem.
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Action.
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In this stage, the risk for premature termination from treatment significantly decreases in this stage.
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Action.
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In this stage, females are twice as likely to progress to this stage than males.
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Action.
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In this stage, there is a continued effort of change to prevent relapse.
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Maintenance.
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During this stage, individuals have changed the behavior for more than 6 months.
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Maintenance.
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In this stage, an individual has no temptation to behave the way they previously did.
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Termination.
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What are the 10 processes of change?
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Consciousness-raising. Self-reevaluation. Self-liberation. Counterconditioning. Stimulus control. Reinforcement management. Helping relationships. Dramatic relief. Environmental re-evaluation. Social liberation.
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This process of change consists of increasing information about self and problem: observations, confrontations, interpretations, bibliotherapy.
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Consciousness-raising (contemplation and preparation).
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This process of change consists of assessing how one feels and thinks about oneself with respect to a problem: value clarification, imagery, corrective emotional experience.
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Self-reevaluation (contemplation and preparation).
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This process of change consists of choosing and commitment to act or belief in ability to change.
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Self-liberation (preparation).
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This process of change consists of substituting alternatives for problem behaviors: relaxation, desensitization, assertion, positive self-statements.
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Counterconditioning (action and maintenance).
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This process of change consists of avoiding or countering stimuli that elicit problem behaviors: restructuring one's environment, avoiding high risk cues, fading techniques.
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Stimulu control (action and maintenance).
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This process of change consists of rewarding one's self or being rewarded by others for making changes: contingency contracts, overt and covert reinforcements, self-reward.
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Reinforcement management (action).
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This process of change consists of being open and trusting about problems with someone who cares: Therapeutic alliance, social supoprt, self-help groups.
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Helping relationships.
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This process of change is experiencing and expressing feelings about one's problems and solutions: psychodrama, grieving losses, role playing.
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Dramatic relief (contemplation, preparation, and action).
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This process of change is assessing how one's problems affect the physical environment: empathy training, documentaries.
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Environmental re-evaluation (precontemplation).
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This process of change is increasing alternatives for non-problem behaviors available in society: advocationg for rights of oppressed, empowering, policy interventions.
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Social Liberation (contemplation and preparation).
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What process of change are in the Experiential (or cognitive) processes group?
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Consciousness-raising, drmatic relief, environmental reevaluation, social liberation and self-reevaluation.
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What processes of change are in the Behavioral processes group?
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Helping relationships, stimulus control, counterconditioning, reinforcement management and self liberation.
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What is the definition of motivational interviewing?
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A client-centered, directive method for enhancing intrinsic motivation to change by exploring and resolving ambivalence.
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What technique is defined as A client-centered, directive method for enhancing intrinsic motivation to change by exploring and resolving ambivalence.
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Motivational Interviewing.
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What does MI not focus on?
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Coping skills, reshaping cognitions, or excavating the past.
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What is ambivalence?
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A person may want to change, but they don't want to change.
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What facilitates change talk? (DARN)
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D.A.R.N. Desire to change. Ability to change. Reason to change. Need to change.
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What demonstrates resistence to change (DIRN)?
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D.I.R.N. Desire for status quo. Inability to change. Reason for status quo. Need for status quo.
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What are 4 ideas in the spirit of Motivational Interviewing?
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1. Express empathy. 2. Develop discrepancy. 3. Roll with resistance. 4. Support self-efficacy.
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What are 4 process categories of client resistance behavior?
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1. Arguing. 2. Negating. 3. Interrupting. 4. Ignoring.
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What are 6 counselor responses that can hinder change in MI?
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1. Arguing for change. 2. Assuming the expert role. 3. Criticiazing, shaming or blaming. 4. Labeling. 5. Being in a hurry. 6. Claiming preeminence - the counselor's goals overrides the clients. "I know what's best for you."
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What are the 2 phases to MI?
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Phase 1 : Building Motivation to Change. Phase 2: Strengthening Commitment to Change.
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How do you avoid the Question-Answer trap?
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Don't ask more than 3 questions in a row.
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How do you avoid the Premature-Focus trap?
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Avoid focusing prematurely on issues that are concerning to the counselor but not to the client.
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What are 3 traps to avoid during MI?
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1. Question-Answer Trap. 2. Expert Trap. 3. Premature-Focus Trap.
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What are the 4 client profile groups in MI?
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Group A: Low Importance; Low Confidence Group B: Low Importance; High Confidence Group C: High Importance; Low Confidence Group D: High Importance; High Confidence
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What type of client profile is characterized by they don't see change and importance or believe they can make a change on their own?
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Low Importance; Low Confidence (Group A)
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What type of client profile is characterized by someone who is confident they could make the change if they thought it was important; not persuaded that they want to change?
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Low Importance; High Confidence (Group B)
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What type of client profile is characterized by someone who expresses desire to change, but have low confidence that they could succeed in change?
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High Importance; Low Confidence (Group C).
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What type of client profile is characterized by someone who sees that it is important to change and they believe they can?
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High Importance; High Confidence (Group D).
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What are 5 methods to use in MI?
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1. Ask open questions. 2. Reflective listening. 3. Affirm. 4. Summarize. 5. Elicite Change Talk.
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Describe the Importance Ruler.
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"What would it take for you to go from ________ to (a higher number) here?
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Describe Querying Extremes.
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This involves asking someone to describe the most extremes of their concerns.
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Describe Looking Back.
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Remember times before the problem occurred and compare the times to the present.
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Describe Looking Forward.
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A realistic appraisal of a future that is unchanged or their realistic hopes for a different future.
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What are signs of readiness to change?
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Descreased resistance. Decreased discussions about the problem. Resolve. Change talk. Envisioning. Experimenting with change actions.
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What are key questions to initiating Phase 2?
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"What changes, if any, are you thinking about making?" "What could you do? What are your options?" "What happens next?"
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What are the only 2 conditions for giving advice?
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1. Only if a person requests it. 2. The person gives permission.
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What are 4 steps to negotiating a change plan?
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1. Goal Setting - "What do you think is the first step?" 2. Considering Change - Options. - Brainstorm with the client. 3. Arriving at a Plan. - "How will you go about completing the plan?" 4. Eliciting Commitment. "Is this what you want to do?
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1. Goal Setting 2. Considering Change Options 3. Arriving at a plan. 4. Eliciting Commitment. All steps for ...
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Negotiating a Change Plan.
