cg Ethics & Clinical
Terms
undefined, object
copy deck
- Sex w/clients
-
- Therapist more likely to have other dual rels
- Can engage in 2 yrs after termination
- Never see new client who therapist used to have sex wtih - Fact witness vs. Expert Witness
- Court ordered vs. approved expertise by the court
- Sanctioner
- People who have legitimate concern related to provision of psych svcs, e.g., court
- SI
- deal with "immediately"
- Fax
- Should code pt identity, even when to insurance company
- Obtain Consent before Breach of Confidentiality
- "Some of the time" -- refers to Tarasoff & abuse reporting w/o consent
- Quality Assessment
-
1. pt satisfaction
2. tx effectiveness
3. access to svcs - Baumrind
- Criticized Milgram's methods of research
- Milgram
- Wrong b/c deception w/resulting distress
- Subpoena
- Have to appear in person w/documents, but don't have to release documents unless ordered by judge
- Malpractice
- Dereliction of duty directly causing damage -- does not have to be "severe" or "extreme" damage; can be any harm
- HMO
- Fed Law: must provide -- 1. short-term outpt crisis intervention & 2. medical tx & referral for ETOH/drug addiction
- Referral fees
-
Should be based on svcs provided, not on referral itself.
Can accept legit consulting fees on case that you previously referred (e.g. testing). - Test Results
- Must provide in "simple & clear language."
- Raw Test Data
- May consist of raw & scaled scores, responses to stimuli, & behavioral observations during testing. Should not be given. Best to meet w/pt for results, in order to avoid misunderstanding. Should not be released to unqualified individual if it can be avoided.
- Utilization Review
- Cost containment technique. May result in denial of svcs.
- Terminating Therapy
-
Provide:
1. pretermination counseling
2. alternative svc providers as appropriate - Capitation
- Contract for svcs on a predetermined fee.
- Relationships w/former patients
-
Friendships should be avoided b/c:
1. unequal situation
2. would preclude pt's rtn to tx - Forensic Eval
- May not use data for any other purpose (e.g., book) w/o explicit waiver (even if data was presented in court).
- Exceptions/waiver to privilege
- May differ from state to state.
- Violence against Gays
- Acc. to Herek (1992) due to hetersexism.
- Ackerman
- Applied psychodynamic theory to families in 30s & 40s
- Whitaker
- Applied experiential/humanistic to families
- Kempler
- Applied Gestalt to family therapy
- Liberman
- Behavioral family therapy
- Richard Stuart
- Operant interpersonal therapy: combines operant conditioning w/social exchange theory marriage counseling.
- Bowen
- Family therapy, triangulation, differentiation (avoids triangulation), family emotional system, uses psychodynamic & systems theories
- Minuchin
-
Structural family therapy, disengagement, therapist "joins" the family, mark boundaries, manipulate mood, escalate stress, utilize symptoms. Minuchin is manip & unyielding.
1. Triangulation
2. Detouring
3. Stable Coalition - Ho
- Family therapy with ethnic minorities: use ecostructural model including extended family & church
- Caplan -- types of consultation
-
1. Consultee-centered case
2. Client-centered case
3. Program-centered administrative
4. Consultee-centered administrative.
Theme interference = transference. - Types of prevention
-
Primary - prevent from occurring
Secondary - early i.d. & intervention
Tertiary - prevent from becoming chronic or a relapse - Klein -- Object Relations
- Introjection - assimilation of parts of an object as part of oneself
- Cross Identity Model
-
Pre-Encounter
Encounter
Immersion-emersion
Internalization - Berry - Enculturation
-
Vertical - from parents
Horizontal - from peers
Oblique - from others & institutions - Kohut - Narcissism
- Results from mother's (self-object) lack of empathy to child
- Brief Psychodynamic Therapy
- Values positive transference -- negative is not approp. for brief therapy
- Fallon
- Inner/Outer externalizations
- Adler
-
People are motivated by need to belong.
Need may be interrupted by:
1. attn
2. power
3. revenge
4. inadequacy - Eysenck
- Therapy recovery is really just spontaneous recovery -- 50s
- Smith & Glass
- Tx better than 75% of pts w/no tx. Slight differences between theories, with beh more effective for some disorders.
- Instrumental vs. Expressive abuse in marriage
-
Instrumental - brutal, dangerous, little provocation.
Expressive - rel to emot process of couple, results from escalating conflict. - Brief Therapy
- Relieve pathological symptoms in brief period of time.
- Double-bind
- Used in cmmn family therapy- Jackson.
- Family Systems
-
Positive Feedback - produces change
Negative Feedback - maintains status quo
Feedback Loop - contains both neg & pos
Circular Questioning - used to show differences in perceptions - MOtivational Interviewing
- Designed to help pts build commitment & readiness to change.
- Gestalt therapy
-
Contact - here&now
Conscious awareness - focused attn
Experimentation - goal is to increase understanding
"Response-ability" - Helms - White Identity Model
-
1. Contact
2. Disintegration
3. Reintegration
4. Pseudo-independece
5. Immersion-emersion
6. Autonomy