Psych 360 - Final

Explain the elements of the Hexaflex in ACT.

• Helps people work to achieve psychological flexibility

  • Staying in the present

  • Detaching from self-narratives

  • Accepting life’s difficulties and your thoughts

    • Not fighting/challenging them

  • Connecting with values

    • Committed, driven action towards them

    • Leads to a more process-oriented, values-driven life

Explain the 3 fundamental techniques of TFP. About what percent do you use them in therapy?

• Clarification - Helps the client identify what they really want to express to the therapist

• Confrontation - Helps the therapist challenge the client’s defenses with contradicting ideas to gauge their reactions

• Interpretation - Provides logic and reason for the client to understand

What is the fundamental rule of psychoanalysis in general and TFP in particular?

The concept of free association

• Client’s role - speak freely about whatever comes to mind without censorship

• Therapist’s role - To listen and gain access to the client’s thought process

Explain the elements of an object relations dyad. Give an example.

• A model w/ 2 circles and an arrow in the middle

  • Self and other in the circles

  • Arrow represents how they affect each other

• Helps regulate what goes on in a therapy session

• Ex: If a client has intense feelings about someone, it will impact how they feel about themselves and vice versa

What are transference and counter-transference?

• Transference - The client unconsciously projecting their thoughts/feelings about someone/thing onto the therapist

• Counter-transference - The therapist’s unconscious response and reaction to the client’s projection

What are the 3 levels of thought in CBT?

• Automatic thoughts - Always running through our minds that we rarely pay attention to

• Conditional Beliefs - Thoughts we live by circumstantially

• Core beliefs - Thoughts we whole-heartedly believe about ourselves

  • Usually negative when depressed

Explain the 5 column thought record used in CBT?

• Helps challenge unwanted thoughts

  • Describe the event

  • Rank how it made you feel (1-100)

  • Describes thoughts you had about it

  • Challenge cognitive distortions

    • Probability or evidence statements

  • Re-rank your outcome w/ new feelings score

What are the elements of a DBT chain analysis?

• Problem behavior - What happened to client

  • Usually a behavior they want to change

• Prompting event - What triggered the event leading to problem behavior

• Links in chain - Whatever happened between the P.E. and the P.B

  • Our thoughts, emotions, sensations, etc.

• Vulnerability factors - What made them susceptible to the prompting event

• Consequences - What happens following the problem behavior

  • Either long or short (immediate) term

According to DBT, how does invalidation disrupt emotion regulation?

• Invalidating environment

• Where problematic behavior serves to validate the negative emotions

• Your thoughts and feelings are responded to in ways that suggest they are invalid (ex:neglect)

• Leads to emotional dysregulation and extreme behaviors

What is creative hopelessness?

• A strategy therapists use to help clients let go of the agenda that they’re in control of their feelings

  • People tend to believe that you can hold on to happiness or that it's a permanent feeling

  • Happiness, like all other emotions, come and go

Explain STRUGGLE and OBEY mode according to the Happiness Trap?

• OBEY - Fusion; Our thoughts and feelings dominate us

  • Command our attention and dictate our actions

• STRUGGLE - Experiential avoidance; Attempting to actively and unsuccessfully block out and ignore unwanted thoughts

Explain the 4 steps as discussed in class for treating anxiety according to CBT.

• Education

  • Coaching to reinforce skills outside of the session

  • Learning about the anxiety

  • Usually w/ other people

• Relaxation

  • Calms the body’s stress response

  • Regulates emotions

• Cognitive Restruction

  • Helps brain reorganize its thought process regarding the anxiety

• Exposure

  • Attempting to face the anxious feelings head-on

What are you trying to do when saying the phrase, “I’m noticing I’m having the thought…?”

• Fundamental unhooking skill

• Acknowledging unwanted thought and not dwelling on it

  • You have to acknowledge that's how the brain works; No point trying to deny it

• Creating separation (diffusion) between your brain and the thoughts

  • Giving the thoughts less power over you

Why is the concept of workability so important in ACT?

• Helps us determine whether the actions we take move us in the direction of our chosen values

• Encourages people to step outside of fundamental truths and focus on what is important to them

Describe 3 of your favorite unhooking techniques from the Happiness Trap.

• Silly voices, Thanking the mind, Musical thought

  • Helps you realize the hooked thoughts are nothing more than a string of words in your head

  • Gives them less power over you

  • Loses its impact on you

Draw and label the essential elements of a choice point diagram.

List the 6 unhooking skills.

• Core unhooking skills

  • Name the story - Acknowledging the thought by giving it a name

  • Name the process - Acknowledging the mind’s thought process, especially when worrying/obsessing

• Playful unhooking skills

  • Play w/ text - Imagine thought as words on screen; Changing size, font, color, etc.

  • Silly voices - Saying thought aloud in silly character voice

  • Thank the mind - playfully thanking mind for hooked thought

  • Musical thought - Singing the thought in musical form

What is the difference between the noticing and thinking self?

• Thinking Self

  • Commenting, judging,analyzing your experiences

  • Like a radio constantly playing in the background (usually negative thoughts)

  • CBT fights and challenges the thinking self

    • Becoming aware of your negative automatic thoughts and challenging them

• Noticing Self

  • Noticing whatever thoughts/images appear from the thinking self

  • ACT tries to develop and emphasize the noticing self

    • No point challenging the thoughts

    • Helps diffuse and distance yourself from the thoughts and let them go

List 3 mindfulness practices.

• Ten Slow Breaths Exercise, mindful walking, bodily scans

  • A good way to practice ACT and develop the noticing self skill

  • Whenever your mind gets distracted as you're breathing, you learn to let them come and go

  • Gently unhook from the thoughts that pull you off task and refocus your attention

What is the difference between values and goals?

• Goals - Your destination and what you want to achieve

• Values - The process of how to get to your goals

  • How you view yourself, others, and situations regardless on whether you accomplish your goals

Why is it better to be process rather than outcome oriented?

• Process oriented - Able to appreciate and acknowledge the journey you took to move closer towards your goals.

  • Able to say you did your best with what you could control even if you don’t reach your goals

• Outcome oriented - Cannot control outcome

  • More painful if you fail

What are SMART(ER) goals?

• Makes your broad goal clearer and easier to achieve

  • Specific

  • Measurable

  • Achievable

  • Relevant

  • Time-bound

  • Evaluate

    • Did you accomplish goal?

    • What got in the way?

  • Revise

What is TAME?

• Similar to ACE

  • Take note

    • Similar to acknowledging the feeling

  • Allow

    • Giving the feeling permission to be there

  • Make Room

    • Open up to the feeling; Letting it freely flow through you; Invite it in

  • Expand awareness

    • Broaden our focus to include everything around

Use the pac-man model to explain the Documentary of You and cognitive filter.

• Pac-man - Self view (story)

  • Biased story in the documentary of your life

• Cognitive filter - chooses what thoughts are consistent with self view

  • usually negative

• Documentary is not a complete accurate representation of who we are