Psychotherapy Exam 2

Humanistic approach to psychopathology

Deemphasis on Symptoms

Dysfunctions related to freedom, experiential reflection, responsibility

Goal of Humanistic Therapy

increase personal freedom and sense of autonmony

Gestalt

In humanistic psychology — person as a whole through their lived experiences

Humanistic therapy seeks to promote:

agency - taking ownership of one’s life

freedom - choosing how to experience the world

responsibility - taking ownership over one’s choices

change - creating new meaning about the self and the world

Therapeutic techniques in humanistic psychology

presence - increasing in the moment awareness through:

• listening - intentionally using silence

• guiding - steering the conversation towards a topic

• instructing - leading an exercise on noting bodily sensation

• requiring - pushing client to confront an area of resistance

• mirroring work

Humanistic psychology treatment mechanisms

Cultivating presence:

• exploring what gives life meaning

• connecting to avoided areas of pain

• growth despite past pain

• increasing attention, choice, and freedom

Cultivating responsibility

• developing inner vision

  • experiencing past, present, and future issues and willingness to respond to them

Behavioral psychology is based in

learning theory

What 3 people contributed to behavior psychology and how

Ivan Pavlov and JB Watson

• Classical conditioning

BF Skinner

• operant conditioning

Albert Bandura

• modeling

  • learning behavior from observing others

Classical conditioning

Uncontrolled stimulus from neutral stimulus

produces uncontrolled response

becomes conditioned stimulus

produces conditioned response

Generalization

spreading of a learned assosciation to a new stimulus or situation

Operant conditioning

Reinforcement or punishment to increase or decrease a target behavior

Reinforcement

increases a behavior

Punishment

decreases a behavior

Positive

adding a stimulus

negative

removing a stimulus

Behavioral psychology sources of psychopathology

• Aligned with DSM diagnoses

  • applied to most types of psychopathology

• Adaptive vs. unadaptive behaviors

  • context dependent

  • developed from learning history through conditioning or modeling

  • inappropriate stimulus generalization

• Factors that predispose, trigger, strengthen, or maintain a problematic behavior

Focus of therapy in behavioral psychology

• Assessing and understanding target behaviors

• Changing and learning around target behaviors

• Approach

  • directive

  • goal-focused

  • skill-based

  • evidence-based practice

  • Therapeutic relationship de-emphasized

• Manualized treatment options

  • standardized approach

  • session by session guides

• Brief, usually less than 20 sessions

Therapy techniques in behavioral therapy

psychoeducation on target behaviors and therapy

• Exposure

  • developing new learning to replace feared associations

• Functional analysis

  • understanding the target behaviors and factors controlling it

• Behavioral action

  • Increasing positive reinforcement through rewarding activities

Exposure therapy techniques in behavioral therapy

Exposure to anxiety provoking situations

Graduated

• Anxiety hierarchy

Types

• imaginal - imagining and reliving feared events in a safe supportive environment

• in-vivo - gradual exposure to real life situations in a safe and controlled environment

• interoceptive - exposing to own bodily sensations such as heart palptations, dizziness, and shortness of breath

Subjective units of distress

ranges from 0 to 100 

0 - no distress, totally relaxed

100 - highest anxiety/distress that you have ever felt

Repeated exposure leads to

inhibitory learning - supresses or inhibits prevously conditioned response

Functional analysis in behavioral therapy

SORC model

Stimulus - antecedent

Organism - variables unique to individual

Response - behavior of interest

Consequence - punishment or reinforcement

Behavioral activation

addresses depressive disorders through improving mood and anhedonia (inability to feel joy or pleasure)

Focused on postitive reinforcement

increasing reward and pleasure

Primary components:

• activity monitoring and scheduling

• increasing mastert and pleasure experiences

• decreasing avoidance behaviors

• goal setting

• role playing / social skills training

Behavioral therapy treatment mechanisms

• change in reinforcement contingencies

  • reinforcement of more adaptive, varied alternative behaviors

  • increased behavioral repertoire for increase of flexibility in how people respond to situations

• Inhibitory learning

  • cognitive changes

    • new beleifs that feared situations are not dangerous

• Increased tolerance of negative emotions

Cognitive-behavioral theory

thoughts produce emotional and behavioral responses

The interpretation of an event leads to the emotional response and subsequent behaviors — not the event itself

Schemas

A definition from cognitive behavioral thereapy — deeper beleifs that provide a framework for how a person understands and organizes the world

Schemas can lead to the development of

Biases, as new information is framed to fit old schemas

Sources of psychopathology in cognitive behavioral therapy

maladaptive beleifs developed earlier in life that have been ingrained over time and lead to difficulties with emotions, well-being, and functioning

assumptions that maladaptive beleifs are true

overly general, extreme, or rigid beliefs

Focus of cognitive behavioral therapy

bringing awareness to the thoughts on emotions and behaviors

modifying maladaptive thinking

Therapeutic techniques in cognitive behavioral therapy

functional analysis

thought monitoring

downward arrow

labelling cognitive dysfunctions

cognitive restructuring

thought records

Functional analysis

involves identifying the relationship between a person’s thoughts, feelings, and behaviors — specifically what triggers a behavior and what maintains it (the antecedents and consequences).

ABC Model - activating events, beliefs, consequences

Thought monitoring

This is the process of observing and recording one’s automatic thoughts as they occur, especially during emotional distress or triggering events.

Downward arror technique

A method used to uncover core beliefs or deeply held assumptions underlying automatic thoughts.

In therapy:

The therapist repeatedly asks questions like, “If that were true, what would it mean about you?” or “What’s so bad about that?”

Each answer reveals a deeper layer of belief.

Labeling cognitive dysfunctions (Cognitive distortions)

Cognitive distortions are biased or irrational thinking patterns that distort reality and contribute to negative emotions.
Clients learn to identify and label these distortions to help separate facts from interpretations

Cognitive restructuring

The process of challenging and modifying irrational or unhelpful thoughts to develop more balanced, realistic ones.

Thought records

A structured worksheet used to practice thought monitoring and cognitive restructuring

All or nothing thinking

cognitive dysfunction that sees things in either “black or white”
If I don’t get an A in the course, I might as well get an F"

Overgeneralization

Seeing a single negative event as a never ending pattern

“No one ever wants to be with me”

Mental filter

exclusively focusing on a negative aspect of a situation

“I ruined the whole presentation because I couldn’t answer one audience member’s question”

Discounting the positive

Rejecting positive experiences by insisting that they do not count for one reason or another

“only 25 people liked my social media post, so it must not have been witty enough”

Jumping to conclusions

making negative interpretations withough adequate evidence

“my doctor wants me to have another test, so there must be something seriously wrong with me”

Mind reading

Assuming you know what others are thinking without adequate evidence

“she didn’t text me back immediately, so she must be upset with me”

Catastrophizing

Attributing or anticipating extremely awful consequences to events

“If I get anxious and stumble over my

words, my boss will think I’m not fit to

work here and fire me; then I’ll be

unemployed for the rest of my life.”

Emotional Reasoning

Assuming that negative emotions necessarily reflect the situational reality

“I’m feeling depressed; therefore, I must be seriously flawed”

Should and must statements

endrosing rigid yet arbitrary rules

“I must receive praise when I make an effort”

Labeling and mislabeling

Taking one behavior or characteristic of oneself (or others) and applying it ot the whole person

“He won’t go on roller coasters, so he’s a just a big wuss”

Personalizing

entirely blaming oneself for a situation that involved many factors or ws out of your control

“If I had been on time, she wouldn’t have had to run down the stairs, so it’s completely my fault that she fell and broke her leg”

Acceptance-based therapy is based in

functional contextualism

Psychological flexibility

being able to adapt and cope even during suffering

Centered response style

being present and anchored

engaged response style

do what matters, take purposeful action

open response style

be open, be willing and accepting

Acceptance

Making room for unpleasant thoughts and

feelings; allowing them to come and go

without struggling with them or giving them

too much attention/power

Defusion

Learning to perceive thoughts and feelings

as bits of language, words, and pictures,

rather than taking them as facts

Contact with the present moment

Bringing full awareness to the here and

now; focusing on, and engaging fully in,

whatever one is doing

Self-as-context

Understanding that thoughts and feelings

are not the essence of who we are; they are

just aspects of us that change constantly

Values

Clarifying what is most important,

significant, and meaningful in our lives

committed action

setting goals, guided by values, and taking action to acheive them

Dialectical behavior therapy was developed to treat…

chronic suicidality and borderline personality disorder — a pervasive pattern of instability…beginning early adulthood… as indicated by:

Dialectice

integrating and resolving opposing ideas

acceptance vs. change

validation vs. confrontation

emotion mind vs. resonable mind

walking the middle path

radical acceptance

fully acknowledging and embracing what comes up “all the way”

accepting reality without really trying to change or control it

How long is dialectical therapy

6 months minimum

What are the 4 stages of dialectical therapy

1. build a life worth living

2. Decrease misery and increase emotional experiences (both good and bad)

3. Attain ordinary happiness

4. Increase joy

Core mindfulness

teaches present-focused, nonjudgemental awareness to help individuals observe, describe, and participate their experiences

Distress tolerance

provides crisis survival strategies and acceptance skills to manage intense emotions without making things worse

Emotional regulation

Focuses on understanding and adjusting emotions through identifying feelings and reducing intense emotional reactions

interpersonal effectiveness

build skills for assertiveness, maintaining relationships and self-respect