Intro to Clinical Psychology Unit 2

topographical model

Freud’s model of the mind; a continuum from unconscious, preconscious, to conscious. Fundamental to understanding Freud’s view of personality.

How do we know that something is important for ‘normal’ development?

We look at the consequences of having it or not. Atypical development leads to questions about typical or normative processes. To treat or prevent maladaptations, we need to know the processes that underlie typical development

protective factors

similar to an airbag in your car. They moderate risk and create better outcomes for certain populations

individual differences in stress affecting well being

regulation differences, perceptual differences (ex. ASD), cognitive differences in how the stressor is perceived, environmental differences, life history, differences in the stressor itself, racism and stress (stress equity)

biopsychosocial model

argues that, with BPD, there is a biological root, a psychological/cognitive component, and that some component comes from social experience

BPD

Characterized by a difficulty regulating very intense, overwhelming emotions. Begins with a physiological propensity toward poor regulation (greater arousal to emotional events and intense arousal triggered more quickly), and environment further impairs development of regulatory processes (maltreatment, trauma, unstable family relationships, invalidating environments). Sense of self often very reliant on validation from other people

DBT formula

zen + dialectical + behavioral therapy

Zen

Mindfulness derived from Zen Buddhism. Awareness and acceptance of self → identifying judgmental thoughts as a product of the mind and not necessarily a truth. Being in the present moment vs. projecting forward and backwards

Dialectics

1. Interconnectedness → actions and reactions of client and therapist work together in a transactional way

2. Synthesis between the thesis and antithesis

3. Balance between acceptance and change (i.e. I can be flawed AND worthy of love, I can struggle in school AND still be intelligent)

Functions of DBT

enhancing client skills and capacities, enhancing client motivation, enhancing generalization to real world situations, structuring the environment, enhancing therapist capacities

DBT Modes

1. Group therapy (skills training), just more efficient and affordable

2. Individual therapy (client motivation)

3. Telephone consultation (generalization)

4. Case management (structuring the environment)

5. Consolation team (enhancing therapist capabilities)

Stages of DBT

1. Pre-commitment → dialectic of acceptance and change

2. Stage 1: skill development to reduce self-harm/high-risk behaviors

3. Stage 2: increase client capacity to experience full range of emotions, address PTSD

4. Stage 3: development of self-respect

5. Stage 4: resolve existential issues → what is your reason for living

Evolutionary component of attachment theory

Attachment promotes survival, attachment strategies are adaptive and experience expectant. There is supportive evidence of this in cross-species data, deprivation studies, and patterns found around the world

Cognitive component of attachment theory

Internal working models = expectations about self, others, relationships, We cary these forward in other relationships and they serve as a guide for how one should behave, as well as shaping our self of self (self confidence and persistence)

Specific attachment pathways

1. Secure

2. Anxious resistant (leads to reactivity, clinginess caused by inconsistently available parents)

3. Anxious avoidant (caused by consistent rejecting of emotional needs. Thus, the child stops asking for things)

4. Disorganized (associated with parents that harm their children, leads to the question of the attachment paradox)

duty to warn

a therapist’s obligation or option to notify potential victims about potentially dangerous clients

seduction theory

a Freudian theory that suggests that hysteria in adults is rooted in repressed memories of sexual abuse in early childhood

drive theory

a Freudian theory that proposes that behavior is motivated by internal states of need or drive, triggered by disruptions on homeostasis

Freudian defense mechanisms (the ego’s toolbox)

Repression, projection, reaction formation, displacement/sublimation (passing your issue onto someone else, and sublimation = taking difficult things and finding something positive to do with it), regression, rationalization, denial, and identification (identifying with parent or aggressor, like becoming a bully after you have been bullied)

projection

a psychological defense mechanism where individuals attribute their own unacceptable thoughts, feelings, or motives to another person. For example, someone feeling guilty about their dishonesty might accuse others of lying.

transference

people project onto the therapist what they’ve learned in other important relationships

analysis of resistance

the patient will fight and resist analysis when the “good stuff” is about to emerge

countertransference

How the therapist feels about the patient. Can tell you how others likely feel about them, or can just be a demonstration of you bringing our your own baggage

Goals of psychoanalysis

Insight, reworking developmental stages, strengthening ego, and restructuring the personality

major players of CBT

Thoughts, feelings, actions, and behaviors. Situation → thoughts → feelings

Types of logic flaws in CBT

overgeneralization, negative mental filter, discounting the positive, magnifying, emotional reasoning, blame (assuming single causality), labelling, “should” statements

Intervention for all or nothing thinking

Catch overgeneralization, look for contrary evidence, imagine life with a different filter

Intervention for overgeneralization

Challenge black and white thinking, ask to expand perspective, see shades between black and white

Intervention for jumping to conclusions (psychic, fortune telling, mind reading)

Stay in the present and play the numbers, most people don’t care very much about things. Ask for clear communication and ask for input

reaction formation

a defense mechanism in which people express the opposite of their true feelings, sometimes to an exaggerated extent. For instance, a man who feels insecure about his masculinity might act overly aggressive

not guilty by reason of insanity (NGRI)

a verdict that, at the time of a crime, a defendant was suffering a mental disorder and either did not realize the wrongfulness of the act or was unable to conform to the law

expert witness

someone with scientific, technical, or other specialized knowledge acquired by means of experience, training, or education who may testify in the form of an opinion

child custody evaluation

a clinical assessment designed to make recommendations to help a court settle disputes over which parent should be granted custody of children

covil competency

a finding that an individual has the capacity other than understand the information relevant for making a decision and to make an informed choice based on that decision

mental-physical

work-related stress is blamed for the onset or worsening of a physical disorder, such as high blood pressure or asthma

mental-mental

an individual suffers a traumatic incident at work (or undergoes a long period of continual stress) that leads to psychological difficulties

physical-mental

a worker sustains a serious physical injury, and as the pain continues, the worker begins to experience psychological problems

tort law

provides a mechanism for individuals to seek redress for the harm they have suffered from the wrongful acts of another party. Differs from criminal law which, acting on behalf of society as a whole, prosecutes defendants for wrongful behavior and seeks to punish them in an attempt to maintain society’s overall sense of justice.

guilty but mentally ill (GBMI)

a verdict in which a mentally disordered criminal is to be treated for the disorder while serving a prison sentence for a crime

competence to stand trial

a requirement that defendants must be able to understand legal proceedings against them and to help attorneys to prepare their defense. Focuses on the defendant’s “present ability” to proceed trial, and should be distinguished from retrospective inquiries regarding criminal responsibility, such as the insanity defense. The defendants most likely to be found incompetent are unemployed, diagnosed with a severe disorder such as schizophrenia, and/or have a history of psychiatric hospitalization

forensic psychology

a specialty that applies psychological principles and knowledge to legal issues and proceedings

health belief model

according to this model, patients’ adherence to treatment depends on four factors

1. how susceptible to a given illness they perceive themselves and how severe the consequences of the illness are thought to be

2. how effective and feasible versus how costly and difficult the prescribed treatment is perceived to be

3. internal and external cues in triggering health behaviors

4. demographic and personality variables

hostility

a trait characterized by suspiciousness, resentment, frequent anger, antagonism, and distrust of others

social support

the experience and perception of being cared for, loved, esteemed, and part of a network of communication and mutual obligation

coping

refers to people’s cognitive, emotional, and behavioral efforts at modifying, tolerating, or eliminating stressors that threaten them

general adaptation syndrome

a pattern of physiological reactions to stressors that includes stages of alarm, resistance, and exhaustion

health psychology

a psychological subfield devoted to studying psychological factors influencing health, illness, and coping with illness

Jean Piaget

among the first to point out that children are not miniature adults in their thinking, and that they conceptualize the world in fundamentally different ways than adults do

Resilience

a characteristic or set of characteristics seen in some children that acts as a protective factor against the development of emotional and behavioral problems in the face of stressors

developmental psychopathology

A research field focused on maladaptive behavior in childhood and adolescence and how they are influenced by developmental stages

id

the source of our most fundamental biological drives, especially sexual/sensual and aggressive ones. These drives are present at birth.

superego

the part of personality that incorporates social behavioral norms from our parents, family, and culture. Contains both our conscience, which punishes us with guilt when we do things that are morally wrong, and our ego ideal, which reflects how we would ideally like to be and which rewards us with pride when we do things that are morally right.

ego

the part of the personality that tries to mediate between these conflicting demands while also recognizing and responding to external realities.

defense mechanisms

unconscious mental strategies designed to keep anxiety-provoking material from reaching consciousness

free association

saying whatever comes to mind, without censorship, to provide clues to unconscious memories, impulses, and fantasies

psychoanalysis

a memory of psychotherapy that seeks to help clients gain insight into, and work through, unconscious thoughts and emotions presumed to cause psychological problems.ransfet

transference

a process in which a client’s typical relationship patterns and defense mechanisms appear in the therapy relationship

resistance

a process in which clients behave in ways that interfere with the psychoanalytic process

insight

a client’s conscious awareness of the underlying causes of psychological problems

working through

fully understanding the implications of insights gained throughout psychoanalysis

psychodynamic psychotherapies

variations on psychoanalytic treatment that departed significantly from the principles and methods of Freud’s original theories. Instead of focusing on sexual and aggressive instincts in the development of behavior and behavior disorder, these therapies emphasize more positive aspects of personality, especially the role of the ego in motivating psychological growth, not just in resolving intrapsychic conflicts. These theorists did not see early life relationships revolving mainly around sexuality. These alternative treatments tend to see the therapeutic relationship not just as an area for analyzing transference but as having healing properties in and of itself.

interpersonal psychotherapy

a time limited treatment that focuses on resolving the interpersonal problems that underly psychological problems such as depression

person-centered therapy

treatment that focuses on creating a client-therapist relationship characterized by unconditional positive regard, empathy, and congruence that allows clients to become aware of their true thoughts and feelings and thus remove blockages to their personal growth

unconditional positive regard

a therapeutic attitude that makes it clear that the therapist cares about the client, accepts the client, and trusts the client’s ability to change

empathy

in order to understand a client’s behavior and help the client understand it, the therapist must try to see the world as the client sees it

congruence

in person centered therapy, a consistency between the way therapists feel and the way they act toward clients

gestalt theory

an active form of humanistic treatment that seeks to create conditions in which clients can become more unified, self-aware, and self-accepting