PSYC 360 Exp Psych Final Exam

Binghamton

Biomedical Model Description of Disease/Illness

Abnormal Biological Processes

Biomedical Model Description of Health

Absence of disease

Biopsychosocial Model Description of Disease/Illness

Explained by interaction between biological, social and psychological factors

Biopsychosocial Model Description of Health

Balance between biological, social and psychological factors

Colocating Care

Delivering mental health support in the same location where someone may also be receiving treatment for physical illness or ailment

SMART Goals

Goal setting Methods
Specific, Measurable, Attainable, Realistic and Time Limited

SMART Specific Goals

Goals need to be specific, not broad

Ex. “I’m going to get healthy” vs “I’m going to join an exercise program”

SMART Measurable Goals

Goals that you can track your progress for

SMART Attainable Goals

Goals that are achievable or feasible, may involve breaking up a goal into smaller, easier steps

SMART Realistic Goals

Goals should be realistic to what you can and will be able to do

SMART Time Limited Goals

Goals should have a time frame to encourage sticking with it, rather than brushing it off

SMART Goal Strategy Benefits

Increases likelihood of reaching goals, anticipates potential barriers, and reinforced continued success through a progressive series of goals

How does problem solving promote treatment adherence?

Patients will have barriers or challenges when going through treatment. Problem solving will help them to develop skill on how to overcome these barriers.

Problem Solving Steps

1. Define Problem

2. Think outside of the Box/Brainstorm

3. Evaluate the pros and Cons of Responses

4. Rank order of Responses

5. Act out Response

6. Evaluate Response

Problem Solving Step 1

Define Problem

• State problem in clear and achievable problem

Problem Solving Step 2

Think outside of the Box/Brainstorm

• Generate a wide array of responses

Problem Solving Step 3

Evaluate the pros and Cons of Responses

• Determine what is more feasible, most beneficial, most consequential,e tc

Problem Solving Step 4

Rank order of Responses

• Identify the most optimal response

Problem Solving Step 5

Act out Response

• Therapist helps the patient develop and implement the response

Problem Solving Step 6

Evaluate Response

• Determining if response helps with problem

Activity Scheduling Strategy

Helps to manage chronic illness by getting patients to do things they enjoy, improving their mental well-being, and preventing disability spiral.

Activity Scheduling Steps

1. Identify pleasurable or valued activies

2. Plan specific times for the activity

3. Anticipate and problem-solve barriers as they appear

4. Monitor your mood before and after activity

Components of Disability Spiral

Negative Thoughts (“I need to rest”) →
Behaviors (Not going to see friends) →
Emotions (Becoming depressed) →
Physical Sensations (Physical sensations worsen) →
Negative Thoughts… (Worse pain causes more negative thinking, loops)

Cognitive Therapy Theory of Personality

People respond to life events through cognitive, affective, motivational, and behavioral responses.

Temperament Definition

Inborn characteristics within people, primarily genetic. Can change from birth due to learning and socialization

Genetic predisposition to emotions and moods

Cognitive Schemas

Schemas (structure of survival system) that contains one’s perceptions of themselves and others, along with their goals, expectations, memories, fantasies, and previous learning.

Structures that contain an individuals fundamental beliefs and perception

Develop early in life from person experience and identification with significant others. Further reinforced by learning experiences

Can be adaptive or dysfunctional

Hierarchy of Cognition

Core Beliefs (Bottom, very ingrained)
Underlying Assumptions (2nd to Bottom, less ingrained)
Automatic Thoughts (2nd to Top, somewhat accessible)
Voluntary Thoughts (Top, most accessible)

Core Beliefs

Strong, specific, rigid attitudes/beliefs that a person has that can affect their perception of the world, themselves, others, etc.

Also known as Cognitive Vulnerabilities

Typically negative core beliefs that can harm one’s perception of oneself or the world

Ex. “I am not good enough,”

Underlying assumptions

Conclusion drawn without evidence, in line with core beliefs

“I am responsible for other people’s happiness”

Automatic Thoughts

What one thinks or says to themselves based on their underlying assumptions, that is situation specific

Come to mind spontaneously under certain circumstances.

Ex. Tripping and falling and falling, automatic thought would be “Crap, everyone thinks I’m clumsy,” underlying assumption would be that everyone looks at them

Voluntary Thoughts

Thoughts we choose to think about

Most accessible thoughts

Ex. Someone asks what you want for lunch, your ideas of what to have are voluntary thoughts

Cognitive Distortions

Irrational or exaggerated thought patterns about the world or self that can lead to inaccurate perceptions of reality

Catastrophizing

Cognitive distortion that causes a tendency to blow things out of proportion

Assuming the worst to happen in the future (If/then)

Personalization

Cognitive distortion that occurs when one attributes external events to oneself without evidence of a causal connection

Ex. A friend doesn’t respond when you wave at them, you think “I must have made them upset”

Overgeneralizing

Cognitive distortion when one creates general rules from one or a few isolated incidents, and applies them broadly and to unrelated situations

ex. A man after a bad date going “Women are all the same, I’ll always be rejected”

Emotional Reasoning

Cognitive distortion in which one interprets experiences based on their feeling and not on what they experience

Ex. Someone with social anxiety doing a presentation may feel embarassed, and applies that feeling to their performance and think the presentation went horribly

Shoulding and Musting

Cognitive distortion in which one has a tendency to make unrealistic and unreasonable demands on themself and others

ex. I SHOULD do this thing or else…, I MUST do this thing or else…

Magnification and Minimization

Cognitive distortion where one sees things as more or less significant than they actually are in the moment
ex.A student thinking they’re a horrible student because they got their first B on an exam
or; A person with a potentially dangerous illness or injury going “Eh, I’ll be fine”

Mind-Reading

Cognitive distortion in which one assumes what those around them are thinking, and jumps to conclusions based on that assumption

Arbitrary Inference

Cognitive distortion in which one draws conclusions without supporting evidence, or even with contradictory evidence

Selective Abstraction

Cognitive distortion in which one conceptualizes a situation based on a detail taken out of context, ignoring any other information.

ex. A man gets jealous because his girlfriend tilts her head at a man at a party to hear him better

Dichotomous Thinking

Cognitive distortion where one categorizes their experiences in one of two extremes, extremely positive, or extremely negative.

ex. Student saying “If I don’t write the best exam ever, I’m a complete failure”

Therapeutic Relationship of Cognitive Behavior Therapy

Collaborative; Therapist works with patient, acting more as a guide to develop and work on goals, with patient expected to set goals, do homework
Empathetic; Therapist is empathetic, genuine and warm to patient
Flexible; Therapist provides support when needed, and is sensitive to the patient’s comfort
Feedback; Therapist will ask patient for feedback after session about what was helpful/unhelpful, and change course if needed

Goal of Cognitive Therapy

To correct faulty information processing and help patients modify assumptions that create and maintain maladaptive behaviors.
Remove systematic biases, and modify core beliefs
Not replacing patient’s views with therapists views or “correct” views, but guiding to more realistic views

Cognitive Triad of Depression

Factors that depressed individuals view negatively

Self: Views as inadequate, deserted, worthless

World: Views as devoid of joy or gratification, focuses on negatives

Future: Pessimistic, things will not get better, or will get worse

Three Biases/Hallmarks of Anxiety

1. An exaggerated perception of danger

2. Difficulty recognizing safety cues

3. Minimized ability to cope

Initial Phase of Cognitive Therapy Treatment

Assessment and Contract: Assess goals of treatment, determine number of sessions, establishes collaborative framework. Contract is renegotiatable
Skills Education: Define problems, begin symptom relief. Teach patient to identify thoughts, notice cognitive distortions. Patient expected to do a majority of talking

Middle and Later Sessions of Cognitive Therapy Treatment

Identify Themes in automatic thoughts, hypothesize the assumptions and core beliefs affecting those assumptions and thoughts
Challenge core beliefs and cognitive distortions
Patient continues to lead the care

Ending Treatment of Cognitive Therapy

Spaced Out Session; Last few sessions are spaced out, gives patients more time to work on themself and employ skills out of office.
Relapse Prevention; Patients will be made aware of how to recognize when they need to use the skills and tools used in treatment. This can prevent them from forgetting skills and relapsing
Booster Session; If skills are “lost,” later schedules to redevelop those skills

Collaborative Empiricism Definition

Therapist and patient work as “Co-Investigators,” examining evidence to support or modify the patients assumptions.
Patient plays an active role in determining what they like different, and what they may be able to do to create that change.
Therapist exposes or leads patient to alternative forms of thinking aside from their biased form.

Co-Investigators Definition

The roles the patient and therapist take in collaborative empiricism

Therapist and patients will investigate thoughts together

Guided Discovery Definition

Strategy in cognitive therapy where therapist and patient work together to find links between patient’s misconceptions or beliefs, and past experiences to understand how the patient develop their disorder.
Therapist does not provide answers, but with work with patients to interpret data, and ask how patient’s feel

Socratic Dialogue Definition

Style of question that helps to uncover patient’s views along with their level of adaptive or maladaptiveness.

Socratic Dialogue Steps

1. Asking informal questions

2. Listening

3. Summarizing

4. Asking synthesizing or analytical questions

Socratic Dialogue Step 1

Asking informal questions: Questions to clarify or define problems, assist in the identification of thoughts and assumptions, examine meanings of events, and assess the consequences of the patient’s maladaptive thoughts and behaviors

Socratic Dialogue Step 2

Listening: Therapist listens to the answers of the patients closely

Socratic Dialogue Step 3

Summarizing: Describing what a patient said back to them

ex. “So you’re saying xyz”

Socratic Dialogue Step 4

• Asking synthesizing or analytical questions that apply information previously discovered to the patient’s original belief

  • “How does this new info fit with your belief that you can’t do anything right?”

  • Designed to guide patients to conclusions rather to point them to one correct conclusion. The conclusion is up to the patient, and the therapist must understand the patients point of view to understand the assumptions the patient makes

Steps of CBT Session Structure

1. Set the agenda

2. Review previous material

3. Review Homework

4. Cover new material

5. Summarize and assign homework

6. Elicit Feedback

First Step of CBT Session Structure

• Set the agenda

  • Asking patients what to do, and goals for the day.

  • Time management is important

    • Therapist can shelve topics for later sessions

Second Step of CBT Session Structure

• Review previous material

  • Review what was learned in the prior session

  • What goals were accomplished last session

Third Step of CBT Session Structure

• Review Homework

  • Review homework from the prior session. If patient didn’t complete homework, go over barriers or challenges preventing that

  • Homework can include worksheets, logs, journals, etc.

Fourth Step of CBT Session Structure

• Cover new material

  • New material based on the agenda and goals the patient wants to focus on

Fifth Step of CBT Session Structure

• Summarize and assign homework

  • Summary of new materials and skills learned this session

  • Homework based on new material and skills, so that patient can practice

Sixth Step of CBT Session Structure

• Elicit Feedback

  • Therapist asks client how the session went, if anything was missed, and what may be covered next session

  • Therapist will adjust next session based on feedback

Decatastrophizing Definition

Technique to challenge cognitive distortions, helps to prepare patients for feared consequences and decrease avoidance, especially when combined with coping plans. Can help to identify problem solving strategies.
Also known as “what-if” technique, because you ask “what if this event occured, what would happen?”

Reattribution Definition

Techniques that test automatic thoughts and assumptions by considering different causes for events, aside from assumed causes.

Especially helps when the patient believes themselves to bethe cause of events. Encourages reality testing and appropriate assignment of responsibility by requiring examination of all the factors that negatively affect a situation.

Redefining Definiiton

Technique to mobilize a patient that believes their problem is beyond their control. Redefining a problem may involve making it more concrete and specific, and based on the patient’s own behavior

Ex. “I am a terrible student, and destined to fail” -> “I need to better my study habits if I want to succeed in school”

Decentering Definition

Technique often used on patients believing themselves to be the focus of everyone’s attention.
Encourages patients to examine logic behind why others would pay attention to them, perform behavior experiments to test beliefs, often leading to patient realizing others typically focus on other things

Mechanism of Change for Cognitive Therapy

Modification of dysfunctional assumptions leads to effective change

Core beliefs must be made accessible to be modified

Patients must be able to understand and analyze their core beliefs

Therapy allows patients to experience emotion and reality testing simultaneously

Cultural Considerations of Cognitive Therapy

Understand the patient’s beliefs, values, and attitudes, and how they exist within a cultural context. Therapist must understand that we are not actively changing beliefs, or imposing their own onto the patient.

Mode Definiton

Networks of cognitive, affective, motivational, and behavioral schemas that compose one’s personality and how they interpret ongoing situations

Types of Modes

Primal Modes - Universal and linked to survivability. Fear and stress responses
Consciously Controlled Modes - Minor and under conscious control

Stages of Minority Identity Development

1. Conformity

2. Dissonance

3. Resistance Immersion

4. Introspection

5. Synergistic

Minority Identity Development Stage 1

• Conformity

  • Minority individual internalizes racism or discrimination, and chooses values, lifestyles, and role models from the majority group

  • Internalized Racism/Sexism/Homophobia/etc

Minority Identity Development Stage 2

• Dissonance

  • Minority individual begins to question cultural values of the dominant group

Minority Identity Development Stage 3

• Resistance Immersion

  • Minority individual begins to endorse minority-held views and reject majority-held values

Minority Identity Development Stage 4

• Introspection

  • Minority individual establishes identity without following cultural norms, and begin to question how cultural values fit their personal identity

Minority Identity Development Stage 5

• Synergistic

  • Minority individual feels self-fulfillment toward self-identity; Doesn't accept every aspect of minority group values, may take in values from majority group

Stages of White American Identity Development

1. Contact

2. Disintegration

3. Reintegration

4. Psuedoindependence

5. Autonomy

White American Identity Development Stage 1

• Contact

  • Aware of minorities, but doesn’t view themselves as racial beings

  • “I Don’t See Color”

White American Identity Development Stage 2

• Disintegration

  • Acknowledgement of discrimination and prejudice

White American Identity Development Stage 3

• Reintegration

  • Individual blames victim (minority group) and engages in reverse discrimination

  • Reverse Discrimination

    • Belief that their group, the majority, is the one being discriminated against

White American Identity Development Stage 4

• Psuedoindependence

  • Becoming interested in understanding cultural differences

White American Identity Development Stage 5

• Autonomy

  • Learning about cultural differences and beginning to accept, respect, and appreciate members of both the minority and majority groups

Stages of Sexual Orientation Identity Development

1. Confusion

2. Comparison

3. Tolerance

4. Acceptance

5. Pride

6. Synthesis

Sexual Orientation Identity Development Stage 1

• Confusion

  • Individual questions sexual orientation (or gender identity) for the first time

Sexual Orientation Identity Development Stage 2

• Comparison

  • Individual compares themselves to members of that sexual minority, begins to accept the possibility they belong to it

Sexual Orientation Identity Development Stage 3

• Tolerance

  • Individual begins to identify with their sexual identity

Sexual Orientation Identity Development Stage 4

• Acceptance

  • Individual increases contact with other LGBTQ people, begins to accept their identity as part of themself

Sexual Orientation Identity Development Stage 5

• Pride

  • Individual begins to embrace their identity and is proud of themself

Sexual Orientation Identity Development Stage 6

• Synthesis

  • Individual finds peace with their sexual orientation, and begins to reach out to supportive cishet people so that they can understand

Intersectionality

Illuminates the multiple overlapping impacts of class, race, gender, sexual orientation, immigrant status, ability status, and religious affiliation.

Someone who fits under multiple identities doesn’t exist independent to each identity.

ADDRESSING Acronym

Various identity categories one can fall under
Age, Development and acquired Disabilities, Religion, Ethnicity, Socioeconomic Status, Sexual Orientation, Indigenous Heritage, National Origin, Gender

Collectivistic Worldviews

More community focused, people typically base their happiness on the success of their community or family

Identity is associated more with their relationships with others

Focus on interdependence, working together, social harmony, communication, conformity or tolerance

Individualistic Worldviews

More self-focused, people focus their happiness on their personal success.

Identity is viewed independent from others

We define people based on their traits, values, abilities, attitudes, beliefs, etc.

Ethnocentric Perspectives

Belief that one’s own worldview or culture is superior from others

Belief everyone should share your culture

Ethnorelative Perspectives

Belief that cultures are relative to one another and that behaviors can only be understood within a cultural context.