Structural, Bowen, Narrative, CBT, Solution-Focused therapy terms – Nichols LIOS – Flashcards
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Natural systems within a family. Example: Parents and siblings -structural family therapy term
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Subsystems
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Necessary component in family systems to bob and weave through life's surprises -structural family therapy term
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Flexibity
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Intervention to transform the family structure -structural family therapy term
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Restructuring
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Emotional and physical barriers that protect and enhance the integrity of individuals, subsystems and families -structural family therapy term
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Boundaries
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Most common expression of fear -structural family therapy term
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Conflict avoidence
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When a therapist stimulates the family to demonstrate how they handle a particular problem. -structural family therapy term
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Enactments
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Intervention to create conflict as it would happen outside of therapy -structural family therapy term
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Enactment
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When family members shy away from addressing their disagreements -structural family therapy term
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Conflict avoidence
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Guiding the family to modify their behavior to solving a problem -structural family therapy term
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Most important step on an enactment
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Minimizing contact to avoid conflict -structural family therapy term
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disengaged people
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Structural Family therapy founder
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Salvador Minuchiin
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Joining and witnessing enactments to observe how family members interact -structural family therapy term
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Structural assessment
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A second, lesser known, founder of Structural Family Therapy
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Bravulio Montalvo
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Avoid conflict by denying differences or by constant bickering -structural family therapy term
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Enmeshed people
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Daughter problems could be due to mother's enmeshment with her and lack of boundaries between dad is an example of what? -structural family therapy
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Structural assessments focus on all subsystems
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Structure, subsystems, and boundaries -structural family therapy terms
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Three constructs essential to structural family therapy are:
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Mother and father focus on their child instead of working on their own issues is an example of? -structural family therapy term
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Scapegoating as a means of avoiding conflict example
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1. Ask questions about the problem that expands systemwide; 2. Help family members see their role in the problem; 3. Brief exploration into the past to see how actions were developed; 4. Explore new ways to interact with the problem. -structural family therapy
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Four steps of assessment
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1. Joining and accommodating; 2. Enactment 3. Structural mapping 4. Highlighting and modifying interactions 5. Boundary making 6. Unbalancing 7. Challenging unproductive assumptions
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Seven structural family therapy steps
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Avoid conflict with each other -structural family therapy
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Parents focus on their children to ?
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The family organized into subsystems and how the subsystems are regulated by boundaries -structural family therapy term
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Family structure
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A coalition to relieve stress in a martial subsystem -structural family therapy term
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Parent-Child coalition
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Minuchin's term for changing destructive patterns by using strong affect, prolonged pressure or repeated intervention.
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Intensity
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Who sits where, unwritten rules; unspoken alliances outside of subsystems; patterns; etc -structural family therapy
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Structure in a family may include:
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1. Rigid/Disengagement 2. Clear Boundaries/Normal Range 3. Diffused boundary/Enmeshment -structural family therapy
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3 Boundary types
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Enmeshment =
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Diffused Boundary =
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Disengagement =
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Rigid Boundary =
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Normal range =
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Clear Boundary =
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When one parent joins forces with a child against the other parent -structural family therapy term
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Parent-Child Coalition
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Attuning with a family, subsystem, or individual in a family as an intervention. -structural family therapy term
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Empathy
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Rigid and disengaged -structural family therapy term
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Independent subsystems
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Hallmark intervention in structural family therapy
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Shaping compentence
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Relieves anxiety by blurring boundaries between subsystems -structural family therapy term
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Enmeshed subsystems
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young children -structural family therapy
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Parents enmeshment is good with
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Altering the direction of the flow by highlighting and reinforcing the positive -structural family therapy term
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Shaping Compentence is
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Boundary form parents, children, and other "outsiders" that reserve some functions as special. -structural family therapy
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Key ingredients for spouse subsystems (boundary)
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Children unable to navigate school or relationship outside of the family system -structural family therapy
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An example of Parents enmeshed with young children that cannot establish or hold rules
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When personal boundaries are permeable and unclear. -structural family therapy
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Enmeshed boundary making
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Clear generational boundaries where the parents maintain control and authority -structural family therapy
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Hierarchical Structure
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Therapist intervenes to challenge conflict avoidance and block detouring to help break down walls -structural family therapy
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Disengaged boundary intervention
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Therapists directs conversation outside of the enmeshed system -structural family therapy
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Enmeshed Boundary intervention
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Accommodation -structural family therapy
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1st step in forming a couple
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Learning to live together and create new rules to negotiate the new boundary between them and the outside systems (FOO, friends, work, children) -structural family therapy
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Accommodation in creating a couple subsystem
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The goal to change the relationship within a subsystem -structural family therapy
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Unbalancing
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Failure to accept step-parent -structural family therapy
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M *** Stepfather children
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Boundary making -structural family therapy
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2nd step in forming a new couple
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Defining the boundaries between them and their original families -structural family therapy
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Boundary making in creating a couple subsystem
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A therapist taking sides to realign the system -structural family therapy
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Unbalancing intervention
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Failure to engage with interests and people outside of the family or subsystems -structural family therapy
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Enmeshments can cause
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Instant creation of a subsystem -- parental and child subsystems -structural family therapy
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Enter the child into the family system
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Offering alternative views of the family situation -structural family therapy
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Challenging unproductive assumptions
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To alter the family structure so the family can solve its own problems -structural family therapy
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Structural Intervention
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When a therapist wins trust and enters the family system -structural family therapy
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Joining
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Highlight a positive to one member and shine the negative affect I has on another member -structural family therapy
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"Stroke and kick"
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Children needs different styles of parenting depending on their ages. What is appropriate for a toddler is not appropriate for a teen. -structural family therapy
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Parent subsystem growing with the child
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To flow into the family system -structural family therapy
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Accomodiating
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The father doesn't have to bond with mother while the mother gets what she needs emotionally from the child. -structural family therapy
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Enmeshed mother/disengaged father syndrome
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Clear enough to protect independence and permeable enough to allow mutual support. -structural family therapy
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Boundaries in healthy families are:
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1. Shaping 2. Token economies 3. Contingency contracting 4. Contingency management 5. Timeouts -CBT
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5 Operant techniques
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the most difficult to extinguish behavior because the consequence doesn't match the behavoior with each occurance. -CBT
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Intermittently reinforced behavior is ...
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An intervention that accelerates behavior change -CBT
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Premack principle
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Use high-probability behavior (preferred activities) to reinforce low probability behavior (non-preferred) ex: Use screen time to reinforce household chores. -CBT
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Premack principle technique
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Stimulus, Organism, target Response nature and contingency of of consequences (KC) -CBT
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Kanfer and Phillip's SORKC means
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Albert Ellis -CBT
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ABC theory invented by
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Activating event leads to Behavior which leads to Emotional Consequences -CBT
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ABC Theory explained
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B.F. Skinner -CBT
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Operant conditioning inventor
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Theory in which people strive to maximize rewards and minimize cost in relationships -CBT
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Theory of social exchange
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1. Discussions are limited to one problem at a time 2. Encouraged to avoid aversive responses 3. I-Statements -CBT
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CBT Problem-Solving training when quad pro quo and good faith contracts don't work
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A form of learning where a person is rewarded for performing certain behaviors. -CBT
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Classical conditioning
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Thibant and Kelley -CBT
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Theory of social exchange inventors
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1. Taught to express themselves clearly using behavior descriptions 2. Taught new behavior emphasizing the positive 3. Improve communication 4. Establish sharing power and decision-making 5. Taught strategies for solving future problems -CBT
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Stuarts lists 5 strategies for troubled marriages
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A form of learning where a person is rewarded for performing certain behaviors -CBT
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Operant Conditioning
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Partners agree to make changes that aren't contingent on what the other does -CBT
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Good faith contract
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Distorted conclusions based on personal beliefs (schemas) -CBT
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Automatic thoughts
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An unconditioned stimulus leads to an unconditional response is paired with a conditioned stimulus to result in the (CS) evoking the same (UCT) -CBT
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Classical conditioning
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Russian physiologist who developed classical conditioning -CBT
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Ivan Pavlov
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Reinforcing behavior +/- to get a reaction -CBT
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Social reinforcer
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Core beliefs -CBT
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Schemas
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Operant behavior therapy a study of a particular behavior what elicits it, what reinforces it. -CBT
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functional analysis of behavior
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Thibant and kelley -CBT
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Theory of social exchange was created by
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Use points or stars to reward children -CBT
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Token economics
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consists of reinforcing change in small steps -CBT
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Shaping
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The frequency of operant responses is determined by their consequences -CBT
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Skinner's operant conditioning
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Reinforcer -CBT
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Accelerate behavior is a
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Agreements by parents to make certain changes following changes made by children -CBT
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contingency contracting
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Occurs when no reinforcement follows a response -CBT
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Extinction
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Nagging, crying, withdrawing is major determinant of marital unhappiness -CBT
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Aversive control
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Classical conditioning creator -CBT
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Ivan Pavlov created
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Mouse to food -CBT
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Classical conditioning
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Created by Richard Staurt -CBT
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Contingency conditioning
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CBT
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Albert Ellis and Aaron Beck inspired
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emphasizes the need for attitude change to promote and maintain behavioral modification
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CBT
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In a relaxed state, expose client to fears/anxiety. -CBT
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Systematic desensitization
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Focuses on positive reinforcement -CBT
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Reinforcement reciprocity
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Systematic desensitization -CBT
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Joseph Wolpe created
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Rather than focus on how the undesired behavior of one family member could be reduced. Focused on positive behavior using reinforcement reciprocity. -CBT
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Contingency contracting
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Couples agree to do certain things for each other -CBT
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Quid pro quo
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1. Careful assessment to determine the baseline for frequency of problem behavior 2. Strategies designed to modify the contingencies of reinforcement in an unique client family -CBT
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Hallmarks of behavior therapy
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Observes target behavior and judges frequency and rate -CBT
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Functional analysis of behavior
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Nagging, crying, and withdrawing -CBT
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Aversive control
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Low sex drive to sexual aversion -CBT
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Disorders of desire
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Punished or ignored behaviors will be extinguished -CBT
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Negative trait of operant conditioning
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Positively reinforced responses will be repeated more frequently -CBT
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Positive Traits of operant conditioning
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When a behavior ceases by a positive/negative action -CBT
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Reciprocal reinforcement
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Decreased emotional arousal to achieving and maintaining arousal/lubercation -CBT
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Arousal disorders
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people strive to maximize rewards and minimize costs in relations -CBT
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Theory of social exchange
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A form of learning whereby a personis rewarded for performing certain behaviors -CBT
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Operant conditioning
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Four Subscales: Emotional Cutoff, "I-position", Emotional reactivity, and fusion with others - measures chronic anxiety, psychological distress and marital satisfaction. -Bowen
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Skowron's Differentiation of self inventory (DSI)
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Designed to measure Bowen's intrapsychic aspect of differentiation. -Bowen
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Chabot's Emotional Differentiation (CED) Scale
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Differentiation -Bowen
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The ability to think rationally in emotionally charged situations
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Levels of undifferentiation is caused by ____ -Bowen
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the extent of unresolved emotional attachment to parents
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Bowen's students that championing feminism in family therapy. -Bowen
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Betty Carter and Monica McGoldrick were ?
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2nd major technique in Bowenian therapy -Bowen
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Relationship experiment
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Bowen believed children develop personality characteristic based on their position in the family -Bowen
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Sibling position
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The capacity to think and reflect, to not respond automatically to emotional pressures, -Bowen
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Differentiation of self
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Primary task for young adults to separate from their families without cutting off -Bowen
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Leaving home stage
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Designed to help clients experience what it's like to act counter to their usual emotionally driven response -Bowen
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Relationship experiment defined
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When a therapist takes an autonomous position in relation to the family, the members have an easier time defining themselves to each other -Bowen
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I-Position
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"When your boyfriend neglects you, how do you deal with it?" This question is an example of what? -Bowen
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Process Question example
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The ability to be flexible and act wisely, even in the face of anxiety. -Bowen
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Differentiation of self
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Some of these experiments may help clients resolve their problems but their primary purpose is to help people discover their ability to move against the ways their emotions drive them. -Bowen
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why do relationship experiments?
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Why develop relationships with people in the extended family? -Bowen
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The process of differentiating - the more relationships will enable an individual to spread out their emotional energy
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An unhealthy exaggeration of the instinctual need of others -Bowen
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Emotional Fusion
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I statements between family members and therapist to clients. -Bowen
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I-Position
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"When your daughter resists doing what she is told, how do you react?" is an example of what? -Bowen
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Process question example
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Differentiated people/person -Bowen
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The ability to be flexible and act accordingly, especially under anxiety?
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Vertical problems to horizontal stresses of transition points equal -Bowen
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Acting out (cutoff, retreats, fight, flight, and freeze) -Bowen
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Normalizing a family crisis by sharing a similar story of another family.
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Displacement story -Bowen
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National Institute of Mental Health
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NIMH
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technique for therapists to remain objective -Bowen
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Coaching
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Process, not content -Bowen
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In couples therapy it is important for the therapist to focus on ___
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To get the clients to express themselves, settle disputes and differentiate from each other
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The aim of Bowen couples work is ___
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Developing person - to - person relationships, seeing family members as people, learning to observe one's self in triangles, and detriangling oneself
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Bowenian therapy with one person
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turning away from the family under the facade of independence -Bowen
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Emotional cutoff
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The idea to open a closed system. (Prodigal child returns) -Bowen
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Reentry
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The idea to get two people to work out a problem together and not through a third party. -Bowen
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Detrianglation
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24 items that focus on emotional maturity - measures chronic anxiety and psychological distress. -Bowen
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Haber's level of differentiation of self scale
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Emotional forces in families that operate over the years in interconnected patterns -Bowen
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Mulitgeneration Transmission Process
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1. Genogram 2. process questions 3. relationship experiments 4. detriangling 5. coaching 6. I-statements 7. Displacement stories -Bowen
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The major techniques in Bowenian therapy include
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Philip Guerin, Thomas Fogarty, and Michael Kerr were who? -Bowen
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Bowen's students in 70's (males)
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that the same traits in these "more normal" families were the same as those with a schizophrenic member. -Bowen
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After NIMH, Bowen went to Georgetown to work with families whose problems were less severe Bowen was surprised to find
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Describes the way people manage anxiety between generations -Bowen
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Emotional cutoff
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Queries designed to explore what's going on inside people and between them (relational) -Bowen
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Process questions are ?
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Anxiety -Bowen
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Triangles relieve what in a system?
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It is diagram of a family history of mental health, addiction, relationship histories, and other traumas that influence the client through a multi-generational transmission process -Bowen
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What is a Genogram?
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In 1954 Bowen when to the NIMH to study families with a schizophrenic member. He found that typically mothers and the schizophrenic child were overly attached in what he called anxious attachment. The patterns were similar from family to family
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Where did Bowen's interest in families start?
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Differentiation of self -Bowen
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Key to how people reconcile the individual vs closeness polarity
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refers to the patterns of emotional reactivity -Bowen
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Process:
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refers to the interlocking network of triangles -Bowen
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Structure:
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1. Leaving Home Stage 2. Joining of families through marriag stage 3. families with young children 4. Adolescence 5. Launching of children and moving on stage 6. families in later life -Bowen
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Stages in the family life cycle (Carter and McGoldrick)
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1. Differentiation of self 2. Triangulation 3. nuclear family emotional process 4. family projection process 5. Mulitgeneration transmission process 6. Sibling position -Bowen
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what are Bowen's 6 interlocking concepts?
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When problems become bigger than life. Evidence is sought to support the stories making it bigger and bigger -Narrative
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Problem-saturated stories
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Questions designed to see how a problem has dominated a client vs. client's control of it -Narrative
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Relative influence questions
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Started the "clients are the experts on their own lives" stance ... Adopted a "not-knowing" stance -Narrative
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Harlene Anderson and Harry Goolinshian
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People 1) Have Good Intentions 2) Are influence by the discourse around them 3) Are not their problems 4) Can develop new, empowering stories once separated from their problems and internalized cultural myths
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Basic Narrative Therapy Assumptions
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By using externalizing language the therapist separates the client from the problem -Narrative
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Externalizing conversations
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Founded the Vancouver Anti-Anorexia/Anti-Bulimia league -Narrative
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Stephan Madigan
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What is normal
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Narrative therapist reject
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Do not judge
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Narrative therapists
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Exploring the extent to which the family have been able to stand up to the problem's oppression. -Narrative
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Step 2 of Mapping the Family
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Taught at MRI and pioneered the use of narrative therapy with "difficult" adolences and couples -Narrative
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Jeffery Zimmerman and Vicki Dickerson
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Worked with Michael White to expose how social discourses objectified and dehumanized marginalized groups -Narrative
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Michel Foucault
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Ask how a client was recruited to believe the dominate cultural myth and see themselves as unworthy -Narrative
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deconstructing destructive cultural assumptions intervention
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Two important interventions in Narrative Therapy
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Narrative metaphor and Externalizing the problem
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finding external examples or people to validate the new story -Narrative
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Reinforcing the new story
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Self Help Leagues and Letter Writing -Narrative
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Two things Epston used
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A therapist writes a letter to their client sharing their insights and story that does not support the original client story. It is used so the client can reread when they are falling back into their old, destructive narrative -Narrative
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Letter Writing intervention
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Creating new and more optimistic accounts of experience -Narrative
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Reconstruction
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Separate self from the problem -Narrative
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Externalizing problems
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When a narrative becomes "The" truth for a client ... Narrative therapists believe there are no truths
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Internalized Truths
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seeing the best of someone even when they have lost sight of themselves
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A narrative intervention
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2nd most influential leader of the Narrative Therapy movement
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David Epston
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questioning assumptions -Narrative
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Deconstruction
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The narrative metaphor was more useful than cybernetics
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Eptson convince Michael White that
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Focuses on self-defeating cognitions--the stories people tell themselves about their problems.
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Narrative Metaphor
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The science of of feedbacks; how information, especially positive and negative feedback loops, can help self-regulate a system. -Narrative
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Cybernetices
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Founder of Narrative Therapy
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Michael White
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Highlighting successful moments over the problems -Narrative
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Reauthoring
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Seeing times when the client overcame their problems ... what was different then -Narrative
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Unique Outcomes
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Co-authored a volume of SF case studies that showed the application of SF in agency settings -solution focused
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Yvonne Dolan
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Amplify exceptions to their problems
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Task of solution-focused therapy
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The formula first-session task -solution focused
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Focus on the positive and what is working between sessions
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positive and exceptions to the problems. Focus is on the future not the past.
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SF therapists look to the
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The client is the authority on their life situation.
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Solution-Focused Assumption
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If a client talks positively, it will help them to think positively which in turn will help them to design active positive solutions to their probelms
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Solution-Focused Assumption
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Do more that works task -solution focused
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Why change what is working
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The belief that when a client rejects, ignores, or withdrawals it isn't about the therapy. It is that what was suggested doesn't work in the clients' reality or fit into how they do things. -solution focused
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"The death of resistance"
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Ericksonian perspective that influenced De Salzar -solution focused
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The therapist creates an atmosphere in therapy in which people's strengths come forward from the shadows.
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Do something different tasks -solution focused
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An experiment task designed to test exceptions
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Opposition -solution focused
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Imposition breeds
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Little
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Solution-focused therapists spend _______ time talking about problems
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Go Slow Task -solution focused
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tasks designed to help clients overcome fear and resistance to change
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Changing the way clients talk about their problems
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solution-focused therapy involves
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Turn attention to the solutions through using exceptions and positive, futuristic conversations
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After a brief description of a problem Solution-Focused therapists ______
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Positive, future conversations -solution focused
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How things will be different in the clients' lives when their problems are solved?
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Exception conversations -solution focused
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Has there been times in their clients' lives when the problem did not happen or was less severe?
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Do the opposite task -solution focused
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A good feedback/suggestion to use with couples
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different than the language of solutions -solution focused
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The language of problems is
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A tool to measure how severe the problems have been over the week (s) between sessions or throughout a client's life -solution focused
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Scaling
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Prediction task -solution focused
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"Before you go to bed together, predict whether the problem will be better, the same, or worse tomorrow. Tomorrow night scale the day and compare it to your prediction"
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Are the experts of their life situations
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In solution focus therapy clients ____
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Comes to therapy without a compliant and doesn't want to be there. Typically is there because they are being made to be there. -solution focused
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A Visitor
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Formulate feedback and suggestions to share with the client(s)
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A SF therapist will step away from the session and ____
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Therapist and client think of the session and share their thoughts. The client thinks about what wasn't shared and the therapist thinks about suggestions for the upcoming break between sessions. -solution focused
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Feedback and suggestion stage of therapy
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First-session formula, do more of what works, go slow, do something different, do the opposite, prediction task -solution focused
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Types of feedback/suggestions to share with clients
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Key question in solution-focused therapy
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"Is there anything else I should have asked you or that you need to tell me?
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People who come to therapy with complaints that focus on other people. Typically bring visitors to therapy -solution focused
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Complainants
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an assessment tool to use at each session -solution focused
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Scaling question
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a powerful intervention to use alone -solution focused
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Scaling question
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Let go of their judgements and take a stance of curiosity about the clients' lives and situations
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SF Therapists are expected to
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Used to quantify clients' confidence that they can maintain their resolve -solution focused
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Scaling
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Focusing on problems and how they were formed. -solution focused
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Solution-focused therapists steer clients away from ___
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Generating solutions based on exceptions -solution focused
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3rd solution-focused goal
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exception questions fail -solution focused
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Coping questions are used when
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A family that has found a solution to a problem and resumed their way of living together
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Solution-focused definition of a "Normal Family" is
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A brief description of the problem -solution focused
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1st solution-focused technique
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"How did you manage the problem (that)?" -solution focused
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Coping questions example
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It is not necessary to dive into the past to solve a problem.
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Solution-focused therapists take the radical position that ______
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one at a time
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Appointments in solution focused are set
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commitment that families have the ability to construct solutions to change lives
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Key concept of solution-focused therapy
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1st brief description of the problems 2nd developing well-focused goals 3rd generate solutions based on exceptions 4th appointments are scheduled one at a time
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Solution-focused techniques
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to happen all of the time. -solution focused
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Problems see overwhelming to clients because they seem ____
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Is not a focus of solution focused therapy
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How families "should" be structured
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Is the focus of solution focused therapy
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What a family wants to be different
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Rejected as flukes -solution focused
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Times problems aren't happening in a client's life can be -----
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Create well-defined goals that are framed in positive terms, concrete and behavioral, while modest enough to be achievable.
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A solution-focused intervention
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Helping clients see that their problems do not happen all of the time -solution focused
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Exceptions
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Helping clients to stop dwelling on their dissatisfaction and envision what they want to be doing instead.
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Solution-focused intervention
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Main architect of the Solution-Focused movement
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Steve de Shazer
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Solution-focused intervention question
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"What will you (or he/she) be doing instead?"
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Influencer of Solution-Focus Therapy
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Milton Erickson
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Success builds on itself
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Solution-focused belief
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worked with de Shazer in designing solution-focus therapy
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Insoo Kim Berg
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Solution-focused belief
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Modest goals are a beginning of change
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Key assumption in solution-focused therapy
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People are resilient and resourceful
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Have a clear complaint and want to find a solution -solution focused
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Customers
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design clear, well-defined goals
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2nd technique of solution-focused therapy
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1. Marital conflict 2. illness in a spouse 3. impairment of children
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3 categories that lead people to therapy -Bowen
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False
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(T/F) Does a client need to be seen with his/her family in Bowen Family Therapy?
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1. When parents lose control of the system 2. Structure maintains dysfunction 3. Family structure is not adaptable to change
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3 categories that lead people to therapy -Structural
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How people do things
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Landscape of action -Narrative Term
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What meaning a problem has
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Landscape of conciousness -Narrative Term
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Person's own story that is suppressed by the dominate culture
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subjugate narrative -Narrative Term
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Belief, values, "the norm" based on dominant social culture
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Dominant narriative -Narrative Term
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Taking apart problem saturated stories --externalize and Reauthoring
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deconstruction -Narrative Term
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When problems bog down the client which then perpetuates the problme
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Problem-saturated stories -Narrative Term
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New narrative
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Unique outcomes -Narrative Term
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Used in narrative therapy. A team of therapists who observe your therapy session who then give you objective feedback on how you are interacting with the client and what might have been missed.
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Reflecting teams
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Are the main intervention of Narrative Therapy
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Questions
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The Interview
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Main invention is Solution Focus
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To resolve the presenting problem
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The main goal of solution - focus therapy
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Questions designed to explore the extent to which the problem has dominated the client versus how much he or she had been able to control it.
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Relative influence questions -narrative