Clinical & Counseling Psych Final Exam

Who is the founder of psychodynamic psychotherapy?

Sigmund Freud

What is the original name of of psychodynamic psychotherapy?

Just known as psychotherapy

What are two other original names for psychodynamic psychotherapy?

• neo freudian

• psychoanalytic

Free Association

Therapist asks client to say whatever comes to mind uncensored & what is said is all unconscious desired/thoughts.

Freudian Slip

There are no random mistakes/slips of the tongue. They are all purposeful unconscious wishes.

Ex: Saying a different woman’s name at the altar

Latent vs. Manifest Dreams

Latent: raw unconscious meaning of the dream/ the hidden or symbolic meaning of a dream.

Manifest: the actual dream

What did dreams used to be thought of as?

The “royal road” to the unconscious.

Dreamworks

Uses symbols to express wishes, which can result in unconscious wishes appearing distorted or disguised.

Resistance

When a client feels exposed by a topic the therapist mentions they will create distractions or obstacles that impede exploration.

Psychodynamic therapists believe that if a client is aware of their defense mechanisms, it will…

Improve quality of life.

Word Association

Therapist provides word/stimulus for client to talk uncensored about. (Jungian)

Transference

Patient transfers feelings, expectations, and assumptions from early/other relationships onto the therapist.

What is required for a client or therapist to experience transference?

Therapist/client must be a “blank slate” / patients knows very little about therapist

Countertransference

Therapist transfers feelings, expectations, and assumptions from early/other relationships onto the client.

List the sexual stage in order:

Oral, Anal, Phallic

Oral Stage (definition, age, and primary issue)

• Gratification from oral fixation like thumb sucking

• First year of life

• Primary Issue if fixated: dependency (to trusting/not, or could become addicted to substances)

Anal Stage (definition, age, and primary issue)

• Learning to control bowel movements

• 1 ½ - 3 years old

• Primary Issue: if fixated on control, parents to strict or lenient could lead to children becoming a slob or neat freak)

Phallic Stage (definition, age, and primary issue)

• When you become fixated and sexually aware of the M & F parts

  • Oedipus & Electra complexes

• 3- 6 years old

• Primary issue: Tied to self-worth

What are the 3 goals of Psychodynamic Psychotherapy?

1. To make the unconscious become conscious.

2. Gain Insight

3. Instead of being controlled by our unconscious, we purposefully become aware so we can control our unconscious thoughts.

What is Insight?

Looking inside oneself & noticing something previously unseen.

True OR False: For psychotherapy, the unconscious is underlying in all mental illness.

True

Id

Impulsive, animalistic, devil on the shoulder. (It)

Superego

Tells us what we “should” do. (everyone else)

Ego

Made up of id & superego, it’s a compromise between the two. (me)

Repression

Ego forgets conscious awareness (forgets the id)

Projection

Ego projecting Id impulse on other people.

Example: a person who is secretly attracted to someone else but, instead of acknowledging their own feelings, they accuse the other person of being attracted to them.

Reaction Formation

Ego forms reaction against Id impulse by doing exact opposite.

Example: I want to smack my brother, but instead I hug him.

Displacement

Ego displaces Id impulse toward safer target rather than desired target.

Example: I can’t beat up my boss because I will get fired, so instead I beat up my wife.

Sublimation

Ego redirects impulse in a way that actually benefits someone else.

Example: Drug addict become a counselor.

What does contemporary psychodynamic psychotherapy deemphasize?

Biological & Sexual elements of psychotherapy

Brief Psychodynamic Psychotherapy

• Successful when problems are mild & narrowly defined

• Therapist is active

• Focus on the present

• Fewer than 24 sessions (6 months)

Interpersonal Therapy

• Created to treat depression but is now used for other disorders

• Usually 14-20 sessions

• Focused and limited goals

• Leader among other therapies empirically

What is the core value of interpersonal therapy?

Improving relationships, improves depressive symptoms.

Interpersonal and Social Rhythm Therapy (IPRST)

• Designed to treat bipolar disorder.

• Changed interpersonal therapy to stabilize daily rhythm.

• 12-20 sessions

Time-Limited Dynamic Psychotherapy

Modern application of corrective emotional experience

Cyclical Maladaptive Pattern

Uses primary diagram to categorize primary issues.

Who created Ego Psychology?

Erik Erikson

What is Ego Psychology?

A variation of psychodynamic psychotherapy emphasizing the adaptive tendencies of the ego over the pleasure-based drive of the id. (eight-stage theory of development)

What is Object Relations Psychology?

A variation of psychodynamic psychotherapy deemphasizing internal conflict (id vs. superego), and instead emphasizing relationships between internalized “objects” (essentially, important people from the client’s life)

Who created Self-Psychology?

Hans Kohut

What is Self-Psychology?

Emphasizes parental roles in the child’s development of self, with special attention paid to the meaning of narcissism at various points, including in therapy

What are the three stages of Interpersonal Therapy?

1. Categorizing the client’s problems into one of the four categories listed above (role transitions, role disputes, interpersonal deficits, or grief) (2 sessions)

2. Intermediate sessions (10 to 12 sessions) emphasize improving the client’s problems as identified in the first stage. AND emphasis on current emotions AND the therapist teaches the client about depression and its symptoms.

3. Final stage (two to four sessions) involves a review of the client’s accomplishments, recognition of the client’s capacity to succeed over depression without the therapist’s continued help, and efforts to prevent relapse

Who created Humanistic Psychotherapy?

Carl Rogers w/ Abraham Maslow

Self Actualization

• Humans have inborn tendency to fulfill ones potential

True OR False: Self-Actualization will proceed without interference if the person’s environment fosters it.

True

Positive Regard

Warmth, Love, and Acceptance of those around us

Prizing

When we receive positive regard from others.

What two concepts are needed for self actualization?

Positive Regard AND Prizing

Real Self (Self-Image)

Who you currently are (What you do).

Ideal Self

The person you would like to be.

Goal of Humanistic Psychotherapy?

To foster self-actualization.

What causes psychological problems in humanism?

Psychological problems are byproducts of stifled growth process (conditions of worth from parents/others).

Incongruence

• The discrepancy between the real and ideal self

• Very little overlap between the two

• Self-actualization will be difficult

Congruence

• Match between real and ideal self

• More overlap between real and ideal self

• The person CAN self actualize

What are the three elements of Humanistic Psychotherapy?

1. Empathy

2. Unconditional Positive Regard

3. Genuinness

What is empathy?

Deep, nonjudgemental understanding of clients experiences

• Emphasized in client centered therapy

• Empathy= Positive impact on client

What is Unconditional Positive Regard?

Full acceptance of a person no matter what

• Humanistic therapists have UPR

• UPR facilitates higher levels of congruence + self actualization

What is Genuinness?

The therapist TRULY is empathetic + non-judgmental. (not acting or pretending to be)

• AKA therapist congruence

• Helps therapists establish relationships that feel real

• High levels of transparency from a therapist

True OR False: Recent research suggests Roger’s core elements are Necessary and Sufficient.

False: Recent research suggests Roger’s core elements are Necessary BUT NOT Sufficient.

True OR False: In humanism the three elements are a therapists attitude, NOT behaviors.

True: Elements emphasize how therapists SHOULD BE with clients rather than what the do with clients.

Reflection

When a therapist responds to clients by restating or rephrasing client statements in a way that emphasizes feelings or emotions.

True OR False: Reflection is an attitude and technical skill.

False: Reflection is an attitude NOT a technical skill.

Why was Existential Psychotherapy created?

Each person is alone and realization of this can overwhelm us with anxiety.

Who is the main founder of Existential Psychotherapy?

Irv Yalom

What are the main goals of Existential Psychotherapy?

• Therapists emphasize clients abilities to overcome meaninglessness by creating own meaning through their decisions.

• Encourage client to make choices that are true to themselves in the present and future.

True OR False: Existential Psychotherapy is not well empirically supported but has been proven to work well for some clients who are physically ill or concerned with meaning of life.

True

What is Gestalt therapy?

• Emphasizes both mental and physical perceptions.

• Deemphasizes past experiences and focuses exclusively on the present moment.

What is Motivational Interviewing?

MI is when a therapist doesn’t pressure the client to change, but instead helps them see the discrepancies between their behaviors and their values.

• Rogers would say clients are experiencing incongruence.

What was motivational interviewing originally used to treat?

Addictive behavior (substance abuse)

What are the 6 central principles of motivational interviewing?

• Expressing Empathy

• Developing the discrepancy

• Avoid Argumentation

• Roll with resistance

• Identify “sustain talk” and “change talk”

• Supporting self-efficacy

List the stages of change:

1. Pre-contemplation

2. Contemplation

3. Preparation

4. Action

5. Maintenance

What is Positive Psychology and Strength Based Counseling?

Emphasizes human strengths rather that pathology, and cultivation of happiness in addition to reduction of symptoms in psychotherapy.

In positive psychology what are the 4 areas of each clients life?

1. Weaknesses & Undermining characteristics within a person

2. Strengths and Assets within a person

3. Destructive factors & Resources lacking in environment

4. Resources and opportunities in environment

7 Basic Categories of Positive Psych Techniques:

1. Savoring

2. Gratitude

3. Kindness

4. Empathy

5. Optimism

6. Strength Based Activities

7. Meaning

Emotion Focused Therapy

• Emotionally focused

• Short-Term Humanistic Therapy

• Significant Empirical Evidence & Popularity

• Frequently Practiced With Couples

What is Behavioral Therapy?

• Client behaviors are the problem.

• Does not endorse the medical model of psychopathology

• Behaviorists do not believe there is an underlying medical/biological basis for “symptoms” of mental illness

What is the goal of Behavioral Therapy?

The goal is to aid clients in changing their behavior.

True OR False: Behavioral therapists don’t place an emphasis on empiricism

False: Behavioral therapists believe:

• Theories should be stated as testable hypotheses

• Like scientists, behavioral therapists collect empirical data

• They collect data, and the beginning, middle, and end, to measure change.

Why do behavioral therapists reject introspection?

•Insight and understanding are not enough to lead to change in our lives

•It is overt behavior, rather than covert mental processes, that demonstrate change.

What did Ivan Pavlov discover?

Classical Conditioning

What is Classical Conditioning?

A learning process where a neutral stimulus, through repeated pairings with an unconditioned stimulus, eventually elicits a conditioned response.

What did John Watson believe?

That classical conditioning could be applied to humans.

Thorndike’s Law of Effect

• Actions that are followed by pleasurable consequences are more likely to recur

• Actions that are followed by unpleasant consequences are less likely to recur.

Who developed Operant Conditioning?

B.F. Skinner

Operant Conditioning

• Shaping through reinforcement and successive approximation

• Occurs when the organism “Operates” on the environment

  • Notices the consequences of the behavior

  • Incorporates those consequences into decisions regarding future behavior

Unconditioned Stimulus

Something that naturally makes you react without you needing to learn it.

Ex: Food

Unconditioned Response

The natural reaction you have when something happens, without being taught.

Ex: Drooling

Conditioned Stimulus

Something you learn to react to (the bell)

Conditioned Response

Something you learn to react to because it gets paired with something else

Ex: A bell rings every time food comes (the bell)

What is Generalization in Classical Conditioning?

When the conditioned response is evoked by stimuli that are similar to, but not an exact match for, the conditioned stimulus.

Ex: You learned to be scared of a white rabbit. But, now you also get scared of white dogs and white cats — even though they aren’t rabbits.

What is Discrimination in Classical Conditioning?

Occurs when such a stimulus does not evoke the conditioned response

Ex: A dog learns that only a bell with a high-pitched sound means food is coming; if a low-pitched bell rings, the dog does not drool.

True OR False: Behavior is a function of its consequences (contingencies)

True: Based on reward/reinforcement and punishment

Exposure Therapy

• Clinical psychologist’s version of “facing your fears”

• Phobia, a particular stimulus becomes paired with an aversive outcome

• The goal of exposure therapy is to break  the conditioned stimulus and response

Imaginal Exposure

Can be asked to imagine anxiety-provoking objects, without ever being exposed to the real thing.

In vivo exposure

Exposed to real-life items or situations that cause fear.

Systematic exposure

Client and therapist create an anxiety hierarchy together

Flooding/Implosion

Exposing the client to the most feared stimulus immediately, without any gradual buildup.

Exposure and response prevention

Involves graded exposure to obsessive thoughts.

What disorder is Exposure and Response Prevention most often used for?

OCD

What’s an anxiety Hierarchy?

A list that the therapist and client create together in which anxiety-producing experiences are listed in ranked order from least to most anxiety-provoking.