Comps Terms
Self Reinforcement [done]
(very important) performance is evaluated against a standard -client evaluates and reinforced self for behavior -overt or covert Sr+ or Sr- -How much reinforcement?; You are not their personal cheerleader let them tell you how they did Ex: "Wow, I did that all by myself!"; feeling of pride, accomplishment
Conditioned and Unconditioned Stimuli [done]
-classical/respondent conditioning -stimulus: any event in the environment
Experiential Family Therapy (tenets of) [done]
* Experiential family therapy is founded on the premise that the root cause of family problems is emotional suppression, lack of awareness, mystification. * Whitaker (self-fulfillment and family cohesiveness) and Satir (focus on communication) were key figures in experiential family therapy * Basic commitment to individual self-expression * Emphasis on flexibility and freedom * Promote individual growth and family cohesion by liberating affects and impulses * Dysfunctional families are locked into self-protection and avoidance - seek security rather than satisfaction * Use of expressive techniques - role-play, props
Exposure with Response Prevention [done]
(ERP) exposure to fearful cues; prevent escape/avoidance (behavioral & cognitive). Obtain detailed description of the situation and context of the problem, define explicit behavior, thoughts, and feelings, explore consequences. Exposure (can be graded or massed), prevent escape or avoidance during these exposures, review coping mechanisms. 2nd generation of exposure therapies; in vivo/direct & indirect Ex: PTSD trauma narrative; panic exposure to activities/situations that elicit physical reactions (increased HR, breathing) & cognitions (fear of losing control, embarrassment) & prevent avoidance Pt. modeling in vivo Ex: ERP to disturb Binge-Purge cycle -Pt eats favorite binge food in therapeutic setting until experiencing the urge to purge (anxiety over wt gain) -Fears of wt gain are often augmented by therapists (exposure) -Purging (escape) is prevented and fear gradually decreases over time -Therapist remains w/ Pt, often w/ other Pts who have also just simulated a "binge" privately in adjoining rooms -After approximately 1- 2 hrs., urge to binge and anxiety subsides -Pt learns that if binging occurs, the urge to purge will decrease over time
Bowen's Family Systems Theory (Tenets of) [done]
* Formulated by Dr. Murray Bowen in the 1950s * Conceptual focus is centered around eight interlocking concepts: o 1) Triangles o 2) Differentiation of Self o 3) Nuclear Family Emotional System o 4) Family Projection Process o 5) Multigenerational Transmission Process o 6) Emotional Cutoff o 7) Sibling Position o 8) Societal Emotional Process * Units of treatment are the multigenerational family system and the interconnecting triangles within and between generations * Emotional fusion (manifested as anxiety) causes problems in the family system * Differentiation of self is the ultimate goal * Genograms
Behavior Therapy
-- reaction to psychodynamic; functional analysis; behavioral analysis - ABCPA; Skinner/Pavlov; classical/operant conditioning
Systematic Desensitization [done]
1st Generation Exposure Therapy: by Reciprocal Inhibition-Joseph Wolpe Three components of systematic desensitization: -Relaxation training; Relaxation is the reciprocal of anxiety and is thought to inhibit it in the pairing process -Anxiety hierarchy; a list of 10-15 situations or items which causes anxiety for the client, rated from lowest to highest on the SUDS scale -Paired presentation of relaxation and anxiety hierarchy Paired presentation: Relaxation Induction -Imagined presentation of items on the hierarchy in consulting room -Graded in vivo exposure usually follows in order to generalize gains in consulting room to the natural environment
Acceptance and Commitment Therapy [done]
3rd generation of CBT; uses acceptance and mindfulness to increase psychological flexibility. Psychopathology comes from experiential avoidance and over-control: unwilling to remain in direct contact with painful experiences, but paradoxically the process of avoiding yields more distress. decreases ANXIETY; objective is not elimination of difficult feelings rather it is to be present with what life brings us and to move forward valued behavior; used with addictions, depression, anxiety • Phase 1: - Creative Hopelessness: challenging client's current solution strategies in order to develop new strategies that are not beset by ineffective rule systems • Phase 2 - Undermine the control agenda: focus on control as the problem which leads to unworkable outcomes through emotional avoidance and escape. Alternative is acceptance of painful, private experiences • Phase 3: Cognitive Diffusion: teach client to see thoughts and feelings for what they are, rather than what they advertise them to be, undermine fusion of self and language • Phase 4 - Discover and Diffuse the Self: undermine the conceptualized self by creating self-awareness and self as perspective w/ flexible contexts • Phase 5: - Valuing: teach importance of value-based living and determine value-based life direction • Phase 6: - Willingness and Commitment: putting goals and values into action. Refuting barriers as they are encountered
Double Bind [done]
A double bind is an emotionally distressing dilemma in communication in which an individual (or group) receives two or more conflicting messages, and one message negates the other. two related but contradictory messages on different levels; escape isn't feasible and response is necessary; concept introduced by Bateson and colleagues. thought to create schizophrenia via schizophrenogenic mother. - There are 6 features which must be present to make it a double bind; 1. two or more persons in an important relationship 2. repeated experience. 3. a primary negative injunction 4. a second injunction at a more abstract level conflicting with the first, also enforced by punishment or perceived threat 5. a tertiary negative injunction prohibiting escape and demanding a response. with out this restriction the victim wont feel bound. 6. the complete set of ingredients is no longer necessary once the victim is conditioned to perceive the world in terms of double binds; any part of the sequence becomes sufficient to trigger panic or rage. Ex: A teacher who urges his students to participate in class but gets impatient if one of them actually interrupts with a question or comment. Students tend not to speak up in classes where their comments are disparaged.
Imaginal Exposure [done]
A form of exposure therapy. Can be indirect/graded or direct. Occurs when the feared stimulus is not physically manifested; instead exposure is done via imagining scenes or speaking about the event repeatedly. Opposite of in vivo. Some types of phobias can only be done with imaginal exposure.
Assets [done]
What the person does well that can be systematically used to overcome behavioral problems. ignored in traditional DSM assessment; What behaviors are in their repertoire?
Genogram [done]
A schematic diagram of the family system, using squares to represent males, circles to indicate females, horizontal lines for marriages, and vertical lines for children. A method to chart family history. Schematic diagrams listing family members and their relationships to one another, including age, marriage/death dates, and geographic locations. Also includes relationships conflicts, cutoffs, and triangles. Developed by Bowen. Used to trace recurring behavior patterns within the family; usually includes 3 generations
Deconstruction in Narrative Therapy [done]
A technique in Narrative family therapy. Therapists help clients take apart and examine taken-for-granted categories and assumptions, making possible newer and sounder constructions of meaning; deconstructing the dominant narrative involves working to understand how the dominant narrative came to be. Common methods are externalizing the problems, finding unique outcomes, and finding counterparts.
Automatic Thought [done]
A type of cognitive distortion. spontaneous, immediate thoughts that appear plausible; usually refer to situations or events which are increasing levels of abstraction e.g. dichotomous reasoning, personalization, emotional reasoning; ANTs - addressed in cognitive restructuring (logic); can be maladaptive and persistent - need to come up with alternative thoughts; help cause/maintain depression/anxiety
Triangulation [done]
According to Bowen the smallest stable unit of relationship; a three-person system; triangulation occurs when two people cannot solve a problem between themselves and pull in a third party - the third party is then the receiver of the anxiety; concept was further developed by Minuchin in the form of coalitions
Assessment Interview [done]
An assessment is a procedure used to evaluate an individual so that one can describe the person in terms of current functioning and also so that one can predict future functioning. tests are used in the assessment process - can be structured (specific set of questions) or unstructured (no guidelines for interviews to follow, open ended questions) - can be affected by the flow/example set by the interviewer - 2 primary sources of error; validity (meaning of the data and reliability (pertaining to its dependability)
Circular Questioning [done]
a method of interviewing developed by the Milan Associates in which questions are asked that highlight differences among family members. Favored by bowenians and structural therapists. explore the process of family interactions. Designed to decenter clients by orienting them toward seeing themselves in a relational context and seeing that context from the perspective of other family members. What's keeping the family stuck?; circular nature of problems becomes apparent
Efficacy expectations [done]
Bandura; prediction that one can perform a given behavior -locus of control, health locus of control, interpersonal trust -fundamental to behavior change -combination of acquisition (attention/retention) and performance (reproduction/reinforcement) necessary to achieve changes in efficacy -self-efficacy can be low or high (how does efficacy influence behavior?) -what you expect affects how many behaviors you attempt Ex: weight loss - low = not confident can exercise effectively, high = confident that can go to the gym and work out 30 minutes a day
Process Questions [done]
Bowen theory; Queries designed to explore what is going on inside people and between them. Designed to slow people down, diminish reactive anxiety, and start them thinking- not just about how others are upsetting them but about how they participate in interpersonal problems. questions aimed at redirecting the family from blaming each other and shift from emotional to more rational responses; Who, What, When, Where, How; promotes thinking and awareness
Multi generational Transmission Process [done]
Bowen's concept for the process occurring over several generations, in which poorly differentiated persons marry equally immature partners, ultimately resulting in children suffering from severe psychological problems. Emotional forces in families that operate over the years in interconnected patterns. Generally seen in one of 4 ways; 1. emotional distance between partners 2. physical or emotional dysfunction in one partner 3. marital conflict 4. projection of problems onto the children. Intensity of problems is related to degree of undifferentiation. describes how small differences in the levels of differentiation between parents and their offspring lead over many generations to marked differences in differentiation among the members of a multigenerational family; problems can compound over successive generations
Differentiation [done]
Bowen's term for psychological separation of intellect and emotions and independence of self from others; autonomy from others and separation of thought from feeling; opposite of fusion. More psychoanalytic in nature.
Narrative Therapy (Tenets of) [done]
a client-focused, strengths-based practice that works from the fundamental position that the client is not the problem: 'the problem is the problem'; developed by White; based on the idea that people create a personal narrative or dominant story to understand and give meaning to their lives and to themselves; these stories are often negative or 'problem saturated'; narrative therapy engages in a process of deconstructing the person's dominant narrative to understand how that narrative influences their thoughts, feelings, behaviors and communication; it then explores whether this narrative is the story the person wants for their life (re-author their story) and works to develop and actualize new, preferred stories for their life; techniques: externalization, deconstruction; can be used with family narrative or individual clients
Enmeshment [done]
Enmeshment is a concept introduced by Salvador Minuchin to describe families where personal boundaries are diffused, sub-systems undifferentiated, and over-concern for others leads to a loss of autonomous development. chaotic and tightly interconnected. family systems theory. opposite is disengagement with rigid boundaries. An enmeshed family allows individual members little to no autonomy or personal boundaries. The roles among family members can be very rigid. parents are dependent on each other and/or their children to make them whole, happy, and loved.
Spontaneous Recovery [done]
a phenomenon of learning and memory which was first seen in classical (Pavlovian) conditioning and refers to the re-emergence of a previously extinguished conditioned response after a delay; after extinction & time interval, CS again is able to elicit CR; extinction is not the same as unlearning; strong positive or negative association with behavior stays in memory - not forgotten
Aptitude Test[done]
Measures potential to learn or natural ability to do something/perform on tasks or react to different situations. Often used for measuring high school students' potential for college. Are prone to bias. Ex: career aptitude test, SAT
Joining [done]
Minuchin. A structural family therapy term for accepting and accommodating to families to win their confidence and circumvent resistance. Makes families more likely to accept treatment. Done with therapist listening to each family members story. Convey respect for each member and current method of interaction.
Unbalancing Technique [done]
Minuchin; used to change the relationship within a subsystem. Used in structural family therapy, occurs when the therapist takes sides by joining and supporting one individual or subsystem, members in conflict are often balanced in opposition and as a result, remain frozen in inaction; "taking sides"
Clinical v Statistical Significance [done]
Clinical sig refers to the outcomes significance in terms of treatment or in a clinical setting. -is the obtained result important or meaningful?; evidence-based treatment Stat sig refers to how likely the results are due to chance .05% is stronger, .01% is better - is the obtained result likely to be attributable to chance factors?; EST clinical sig is more important for me in the long run
Outcome expectations [done]
Mischel's person variables and Bandura's social learning theory; what a person believes will happen; prediction/belief that a behavior will produce a negative or positive stimulus; what will happen? The consequences of behavior; expectations of self, others, systems ex/ if stop smoking for two weeks, you will improve your lung health/overall health - this can improve self efficacy
Problem Solving Therapy [done]
D'Zurilla & Goldfried Problem identification and description: -clarify problem, identify obstacles, determine significance of problem for overall functioning, ABCPA Identification of goals: -set goals, review antecedents, determine consequences of goals Generate solutions to achieve goals: -be creative, no criticism, withhold judgment, free wheel, entertain even bizarre solutions, no stone left unturned, more is better, refine and integrate Decision making -Identify consequences/outcomes (short & long-term) of solutions, cost-benefit of each, rank-order solutions- ex. Probability of success Implementation of solution/follow-up -Carrying out the plan and monitoring progress
Coalitions [done]
Distinct from alliances - cooperative arrangements between 2 parties, formed at the expense of a third. an alliance between two persons or social units against a third; similar to triangulation in Bowen theory. Can be cross generational, with one parent ganging up with a child against the other parent. Triads
Conditioned and Unconditioned Responses [done]
Found in classical/respondent conditioning. anything a person does (If a dead man can do it, it is not behavior) Level -respondents/reflexes/typically micro: movement of muscles/secretion of glands -operants/typically macro: walking, talking, writing, thinking Source -overt/external -covert/internal What of behavior & not products/results: ex. Studying vs earning a grade Conditioned response refers to responses elicited by a conditioned stimulus, due to repeated pairings.
Primary/Secondary Reinforcer[done]
a stimulus that increases (Sr+) or decreases (Sr-) the frequency of a preceding R -Primary reinforcers typically depend on deprivation; Food, water, temperature, etc - secondary reinforcers acquire their value by association with primary reinforcers; control a great number of performances. Can be simple (approval, acceptance, etc) or generalized (tokens, money, etc)
Self Efficacy and Outcome Expectations [done]]
Outcome expectancies: prediction that behavior will produce positive or negative reinforcement; "What will happen?" what will happen? [part of person variables] -If I stop drinking so much, study more, am kind, etc. -prediction that a behavior will produce Sr-/Sr+ Self-efficacy: prediction that one can perform a given behavior; self-efficacy is fundamental to behavior change; "Can I do this?" high SE- attempt difficulty tasks, persist, calm vs. anxious, organized; low SE- question their competency; Can I control my drinking, study time??, situational specific [part of person variables]
Punishment [done]
aversive stimulus/Negative reinforcer is contingent upon a selected behavior. Behavior decreases in frequency. administering an aversive stimulus; effect - temporarily suppresses behavior and doesn't establish a new desirable behavior; needs to be applied consistently; soft (reprimands, chores) or hard punishers (corporal punishment)
Exposure Therapy [done]
Primarily target fears, phobias, and responses to trauma. Focus: primarily on respondents (anxiety) and avoidance as target behaviors including overt and covert escape and avoidance behavior and Physiological/emotional reactivity (CRs to CSs) Conceptual model: initially based on respondent conditioning, later expanded to include operant conditioning, modeling, and cognition Rationale: must elicit fear by exposure to feared stimuli in order to reduce the fear via extinction process, cognitive restructuring-processing and higher self-efficacy Intervention procedure: expose pt to fearful stimulus/event, allow physiological reactivity to abate, prevent escape and avoidance responses. Begin at lowest SUDS rating and build on that. -Reciprocal inhibition & graded exposure not necessary to lower fear in systematic desensitization -Simple exposure is sufficient/necessary to lower fear -Cognitive processing is very helpful, and many think that it is a crucial component TYPES: imagined/indirect, Imagined/direct, in vivo/indirect (graded tasks), in vivo/direct • Imagined and indirect - Less frightening - Less resistance - Coupled with relaxation and pleasant imagery - Prelude to in vivo exposure - Slower results • In vivo and direct - More fearful - Perhaps more resistance - Longer sessions maybe be necessary - (sometimes) Subsequent to imagined exposure - Faster results
Extinction [done]
Reinforcer maintaining the behavior is withdrawn, and the behavior decreases in frequency. This tends to be unpleasant and may be aversive temporarily. learning principle; in both types of condition behavior has been reduced, but in operant, this can also yield an extinction burst; short term increased rate of performance. -respondent -when CS no longer elicits CR -CS repeatedly presented with no UCR -therapeutic extinction -repeated exposure to CS without UCS -CS is trauma narrative -operant -when response no longer produces positive reinforcement -reinforcer maintaining behavior is withdrawn, behavior decreases in frequency
Miracle Question [done]
Solution focused therapy technique. Asking clients to imagine how things would be if they woke up tomorrow and their problem was solved. Used to help clients identify goals and potential solutions. Helps clients look beyond the problem to see what they really want and begin to activate problem solivng. Most effectively introduced when clients complain in vague terms.
Structural Family Therapy (tenets of) [done]
Structural Family Therapy (tenets of): developed by Minuchin -most important tenet - every family has a structure, and this structure is revealed only when the family is in action -family structure is the way the family is organized into subsystems and how the interactions of those subsystems is regulated by boundaries -problems result from the way the family is organized - if organization shifts, the problem will shift -boundaries -rigid - leads to disengagement -clear - normal -diffuse - enmeshment -requirements for the union of a couple are accommodation and boundary making -fear of change - conflict avoidance -cross-generational coalition -joining -enactments
Alignments [done]
Term employed by Wynne. The way that family members team and join together to perform and carry out family tasks. These alignments affect the dynamics of how the family interacts and relates to one another. Can be negative or positive. Counselors may work to enter the family unit through joining in order to break alliances and help up healthier ones.
Achievement Test [done]
Tests individual on previous learning. Generally used in schools and educational settings. Measures or evaluates previous knowledge. can be multiple choice/essay, standardized, 1st, 2nd, 3rd place; higher scores represent mastery Ex: math test in school
Individual and Group contingency [done]
a form of behavior management that emerged from behavioral therapy and behavioral analysis. There are 3 types: individual, standard, group each one describing the consequences of behavior based on the fulfillment of a condition. Individual: specific students are involved with individualized programs - individualized for each student depending on thier level ex/ J must answer 5 out of 7 problems correctly in order to go outside, D must answer 6 out of 7 problems correctly in order to go outside. Group: reinforcement related to satisfying group contingency depends on ALL members satisfying contingency. This promotes peer interaction and influence, effective if done correctly. Can be abused (one person going everyone's work.) ex/ everyone in the class must answer 4 out of 6 problems correctly in order to go to recess Standard:
Homeostasis -ive got emily's and a notecard...
a balanced steady state of equilibrium; family systems when threatened, endeavor to maintain stability Ex: whenever two parents argue, their child exhibits symptomatic behavior - possibly to interrupt the fighting by uniting the parents in concern (this symptomatic behavior can serve the cybernetic function of preserving the family's equilibrium)
Fusion [done]
a blurring of psychological boundaries between self and others and a contamination of emotional and intellectual functioning; opposite of differentiation. Bowen Theory. an excess of emotional reactivity. A psychological quality of individuals. Has an impact on relationships, but it is within a person. manifested as anxiety.
Scapegoat [done]
a member of the family, usually the identified patient, who is the object of displaced conflict or criticism; source of problems or pathology; term used by Ackerman in psychodynamic therapy (unconscious)
Meta analysis and Effect Size [done]
a study of studies that combines the results of multiple studies. Analysis of effect sizes from many studies that satisfy certain criteria. (e.g. random assignment, control group, blinded, etc.) A measure of the strength of relationship versus the control. Can be expressed in z scores or percent of variance accounted for small = .25, medium = .5, large = 1.0+ Ex: comparison of studies measuring peer influence on substance use in adolescence
Token Economy [done]
a system of behavior modification based on the systematic reinforcement of target behavior; the reinforcers are symbols or "tokens" that can be exchanged for other reinforcers; conditioned or secondary reinforcers; acquire their value by association with primary reinforcers; can be simple or generalized
Paradoxical Intervention [done] 553
a technique used in strategic therapy whereby the therapist directs family members to continue their symptomatic behavior; if they conform, they admit control and expose secondary gain; if they rebel, they give up their symptoms; therapist gives client or family a directive that he or she wants to be resisted; overcome or eliminate client resistance or the problem behavior
Multiple Baseline Design [done]
a type of experimental design where either a single participant is observed for multiple behaviors/independent variables or multiple participants are observed for the same behavior/variable in sequence; useful as an alternative research method to reversal designs to avoid ethical questions of removing treatment and want to eliminate carry over effects, but still lacking in generalizability; across situation/participants/behavior
In Vivo Exposure [done]
a type of exposure therapy. Can be direct or indirect/graded. Opposite of Imaginal exposure. Usually has quicker results; using actual objects/situation in safe environment • In vivo and direct - More fearful - Perhaps more resistance - Longer sessions maybe be necessary - (sometimes) Subsequent to imagined exposure - Faster results Ex:
Reactivity of self monitoring [done]
account of how the operation of recording interacts or reacts with the problem behavior; makes clients more aware of and might increase behavior; the (probable) interaction of the measurement operation (taking a test or scale, self- or other person monitoring, etc.) with the behavior being measured; the measurement may/may not interact w/ the behavior; MUST be very careful - solution? Focus on monitoring/recording appropriate "good" behavior instead of inappropriate "bad" behavior Ex: Counselor sees Joe who complains of depression. Joe completes a depression scale prior to the session and his score is not in the clinical range. During the session Joe also minimizes the extent of depression. Counselor has him monitor depressive and "fun" episodes for 1/wk. and there are many more depressive vs. fun times. In light of the difference in the scale and self-monitoring, counselor decides to re-administer the depression scale to Joe, requesting that he not try to either minimize or maximize his responses.
Reciprocal Determinism [done]
affects behaviors and personality development; illustrates reciprocal determinism outlined by Bandura; Person, Behavior, Environment where P, B, E (overriding conceptual framework) influence one another/interact with each other; If....(situation-E), Then....(activation of specific person variable units-P)→ specific behavior pattern-B
Differential reinforcement of Other/Incompatible Behavior (DRO) [done]
aka DRI (incompatible behavior); operant conditioning; behaviors must compete; typically used when trying to decrease the frequency of an undesirable behavior; the "other" behavior is often incompatible with the undesired behavior. Often the most effective way to decrease an undesired behavior.
Discriminative Stimulus [done]
aka cue, signal; operant conditioning; A stimulus (negative or positive) previously associated with a reinforcer (negative or positive) which signals that a response will produce the positive reinforcer or avoid the negative reinforcer
ABA or Reversal Design [done]
an experimental design (single case) consisting of an initial baseline phase, an intervention phase, and a return to baseline conditions by withdrawing the independent variable to see whether responding "reverses" to levels observed in the initial baseline phase; CONS - may not be ethical due to removal of treatment intervention, or skill may not be able to be "unlearned", not generalizable;
Enactment [done]
an interaction stimulated in structural family therapy in order to observe and then change transactions that make up family structure; can being about reframing. Structural technique. observing and modifying the structure of family transactions in the immediate context of the session. therapist works with what they see not what family members describe. therapist stimulates the family to demonstrate how they handle a particular problem. Therapist suggests certain topics for family to discuss. Requires 3 operations; 1. therapist defines/recognizes a problematic sequence 2. therapist direct an enactment 3. therapist guides the family to modify the enactment.
Cognitive Fusion [done]
associated with ACT. The state of mind in which we are so fused with our thoughts that they appear to be synonymous with fact; not being able to see thoughts as thoughts. recognize the thoughts and use logic - 5 senses. verbal regulation of behavior primarily by rules and "reason giving."
Behavior Activation Therapy [done]
based on Lewhinson's theory of depression in which low frequency of engagement in positively reinforcing behaviors causes depression; occurs via monitoring (1), scheduling activities (2), graded exposure (3); is often used initially and if additional therapy is needed cognitive restructuring; therapist helps create opportunities for reinforcing behavior. Implementation can be summed up with ACTION; (A)ssess the activity, what they want, how will it affect depression, (C)hoose to participate, (T)ry the behavior chose, (I)ntegrate new activities into daily routine, (O)bserve the result (did it make things better or worse?) and finally (N)ever give up.
Escape and avoidance [done]
behavior that occurs to avoid negative reinforcement; behavior terminates an aversive stimulus; behavior increases in frequency. figuring a way out of or around punishment; operant avoidance; escape behaviors are learned behaviors - can learn to avoid through recognize the pre-aversive stimulus; first learn the need to escape then avoidance
Positive Reinforcement [done]
behavior theory/therapy; operant conditioning; increase behavior due to reward/desirable stimulus occurring immediately after behavior
Motivational Interviewing [done]
client-centered therapy for eliciting behavior change by helping clients explore and resolve ambivalence; developed by Miller. Developed to increase ETOH abusers involvement in Rx program, it is now incorporated into many CBT formats in a wide variety of settings Many "enter" therapy ambivalent over changing, MI increases motivation for change by exploring/resolving ambivalence (resistance). Referred to as interviewing because it involves listening/questioning rather than therapy/techniques. considers motivation for change as a state not a trait. Main goal: increase cognitive dissonance by encouraging the client to highlight the discrepancy between current behavior and personal goals/values. Resistance is natural part, viewed as opportunity to enhance motivation, not to be attacked. applied in 2 phases; buidling motivation for change, and strengthing commitment to change. techniques include; expressing empathy, develop discrepancies, roll with resistance, support self efficacy, decision balance matrix. Therapist: empathic listening, doesn't extol merits of behavior change, actively elicits +/- of status quo vs. change from patient. Patient: hear themselves state (+/- ) of both positions and articulate costs/benefits for change Stages of change: pre-contemplative, contemplative, preparation, action, maintenance
Spontaneous Remission [done]
clinical improvement/resolution of symptoms which cant be attributed to one clinical reason or another; there is no obvious explanation. Ex: a person who has suffered from depression for several months suddenly notices/reports significant decrease in symptoms despite no treatment interventions or logical explanation for improvement
Operant Conditioning [done]
coined by Skinner and based on Thorndike's law of effect. Part of Behaviorism. changing behavior through use of reinforcement given after desired response; responses are either strengthened/increased (positive/negative reinforcement) or weakened/decreased (punishment/extinction). conditioned stimulus elicits a controlled response; controlled by the antecedent OR an unconditioned stimulus elicits an unconditioned, automatic response. a performance R is followed by a reinforcer Sr and the performance increases or decreases in frequency depending on whether the reinforcer is positive Sr+ or negative Sr-
Construct [done]
complex, abstract concepts that are indirectly observed through a collection of related events; not directly observable; constructs are typically defined prior to conducting a study - can be easy or difficult to measure; characteristic which varies from individual to individual, but which is not directly observable. The characteristic is an internal event or process that must be inferred from external behavior. Constructs may be derived from theory, research, or observation. Tests generally are designed to measure an internal construct. Ex: The counselor administered a paper and pencil assessment measure that solicited responses related to fidgeting, excessive worrying, difficulty concentrating - all representing the construct of anxiety
Learning-Performance Distinction [done]
concept in behaviorism that stresses the difference between the learning of a behavior and actual performance of the behavior; the learning of a behavior or skill doesn't necessarily require the performance or practice of the behavior; learning isn't just the performance of a learned behavior - it is a change in the ability and potential to do the behavior Ex: For example, imagine an individual who has never played basketball before. They watch a basketball game on television and learn the main concept of the game which is getting the ball into the hoop. This behavior is now learned but remains latent until the person actually plays basketball for the first time and shoots the ball into the hoop. The learning-performance distinction show the difference between learning (watching the basketball game and grasping the concept of the behavior) and performance (actually performing the behavior).
Extrinsic and Intrinsic Reinforcers [done]
consequences that occur after behavior and increase frequency of behavior -extrinsic: external consequences of activity (product) -e.g. working for money -intrinsic: inherent in the activity (when you are doing the act, it is reinforcing, NOT the product of the act); more effective at maintaining behaviors and goal should be to fade from extrinsic to intrinsic; self-motivated -e.g. "starving artists", teachers; reading a book
Correlation v Causation [done]
correlation does not imply causation; correlation refers to whether 2 variables are related or the extent to which change in 1 variable corresponds with change in the 2nd variable. this also can include whether association is greater than expected by chance strength of association. These changes may be due to a 3rd variable or external influences on the other 2 variables.uses data/variables that currently exist - NOT manipulated; used to determine: -whether 2 variables co-vary-association - weak, moderate, strong Causation: relationship between cause and effect; causality usually determined via controlled study
Empirically supported therapy/treatments [done]
criteria for EST - met stringent scientific criteria: 1) at least 2 randomized controlled trials (RCT) comparing treatment to placebo and/or established treatment, a large # of single case experimental design studies, or meta-analysis 2) well-defined treatment protocol that can be independently replicated usually following a manual 3) independent investigators reach similar conclusions form basis of evidence based practice
Classical/Respondent Conditioning [done]
developed by Ivan Pavlov. A type of condition which is learned by repeated pairings; a previously neutral stimulus acquires the ability to elicit a respondent (reflex or emotional response). Can also be a discriminative stimulus signaling a response which is followed by a reinforcing stimulus; the response is controlled by the consequences. Measures magnitude/strength; influences internal environment (primarily); CS and CR closely related. CR is stronger if; CS precedes UCS by short vs long time; UCR is powerful internal respondent (eg nausea); greater number of CS-UCS If many neutral Ss are paired with UCS, most salient will be more potent CS PHASES: acquisition, extinction, spontaneous recovery, reconditioning
Dialectical Behavior Therapy [DONE]
developed by Marsha Linehan; type of CBT that includes mindfulness, skills training, and humanistic; usually done by consultation team but also includes individual therapy and skills acquisition group; under theoretical behaviorism and mediation model. Involves changing patterns of behavior that are NOT helpful (ex: self-harm, suicidal thinking) and learning about what triggers those behaviors and how to assess coping skills to apply to avoid undesired reactions. Assumes person is simply lacking the skills or influenced by positive or negative reinforcement that interfere with their ability to function appropriately. Initially developed to treat people with borderline personality disorder and chronically suicidal individuals; Emotional dys-regulation results from high emotional temperament style and difficulty modulating emotions. Dialectical- synthesis develops from combining a thesis and antithesis; Thesis (acceptance and validation)/antithesis (change) - synthesis of that is "I accept that I need to change": Emotional dysregulation + invaliding environment = BPD
Schema [done]
developed by Piaget; an organized way of thinking about the world; organized unit, knowledge about the world; cognitive structures (patterns of thinking) that organize and process information. Content differs depending on the disorder. cognitive information grouped together; cognitions differ in anxiety, depression, OCD; provide a framework for future understanding - accommodation/assimilation; tend to look for info that support schema - can be fixed/rigid Ex: routines; stereotypes; expectations; person variables - expectations given certain situations
Learned Helplessness [done]
exposure to frequent (bombarded) uncontrollable Sr- produces apathy, passivity, depression (prostitutes, depressed, homeless, immigrants); a condition in which a person suffers from a sense of powerlessness, arising from a traumatic event or persistent failure to succeed. It is thought to be one of the underlying causes of depression
Parent-Child Training Therapy [done]
family intervention therapy with goals of improving the parent-child relationship and the parent's behavior management skills by the therapist teaching parents to work with their child positively, set appropriate limits, to act consistently, be fair with their discipline decisions, and to establish more appropriate expectations regarding the child while teaching the child better social skills; ideally strengthening the relationship improves the child's behavior; accomplished in 2 phases: 1) child directed interactions to increase parental responsiveness and establish a secure and nurturing relationship 2) parent directed interactions works on improving parental limit setting and consistency in discipline. Child target behaviors: high rates of opposition, defiance, whining, hitting, yelling, non-compliance -Parental problem behaviors: excessively critical, threatening, and nagging behavior; low level of Sr+ for appropriate behavior
Premack Principle [done]
high frequency behavior (HFB) can function as a positive reinforcer; want low frequency behavior (LFB) to increase and function as intrinsic reinforcer; useful in natural environments; process: to increase the frequency of a low frequency, desired behavior (LFB), arrange for a more frequently occurring behavior (HFB) to be contingent upon it; HFB is withheld until LFB is performed Ex: do your homework, then you can play video games
Entropy [done]
in family systems theory, the tendency of a system to be closed to the environment; lack of energy and information being taken in; within a family system entropy can increase, decrease, or remain the same; gradual decline into disorder; systems that lack the capability to deal with stress may gradually regress into disorder especially when operating as a closed system, not receiving feedback from the outside system, leading to operating in an ineffective, fearful, or confused manner during times of crisis
Reinforcer [done]
in operant conditioning, an event in the environment or stimulus provided as a response to a behavior in order to increase the behavior; the ability of the reinforce to increase a behavior is through the addition of something pleasant (positive) or the removal of something unpleasant (negative) in response to a behavior; typically a reinforcer is more successful in small immediate contingencies as opposed to large delayed ones; schedules of reinforcement; positive and negative reinforcer; primary - food/water; secondary - praise, tokens, money Ex: The counselor used a positive, secondary reinforcer (star stickers) to reward her 6-year-old client each time he successfully completed homework. The counselor noticed after implementation of the reinforcer, the client consistently completed homework each week and looked forward to receiving the sticker.
Shaping [done]
in operant conditioning; to establish a novel behavior not in the repertoire, reinforce in successive approximations to it ex/ to teach a pigeon how to peck a spot on the wall, reinforce getting closer to the wall, then pecking the wall around that spot, then for only pecking the spot on the wall.
Brief Solution Focused Therapy (Tenets of) [done]
laces focus on a person's present and future circumstances and goals rather than past experiences. In this goal-oriented therapy, the symptoms or issues bringing a person to therapy are typically not targeted. Instead, a qualified therapist encourages those in treatment to develop a vision of the future and offers support as they determine the skills, resources, and abilities needed to achieve that vision successfully.grew out of the work of de Shazer and Berg -less than 20 sessions -focus on the present where problems are maintained rather than searching for what caused them -look to the future where problems can be solved - don't necessarily define/identify problem (non-pathologizing) -"problem talk" is negative (focuses on the past and implies permanence of problems) -search for underlying flaws is rejected -language of solutions is more helpful, positive, and future oriented -amplify exceptions to problems - solutions already in repertoire -miracle question -problem is rated on a scale of 1-10 (worst - therapeutic goal) - scaling questions -goal: to resolve presenting problems as expeditiously as possible -achieved by solution talk and setting (modest) goals (What will you be doing instead?) -problems are solved one step at a time
Externalization Technique [done]
michael white's technique of personifying problems as external to persons. A technique in Narrative therapy, instead of having/being a problem, clients are encouraged to think of themselves as struggling against thier problems. No one is the problem, the problem is the problem. the problem is given a name and the client and supporters work together to 'defeat' it; by naming The Problem, clients can take ownership of it and their relationship with it. externalizing starts with language - that is, referring to The Problem with its own identity. This process is seen as critical in narrative therapy. Naming the problem is a shift in language that gives the problem its own identity. Ideally, it involves the name being used by the therapist and the client, and also by significant others in the client's life. This allows the practitioner, the client, their family and significant others to be critical of The Problem, without being critical of the person
Schedules of reinforcement [done]
operant condition; contingencies describing the relationship between a behavior and its consequences; this can be a fixed ratio, variable ratio, fixed interval, and variable interval, where ratio is related to amount and interval is related to time. Fixed means the timing does not change, variable means it is flexible.variable schedules have higher/stable rates of responding and higher resistance to extinction Ex: -continuous (CRF, FR/1) reinforcer delivered after every response -fixed ratio (FR/20) reinforcer delivered after 20 responses -variable ratio (VR/50) reinforcer delivered after 50 responses on average -fixed interval (FI/1 week) reinforcer delivered every week (ex: paycheck every Friday) [FI scallop - gradual increase after reinforcer] -variable interval (VI/30 sec) reinforcer delivered every 30 seconds on average
Chaining [done]
operant conditioning; A sequence of discriminate stimulus, responses, and positive reinforcements, each response produces a discriminate stimulus for the next response ex/ skill development in learning a dance
Negative reinforcement [done]
operant conditioning; Skinner; response that removes an aversive stimulus (consequence/event); behavior increases Ex: applying sunscreen to avoid/prevent sunburn; drinking to avoid withdraw symptoms; OCD - compulsive behaviors are reinforced to remove/avoid thoughts
Outcome vs Process Research [done]
outcome; assesses the effectiveness of a treatment in producing change or determining the extent to which a treatment is better than the control treatment. process; shows how the outcome or impact was achieved or the development of this particular treatment to determine which variables of the treatment are effective. aka a dismantling study
Anxiety Hierarchy [done]
part of systemized desensitization. A generated list of feared/phobic situations with the client; generally 10-15 things. Arranged on the strength of disturbance (SUDS rating) from lowest to highest. fill in any gaps
Generalization and discrimination [done]
phenomenon observed in operant/classical(respondent) conditioning (g)Control of performance by stimuli similar to conditioned stimulus in respondent conditioning or discriminative stimulus in operant conditioning stimulus similar to conditioned stimulus and discriminate stimulus will control the response (d)control of performance by specific discriminative stimulus or conditioned stimulus only; counterpart to generalization - first learn to generalize then learn to discriminate
Iatrogenic Effects [done]
refers to any effect on a person, resulting from any activity of one or more persons acting as healthcare professionals or promoting products or services as beneficial to health, that does not support a goal of the person affected; making things worse through treatment; inadvertent; suggestive therapeutic techniques
Reframing [done]
relabeling a family's description of behavior to make it more amenable to therapeutic change; relabeling behavior to shift how family members respond to it; brief therapy. Central feature in strategic therapy. A method of changing "rules" of how the family interacts.
Social Skills Training [done]
social skills - ability to engage in behavior that is positively reinforced by others and minimize behavior that is punished by others Components of social skills: eye contact, facial expressions, attention to others, listening, appropriate affect expression, gestures, speech duration/silence/latency, compliments, positive statements Basic assumption: psychopathology results from ineffective social behavior &/or problem solving that yields negative consequences and a self-defeating pattern of behavior. Therefore, social skills training develop targeted skills and plan for these skills to generalize to other social situations. 1st target overt behavior, then shift to person variables. 3 phases: 1) Assessment; includes clinical interview ABCPA; Behavioral assessment; self report (scales, self monitoring) 2) Situations and responses • Situational specificity: - In the course of social development, we acquire abilities to perform in specific situations which may/may not generalize to other situations - In therapy, develop targeted skills and plan for these skills to generalize to other social situations • Response mode: - First target overt behaviors in the course of Social Skills Training, then shift to: - Person variables (Mischel): affective/emotional responses, encoding, planning, rehearsal, problem solving, goals, evaluative standards 3) Therapeutic interventions; response definition, behavioral rehearsal, modeling, feedback/coaching/instruction (shaping), homework (try it out)
Scaling Questions [done]
solution focused clients are asked to rate on a 10 pt scale how much they want to resolve their problems, how bad the problem is, ho w much better it is than the last time, and so on. Designed to break change up into small steps. Helps therapists and clients talk about vague topics like depression. Also helps clients quantify their confidence that they can maintain their resolve. These are a useful way of anticipating and disarming resistance and backsliding and of encouraging commitment to change.
Disengagement [done]
structural family therapy - Minuchin. Psychological isolation that results from overly rigid boundaries around individuals and subsystems in a family. Disengagement fosters autonomy but limits affection and nurture. opposite of enmeshment. disengaged families must come under extreme stress before they mobilize assistance
Decision Balance Matrix [done]
technique used with motivational interviewing and often used in working with ambivalence in people who are engaged in behaviors that are harmful to their health; therapist asks the client to list the pros (benefits) and cons (costs) of making a change versus not making a change; the goal being for the client to "tip" the balance in favor of the benefits to making a change. This is usually done in a 2x2 grid.
Functional Analysis [done]
the primary way by which behaviorists identify and assess the purpose and meaning of a client's behavior through the identification of the environmental stimuli that control the behavior, when then allows for the creation of a plan to increase, decrease, or modify the target behaviors. Typically done using the ABCPA model where the behavior (B) is explicitly identified and measurably defined, the circumstances that precede the behavior (antecedents A) and follow it (consequences C)are considered. As well as the client's person variables (P) such as houw the encode, feel and thier self talk along with thier assests (A), things they do well.
Cognitive Restructuring [done]
therapeutic technique in cognitive therapy; Client is encouraged to identify cognitive distortions that are maladaptive, challenge the validity of these distortions, and explore more adaptive alternatives. Monitoring/identifying/categorizing dysfunctional automatic thoughts (cognitive distortions) which are viewed as hypotheses in need of empirical evaluation (not viewed as truth) ----not on card--- - Crucial questions during cognitive restructuring • What is evidence for/against this belief? • What are alternative interpretations of this event? • What are the implications, if the belief is correct? - Progress from events → automatic thoughts →assumptions → schema: identify/categorize and question - Guided discovery and Socratic inquiry: using leading questions
Mindfulness [done]
therapeutic technique often used as a therapy; third wave therapy; originates from Buddhism and eastern meditation. encourages client to accept and come to terms with thoughts/behaviors and internal/external experiences in the present moment and to be aware of them without judging/believing them, to accept them as they are. Adopting an orientation to moment-to-moment experiences that is characterized by openness, curiosity, and acceptance. All experiences are considered initially as relevant, worthy of observation, and accepted. Applications include stress management, stress-related illnesses (pain, headache, etc) anxiety, depression, eating disorders, etc. CBT use: no specific goal, task is to sit still and observe, no striving to relax or change thoughts, emotions, behavior, decrease pain, etc Exercises: -Goal is not to induce relaxation but foster non-judgmental observation of current state -Mind as conveyer belt: experience all sensations/thoughts as they come along, observe, label, categorize, no analysis/evaluation -Mind as sky: clouds are feelings and thoughts -Breadth: observe in and out
Cue exposure therapy [done]
third generation exposure - basically an ERP for substance use - exposure to specific situations and cognitions (CS) [e.g. seeing an ashtray smoking] that induce cravings/urges; initial sessions - repeated cue exposure - cravings will subside extinguish ability of CS CR; later sessions - cue exposure with coping/social skills as alternative responses
Cognitive Therapy [done]
type of therapy developed by Beck Focus on cognitions as the origin of maladaptive behavior, thoughts and emotions, Therapies target cognitive changes as necessary to develop more adaptive emotional and behavioral responses • Assumption - pathology results from cognitive distortions, Cognitions are related to behavior, Cognitive activity is potentially observable, it can be monitored, counted, altered, Client is considered expert and collaborator • Two main components are BA and cognitive restructuring • Levels of cognitive distortions (triggered by event) - (1st level) Automatic thoughts: spontaneous thoughts that appear plausible e.g. dichotomous reasoning, personalization, emotional reasoning "I feel this way... it must be so" - (2nd level) Assumptions: abstract, generalized rules e.g. "I must be perfect in all endeavors", " Everyone should like me", " I must be on guard at all times" - (3rd level) Schemas: cognitive structures (patterns of thinking) that organize and process info e.g. negative cognitive triad (self, world, future), cognitions differ in anxiety, depression, OCD • use treatment to help people recognize their patterns of thought • Goal: aid pt in dealing w/ problems in living • Focus: more on present vs. less on past, pathology and assets, objective data vs. projective tests, interventions and their evaluation • General Process: behavioral analysis of problem, select target behaviors w/ measurement, apply interventions, determine their effectiveness -Bandura's Enviorment ↔Person↔Behavior as a model (change in P changes B and E) TYPES: Meichenbaum's Stress Inoculation Therapy , Ellis' Rational Emotive Behavior Therapy, Beck's Cognitive Therapy
Successive Approximations [done]
used in shaping to control behavior; a behavioral term that refers to gradually molding or training an organism to perform a specific response by reinforcing any responses that come close to the desired response
Confounding Variables [done]
variables which are not the object of the study but still need to be controlled in order for it not to effect the study. 4 ways to control; hold constant, matching, randomized, statistical procedure. aka extraneous variables; may influence outcomes/dependent variable (e.g. symptom reduction and quality of life)
Modeling [done]
vicarious/observational learning - Learning observationally through watching someone else complete the action; accounts for the bulk of human learning. modeling phases/processes: attentional/retention/reproduction/feedback; modeling effects: learning of novel behavior (inhibitory/disinhibitory), facilitation Bandura and Bobo doll experiment;
Contingency [done]
when referring to behavior - contingency-shaped: behavior developed by its consequences; in operant conditioning, relationship between a discriminate stimulus, a behavior, and its consequences. Also a schedule of reinforcement. with this cue, this behavior will result in reinforcing stimuli. rules are a shortened version ex/ when the light turns green, stepping on the gas is reinforced.
