Counseling Psych Final

What is Cognitive Behavioral Therapy (CBT)?

a type of psychotherapy that helps individuals identify and change negative thought patterns and behaviors.

What is Psychodynamic Therapy?

a therapeutic approach that explores unconscious processes as they are manifested in a person's present behavior.

What is Humanistic/Existential Therapy?

emphasizes individual potential and stresses the importance of growth and self-actualization.

What is Constructivist Theory?

individuals construct knowledge and meaning through experiences and interactions.

What is Family/Couple/Group Therapy?

involves treating issues within the dynamics of family systems, romantic partners, or groups, focusing on relationships and communication.

What are Constructivist Approaches in therapy?

reject other therapeutic methods, emphasizing clients' strengths, hopes, and dreams while allowing them to reconstruct their own realities through methods like…

Narrative Therapy, Solution-Focused Brief Therapy, Relational-Cultural Therapy, and Emotion-Focused Therapy.

What is Person Centered Therapy?

An approach developed by Carl Rogers that rejects psychoanalysis and behaviorism, emphasizing a collaborative journey between client and counselor, where the therapist is not seen as the expert and focuses on the quality of the therapeutic relationship.

What are the Three Facilitative Conditions in Person Centered Therapy?

Congruence (genuineness), Unconditional Positive Regard, and Empathy

What behaviors do therapists NOT engage in during Person Centered Therapy?

Therapists do not evaluate, interpret, question in a probing manner, diagnose, reassure, criticize, judge, praise, or describe clients' experiences.

What is Gestalt Therapy?

developed by Fritz Perls and Laura Perls, rejects psychoanalysis and emphasizes the 'here and now' experience, focusing on how current experiences affect individuals.

What are the Mechanisms of Change in Gestalt Therapy?

include experiential techniques that enhance awareness, active engagement between therapist and client, self-knowledge, acceptance, and growth through immersion in current existence.

What are the key concepts in Gestalt Therapy?

Contact, Conscious Awareness, and Experimentation, which are vital to the therapeutic process.

What practices are commonly used in Gestalt Therapy?

Confrontation (naming discrepancies and incongruence), Direct Guidance (exercises and experiments), Self-Involving Disclosures (here and now statements), and the Empty Chair technique (expressing emotions towards an empty chair as if a person is present).

What are Common CBT Techniques?

operant conditioning

positive reinforcement

Socratic questioning (asking probing questions about irrational thoughts)

self-monitoring (recording thoughts, emotions, and behaviors)

systematic desensitization (exposure therapy for phobias)

behavioral experiments (testing beliefs)

cognitive rehearsal (imagining situations and rehearsing positive thoughts)

assertiveness and social skills training (practice and modeling)

activity scheduling/behavioral activation (engaging in pleasant activities)

homework (structured therapeutic activities).

What is Group Therapy?

an effective form of mental health treatment that is cost-effective and equally effective as individual therapy. It includes many different types such as support groups, psychoeducation groups, skills groups, and interpersonal groups.

What are some benefits of Group Therapy according to Yalom?

instillation of hope

universality (realizing one is not alone)

imparting information

altruism (doing something kind)

corrective recapitulation of the primary family group

development of socializing techniques

imitative behavior

interpersonal learning

group cohesiveness

catharsis (being vulnerable)

existential factors (finding meaning and purpose).

What are some reasons for Family Therapy?

conflict (particularly intergenerational)

issues with a child (school problems, substance abuse, eating disorders, behavioral problems)

changes or trauma affecting the whole family, tragic loss of a family member

adding a new family member

a child in foster care

divorce

violence (which is often remedial or already happening).

What is the Family Systems Approach?

supports the idea that family relationships are crucial for the emotional health of each family member. It helps members cope collaboratively with distress, misunderstandings, and pain affecting their relationships.

How does the Family Systems Approach view psychological conditions?

Conditions such as depression, anxiety, and conduct disorder are often viewed as effects of the relationships within the family. These therapists first look for problematic relationship issues when addressing psychological distress.

What are some aspects of Psychoeducation in Family Therapy?

teaches parents how to communicate better, parenting skills, and provides immediate feedback on behaviors they may be exhibiting that are unhelpful.

Why do couples seek therapy according to Snyder/Gottman?

when they are at a breaking point. They aim to establish a collaborative alliance, contain disabling crises, strengthen their relationship, promote relevant skills, challenge cognitive distress components, and examine developmental sources of distress.

What is the focus of treatment in Cyclical Maladaptive Patterns (CMP)?

The focus of treatment is to help the client understand how they relate to others, often addressing inflexible, self-perpetuating, self-defeating expectations, and negative self-evaluations.

What are the 4 components of the Cyclical Maladaptive Pattern (CMP)?

Acts of Self: "I make friends with people going through a tough time because they might need my help".

Expectations of Others' Reactions: "If I can fix her problems, she will value me".

Acts of Others Toward the Self: "She is only talking to me because she needs something".

Acts of Self Toward the Self: "I put a lot of energy into trying to fix people's problems because that is the only time I feel worthy".

What is Object Relations Theory in Psychodynamic therapy?

suggests that 'objects' refer to people and that individuals have internalized relationships with others. This theory was developed by John Bowlby and Mary Ainsworth, attachment theory.

What is Time-Limited Dynamic Psychotherapy (TLDP)?

focuses on a central dysfunctional relationship pattern that the client experiences. The relationship with the therapist is significant as it facilitates change. It usually involves short-term therapy, around 20 sessions, and operates under 'Two-Person psychology', where therapists react to clients and help them identify and shift maladaptive patterns.

What are defense mechanisms in psychology?

psychological strategies that individuals use to cope with reality and maintain their self-image. Common examples include denial, repression, projection, displacement, rationalization, sublimation, regression, intellectualization, and identification.

What is the difference between Psychoanalysis and Psychodynamic therapy?

a specific treatment involving characteristics like lying on the couch, long-term therapy (often open-ended), and intensive frequency (3 times a week). Psychodynamic therapy, however, is a broader range of approaches based on psychoanalytic theory but is typically short-term and utilizes various interventions without some defining characteristics of traditional psychoanalysis.

What are the psychosexual stages of development according to Sigmund Freud?

1. Oral (birth-1 year) - Focus on oral stimulation; infants derive pleasure from oral activities.
2. Anal (1-3 years) - Focus on bowel and bladder control; learning to control urges.
3. Phallic (3-6 years) - Focus on the genital area; includes the Oedipus complex.
4. Latency (6-puberty) - Sexual feelings are dormant; focus on social interactions.
5. Genital (puberty-adult) - Mature sexual interests develop; relationships with others become important.

What are the levels of consciousness proposed by Sigmund Freud?

1. Unconscious - Contains inaccessible thoughts and memories.
2. Pre-conscious - Contains thoughts that can be accessed with effort.
3. Conscious - Contains thoughts currently in awareness.

What are the structures of the mind according to Sigmund Freud?

1. ID - Instinctual drives seeking immediate gratification (e.g., hunger).
2. Ego - Develops during early childhood; mediates between id and reality.
3. Superego - Moral conscience internalized from parents, represents societal standards.

What are the three takeaways from Dr. Westefeld

Asking “the question”, hotline is 988, getting someone into treatment and not giving up

What makes therapy more impactful

Clients motivation to change, therapy method, client taking prescribed medication

What does not make therapy more impactful

Degree level, age, gender

5 aspects of medical model in psychotherapy

• Illness or disease

• Biological explanation

• Mechanism of change

• Therapeutic of Change

• Specificity

Three parts of Evidence Based Practice in Psychology (EBPP)

Evidence, clients values/preferences, clinical judgement

What most contributes to client getting better

outside factors getting better

3 parts of the contextual modal for the best therapeutic relationship

Real relationship, Expectations created through explanation, Health promoting actions (ingredients)

What is Real Relationship in contextual model

Genuineness, realistic perceptions of the other. It is unique because its confidential.

What are expectations

Therapy can provide some kind of explanation for what the client is going through, and client believes tasks and goals will help

What are health promoting actions/specific ingredients

Movement towards goals that help the client enact health-promoting actions

What is the most studied component of the therapeutic relationship

Working Alliance - Agreement on goals and task and emotional bond

Nonverbal Relationship Builders

• Eye Contact  

• Body Language

• Vocal Quality

• Silence

• Empathy

Verbal Relationship Builders

• Open-Ended Questions 

• Minimal Encouragers  

• Paraphrasing  

• Summarizing  

• Probing

What is Intake

Happens before the first session. Includes screening, diagnostic assessment, consultation, emergencies, assignment to group therapy

What does a good clinical interviewer do

• Obtain large amount of relevant information

• Work within time constraints

• Establish good rapport (trustworthy)

• Use microskills

Closed vs open ended questions

• Closed

  • Yes or no, directive

• Open

  • “Could you say more about your upbringing”, nondirective

What happens in the interview

• Review informed consent and confidentiality

• Presenting concern

• History of concern

• Psychosocial factors

• Symptoms

• Risk Assessment

• Mental Status Exam

• Diagnosis and treatment plan

Three stages of microskills counseling

Exploration, Insight, Action

Exploration Stage

The first stage of counseling where the counselor helps the client explore thoughts, feelings, and behaviors in depth to understand their issues more clearly. Based on person-centered theory/

Insight Stage

The second stage in counseling where the counselor assists the client in gaining insights into their thoughts and behaviors, fostering self-awareness and understanding of underlying issues. Based on psychoanalytic/psychodynamic theories.

Action Stage

The third stage of counseling where the counselor supports the client in developing actionable strategies and plans to implement changes in their life, fostering personal growth and empowerment. Based on behavioral and cognitive theories.

Each therapy session, and therapy in general, is like a…

bowl

Microskills Hierarchy

Attending, listening/observing, minimal encouragers, paraphrasing/reflecting content, clarifying questions, reflecting feelings, summarizing

Attending (Non-Verbal Communication)

Counselors orienting themselves physically toward clients, including:

• Eye-contact
• Verbal tracking (nodding)
• Posture
• Vocal quality

Listening and Observing

Active Listening: Attempting to understand the client's verbal messages (e.g., head nodding, gestures).

Observing: Paying attention to the client's nonverbal behavior (e.g., smile, expressions, tone of voice, posture).

Minimal Encouragers

Little things that show you are listening without much context. Provides reassurance, encouragement, and reinforcement. Examples: Mmhmm, sure, yeah, okay, fr.

Paraphrasing/Reflecting Content

When a therapist takes important details from what a client told them and reflects that information back to the client. (Not just repeating)

Clarifying Questions

A tool that invites someone to elaborate. Have to be careful because sometimes the question can be loaded, so make it brief. Types include open-ended and closed-ended.

Reflecting Feelings

Identifying and naming emotions. Conveys understanding, validates, and gains insight. Affect = emotions: What was her affect? How was she affecting your emotions?

Summarizing

Reflecting back to the client the different points and themes that have come up during the session.