4thexam

What is the primary goal of exposure therapy?

To help people confront their fears and break the pattern of avoidance and fear in a safe environment.

In exposure therapy, what is 'in vivo exposure'?

Directly facing a feared object, situation, or activity in real life.

What type of exposure therapy involves vividly imagining the feared object, situation, or activity?

Imaginal exposure.

Interoceptive exposure involves deliberately bringing on physical sensations that are harmless, yet ____.

feared

What is 'graded exposure' in the context of psychotherapy?

An approach where the client and therapist construct a fear hierarchy and begin with mildly difficult exposures, progressing to harder ones.

What is the core concept behind Eye Movement Desensitization and Reprocessing (EMDR) therapy?

The idea that PTSD symptoms result from incompletely processed traumatic experiences, which EMDR helps to resolve.

According to Deb Dana's explanation of Polyvagal Theory, what is 'neuroception'?

The nervous system's way of taking in information and responding to cues of safety and danger below the level of conscious awareness.

In Polyvagal Theory, the _____ state is at the top of the autonomic ladder and is associated with safety and social engagement.

ventral

In Polyvagal Theory, the _____ state is in the middle of the autonomic ladder and is associated with a neuroception of danger, mobilizing a fight-or-flight response.

sympathetic

In Polyvagal Theory, the _____ state is at the bottom of the autonomic ladder and is associated with a neuroception of life threat, leading to shutdown or collapse.

dorsal

What is a 'neuroceptive mismatch'?

A situation where the nervous system's response (e.g., activating defense systems) does not match the actual level of safety or risk in the environment.

What are the three main components of Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) for children?

Laying the groundwork (psychoeducation), teaching coping skills, and processing the trauma through a trauma narrative.

What is the purpose of creating a 'trauma narrative' in TF-CBT?

To have the child retell the story of the trauma repeatedly until they can do so without getting highly upset, thus processing the associated emotions.

Why is play therapy considered an effective modality for children?

Because play is a child's natural way to work through stuck emotions and process experiences in a safe, indirect manner.

According to Erik Erikson's stages of psychosocial development, what is the primary conflict faced by older adults?

Integrity vs. Despair.

What term did Joan Erikson add to her husband's developmental stages to emphasize ongoing growth in later years?

Gero-transcendence.

What is the most extensively studied psychotherapy modality for older adults, particularly for depression and anxiety?

Cognitive-Behavioral Therapy (CBT).

Which psychotherapy for older adults focuses on grief, loss, and role transitions to improve social functioning and prevent depression relapse?

Interpersonal Psychotherapy (IPT).

What is the key difference between Reminiscence Therapy and Life Review Therapy (LRT) for older adults?

Life Review Therapy involves an evaluative or analytical component covering the entire life span, while Reminiscence focuses on pleasurable memories without evaluation.

How might a therapist adapt CBT for an older adult who has difficulty increasing pleasant events due to physical limitations?

Adapt the Pleasant Events list to realistic and nonphysical activities, and ask the patient to identify a smaller number of events.

What is a major reason for the predicted increase in mental illness among the aging baby boomer generation compared to previous cohorts?

Baby boomers have higher historical levels of illicit drug use and prescription drug misuse.

In older adults with schizophrenia, _____ symptoms typically become less prominent with age, while _____ symptoms persist.

positive; negative

Anxiety in older adults is often associated with specific worries about what three things?

Death, health, and becoming dependent.

What is a primary assumption of all family therapy approaches?

An individual's symptoms are viewed as an expression of dysfunction within the family system.

Who is the primary pioneer of Systemic Family Therapy?

Murray Bowen.

What is the most important goal of Systemic Family Therapy?

To help family members, especially the adult couple, increase their level of self-differentiation.

Key Concept: Differentiation of Self (Systemic Family Therapy)

The ability to separate one's intellectual and emotional functioning, resulting in a firm sense of self that is less susceptible to family influence.

In Systemic Family Therapy, a three-person system that is used to manage tension and anxiety between two people is called a _____.

triangle

What is a 'genogram' as used in Systemic Family Therapy?

A three-generational graphic diagram of family processes used during assessment to identify patterns and generate hypotheses.

Key Concept: Nuclear Family Emotional System (Systemic Family Therapy)

Ineffective patterns used in fused families to cope with problems and stress, often manifesting as marital conflict, dysfunction in one spouse, or impairment in a child.

What is the 'multigenerational transmission process' in Bowen's theory?

The process by which dysfunctional family patterns and levels of differentiation are passed down from one generation to the next.

Who developed Structural Family Therapy?

Salvadore Minuchin.

What is the primary goal of Structural Family Therapy?

To restructure the family by creating a more effective hierarchical structure, establishing clear boundaries, and resolving dysfunctional coalitions.

Key Concept: Family Structure (Structural Family Therapy)

An invisible set of functional, recurrent patterns that organize how family members relate, including roles, rules, hierarchy, and power.

In Structural Family Therapy, what term describes a family organization with diffuse and permeable boundaries, leading to over-dependence and loss of autonomy?

Enmeshed family.

In Structural Family Therapy, what term describes a family organization with rigid and impermeable boundaries, leading to disconnection and interpersonal isolation?

Disengaged family.

A dysfunctional alliance between a parent and child against the other parent is known as a _____ coalition.

cross-generational

What is the 'joining' technique in Structural Family Therapy?

The process where the therapist unites empathically with the family, temporarily becoming part of the system to build a therapeutic alliance.

What is the primary focus of Strategic Family Therapy?

To identify and change the problem-maintaining sequences of behavior and misguided attempts to solve problems within the family.

Who were the founders of Strategic Family Therapy?

Jay Haley and Milton Erikson.

What is the primary goal of Strategic Family Therapy?

To alter problematic patterns of behavior by using strategic directives or behavioral tasks to disrupt dysfunctional sequences.

Key Concept: Circular Causality (Strategic Family Therapy)

The view that causality is nonlinear, occurring within a relationship context through a network of interacting feedback loops, where any cause is also an effect of a prior cause.

Differentiate between first-order and second-order changes in Strategic Family Therapy.

First-order changes are superficial behavioral changes that do not alter the system's structure, while second-order changes require a fundamental revision of the system's rules and function.

What is a 'paradoxical technique' in Strategic Family Therapy?

A seemingly illogical intervention that runs counter to common sense, such as prescribing the symptom, designed to bring about positive change.

The 'invariant prescription' technique in strategic therapy is used to break up unhealthy coalitions by having the parents form a _____.

secret alliance

What is the primary focus of Emotionally Focused Therapy (EFT)?

To address attachment injuries and help partners express their primary emotions and attachment needs to create a more secure bond.

In EFT, what is meant by 'softening'?

A process where dominant or pursuing partners own and express their primary vulnerability, such as the fear of being unlovable.

In family therapy, what is an 'identified patient'?

The family member whose symptoms or behaviors are initially presented as the problem, though the focus of therapy is on the entire family system.

What is the general duration for a course of family therapy?

It is typically brief, often lasting between 8 to 20 sessions.

What does the full scope of practice for an Advanced Practice Psychiatric Nurse (APPN) ideally integrate?

A comprehensive psychotherapeutic approach that integrates both psychotherapy and pharmacotherapy.

What are the four main practice models an APPN might use?

1. Psychotherapy and pharmacotherapy for all patients; 2. Both, but not with the same patient; 3. Psychotherapy only; 4. Pharmacotherapy only.

In states that do not grant full practice authority, an APPN must have a written _____ with a physician.

Collaborative Practice Agreement (CPA)

What is the role of the APPN therapist regarding licensure and certification?

APPNs must hold an RN license and be certified by a national accrediting body, such as the American Nurses Credentialing Center (ANCC).

True or False: A Collaborative Practice Agreement (CPA) shifts legal responsibility for prescribing from the APPN to the supervising physician.

False. The CPA does not shift responsibility or liability for prescribing to the physician.

What term refers to the process of discontinuing medications when they are no longer beneficial or may be causing harm?

Deprescribing.

Research shows that the best treatment outcomes occur when pharmacotherapy, if indicated, is combined with _____.

psychotherapy

What is a significant barrier to APPNs practicing to their full scope?

A power shift in interprofessional relationships, requiring renegotiation of role boundaries with physicians and pharmacists.

What is the first step in the EMDR process after a client comes in for therapy?

The client is asked to identify the most disturbing part of the trauma memory, often a single image.

Which therapy for PTSD conditionally recommended for use in adults?

EMDR.

In addition to a narrative, what is the core intervention in Prolonged Exposure (PE) therapy?

In-vivo and imaginal exposure to trauma-related cues.

What is the purpose of setting limits in a playroom during child therapy?

To establish safety and teach children that while feelings are acceptable, certain behaviors (like hitting the therapist) are not, and to provide alternatives.

Which population has the highest rate of completed suicides?

Older adults, especially older white males.

What does 'gero-transcendence' emphasize?

Ongoing growth over decrements in later life.

How can an APRN therapist accommodate an older adult patient with cognitive impairment in a therapy session?

By using shorter sessions, memory aids, summarizing previous sessions, and allowing the patient to take notes.

What are 'cohort effects' in the context of working with older adults?

The impact of having been socialized with certain beliefs, attitudes, and abilities that are specific to a generation.

What is the Geriatric Depression Scale (GDS)?

A self-report screening tool commonly used to assess depression in older adults.

What is the Mini-Mental State Examination (MMSE)?

A screening tool used to measure cognitive impairment and screen for dementia.

What is the Abnormal Involuntary Movement Scale (AIMS)?

A rating scale used to measure involuntary movements, particularly tardive dyskinesia, as a side effect of antipsychotic medications.

According to the provided sources, family therapy is a more complex intervention reserved for the _____, while supportive and psychoeducational approaches are taught at the undergraduate level.

Advanced Practice Psychiatric Nurse (APPN)

What are the four contemporary family therapy approaches reviewed in the lectures that use a family systems perspective?

Systemic, Structural, Strategic, and Emotionally Focused.

What is 'fusion' in systemic family therapy?

A blurring between self and other that occurs when two undifferentiated people form a dysfunctional interaction pattern and function as a single emotional system.

In structural family therapy, what is the core intervention that involves challenging and changing the family's structure?

Restructuring.

What is the focus of strategic family therapy, as opposed to insight-based therapies?

Its focus is on behavioral change rather than insight.

What is the national certifying exam available for family therapists?

The Association of Marital and Family Therapy Regulatory Board (AMFTRB) examination.

What is 'emotional cutoff' in systemic family therapy?

Reducing or completely cutting off emotional contact with family members as a way to manage unresolved anxiety and conflict.