KEY TERMS: Assessment/Intervention
Terms
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- Counterconditioning vs. Extinction
- COUNTERCONDITIONING: reciprocal inhibition--2 incompatible responses can't be experienced at same time (stronger response will inhibit the weaker)-Aversive Conditioning (negative response paired with bad bx, Systematic Desensitization (relaxation paired with fear), Sensate Focus (pleasure vs anxiety), Assertiveness Training; EXTINCTION: presenting CS w/o the US over several trials-Flooding, Implosive Therapy (imagination only, psychosexual themes)
- Aversive Conditioning vs. Systematic Desensitization
- AVERSIVE CONDITIONING: pair bad behavior with stronger, negative response (imagination=covert sensitization), best for "deviant" behaviors (substance abuse, fetishes); SYSTEMATIC DESENSITIZATION: pair situation with relaxation response instead of anxiety (best for phobias)
- Flooding vs. Implosive Therapy
- FLOODING: presenting CS w/o US (prolonged exposure w/response prevention, best for OCD, specific phobias, agoraphobia); IMPLOSIVE THERAPY: imagination only, interpreting psychosexual themes
- Primary, Secondary, and Generalized Reinforcers
- PRIMARY: reinforce everyone at all ages in all cultures (e.g., food); SECONDARY: acquire reinforcing value through training or experience (e.g., praise); GENERALIZED: not inherently reinforcing but give access to other reinforcers (e.g., money, tokens)
- Self-Control Procedures: Self-Monitoring vs. Stimulus Control
- Person administers reinforcement to him/herself; SELF MONITORING: keep dtailed record of what one's done; STIMULUS CONTRO: narrowing range of stimuli that elicit particular bx (e.g., eating only at specific times in specific place and dvplg incompatible responses, e.g., take a walk when hungry)
- Optimizing Effects of Punishment
- Punishment should be delivered at maximum intensity right from the start, the punishment should be certain, and there should be little delay between undesirable bx occurrence and punishment; in sequence of undesirable bx, punishment should be delivered early rather than late in response sequence; one should make alternative routes to reinforcement clear
- Escape vs. Avoidance Learning
- ESCAPE: aversive stimulus cannot be avoided but can be stopped by emitting desired bx; AVOIDANCE: one can entirely avoid aversive stimulus by emitting desired bx in time
- Symbolic vs. Live vs. Participant Modeling
- SYMBOLIC MODELING: aka Filmed Modeling, observing film of model enjoying progressively more intimate interaction w/feared object; LIVE MODELING: aka In Vivo, person observes live model engage in graduated interactions w/feared object; PARTICIPANT MODELING: live modeling plus contact w/model who guides person in approaching feared stimulus
- Kohler vs. Tolman
- KOHLER: one of the earliest critics of pure behavioral models of learning (insight studies w/chimps; learning); TOLMAN: behaviorally-oriented
- Beck vs. Ellis
- BECK: Cognitive Therapy-emphasizes empirical hypothesis testing as means of changing existing beliefs, collaborative, Socratic questioning, maladaptive cognitive triad; ELLIS: Rational-Emotive Therapy-emotional disturbances thought to result from irrational beliefs, direct instuction, persuasion, logical disputation, active, confrontative
- Cognitive Triad of Depression
- Negative view of self, world, future
- Self-Instructional Training vs. Stress Inoculation
- SELF-INSTRUCTIONAL TX: combines modeling and graduated practice w/elements for RET, good for ADHD; therapist modeling->therapist verbalization->patient verbalization->pt silently talks through task->ind task perf; STRESS INOCULATION TRAINING: good for anxiety, stress, anger, med problems, Education & cognitive prep->coping skills acquisition->app of skills in imagination and in vivo
- Protocol Analysis
- Procedure used when person is learning taks and asked to describe aloud the steps being taken to solve the task (way to gain access to people's problem solving strategies)
- Rehm's Self-Control Theory of Depression
- Attempts to integrate cognitive and behavioral models of dpression->believes reinforcement can be self-generated rather than from external sources; believes depression and low bx rate as result of negative self-evaluations, lack of self-reinforcement, and high rates of self-punishment
- Pleasure vs. Reality Principle
- PLEASURE PRINCIPLE: Id (seeks immediate gratification); REALITY PRINCIPLE: Ego (alert to real world and consequences of bx) *Superego=embodies the ideal, standard of perfection
- Primary vs. Secondary Process
- PRIMARY PROCESS: dreams, hallucinations, an urgent attempt at tension reduction; SECONDARY PROCESS: thinking ,speaking, focus on meeting demands of reality and ability to delay gratification
- Repression and Other Defense Mechanisms
- REPRESSION: most basic and commonly used, forcing disturbing impulses out of CS, underlies all other defenses; REGRESSION (Borderline): retreat to bx of earlier, less demanding stage of dvpt; PROJECTION (Paranoid): seeing one's UC urges in another's bx; DISPLACEMENT: transference of emotions from orig obj to substitute (phobia); REACTION FORMATION: engaging in opp actions from id's urges; INTELLECTUALIZATION (Schizoid): RATIONALIZATION (Narcissistic): SUBLIMATION: finding socially acceptable ways of discharging energy from UC imp
- Transference and Countertransference
- TRANSFERENCE: pt-> therapist; COUNTERTRANSFERENCE: therapist->pt (can be positive or negative)
- Ego Psychology vs. Object Relations vs. Neo-Freudian vs. Self Psychology
- EGO PSYCH: focus on ego's capacity for integration and adaptation (Hartmann, A. Freud, Erikson, Kris, Rappaport); OBJ REL: capacity to have mutually satisfying rltnshps--focus on childhood relations (Klein, Winnicott, Mahler, Fairbairn, Guntrip); NEO-FREUDIAN: impact of socio-cultural factors in determining personality (Sullvian, Horney, Fromm); SELF PSYCH: dvpt of self basd on infant interactions w/caregivers, empathic attunement, primary narcissism (Kohut)
- Defensive vs. Adaptive Functions of the Ego
- Classical psychoanalysis: Ego is helpless rider of the id horse TO Ego psychology: Ego guides a person's capacity to master life
- Object Permanence vs. Object Constancy
- MAHLER: Object constancy=ability to maintain image of mother when she is not present and to unify good and bad into whole representation; PIAGET: Object permanence=ability to recognize object still exists when not visible
- Neo-Freudians
- Focus on social and cultural factors
- Teleological vs. Deterministic
- TELEOLOGICAL: behavior is determined by the future; DETERMINISTIC: behavior is determined by the past
- Adler
- Social interest, struggle for superiority & mastery, motivated by social (aggressive) rather than sexual urges, looks for mistaken goals and faulty assumptions, STEP (parenting training w/logical and natural bx consequences)
- Jung
- Archetypes, personal and collective unconscious, transference, adult focus
- Jung vs. Freud
- JUNG: more focused on adult dvpt, neurosis=striving for psychological maturity (individuation), teleological, direct focusin in sessions, real relationship level; FREUD: more focused on infantile dvpt, deterministic, free association, utilizes transference
- Phenomenological Perspective
- Therapist must enter patient's subjective world
- Maslow's Hierarchy of Needs
- Hierarchy of basic needs twds ultimate health and a fully spontaneous expression of the self=self-actualization
- Empathy, Unconditional Positive Regard, Congruence
- ROGERS: Client/Person-Centered Therapy=Empathy, Warmth (uncond positive regard), Genuineness (congruence of therapist)
- Introjection, Projection, Retroflection, Deflection, and Confluence
- PERLS: Gestalt Therapy=INTROJECTION (take info in whole, compliant & gullible), PROJECTION (project feelings onto others), RETROFLECTION (turn back on self what one wants to do to others), DEFLECTION (distance self from feelings), CONFLUENCE (lack of awareness of differentiation btwn self and others, in attempt to avoid conflict)
- Reality Therapy
- Focus on Responsibility; key element is Control theory (we create inner "need-satisfying" world that satisfies our needs, not necessarily reflective or real world)
- Hypnosis
- Subjective experiential change, anesthesia, pain control
- Biofeedback Techinques
- EMG (Electromyography): measures surface muscle tension-tension, joint pain, neuromuscular rehab, EEG (Electroencephalography): measures brain waves-hyperactivity & seizures, GSR (Galvanic Skin Response), measures skin conductivity or sweat-Gen Anx, hypertension, THERMAL BIOFEEDBACK: (temperature) measures peripheral skin temperature-migraines and Reynaud's disease
- Biofeedback Definition
- Focus on decreased arousal of the Sympathetic nervous system; commonly used in conjunction w/relaxation training
- Feminist Therapy
- Focus on socio-political climate, egalitarian relationship; sexism viewed as underlying cause of problems; reframe symtpoms as response to envmt
- Negative vs. Positive Feedback Loop
- NEGATIVE FEEDBACK LOOP: decreases deviation in system, w/result of maintaining status quo (e.g., return to previous dynamics after bad event); POSITIVE FEEDBACK LOOP: increases deviaton or change (e.g., lasting change due to therapy)
- Object Relational Family Therapy
- Framo; focuses on transferences and projections between couples or family members (people project unwanted elements of themselves onto others)
- Boundaries and Hierarchy
- STRUCTURAL FAMILY THERAPY: BOUNDARIES=healthy: clear and firm w/flexibility; unhealthy=too rigid/disengaged or too diffuse/enmeshed; HIERACHY=healthy: strong parental coalition; unhealthy=triangulation, detouring (identified pt), stable coaltion
- Coalition vs. Triangulation vs. Joining
- (STRUCTURAL FT) COALITON: (stable type), one parent unites w/child against other parent; TRIANGULATION: child caught in middle of parents' conflict w/each parent demanding that s/he side with them; JOINING: what therapist does at onset of therapy, attempts to understand family dynamics by adopting their interactional style
- Disengaged vs. Enmeshed
- Structural FT BOUNDARIES: Disengaged (rigid) and Enmeshed (diffuse)
- Double Bind vs. Paradox
- COMMUNICATIONS FT (MRI GROUP): DOUBLE BIND: damned if you, damned if you don't, and no escape or ability to point out the inconsistency; PARADOXICAL INTERVENTION: prescribing the symptom
- Multigenerational Transmission Process and Undifferentiated Ego Mass
- BOWEN FAMILY SYSTEMS THERAPY: MULTIGENERATIONAL TRANSMISSION PROCESS: pathology in family repeated throughout generations; UNDIFFERENTIATED EGO MASS: emotional oneness in famihat exists and shifts in definited pattern
- Social Learning Family Therapy
- PATHOLOGY: maladaptive bx rewarded and reinforced, deficient rewards, and communication deficits
- Most effective components of groups
- Cohesiveness (rapport), catharsis, and self-understanding
- Crisis intervention vs. Brief therapy
- CRISIS INTERVENTION: focus on crisis itself and restoring pt to previous level of fx (before crisis); BRIEF THERAPY: focus on helping pt attain level of improved fx (based on pathology)
- Client centered case consultation, consultee centered case consultation, program centered administrative consultation, consultee centered administrative consultation
- CT CENT CASE CONSULT: helps consultee w/individual case (e.g., dvpt tx plan for child w/GAD); CONSULTEE CENT CASE CONSULT: helps consultee w/difficulties working with multiple pts (e.g., therapist w/countertransf to borderlines); CONSULTEE CENT ADMIN CONSULT: helps consultee w/own difficulties which limit effectiveness in insituting program change; PROGRAM CENT ADMIN CONSULT: focus on developing, expanding, or modifying a program
- Primary vs. Secondary vs. Tertiary prevention
- PRIMARY PREVENTION: prevent onset or occurrence of disease; SECONDARY PREVENTION: focus on early identification and prompt tx of existing illness/disorder; TERTIARY PREVENTION: focuses on reducing residual effects of chronic disability
- Summative vs. Formative Evaluation
- FORMATIVE EVALUATION: evaluating program on an ongoing basis as it is being implemented; SUMMATIVE EVALUATION: program evaluation that only occurs at the end of the program
- Effects of Divorce
- Age impacts rx (3-6 yo: feel responsible, 7-12 decrease school performance, adolescents, feel they could have prevented it, feel hurt and critical), recovery takes 3-5 yrs for children; up to 1/3 experience lasting trauma; better outcome w/divorce than living w/conflict; girls initially appear to adjust beter but more vulnerable in adolescen or if mother remarries; younger children adapt better than older; adult children slightly more depressed, more marital problems, poorer health, lower SES
- Meta-Analysis: Effect Size (Smith and Glass)
- Average Effect size of 0.85 in comparing treated and untreated invidividuals
- Minorities in Treatment: dropouts
- African Americans tend to terminate earlier than Caucasians (findings inconclusive and may be SES related)
- Best Option for Violent Husband
- Arrest of the husband