PSYC-420: Exam 1 (Introduction, Theoretical Orientation and Practice, Codes of Ethics, Psychoanalytic, Adlerian/Individual, Existential, and Person-Centered)

Psychoanalytic Therapy

Focuses on behaviors buried in the subconscious, analyzes inner conflicts rooted in the past
-Assessment: Interested in client's early history, understand personality dynamics, and origin of emotional disorders

Adlerian/Individual Therapy

Focuses on unity of the person and understanding the individual's subjective experience
- To understand human behavior, it is essential to grasp the ideas of basic inferiority and compensation
-Assessment: Lifestyle questionnaires, life perceptions, familial origins, and relationships, projective techniques

Existential Therapy

Helps confront client with their awareness in creating conditions, recognize patterns of living, and accept responsibility in changing their future
- One of the aims of existential therapy is to help people face up to the difficulties of life with courage rather than avoiding life's struggles
-Assessment: Understand how client structures existence and grasps subjective world, opposed to formal diagnosis, diverse methods

Person-Centered Therapy

Centers on the client's goals and ways of solving problems, focuses on the constructive side of human nature
-Assessment: Opposed to traditional diagnosis and assessment, develop a nonjudgmental attitude and actively listen to patient and understand them through their subjective world

Gestalt Therapy

Looks at individuals and behavior in the context of their relationship in the present environment
-Assessment: Conduct a "functional diagnosis" of how individuals experience satisfaction of blocks/interruptions in the client's relationship with the environment

Behavior Therapy

Assumes people are shaped by learning and sociocultural conditioning
-Assessment: A comprehensive assessment of client's present functioning and past learning, objective appraisal of specific behaviors and stimuli, maintaining them, help create a framework or set goals for new learning and shaping schedule

Cognitive-Behavioral Therapy

Focuses on problems in perceptions of life situations and our thoughts
-Assessment: Identify client's patterns of faulty thinking, cognitive distortions, and negative beliefs

Rational Emotive Behavior Therapy

Emphasizes education, the therapist is the teacher and the client is the learner
-"Unlearn" erroneous thoughts

Reality Therapy

Emphasizes that relationship problems are in the present and must be solved in the present
-Assessment: Not a formal process of diagnosis or psychological testing, focus on present behavior and not the past, evaluate their patterns to see if life is moving in the direction they want

Feminist Therapy

Acknowledges the influence of power inequalities and gender-role expectations at an early stage for women and men
-Assessment: Criticizes current classification because it was developed by White male psychiatrists, demystification of therapy, assertion training

Solution-Focused Brief Therapy

A postmodern approach that is simple and brief. Problem-talk to solution-talk, little attention to pathology or diagnostic labels. Focus on the present and future, not the past. Help the client plan for solutions rather than focus on past "problems."
-Assessment: Doesn't focus on it

Narrative Therapy

A postmodern approach that centers on how problems are disrupting, dominating, or discouraging to a person. Clients are asked to support a new view of being competent enough to escape the dominance of a problem and consider what kind of future to expect from that competent person
-Assessment: Doesn't focus on it

Not-Knowing Position

See client as "expert"

Family Systems Therapy

Assumes that the individual can't be fully understood apart from their family system
-Assessment: Trace family history and origin, learn about family's interactions, therapist and client are both involved in the assessment

Assessment

The evaluation or estimation of the nature, quality, or ability of someone or something

Medical Diagnosis

Process of examining physical disorders or diseases, prescribe an appropriate treatment

Pathological Diagnosis

Identify an emotional or behavioral problem and making a statement about the current status of the client
-Find appropriate therapeutic techniques for a successful resolution

Differential Diagnosis

Distinguish one form of psychiatric disorder from another, determining which of two or more disorders with similar symptoms that the client is suffering from

Mental Status Examination

Structured interview about the client's psychological level of functioning

Active Listening

Empathic listening in which the listener echoes, restates, and clarifies. A feature of Rogers' person-centered therapy.

Empathetic Responding

Showing awareness of the emotions the client has experienced or is currently experiencing.

Therapeutic Alliance

A bond of trust and mutual understanding between a therapist and client who work together constructively to overcome the client's problem

Extra-therapeutic Factors

Qualities of the client or qualities of their environment that aid in recovery regardless of his or her participation in therapy

Treatment Plan

A proposed course of therapy, developed collaboratively by a therapist and client that addresses the client's most distressing mental health symptoms

Case Conceptualization

How a therapist understands what's happening with a specific client; can be hypotheses that shift or change over time.

Aspirational Ethics

A higher level of ethical practice that addresses doing what is in the best interests of clients.
-Beneficence and nonmaleficence
-Fidelity and responsibility
-Integrity
-Justice
-Respect for people's rights and dignity

Mandatory Ethics

The view of ethical practice that deals with the minimum level of professional practice.

Informed Consent

Rights of clients to be informed about their therapy to make autonomous decisions pertaining to it. An ethical principle that research participants be told enough to enable them to choose whether they wish to participate

Confidentiality

The act of holding information in confidence, not to be released to unauthorized individuals

Multiple Relationships

A therapist should not have another form (or more forms) of a relationship with the client.
Ex: A therapist whose client is also their friend or their romantic partner

Therapist Competence

The skills and training required to effectively and appropriately treat clients in a specific area of practice

Evidence Based Practice

Clinical decision making that integrates the best available research with clinical expertise and patient characteristics and preferences

Privileged Communication

Information held confidential within a protected relationship

Ethical Decision Making Model

Know that there may not be one "right answer" to a dilemma

Dodo Bird Effect

All established forms of psychotherapy are more or less equally effective.

Changes in Psychotherapy

Hypothesized factors that result in changes in psychotherapy.
-40% Extra-therapeutic factors
-30% Common factors
-15% Specific techniques
-15% Expectation or placebo

What Do Clients Want?

An active explanation (What I'm going through is understandable, I'm not alone), a hopeful story (Let's take steps together and perhaps turn what's chaotic into something that's more understandable or manageable), paths/goals that are acceptable, and to work with someone trustworthy (reliable, competent, empathetic)

QQ-45: The Outcome Questionnaire

Measures psychotherapy progress in clients
-Created by Michael Lambert and colleagues at BYU

Deterministic View

The idea that human behavior or actions are entirely controlled by outside forces.

Classic Psychoanalysis

The traditional (Freudian) approach to psychoanalysis based on a long-term exploration of past conflicts, many of which are unconscious, and an extensive process of working through early wounds.

Contemporary Relational Psychoanalytic Therapy

An intergration of the intrapsychic world of object relationships (early caregiver bonds) and the external world of interpersonal relationships
-Explores transference and countertransference
-Emphasizes the origins and the transformation of the self, differentiation between the self and others, integration of self and others, and influence of critical factors in early development and later development

Countertransference

Includes any of our projections that influence the way we perceive and react to a client
- necessary to be aware of our own conflicts/needs to be available for clients

Time-Limited Dynamic Psychotherapy (TLDP)

A specific, contemporary form of psychodynamic psychotherapy in which the therapist makes efforts to form a "corrective" relationship with the client that does not follow the same unconscious "script" as the client's previous problematic relationships
-Focus more on client's present life than their childhood memories
-Generally 10-25 sessions
-Goal is to foster changes in behavior, thinking, and feeling that will continue after the end of therapy

Clarification (Psychoanalytic)

(About 60% of comments), notice it, emphasize it, restate what the client said

Confrontation (Psychoanalytic)

(About 30% of comments) Bring greater thought or awareness of some observable behavior, "why is that?"

Interpretation (Psychoanalytic)

(About 10% of comments, "economical") Explain with an alternative hypothesis than what the client thinks

Working Through (Psychoanalytic)

Repeat clarification, confrontation, and interpretation over and over so the client understands (with therapist, friends at home, etc.)

Intersubjectivity (Psychoanaytic)

The mutual understanding that people share during communication

Conscious (Psychoanalytic)

What's on the surface, or within the client's awareness

Pre-conscious (Psychoanalytic)

May be brought to awareness with some of the therapist's input, unconscious is brought to conscious

Unconscious (Psychoanalytic)

Innate impulses that drive us internally
-Cannot be studied directly, but the workings of the unconscious may be inferred
-Ex: Dreams, slips of the tongue, posthypnotic suggestions, free associations, projective techniques (Rorshach tests), symbols in psychotic dreams

Free Association

Saying whatever comes to mind without self censorship
- known as the "fundamental rule"

Libido/Life Instincts (Psychoanalytic)

Sexual energy, goals oriented towards gaining pleasure for the purpose of human survival

Death Instincts (Psychoanalytic)

The unconscious drive toward decay, destruction, and aggression, self-destructive energy

Lifestyle Assessment

Explore family of origin, birth order, early memories, gender beliefs, achievement, significance, belonging, and identity

Family Constellation (Adlerian)

Roles individuals adopt within their family of origin, shaping their behaviors and beliefs

Early Recollections (Adlerian)

A projective technique, client recounts 6-12 early memories chosen by the person to reflect images of self, others, the world, and sometimes ethical convictions

Basic Mistakes (Adlerian)

Faulty, self-defeating perceptions, attitudes, and beliefs that may have been appropriate at one time but are no longer useful. These are myths that are influential in shaping personality.

Fictional Finalism (Adlerian)

Alder's theory that an individual is motivated more by his expectations of the future than by past experiences

Holism (Adlerian)

A person is not divided into parts but viewed as indivisible. Focus on yourself as a whole where the mind, body, and emotions work together all in the service of the individual's final fictional goal.

Life Tasks (Adlerian)

Tasks of friendship and social relations, work and occupation, love, intimacy, and sexuality.

Phenomenological Approach

The scientific study of subjective experiences
-Client's frame of reference
-Client's perception of their reality is most important

Private Logic (Adlerian)

Basic convictions and assumptions of the individual that underlie the lifestyle pattern and explain how behaviors fit together to provide consistency; the concepts about self, others, and life that constitute the philosophy on which an individual's lifestyle is based

Reorientation (Adlerian)

The phase of the counseling process in which clients are helped to discover a new and more functional perspective and are encouraged to take risks and make changes in their lives.
-Motivation Modification

Healthy Adaptation (Adlerian)

Being the best you can be, cooperating, contributing, belonging to a community

Poor Adjustment (Adlerian)

Striving to be better than someone else, feeling unworthy, avoiding life obligations, and not taking risks

Inferiority Complex (Adlerian)

Adler's conception of a basic feeling of inadequacy stemming from childhood experiences

Technical Eclecticism (Adlerian)

Strategies and techniques suited to the unique needs of patients

Superiority Complex (Adlerian)

Adler's conception that a person overcompensates for normal inferiority feelings by appearing confident in oneself

Social Interest (Adlerian)

Adler's criterion for mental health that provides further direction for therapeutic interventions and evaluation of the therapy process

Community Feeling (Adlerian)

Aka "Gemeinschaftsgefühl," a sense of belonging, of being part of the flow of humankind and connected with one's fellow humans

Existential Anxiety

An outcome of being confronted with the four givens of existence: death, freedom, existential isolation, and meaninglessness.

Existentialism

We are responsible for the choices through which we give meaning to the circumstances in which we find ourselves.

Congruence (Person-Centered)

The necessary quality of a counselor being in touch with reality and other's perception of oneself.
-The therapist is genuine with themselves and with the client

Unconditional Positive Regard (Person-Centered)

A caring, accepting, nonjudgmental attitude. The therapist accepts the client fully no matter their behavior, feelings, or condition.
-Helps with client's unconditional self-worth

Accurate Empathic Understanding

Therapist experiences a continuing desire to seek to understand a client's experience
- conveys a true sense of acceptance
- freedom to explore all of one's experiences
- "to see his private world through his eyes"

Actualizing Tendency (Person-Centered)

The innate drive to maintain and enhance the human organism

Presence (Person-Centered)

Being completely attentive to and immersed in the client as well as in the client's expressed concerns

Immediacy (Person-Centered)

The ability of the therapist to use the immediate situation to invite the client to look at what's going on in their relationship

Humanistic Psychology

An approach to understanding human nature that emphasizes the positive potential of human beings

Therapeutic Core Conditions of the Therapeutic Relationship

Congruence, Unconditional Positive Regard, accurate empathic understanding

Foundational Skills of Practice

Active listening, emphatic responding, asking open-ended questions, therapeutic alliance

Id

Roughly all the untamed drives or impulses that might be likened to the biological component;
- ruled by the pleasure principle

Ego

Attempts to organize and medicate between the id and the reality of dangers posed by the id's impulses (may or may not be conscious)
- ruled by the reality principle

Superego

The internalized social component, largely rooted in what the person imagines to be the expectations of parental figures
- one way to protect ourselves from the dangers of our own drives

Projection

Attributing to others one's own unacceptable desires and impulses
- lustful, aggressive, or other impulses are seen as being possed by "those people out there, but not me"

Repression

Threatening or painful thoughts and feeligns are excluded from awareness
- i.e. threatening or painful thoughts and feeligns are excluded from awareness

Regression

Going back to an earlier phase of development when there were fewer demands
I.e. cope to anxiety by clinging onto inappropriate behaviors (children with anxiety sucking on thumb, excessive dependence, hiding)

Intellecutalization

Reasoning is used to block confrontation with an unconscious conflict and its associated emotional stress
- I.e. emotinally removing one's self from a stressful event

Sublimation

Diverting sexual or aggressive energy into other channels
- I.e. aggressive impulses channeled into athletic activities

Existentialist Therapist

"Fellow traveler"
- the therapist becomes less problem-solver and more present

Freedom (Existential)

Implies that we are responsible for our lives, actions, and failures to take action

How did Rogers conceptualize the change process?

Rogers divided the self into two categories; ideal and real self.
The ideal self is the person you would like to be, and the real self is what you really are.

In the real world, a person's ideal self is not consistent with what happens in life with a person.

Six Basic Techniques of Psychoanalytic Therapy

1. maintaining analytic framework
2. free association
3. interpretation
4. dream analysis
5. analysis of resistance
6. analysis of transference

Maintaining the analytic framework (basic techniques of Psychoanalytic therapy)

Refers to a whole range of procedural and stylistic factors
- boundaries, neutrality, consistency, ending and starting sessions on time

Free Association (basic techniques of Psychoanalytic therapy)

Clients are encouraged to say whatever comes to mind, regardless of how painful, silly, illogical

Interpretation (basic techniques of Psychoanalytic therapy)

Consists of the analyst pointing out, explaining, or even teaching the client the meanings of behavior that is manifested in dreams, free association, resistance, etc.

Dream Analysis (basic techniques of Psychoanalytic therapy)

Important procedure for uncovering unconscious material and giving the client insight into some areas of unresolved problems

Analysis of resistance (basic techniques of Psychoanalytic therapy)

anything that works again the progress of therapy and prevents from producing previously unconscious material

Analysis of transference

Allows clients to achieve here and now insights into the influence of past on their present functioning