Counselling Psychology Final

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In clinical work, what does the Gestalt principle of "figure-ground" suggest?

Unresolved background conflicts make it difficult for clients to focus on the present moment (figure).

What is Gestalt Psychology

The whole is greater than the sum of its parts. A system of thought, derived from experiments that created experiments to study perception and attention. 
Essence or shape of an entity's complete form, a “unified whole” 

What is the primary Goal of Gestalt

Gain awareness of what clients are experiencing and doing now. Direct genuine experiencing.

Where does gestalt see our power

In the present “Now”, the past is gone and future hasnt arrived.
Our power is in the present

What does it mean to be fragmented

Ruminating on past or worrying about future you cant access resources in the here and now.

What does the term intergration mean in reference to Gestalt

bringing issues to present/experience issues now to complete unfinished business

What are some Gestalt therapy techniques

• Internal dialogue exercise - Top dog and underdog converstionconversation

• Empty chair technique - The client switches between chairs as personalities of top dog or under dogunderdog. Using 2 chairs for dialogue

• Exaggeration exercise - Intensify a physical movement to tighten awareness of emotional significance

What does Gestalt say about authenticity

We are like onions we have many layers and we need to peel away the layers to reveal that.

What are the 5 layers of Gestalt

• Phony layer - Living authentically conforming to social norms

• Phobic layers - Avoiding pain, fears and emotions prevent anxiety

• Impasse layer - stuck and powerless

• Implosive layer - Aware of suppressed emotions and fears

• Explosive layer - Releasing pent-up energy/emotions can lead to authentic self growth and expression.
  

What are the 5 main principles of Gestalt

1. Closure - Without this we cannot be present

2. Unfinished business/figure ground - Feelings about past stop us from growing

3. Awareness/present-ness - Being present

4. Contact - Interact in real/authentic way

5. Authenticity - Removing layers

What are boundary disturbances

They are things that get in the way of authentic contact such as
- Projection
- Confluence (Lack of awareness)
- Deflection (Distancing from feelings)

What leads to change in Gestalt clients

• Active experiencing

• Increased contact

• Rely on self not environment

• Experiments like the Empty chair.

What is the therapists Goal in therapy

Create experiments to assist self-awareness of what they are doing and how they are doing it. Through methods like

• Try on new behaviour

• Focus on non verbals

• Experiments that bring struggles to life and invite clients in present to interact.

What is the Top Dog/underdog technique

Its where the client faces their top dog which is the critical, Demanding, controlling part
and
Underdog which is whipped, pushed around and weak. The helpless part of them

Its key to know both parts as we are responsible for them.

What was the key idea about time orientation in Gestalt theory?

● Most of our worries are about the past and future.

● Focusing on the present and bringing past/future anxieties into the now benefits mental health.

● Simply talking about the past and future isn't as helpful as making these issues present-centered.

● All of the above

All of the above

What culturally relevant controversy exists in existential therapy?

● Anxiety is openly discussed only in Western cultures.

● Not everyone realistically has freedom or choice.

● Meaning-making is primarily emphasized in industrialized cultures.

● All of the above

Anxiety is openly discussed only in Western cultures.

During COVID, what existential themes became especially relevant according to the lecture?

● Death from COVID highlighted assumptions of cognitive therapy.

● The shift to Zoom caused many mental health issues.

● Fake news and political controversies made people question life’s purpose.

● People faced isolation, uncertainty about health, and an increased awareness of mortalit

●People faced isolation, uncertainty about health, and an increased awareness of mortality.

Name a famous Existential philosopher mentioned in class

• Jean paul sartre

• Fredrick nietzsche

• Soren Kierkergarrd 

• Martin heidegger

Who was Viktor Frankl

Writer of a mans search for meaning he survived the concentration camps. He wrote on how spiritual freedom and interdependence of mind can be hard but meaning is found in the search for purpose and meaning.

Who was Rollo may

American psychiatrist; many books on existential therapy, intergrated psychoanalysis and existential therapy

Who was Irvin Yalom

Therapy through meaning therapeutic love themes of existential work.

What are existential assumptions

• Anxiety stems from a key paradox - Life will end in death yet death brings meaning to our existence 

• When we acknowledege things that makes us anxious instead of avoiding it makes us live more authentically. Don be consumed by anxiety but instead confront it.

Explain covid-19 link to existentialism

Existentialism is an area of philosophy and psychology linked to human experience. Covid was an existential time as it made many aware of death.

What are the 4 realities that anxiety can emerge from

• Acknowledgement of death

• Freedom

• Our ultimate aloneness

• Meaninglessness

How does wizard of oz link with Existentialism

The album dark side of the moon links with the movie. The lyrics confront the themes of existentialism like death, time and finding purpose.

Explain existentialists view on meaning

Life doesnt inherently have meaning its our job to find meaning and create it. Meaning is our primary drive we must create and discover it.

What is non deterministic?

• Oversimplification to view people as

  controlled by fixed physical laws

• Focus on active, positive aspects of human

  growth and achievement

• Focus on self-responsibility, choice, decision

  making – anxiety often at root

In REBT, at what point in the ABC model does disputing occur?

● At the Activating Event.

● At the Belief about the event.

● At the Emotional and Behavioral Consequence.

● At the Feeling response.

At the Belief about the event

What is the academic term for learning gender behaviors, attitudes, and expectations?

● Sex & Gender Role Typing.

● Gender Role Construction & Analysis.

● Cultural & Gender Role Analysis.

● Gender Role Socialization.

Gender Role Socialization

What does "homeostasis" refer to in family systems theory?

● A family's ability to adjust after life changes.

● The family’s tendency to resist change and maintain stability.

● Personal growth among family members.

● Therapy improves communication between parents and children

The family’s tendency to resist change and maintain stability.

9. What was the main takeaway from Dr. Rochlen’s multicultural case example (African-American gay

client with disability)?

● You must always address the intersections of client identities.

● A client may or may not see their identities as central to their presenting concerns.

● You must be an expert on all identities before working with diverse clients.

● Always refer clients to therapists who share their racial/ethnic identity.

A client may or may not see their identities as central to their presenting concerns.

How was the difference between race and ethnicity defined?

● Race is about physical features, ethnicity is labeled by others.

● Ethnicity is personal cultural identity; race is often assigned by others.

● Race is based on place of origin, ethnicity on cultural expression.

● Ethnicity is based on physical features; race is about cultural background.

Ethnicity is personal cultural identity; race is often assigned by others

Which is NOT a core assumption of the Hill model of dream interpretation?

● Dreams can have multiple meanings.

● Universal meanings of dream images apply to everyone.

● Dreams reflect waking life struggles.

● Dream meanings are highly personal.

Universal meanings of dream images apply to everyone.

In the Action Stage of the Hill model, what is emphasized?

● Discussing client actions the day after the dream.

● Helping the client modify the dream’s events and relate changes to waking life goals.

● Focusing on action-oriented parts of the dream for insight.

● None of the above

Helping the client modify the dream’s events and relate changes to waking life goals.

How does college link to existentialism

College is a space where children get first experience of being ultimately in charge of their own life, here you can chose to be who you want. Additionally at age people likely experience the first significant experince with loss

What is the tragic triad

Pain, Death and Guilt - We can't avoid suffering but we can turn this into triumph and achievement.

What are the 2 forms of anxiety

Normal anxiety - Proportionate to cause, doesn’t need repression.

Neurotic anxiety - When we evade normal anxiety we get this and it is an inibility to take responsibility for life

Explain therapy in a existential session

Goal is to reduce neurotic anxiety and increase authenticity.

Therapist and client strive towards and honest, open and egalitarian relationship. Client develops authentic relationships

Explain the importance of death to Existentialists

Awareness of death is important, as it's a human condition that gives significance to living. We must think about death if we are to have a meaningful life.

What is REBT

Rational emotive behavioral therapy created by Albert Ellis is a philosophy based approach that we contribute to our own psychological problems.philosophy-based

We make problems when we mistake preferences for needs. We keep ourselves disturbed due to internal thoughts

Explain the reciprocal relationship

Everything influences everything

Thoughts- What we think affects how we feel and act

Behaviours - What we do affects how we feel and think.

Emotions - What we feel affects how we think and act

What is the relationship between thoughts and depression

Based on our internal belief we can cause it. Like in example below

Failed test -> Internal belief: I'm worthless and stupid -> Depression

Failed test -> Internal belief: I'm smart, but I didn't study for this test I can do better -> No depression

Explain a therapy based REBT Session

Therapy is an educational and experiental process where the therapist is the teacher and gives validation/empathy. The client learns to Identify and dispute unhelpful beliefs.

How do schemas play a role

We have schemas for things we experience in life whether good or bad. You remember information that links to a schema you have, we forget things that don’t fit our schema.

They are difficult to change and therapy is where we can start to shake these up.

How does Covid or 9/11 link to schemas?

changed the Schema of things and shook us all not something we ever thought could happen.

What are the 3 cs of cognitive therapy

Catch thoughts
Check out accuracy
Change them

What is the ABC Theory and when would a therapist get involved.

A letter-based theory that speaks on changing behaviour. Therapists get involved at belief by using disruptive intervention leading to new effective philosophy.

A -> Activating event

B → Belief

C -> Consequence - Emotional and behavioural

D -> Disputing intervention

E -> Effect - an effective philosophy is developed

F -> New feeling

What are the 3 D’s

• Detect - Shoulds and musts

• Debate - learn to logically question

• Discriminate - Irrational self-defeating beliefs

What are the similarities and differences between REBT AND CBT

Similarities

• Both cognitive approaches

• Our thoughts influence emotions and behaviour

Differences

• CBT a softer model

• REBT Uses term irrational cognitive doesnt use that word

• Cognitive focuses more on relationship

• Cognitive is more exploratory of background

• REBT Ellis persuades clients that beliefs are irrational. CBT Beck says views are distorted due to cognitive error not irrational beliefs.

What is schema shifting

1. Schema exist for a reason

2. To Reshape organically, something significant has to happen

3. Schemas can be shifted through therapeutic intervention

4. Memory, emotions and attitudes consistent with new schemas

What is the Cognitive model

Created by aaron beck it emphasizes changing negative thoughts and maladaptive beliefs.

Critical assumption - The meaning behind unhelpful thoughts and beliefs can be discovered by the client rather than needing to be taught or interpreted by the therapist.

What is the cognitive triad

Relates to the self, the world, and the future

Negative views about the world <-> Negative view about oneself
<-> Negative views about the future

What is the cognitive triad 2

Negative view of the past <-> negative view of the future <-> negative view of the present

What would a CBT therapy session look like

1. Build a strong therepeutic alliance

2. Identify symptoms and goals

3. Identify symptoms and goals. Identify unhelpful and automatic thoughts

4. Develop problem-solving skills

5. Focus on generalizing skills and relapse prevention

6. We use a downward spiral to challenge people's negative beliefs

What are the pros of CBT/REBT

• Most researched strongest evidence based research.

• Easiest to do with clear manuals and instruction

• Shorter than other therapies and helps empower client over time

• Effective for depression, anxiety, panic,ptsd, substance use disorders, Chronic illness/pain, insomnia, and OCD.

What are the Cons of CBT/REBT

• Clients need to be very involved in the process

• Clients have to accept therapist as teacher

• Some challenging techniques

• Cleints have to face own thoughts, feelings emotions and fears which can increase anxiety.

What are the Pros of Existential

• Something for all counselors

• Provides perspective for understanding and value of anxiety/guilt.

• Creative aspects of being alone/choosing for oneself

What are the Cons of Existential

• Lacks systematic statement of principles and practices

• Very little research with limited application for lower functioning clients or nonverbal

• Writers use vague and global terms with abstract concepts

What are the Pros of Gestalt

• Active process that gets deeper level sooner

• Great for creative clients looking for interactive therapy

What are the Cons of Gestalt

• Confrontational where rapport can be tricky, if expectations arent set clearly beforehand difficult.

• Cross cultural limitations

What is family therapy

• Focus on the system as opposed to just the individual. System includes friends, schools, places of worship etc

• Difficulties not with individuals but with the system

What is marriage / family therapy

• See individuals, couples, families or groups

• Emphasis on interactions - Regardless of clients

• Builds on client strengths rather than assumed pathology

What is different between family therapy and individual therapy

Individuals ask why , linear cause and effect, individualistic

Family therapy ask why, reciprocal casualty, collective/rational

What are some assumptions of family therapy

• Families operate on predictable interaction patterns

• Patterns of behaviour are passed from generation to generation

• Family members are always affected by another

  A change in one part of a family structure impacts another

What is homeostasis in family therapy

• When disruption occurs, family members functional try to regain a stable environment using strategies that decrease stress and restore balance. Even if homeostasis is dysfunctional

What are some things to maintain homeostasis in a family

• Boundaries - Rules of interaction for family members that can be rigid or loose

• Homeostasis - Maintain a sense of coherence, equilibrium, and structure in the face of change

• Subsystems - Smaller systems within the larger family system

• Rules - Spoken or unspoken codes that develop through interaction and reaction.

What is emeshment

Enmeshment/fused individuals are unable to think/act autonomously. Low differentiation

What is not emeshed

• Autonomous individuals with Emotional separation

What are genograms

• Living family trees show how people relate biologically, relationally etc,

• Documents how the relationships emerge and are sustained over time.

What might a family therapy session look like

Session 1 - Pre-session planning - Therapist and family decide who will all attend

Session 2 - Joining stage - Must integrate into the family system but not become like a member

Session 3 - Problem statement stage - Who gets to frame the problem – getting all perspectives for big picture understanding.

What are the importance of family boundaries

• Rules get set and established over time

• Healthy boundaries are fluid but not too flexible or too rigid

• When rules are not enforced family is chaotic. With rules too rigid families cant adapt to change

What are some outdated family assumptions

• Father is breadwinner

• Heterosexual family of origin

• Kids leave home at college

• Not recognizing growing diversity

What is culture

Any group of people who identify or associate wth one another on based on common purpose, need or similarity in background. Early 90’s when this became bigger.

Multicultural counselling

• Developed from limitations of other approaches

• Increased diversity in communities/countries

• Recognition of who theories developed by & who is treated

• Role of context/culture/system

How did the journal name change link to Multiculturalism

Male journal changed name to “Male and masculinity that changed to masculinities implying a spectrum.”

What are the steps in the cultural competency model

1. Awareness

2. knowledge

3. skills

What is cultural humility

The understanding that we cannot be totally competent. We can more easily enact humility than knowing everything. Humility is a recognition of our need to be curious, humble and not prioritize/believe in anyone's cultural identity being ahead/more important than anyone else's.

What are some steps in discussing race & ethnicity during a session

• Suspend preconceptions about clients' race/ethnicity and family

• Recognize that clients may be quite different from other members of the same background

• Consider how racial/ethnic differences between therapist and client might affect psychotherapy

• Acknowledge that power, privilege and racism might affect interaction with clients. Acknowledge existing power struggle in relationship.

• When in doubt about the importance of race and ethnicity in treatment, talk and ake risks

• Keep learning and repair mistakes is key.

What is cultural competency

• Awareness

• Knowledge

• Skills

What is gender role socialization

Process by which individuals learn the behaviors, attitudes, and expectations associated with their assigned gender in a given society. Has to do with gender norms

Do people like therapists with the same identities as them?

Generally yes however there is no real confirmation that this is needed or effective and a potential problem is therapists can over identify and not ask the right questions.

What are 3 stages of sleep dream exploration

1. Exploration

2. Insight

3. Action

What are some big picture ideas of dream theory

• Physiological - Preserve neural pathways and brain weaves memories into stories.

• Information processing - Sort out day activities and consolidate memories

• Personal growth/psychological - Can be used for growth and insight

How many stages of sleep are there

4 stages + Rem
Everyone dreams even animals

What are some ways to study brain,body and eyes

EEG - Brain activity, tighter waves means more

EMG - Muscle movement, body - Nothing during rem

EOG - Eyes - Way more active during REM then waking

What did Freud think of dreams

• Repression - Not active/disguise factor

• Dreams as wishes - Id based

• Day residue - Something that happens that day that makes it into the dream.

What did Jung think of dreams

Material comes from personal unconscious and collective unconscious Common archetype dreams eg - School situations, falling, being chased, flying …

What did Adler think of dreams

• Looked to identify dreams as representations of ones lifestyle, remaining barriers to overcome (Goal recognition)

What does Gestalt think of dreams

• Characters objects - Projections of ourselves 

• Focus on taking on images, playing out pieces, moving towards insight and re intergration of disowned or projected pieces of identity

What are the stages in Hills dream interpretation model

• Exploration (Client centered/humanistic) 

• Insight(psychodynamic) 

• Action(behaviour) 

What does the DRAW acronym mean in the exploration stage

D - Describe - More detail
R - Re experience - Emotions
A - Associate - What does that make you think off, what does x mean

W - Waking life triggers - Whats going on in life right now

What happens in the exploration stage of dream interpretation

Introduce yourself, Give a brief overview of the three stages, and Have the client retell the dream in the first-person present tense as if they are experiencing it.

After explore 2-4 images with DRAW. Do DRAW with 3 scenes or powerful images.

What happenes in the Insight stage of dream interpretation

Understanding of dream

Collaborate construct understanding 

Choice of several levels of insight

Ask client to sumarize

What happens in the action stage of dream interpretation

How would you change the dream

Bridge to changes in waking life

Continue working with the dream.