PSY 210 FINAL EXAM


The Great Storyteller and True Blues


  1. What are “thoughts?”  In ACT, is it important whether our thoughts are true or false?  What is most important?

Thought: Words inside our heads. They tell us how we are and how we should be, what to do and what to avoid. In ACT we often refer to thoughts as stories. Sometimes they are true stories, called facts and sometimes they are false. But more of our thoughts are neither true or false. Most of them are either stories about how we see life or about what we want to do. In ACT, the main interest in a thought is not whether it is true or false, but whether it is helpful. If we pay attention to this thought, will it help us create the life we want?

  1. What is the process of cognitive defusion? 

If you have a thought that “life sucks” then simply acknowledge that you’re having a thought that life sucks. Using that phrase means you’re less likely to get beaten up or pushed around by your thoughts. Instead, you can step back and see thoughts for what they are. Nothing more than words passing through your head. 

  1. How does all of this differ from traditional Cognitive Therapy?

Traditional believes, It's not the A (event) that causes C (the emotion), it’s B (your belief) in between. This method above just acknowledges the thought for what it is.



Integrative Counseling 


  1. Define the integrative therapy premise 

Integrative therapy helps to create a healthy alliance between mind and body. Empowering clients to start setting goals and practising new behaviors that will enable them to move beyond their limitations and discover greater life satisfaction. This will help with other goals that are drawn into therapy. 

  • It is the personal integreation of therapists




Supershrinks 


  1. Did the most ineffective therapists know they were ineffective?  Why do you think this is?

NO → They think they are on par, but it is not backed up. Most grow more confident in their careers, despite their success. 

  1. Do therapists typically get more effective through the years, as they gain experience?  

  2. What is the way that “Supershrinks” become so successful?

Attentiveness to feedback: How did the client feel about the therapy? How is it going? What are the feedback forms? How did I do? To solicit the genuine feedback of how things are going

Situational awareness, more observant and attentive

Deliberate practice




Are All Psychotherapies Created Equal?


  1. Explain what is meant by the “Dodo Bird verdict” and what it means.   

The “Dodo Bird Verdict” means that all therapies are equivalent in their effects. “everyone has one and all much have prizes”

  1. The authors state that effective treatments might have similar outcomes because they include similar features. What might be some similar features of effective therapies?

  2. After reading this article, how would you answer the question posed by the title: Are all psychotherapies created equal? 

Empirical outcomes of therapies shows that competing therapies work about equally well 

Common factors across all forms of psychtherapy

Therapies are more or less equivalent to eachother

Yes there are distinct differences, but they also have other things in common that are effective in changing, the common factors are effective. 




Exam 4 Study Guide:

Lecture Material


Following are some of the basic concepts we covered in Module 2, to help you organize your studying.  It is not a list of what will be on the exam – I may forget to put things on here that I covered in the lecture material, or I may decide to include concepts in class later, after I’ve made this study guide.  Anything we discussed in class may show up on the exam, as well as concepts covered in your writing assignments in and out of class, the videos you were assigned to watch, and anything from the articles.  Good luck on the exam, everyone!  I hope you study hard and do really well.  – Jaclyn 


Note:  Know the major theorists/psychologists associated with the theories and therapies we covered.    


Albert Ellis, Aaron Beck → CBT 

Fritz Pearls → Gestalt

Frued → Psychoanalysis 



For all of the below approaches: 

  • how might a therapist from each of these work; specific techniques

  • the common core of these, and the distinctions between them

  • historical figures associated with these approaches

  • which approaches incorporate mindfulness


Psychoanalysis: Freudian theories about the unconscious and the basic assumptions 

Unconscious needs, desires, and fears underlie behavior and form personality and related difficulties


  • “The Iceberg” aka Freud’s personality theory (id, ego, superego, unconscious, preconscious, conscious)

Id: based instincts, geared toward instant gratification 

Ego: Mediator, suppresses the id based on constraints of reality 

Superego: ideals, tried to block the id 

Conscious: tip of the iceberg

  • Thoughts and perceptions 

Perconscous: Middle of the iceberg 

  • Memories store knowledge 

Unconscious: Bottom of the iceberg 

  • Instincts, fears, trauma, violence, selflessness

  • Tools associated with this approach and their definitions: insight, dream interpretation, free association, transference 

Method: “talking cure” 

Couch lying down 

The therapist's interpretation helps to provide insight and eventual relief

Insight: a clear understanding of the human mind and behavior

Dream Interpretation: represents the fulfillment, unconscious desires, and conflict. Process of analyzing the imagery, symbols, and emotions in dreams to uncover their hidden meaning

Free association: the practice of allowing the patient to discuss thoughts, dreams, memories, or words, regardless of coherence

Transference: When you project feelings of someone else onto your therapist

  • Psychodynamic therapy

Psychoanalysis is the more modern version:it  explains personality in terms of the unconscious psychological process



Behavioral therapy: Emphasized observable behavior and empirical validation 

BEHAVIOR IS LEARNED

  • Figures associated with this approach 

Ivan Pavlov: Pavlov’s Dog: Saliva by bell 

John Garcia: Rats drinking water

Rosalie Raynor: baby conditioning

B.F. Skinner: Pigeons 

Albert Bandura: Bobo doll 

  • Classic learning theories:  classical conditioning, operant conditioning, and social learning, and historically, who is associated with each of these approaches 

Classical Conditioning: Learning occurs through the association of a neutral stimulus with a stimulus that naturally produces a response. Over time, the neutral stimulus alone can elicit the response

  • EX: a dog salivates at the sound of a bell if it has been repeatedly paired with food

    • Ivan Pavlov (Pavlov’s Dog)

Operant Conditioning: Learning occurs based on the consequences of behavior. Behaviors followed by rewards are strengthened, while those followed by punishment are weakened 

  • EX: Reinforcement (positive and negative), punishment, shapin,g and extinction

    • B.F. Skinner 

    • Developed the Skinner Box to study behavior in animals

    • Emphasized reinforcement

Social Learning Theory: Learning Occurs by observing and imitating others, especially if the model is rewarded or viewed as competent

  • EX: Modeling, Imitation, Self-efficacy 

    • Albert Bandura

    • Bobo doll: children imitated aggressive behavior modeled by adults 

  • what difficulties behaviorists typically treat

Focuses on how behaviors are learned throught interaction or environemtn

Treats: Phobias, Panic Disorder, GAD, OCD, PTSD, Social Anxiety, Addiction, Habits

  • Tools/methods including Desensitization and Exposure/ Exposure and Response Prevention. How these strategies work, and which disorders they are most often applied and helpful for: panic, phobias, anxiety, OCD, PTSD

Systematic Desensitization: Step-by-step exposure to the feared stimulus while staying relaxed

  • Used for Phobias, Anxiety, PTSD

  • Combines exposure + relaxation training 

  • Based on classical conditioning, replace fear with calm

  • EX: Afraid of spiders → start with photos → videos → seeing one → being near → touching (all while relaxed).

Exposure Therapy: Repeated controlled exposure to the feared object, memory or situation

  • Helps reduce avoidance and weakens the fear response

  • Used for Phobias, PTSD, panic disorder, and social anxiety

  • EX:  PTSD client re-tells traumatic memory repeatedly in a safe space until it no longer triggers extreme anxiety.

Exposure and Resonse Prevention (ERP) 

  • Used for OCD

  • Expose the person to feared thoughts or situations (dirt under nails)

  • Prevent the compulsive behavior (prevent washing hands)

  • Over time the anxiety fades without compulsion

  • GOAL: teach the brain that feared outcomes won’t happen and that anxiety is tolerable

  • How a behavioral therapist does their work

Goal: unlearn OLD behavior and learn NEW, more adaptive behavior


Humanism 

  • Key terms: Self-actualization, congruence, conditions of worth, and positive regard

Self-actualization: Occurs when an inborn tendency develops if the environment fosters it 

Congruence: When a person’s self-concept (how they see themselves) matches their actual experiences. They accept who they really are and their inner feelings in real situations are in alignment

  • “I feel sad, and I allow myself to express it openly.”

Conditions of worth are the expectations or standards that others place on us to receive love, approval, or acceptance. 

  • “I must always be perfect to be valued.” 

Positive Regard: Warmth, love, and acceptance of those around us

  • Includes Client-Centered/Adlerian Therapy and Gestalt Therapy

    • Gestalt: the founder, the meaning of “gestalt”

    • The Empty Chair Technique 

Client-Centered: Carl Rogers

Alderian: Alfred Adler

Gestalt: Fritz Perls

  • Emphasized personal responsibility, awareness, and experiencing the present moment

  • “Gestalt” is a german word meaning “whole” or “complete form” 

  • We perceive and experience things as unified wholes

  • Have clients become aware of thoughts, feelings and actions as a whole especially in the here and now

Empty Chair Technique: The client speaks to an empty chair as if another person is sitting in it

  • They may switch roles, move between chairs, to explore both sides of conflict

  • Helps people express unresolved feelings and gain insight into internal conflict or practive assertiveness

  • What are the 3 elements of Client-Centered Therapy: Genuineness, Empathy, & Unconditional Positive Regard  

#1 Empathy → Involves a deep, nonjudegmental understanding or client’s experience

  • Client-centered therapy emphasizes empathic understanding

  • Empathy can have a positive impact on the client 

#2 Unconditional Positive Regard → Full acceptances of another person no matter what

Facilitates higher levels of congruence and self-actualizatioon 

The Therpist accepts clients entirely and unconditionally 

#3 Genuineness → Therapist’s congruence

  • Helps the therapist establish relationships that feel “real”

  • Encourages a relatively high degree of transparency by the therapist

  • Common Factors of therapy

They are attitudes, not behaviors


Cognitive therapy

  • The idea (the A, B, and C), from Rational Emotive Behavior Therapy, and the connection between thinking and emotion

CBT: Focuses on behavioral change through changing dysfunctional thought processes

  • Relationship between thoughts, feelings, and behaviors

A: Activating events lead to 

B: Thoughts which lead to 

C: Consequences

It's not the A (event) that causes C (the emotion), it’s B (your belief) in between 

Rational Emotive Behavior Therapy: change the belief, and the emotion will follow

Thinking and Emotion: deeply connected 

Negative Thoughts → cause depression, anxiety, etc. 

Cognitive Distortions: like catastrophizing, black and white thinking, or mind-reading distort our view and trigger emotional response


  • The therapist’s role and method

Therapist role: act as a collaborative guide or coach and help the client identify, challenge, and change distorted thinking. Teaches clients to become their own “thought detectives”

Method: Identify situation or triggering event, identify automatic thought, examine the emotional/behavioral consequences, change the thought's accuracy or helpfulness, replace it with a more balanced or realistic thought, practice with guidance, and then independently

  • Define and differentiate between automatic thoughts, cognitive distortions, and core beliefs

Automatic thoughts: quick reflex-like thoughts that pop into your mind in response to situation, often negative and unexamined

Cognitive Distortions: Patterns of biased or irrational thinking that maintain negative emotions

  • Exaggerations, misinterpretations, or inflexible rules

Core Beliefs: Deep, often unconscious beliefs that we hold onto about ourselves, others, and the world. They shape how we interpret events

Know some common cognitive distortions (e.g., labeling, personalization, emotional reasoning, catastrophizing, all or nothing, should thinking) 

  • Labeling: Define yourself/others with a negative term 

  • Personalization: taking responsibility for things that are not your fault

  • Emotional Reasoning: Believing something is true just because you feel it

  • Catastrophizing: expecting the worst possible outcome

  • All-or-nothing belief: seeing things in black-and-white terms 

  • Should/Must Thinking: holding rigid rules for yourself or others


  • historical figures associated with the approach (Beck, Ellis) 

Aaron Beck: founder of cognitive therapy 

Albert Ellis: Developed rational emotive therapy (introduced Athe BC model)

Norman Cotterell and Judith Beck

  • CBT and the relationship between thoughts, feelings, and behaviors 

                Thoughts

                   /     \

     Behavior — Emotions

Change one, and you can influence others



Acceptance and Commitment Therapy

  • Key ideas in ACT

A: Accept your reactions and be present

C: Choose a valued direction 

T: Take action

  • Main Theory: It is counterproductive to try and control our emotions

  • Avoiding or suppressing of these feelings leads to more distress 

  • Rather than avoiding try accepting

  • Define the 3rd wave movement 

An offshore of CBT

  • Define mindfulness: Awareness of the present moment. Full engagement in present activity, Non-judgmental awareness of thoughts, emotions, and senses

    • 6 components: acceptance, defusion, being present/mindfulness, self-as-context, values, committed action 

Acceptance: aka expansion 

  • “making room for unpleasant feelings and sensations” 

Self-as-context: the part of the mind that notices

  • A safe place to acknowledge of difficult thoughts and feelings

  • Enhances defusion

Values: What you stand for, how you treat yourself, others, and the world, guiding compass

Committed Action: Behaving in the service of your chosen values

  • ACT therapists encourage behavior change

  • who is the founder of the approach 🡪 Steven Hayes 


Dialectical Behavior Therapy: A type of cognitive-behavioral therapy that emphasizes acceptance and change, designed to help people regulate intense emotions, improve relationships and reduct self-destructive behaviors

  • Why DBT was developed (for what population?)

Originally developed for people with Borderline Personality Disorder

  • Also a 3rd wave, and what that means 

There have been multiple adaptations to cognitive-behavioral therapies. 

  • The main idea: Emotion-regulation difficulties are the core of serious dysfunction; people can learn healthier ways of reacting and relating

  • components of DBT 

Therapy: Emotion-regulation and for learning new skills 

Distress tolerance: Radical acceptance, self-soothing, distracting oneself

Emotion Regulation: describing your emotion, doing the opposite, mindfulness, defusion 

Interpersonal effectiveness: I-want-they-want, identify needs, effective communication style

Mindfulness: being present in the moment, observing thoughts/feelings non judgmentally

  • what is generally meant by “dialectics” in DBT, and examples of them (e.g., “The Power of And”) 

Dialectics: the idea that two opposing things can both be true at the same time

  • it is not either nor it’s both/and

“I hate how i feel AND i’m working on change”

  • who is the founder of the approach

    • Marsha Linehan  


The Feminist and Multicultural Approaches 

  • describe these frameworks

Multicultural therapy: issues that arise for minority groups (oppression, racism, marginalization) are relevant for mental illness and should be acknowledged durign therapy

Feminist Therapy: Mental health can be understood through an individual's social and cultural identities and the political environment in which they live 

  • what is emphasized; what is important in therapy – empowerment, equal relationships, appropriate self-disclosure 

Main Ideas: 

  • Empowerment of the client: helping them recognize their strengths and resist oppressive messages

  • Egalitarian relationship client and therapist are equal partners; therapists are not “all-knowing” experts

  • Know the Ecological Systems and what each ring (Individual, Microsystem, Mesosystem, Exosystem, and Macrosystem) generally consists of

Individual

  • The person themselves: biology, personality, identity, thoughts, emotions

  • E.g.: Temperament, gender identity, values

Microsystem

  • Immediate environments the person directly interacts with

  • E.g.: Family, school, friends, work, religious group

Mesosystem

  • Connections between microsystems

  • E.g.: Parent-teacher communication, work-life balance, how school affects home life

Exosystem

  • Systems the person is not directly involved in, but that still affect them

  • E.g.: Parent’s workplace, local government, media influence, social services

Macrosystem

  • The broader cultural and societal forces

Therapists

  • does the therapist’s degree predict effectiveness?  Gender? Age? effectiveness? Experience?

Not really, except for when the client perceives it as important to the alliance and when it builds trust

The therapist does not have to of endured what the client experienced 

  • Which demo is higher rated by clients?

  • do interpersonal skills matter?  What else matters?

YES! (emotional intelligence, being able to read the room/expression. Make connections) 

  • Ability to build rapport, trust, and alliance, positive regard towards each other, both on the same side, even where there are moments of confrontation

  • Warmth, genuineness 

  • Ability to read and identify emotions 

  • Verbal processing skills 

  • Humiltiy, non-defensiveness 





Clients

  • the stages of the Stages of Change model

“Transtheoretical model” motivation and readiness for change, by Clementa developed when noticed people trying to quit smoking cigarettes


Main idea: a client’s readiness to change informs a therapist about what to do 

  • therapist strategies at each stage

  • client factors that predict therapeutic effectiveness (severity of symptoms, extra-therapeutic factors, readiness for change, engagement and participation, specific goals, expectations of success) 


Effectiveness

  • are all therapies equal?

  • The difference between effectiveness and efficacy research studies 

  • dodo bird verdict

  • Important common factors including the therapeutic alliance, hope, shared goals, genuineness, empathy, motivation, affirmation 

  • the takeaways – What percentage of therapeutic effectiveness is attributed to what: specific tx (1%), therapeutic alliance (7%) 

  • manuals: the pros and the cons of using them in therapy