Counseling 505 Study Guide

What are some different views of counseling? (example, medical/pathological model etc.)

- Counselors base treatment plans in accordance with the Diagnostic and Statistical Manual of Mental Disorders (DSM), which is compatible with the International Classification of Diseases (ICD) manual. - Arguments for using the DSM in treatment planning include: § The DSM is universally used in other helping professions and forms the basis for common dialogue between counselors and other mental health specialists. § The DSM system helps counselors recognize patterns of mental distress in clients who need to be referred to other mental health professionals or treated in a certain way. § By learning the DSM system, counselors establish accountability, credibility, uniform record keeping, informed treatment plans, research, and quality assurance.

Are mental ill generally dangerous are there many people with psychotic symptoms in jail for violent crimes?

- The U.S. ranks highest in rate and number of incarcerated persons • Many incarcerated with mental illness • Incarceration does not meet the needs of this population • Recidivism is high - 5 Categories of persons with mental illness who come in contact with the criminal justice system - Programs have been developed to send persons with mental illness to community mental health treatment centers - Reentry programs have been developed to help with transition from jail/ prison to community

What is metic and emic?

Etic and emic are two perspecitves of multicultural couseling: Etic - stating universal qualities exist in counseling that are culturally generalizable; the etic approach can be criticized for not taking important cultural differences into account. Emic - assumes counseling approaches must be designed to be culturally specific; the emic approach can be criticized for placing too much emphasis on specific techniques as the vehicle for client change.

CACREP has identified eight common core areas of study that are required of all students in graduate counseling programs:

Professional Orientation and Ethical Practice Social and Cultural Diversity Human Growth and Development Career Development Counseling and Helping Relationships Group Work Assessment Research and Program Evaluation

What is a psycho educational group?

Psychoeducation groups focus on helping people develop specific skills, understand certain themes, and understand and resolve difficult life transitions

List some specializations within the counseling profession:

School Counselor Career Counselor Mental Health Counselor Marriage Counselor Rehabilitation Counselor

Know the basic principles of the types of therapies mentioned in the chapter. Know the theorists associated with each.

Sigmund Freud (1856-1939) ‒ "Talking out" approach to reduce physical symptoms of hysteria. ‒ Conflict between impulses, societal rules, and reality. ‒ Basic Assumptions: • Psychic determinism: Everything (actions, thoughts, feelings) relates to our drive to fulfill our needs. • Unconscious motivation: Most human behavior stems from factors that lie beyond our awareness - our unconscious attempts to resolve conflicts between urges, reality, and rules. ‒ Structures of Personality: • Id, Ego, Superego ‒ Levels of Awareness: • Conscious, Preconscious, Unconscious ‒ Types of Anxiety: • Reality Anxiety, Moral Anxiety, Neurotic Anxiety ‒ Ego Defense Mechanisms: Unconscious distortion of reality in some way so that the impulses of the id that reach the consciousness will not be recognized by the superego. ‒ Goal of Treatment: • Modify the structure of personality by making the unconscious material conscious, so that the client will increase in awareness. • Transference • Free association • Interpretation Object Relations Therapy Although around 2% of practicing counselors embrace classical psychoanalytic theory, a larger proportion practice modified versions such as object relations, or self-psychology. ‒ Object relations theory goes beyond Freud's analysis of personality structures by focusing on the relationship between the self and objects, which are mental representations of others. ‒ John Bowlby (1988), a well-known object relations theorist, noted the strong emotional bond that develops between the infant and the primary caregiver in the first year. The established attachment relationship, based on the nature of the infant-caregiver interactions, becomes an internalized working model that greatly influences the developing person's capacity to form stable affectional bonds and self-regulate personal emotional experience and behavior-in-relationships. Infants whose primary caregivers are experienced as consistently available, sensitive to the infant's cues, and responsive to those cues develop a secure attachment. ‒ Attachment theory (Bowlby, 1988) suggests that counselors establish a secure base that enables clients to explore unhappy, painful, and traumatic parts of their lives. From this base, clients are encouraged and supported to consider and recognize how current patterns in their relationships relate to internalized working models stemming from their early childhood experiences. Individual Psychology (Alderian Therapy) Alfred Adler (1870-1937) ‒ Adler began to criticize Freud's theory for its overemphasis on sexuality and its discounting of conscious processes. A sharp break in Adler and Freud's relationship resulted, and Adler quickly established individual psychology as an important alternative perspective. Six assumptions are the foundation of the Adlerian perspective: ‒ First, behavior is goal oriented, purposeful, and socially motivated ‒ Adler believed that, rather than being determined by unconscious conflicts or past determinants, behavior is determined by one's outlook on the future. In addition, he believed that behavior results from conscious choice and is motivated by stimuli present in the social situation. ‒ The second assumption is that behavior is best understood from the vantage point of the client's subjective reality. Personal behavior is influenced by the person's thoughts, beliefs, perceptions, and conclusions. To make sense of the client's behavior, the counselor is advised to see the world through the eyes of the client. ‒ Third, personality is an organized whole that interacts within a specific and unique social system. Adlerian theory focuses on interpersonal dynamics rather than intrapsychic structures. ‒ Fourth, the core motive for behavior is to strive for superiority. Each of us has self-identified deficits, or inferiorities, that we desire to overcome. This desire becomes the powerful force that drives behavior, referred to as fictional finalism, which provides direction to each person's strivings. ‒ Fifth, each person develops a type of cognitive map, referred to as a lifestyle, that lends consistency to his or her behavior in striving for chosen goals. ‒ Finally, humans find personal fulfillment and well-being by acting for the general social interest. Thus, being socially connected is critical to our emotional well-being. ‒ Goal of Treatment: The fundamental goal in Adlerian counseling and psychotherapy is to help clients live a more fulfilling life in ways that contribute not only to personal well-being but also to the general well-being of others. In other words, clients develop more effective lifestyles and healthy social interests that facilitate positive strivings for superiority. Behavior Therapy Ivan Pavlov and B. F. Skinner. Classical Conditioning (Ivan Pavlov) - is the type of learning that takes place when specific stimuli elicit particular behavior. ‒ Dogs salivate when presented with food. If a bell is rung every time they are presented with food, they will start to salivate when hearing the bell before they even see the food. ‒ In his classic studies, Pavlov noted, first, that an unlearned stimulus (i.e., food—the unconditioned stimulus) elicited an unlearned response (i.e., saliva—the unconditioned response) from the organism. ‒ He viewed this response as reflexive, not as the result of prior learning. ‒ Then, he presented a neutral stimulus (i.e., the sound of a bell) just before he presented the unconditioned stimulus. ‒ Finally, after several presentations, he found that the bell elicited the saliva without any presentation of food. ‒ Once this learned stimulus-response was displayed, the bell and saliva were referred to as the conditioned (i.e., learned) stimulus and conditioned (i.e., learned) response, respectively. Several other concepts are related to classical conditioning that include: ‒ Acquisition - occurs when the new conditioned response is elicited on presentation of a conditioned stimulus ‒ Extinction - is the "unlearning" of the conditioned response, takes place when the conditioned stimulus is no longer followed by presentation of the unconditioned stimulus, and eventually, the conditioned response stops occurring ‒ Stimulus generalization - occurs when a neutral stimulus that approximates the conditioned stimulus is able to elicit the conditioned response; for example, a young child bitten by a dog may develop a strong fear not only of the specific dog but also of other dogs and four-legged household pets; stimulus generalization occurs when the unconditioned response of fear to the specific dog is elicited when the child is presented with the stimulus of other similar creatures ‒ Stimulus discrimination - is one approach to preventing child sexual abuse involves teaching a child the difference between "good touch" and "bad touch"; the ability to distinguish between the two types of touch illustrates Operant Conditioning (B. F. Skinner) - is the type of learning that takes place in response to how a person's behavior elicits consequences from the environment. Whereas classical conditioning concerns behavior elicited by antecedent conditions (i.e., environmental stimuli), operant conditioning focuses on the consequences of behavior (i.e., what happens after a behavior is emitted). ‒ Behavior is followed by two types of consequences: reinforcers or punishers ‒ Reinforcers increase the chance of the behavior recurring, either by adding something desirable or taking way something undesirable ‒ Punishers decrease the likelihood of a behavior recurring, either by adding something undesirable or taking away something desirable Goal of Treatment: Behavioral therapists see maladaptive behavior in itself as being the problem. Counseling is directed toward correcting or "unlearning" problem behavior. Cognitive Therapy (the second wave of Behavioral Therapies) The research of Albert Bandura (1974, 1977, 1986) provided an empirical foundation for what has become known as the second wave of behavioral therapies, that is, the cognitive-behavioral revolution. ‒ Generally, cognitive therapies accept behavioral principles but take into account the covert behaviors, such as the client's thoughts, beliefs, and underlying attitudes, which are not readily observable. ‒ The most widely practiced cognitive approaches are Albert Ellis's rational emotive behavior therapy, Aaron Beck's cognitive therapy, and Donald Meichenbaum's cognitive-behavioral modification Rational Emotive Behavior Therapy or REBT (Albert Ellis) - clients are made aware of what they are saying to themselves and how such self-statements relate to the emotional pain they experience; clients become aware of the occurrence of such thoughts and learn to replace them with more rational alternatives; irrational internal dialogue related to emotional pain. In REBT, clients are taught that emotional disturbances are explained by a simple ABC formula, where A = activating events; B = irrational beliefs; and C = the emotional and behavioral consequences. The counselor actively works with the client to modify the faulty beliefs into more rational alternatives by learning to dispute (D) the irrational thoughts and replace them with rational alternatives, clients experience the positive effect (E). Cognitive Therapy or CT (Aaron Beck) - seeks to alter cognitive distortions (automatic thoughts) and leads to the construction of thoughts that more accurately reflect the reality of situations; automatic thoughts stemming from cognitive distortions. CT makes extensive use of Socratic questioning and personal experiments to assist clients in changing thoughts and behaviors. Cognitive-Behavioral Modification or CBM (Donald Meichenbaum) - incorporates modeling, learning through observation, and verbal mediation to facilitate behavioral change; faulty behavior which can be changed through modeling, observation, and verbal mediation. CBM also makes use of the cognitive and behavioral techniques listed above but also adds self-instruction, self-reinforcement, graduated in vivo exposure, and personal narrative repair. Goal of Treatment: The primary goal of all cognitive therapies is the removal of or relief from the presenting symptoms. But ultimately, cognitive therapies seek to correct the flawed cognitive structures, processes, and products that give rise to emotional distress. Mindfulness and Acceptance-Based Therapies (the third wave of Cognitive-Behavioral Therapies) Two important contemporary approaches to cognitive behavioral therapies include acceptance and commitment therapy (ACT) and dialectic behavior therapy (DBT). ‒ Acceptance and Commitment Therapy (ACT) - is described as a contextual cognitive-behavioral therapy that is designed to increase personal flexibility by helping clients to more fully experience and embrace their present emotional experience, while assisting them to move in self-selected, personally valued directions. According to Hayes and Smith (2005), psychological pain is viewed as a characteristic of normal human existence. All humans experience it. ‒ The task is to not eliminate or even alter the frequency of maladaptive thoughts. Rather, clients learn to change the manner in which they relate to their thoughts by altering the contexts in which those thoughts occur. Clients learn to recognize the operation of their contextualized self and put it aside, so they can give their real self full expression. ‒ Dialectic Behavior Therapy (DBT) - is a cognitive-behavioral therapy that was originally developed to treat females diagnosed with borderline personality disorder (BPD) and having a history of self-destructive behaviors. ‒ According to DBT, every person who comes in with their personal story has within themselves an alternative story (i.e., a dialectic). Dialectics are used to help clients to develop broadened views of their problems, identify the dialectic poles, consider the resulting options, and move toward increased behavioral and relational competence. Humanistic/Existential Therapy: Carl Rogers (1902-1987) is the founder of person-centered therapy and has been recognized as one of the preeminent leaders in the humanistic movement. ‒ Rogers's approach advocates understanding clients as persons and developing case formulations from that vantage point rather than invoking a theory to understand clients. ‒ Elements of existential theory run through Rogers's approach. The concept of self is central and includes an awareness of one's total being, the way one relates to or is in touch with the immediate environment, and one's existence in the here-and-now. Person-centered therapy has a phenomenological orientation and underscores the significance of personal meaning and subjective reality. Other important themes include personal autonomy, freedom, responsibility, connectedness, and isolation. In addition, we possess a valuing system that places positive value on those experiences that are growth enhancing and negative value on those experiences that limit personal growth. ‒ People demonstrate actualizing tendencies - the inherent tendency to develop capacities in ways that enhance the person. ‒ We possess inherent tendencies that motivate us toward growth and direct us toward growth-enhancing experiences. ‒ Finally, as our awareness of self emerges, we develop a strong need for positive self- regard. This is a universal need to be valued and loved. ‒ Goal of Treatment: Whether one is seeking relief from severe stress, emotional breakdown, lack of meaningfulness, or social alienation, the goal of treatment is to increase the degree of congruence between oneself and one's experience. In other words, mentally healthy persons are more in touch with their immediate experience, more trusting and accepting of themselves, and more capable of self-validation. Narrative Therapy ‒ Some of the key theorists are Insoo Kim Berg, Steve De Shazer, Michael White, and David Epstein. ‒ Clients have stories that they tell about their past and present. ‒ The client's story is the client's reality and functions as a personal narrative metaphor. ‒ Goal of Treatment: Personal narrative repair or reconstruction that involves helping the client to tell their story, identifing alternative ways of reconceptualizing the story, and aiding the client in reauthoring their personal story. Feminist Therapy ‒ Some of the key theorists are Jean Baker Miller, Carolyn Zerbe Enns, and Oliva Espin ‒ Feminist therapy is rooted in pluralism and the women's movement philosophy of the 1960s. ‒ It recognizes the social, political, and cultural forces that influence a person's identity and behavior. ‒ Sexism, racism, classism, and monoculturalism are harmful to personal well-being. ‒ Feminist therapists work to validate and empower clients while also advocating societal change. ‒ Goal of Treatment: Validate and empower clients while advocating societal change, which includes enhancing self-esteem, increasing quality of personal relationships, increasing value of diversity, teaching client about repressive influences of gender roles and their negative impact on self-concept, helping clients develop a cognitive framework for maintaining positive self-evaluation, and using assertiveness training to empower clients. Family Therapy ‒ Generally, family systems approaches focus on the interactions that occur among individuals in a three-generational family system. The family functions as a system and must be viewed within the context of the family system. The entire system becomes the unit for analysis in assessment and therapeutic intervention. ‒ Individual disorders are viewed as family disorders. ‒ Pathology serves a family function. ‒ Family therapists zero in on the transactions and interactions taking place within the system rather than on the specific contents of the presenting problem. ‒ Three classic approaches to therapy include: Bowenian family therapy, Minuchin's structural family therapy, and Haley's strategic family therapy. A fourth approach, emotionally focused therapy, is a recent development. ‒ Bowenian Family Therapy - sees personal, emotional, and behavioral problems as being due to difficulties the individual experiences in differentiating the self from the family of origin. Fusion, Disengagement, and Emotional Cutoff may all occur. The goal is to develop a healthy differentiation of self through promoting self-awareness and learning to balance personal autonomy with connectedness. ‒ Minuchin's Structural Family Therapy - sees families as governed by their structure, a set of covert rules that regulate family transactions. These rules are revealed as the counselor picks up on the consistent, repetitive, and predictable patterns of family behavior. The power hierarchy influences the existing structure. The goal is to create an effective hierarchical structure. ‒ Haley's Strategic Family Therapy - is sometimes referred to as brief problem-solving therapy because it is method oriented and problem focused. The goal of counseling is to solve the presenting problem by directing family members to act in specific ways that disrupt the patterns of behavior that maintain the problem. Emotionally Focused Therapy-was developed by Canadian psychologists Susan Johnson and Leslie Greenberg in reaction to the significant absence of emotion in the family therapies predominating in the 1980s.The problem is related to the developmental attachment histories of the family members. The goal is to understand dysfunctional patterns of interaction and help family members connect in ways that lead to secure attachment bonds.

What types of information should go into a client's record? Name something that should not be there.

Six categories of documents ARE usually included in a client's record: 1. Identifying or intake information: name, address, telephone number(s), date of birth, sex, occupation, and so on 2. Assessment information: psychological evaluation(s), social/family history, health history, etc. 3. Treatment plan: presenting problem, plan of action, steps to be taken to reach targeted behavior, and so on (i.e., clearly define the purpose of counseling) 4. Case notes: for example, documentation of progress in each session toward the stated goal; if documentation is not provided it is almost impossible to verify something happened 5. Termination summary: outcome of treatment, final diagnosis (if any), aftercare plan, and so on 6. Other data: client's signed consent for treatment, copies of correspondence, notations about rationale for any unusual client interventions, administrative problems, and so on

What is Portability?

Portability of licenses refers to the ability of professionals to move or "transfer" their licensed status from one state to the next; one state's honoring another state's license.

Are self-schemas conscious or unconscious?

Unconscious

How can burnout be prevented?

· Associate with healthy individuals · Work with committed colleagues and organizations that have a sense of mission · Be reasonably committed to a theory of counseling · Use stress-reduction exercises · Modify environmental stressors · Engage in self-assessment (i.e., identify stressors and relaxers) · Periodically examine and clarify counseling roles, expectations, and beliefs (i.e., work smarter, not necessarily longer) · Obtain personal therapy · Set aside free and private time (i.e., balance one's lifestyle) · Maintain an attitude of detached

What is a developmental/wellness perspective?

‒ Wellness refers to a positive state of body, mind, and spirit. ‒ It is a developmental approach based on stages that people go through as a normal part of human growth. ‒ From this perspective, counseling is premised on whether a problem a client is having is part of a developmental life task or not. ‒ A cornerstone of the developmental/wellness approach is its stress on prevention and education. ‒ Wellness emphasizes the positive nature of human beings. ‒ Resilience personal qualities and skills, either dynamic or trait, that allow individuals to make healthy, successful, or adaptive responses to disruptive or adversarial life events. ‒ Theories include: Piaget's cognitive development, Developmental Counseling and Therapy (DCT), Solution-Focused Theory, and Stress Inoculation Training (SIT).

1. A counselor intentionally begins to increase the time between counseling sessions for a particular client and also makes a concerted effort to reduce the amount of reinforcement she provides to the client for certain behaviors in which the client is engaging. What is the counselor's actions an example of? A. Resistance B. Indirect transference C. Affective empathy D. Fading

D. fading

What are systemic barriers to obtaining counseling services for undeserved populations?

1. Resistance - cognitive, emotional, and behavioral · Cognitive - when presented with the potential negative bias, persons generally evaluate themselves as above average on any socially desirable scale · Emotional - rooted in the powerful feelings that are experienced when confronted with multicultural topics (guilt, shame, and fear) · Behavioral - resist and distance themselves from the discomfort-provoking context 2. Cultural Encapsulation - counselors tend to choose traditional therapeutic approaches that are in accordance with their own cultural experience 3. Misapplication of traditional theories and techniques - are so much a part of the predominant culture's landscape that their presence and the implications of their operation are ignored. Implicit assumptions the reflect the worldview of the predominant Western culture: · Individualism · View of normalcy and pathology · Functional agnosticism and anti-religiousness · Personal happiness as a legitimate goal of counseling · Insight and process of change 4. Systemic barriers within counseling delivery systems - structures and processes of the traditional delivery of mental health services may act as barriers that keep the culturally different from receiving needed treatment. 5. Language barriers and miscommunication - problems in communication between clients and counselors can prevent minorities from using appropriate services. Adequate command of the spoken language is necessary for accurate information gathering, assessment, identification of goals, treatment planning, and treatment. Mental health counselors may mistakenly assume that clients from minority racial/ethnic groups who communicate reasonably well in other social situations can accurately express and comprehend the meaning of words exchanged in counseling settings. 6. Mistrust - culture and the operation of fundamental attribution errors can be a foundation for the mistrust of certain minority groups. Mistrust may be directed primarily at the counselor, who becomes a symbol of the dominant culture or the holders of societal power. May lie in lack of information regarding the nature of services provided or inappropriate referrals and treatment.

How many states have Mental Health counseling as a licensed profession?

50

Given the interactional nature of the counseling process, the American Psychological Association (2004) concluded what percent of counselor-client relationships are, in fact, multicultural?

50%

What is a mental status exam? What is orientation by 3?

A mental status exam is a relatively brief preliminary test of a client's judgment, orientation to time and place, and emotional and mental state; typically conducted during an initial interview; an evaluation of the client at one point in time. Orientation × 3 - is included in the mental status exam; is an assessment of client's orientation to time (time, date, year), place (where client is), and person (who client is and who clinician is). Orientation is a function of the mind involving awareness of three dimensions: time, place and person. Problems with orientation lead to disorientation.

Libido?

A psychic energy that "powers" psychological work such as thinking, perceiving, and remembering. This energy, Frued believed, is used by the "life instincts" to satisfy needs for survival and reproduction.

What is free association?

A psychoanalytic therapy technique intended to explore threatening material repressed into the unconscious; patient is instructed to say whatever comes to mind without censoring—dreams, memories, fantasies, wishes, thoughts.

What is- Enmeshment, Triangulation, Disengagement, Emotional Cut-Off?

A. Enmeshment - refers to family environments in which members are overly dependent on each other or are undifferentiated; occurs when individuals and subsystems lose autonomy due to a blurring of boundaries. B. Triangulation - describes family fusion situations in which the other members of the triangle pull a person in two different directions C. Disengagement - is caused by overly rigid boundaries around individuals and subsystems. D. Emotional cut off - occurs when the person flees physically from an unresolved emotional attachment.

Ego?

A second personality structure that arises soon after the first year; it mediates between the environment that surrounds the child and his or her urges and instincts; the ego is the rational problem-solver component of the mind that finds realistic means to fulfill the demands of the id. The ego is the part that ensures that we can adapt to the demands of the real world while still finding ways to meet our basic needs.

What are the differences between civil law, criminal law, federal regulations, and peer control mechanisms?

A. Civil law - covers controversies between two or more people. The focus is not the violation of a statute but the possible harm one person has caused another. When harm is judged to have occurred, the offended party is awarded an amount of money. No criminal sentence is imposed because the focus is not violation of the law. B. Criminal law - embodies what the federal and state governments regard as illegal behavior. It also specifies how violations are to be punished. Most violations of criminal law involve such social crimes as murder, larceny, theft, assault, and rape and are prosecuted by local, state, or federal officials. C. Federal regulations - Mental health professionals and the organizations for whom they work are subject to federal regulations. Failure to comply can result in substantial fines, jail sentences, or the suspension or closing of the agency. An example of federal regulations, the Health Insurance Portability and Accountability Act (HIPAA), sets federal regulations that standardize the manner in which protected health-related information is protected, electronically transferred, and secured. Professionals and organizations found to have violated its regulations can be fined in amounts ranging from $100 to $40,000 per violation. D. Peer control mechanisms - are implemented by professional groups that seek to monitor the activities of their group members. The most relevant peer group mechanisms for clinical mental health counselors are the ethics committee of the professional organization and its development and application of that profession's code of ethics.

What is the difference between each of the following and who regulates each?

A. Licensure - is defined as "the statutory process by which an agency of government, usually a state, grants permission to a person meeting predetermined qualifications to engage in a given occupation and/or use a particular title to perform specified functions." Licensure is almost exclusively a state-governed process, and those states that have licensure have established boards to oversee the issuing of licenses. Licensure protects the public from nonqualified mental health practitioners. B. Certification - is a professional, statutory, or nonstatutory process "by which an agency or association grants recognition to an individual for having met certain predetermined professional qualifications, i.e. the National Counselor Examination (NCE). Stated succinctly, certification is a 'limited license,' that is, the protection of title only". Certification is issued by the National Board of Certified Counselors (NBCC). C. Registry - is a list of members of a professional group; being listed on a registry is the simplest and least restrictive method of credentialing; as professionals, simply provide information and pay a small fee in order to be listed. Registration requires practitioners to submit information to the state concerning the nature of their practice.

Who were the following: A. Phillipe Pinél B. Benjamin Rush c. Dorothea Dix D. Emil Kraepelin

A. Phillipe Pinél He reformed asylums and changed the mentally ill were treated in the 18th century; he began treating them using humane conditions and giving them a purpose; he was one of the first people to approach mental illness as a science instead of a religious issue B. Benjamin Rush He wrote the first psychological textbook published in America; he was the first to classify mental illnesses into categories C. Dorothea Dix She was an advocate for the mentally ill who revolutionarily reformed the way mentally ill patients are treated.She created the first mental hospitals across the US and Europe and changed the perception of the mentally ill; she advocated that the mentally ill should be cared for by the state; her work led to the building of a 32 state hospitals and many other facilities for the mentally ill; ex. "The mother of modern psychiatry" D. Emil Kraepelin He was a German psychiatrist who developed the first classification system of all mental illnesses. This allowed doctors to view abnormal psychology in medical terms and laid the groundwork for the classification of mental illness that psychologists use today.

Indicate what distinguishes each of the following mental health fields. What are each ones strength?

A. Psychiatry/Psychiatrist ‒ Psychiatrists earn a medical degree (MD) and complete a residency in psychiatry. ‒ They are schooled in the biomedical model, "which focuses on the physical processes thought to underlay mental and emotional disorders". ‒ They are physicians who specialize in diagnosing, treating, and preventing mental illness. ‒ They can prescribe medications. ‒ Their clients are called patients. B. Psychologists ‒ Psychologist earn a doctoral degree in psychology (Ph.D), philosophy (Psy.D), or education (Ed.D). ‒ They assess, diagnose, and treat mental illness and emotional distress. ‒ That have the statutory right to diagnose and are highly trained in psychological testing. ‒ School work may be concentrated in clinical, counseling, or school-related areas. C. Clinical Psychology/Psychologists ‒ Clinical psychology is the subdiscipline that is primarily focused on the study, assessment, treatment, and prevention of abnormal behavior. ‒ Clinical psychologists focus on a variety of serious mental illnesses, including bipolar disorder, schizophrenia, and major depressive disorders, among others. ‒ Often employed in more clinical settings such as hospitals and medical schools, though many also work in private practice. ‒ Psychologists earn one of the following advanced degrees in psychology: a doctor of philosophy (PhD), a doctor of education (EdD), or a doctor of psychology (PsyD). ‒ Clinical psychologists are often employed in more clinical settings such as hospitals and medical schools, though many also work in private practice. D. Counseling Psychology/Psychologists ‒ A counseling psychologist has a stronger focus on healthy individuals, who have fewer pathological mental problems. ‒ Their work focuses more on emotional, social and physical issues that arise from typical life stresses or more serious issues associated with school, work or family settings. Thus, their work is more client-centric, focusing on wellness and prevention rather than pathology. ‒ Counseling psychologists might see patients for relationship issues, substance abuse counseling, career advice, difficulty adapting to life changes and other such issues. ‒ Counseling psychology programs tend to follow APA standards so they have an emphasis on research, psychopathology, and assessment. ‒ They often use what is referred to as the scientist or practitioner model. ‒ Counseling psychology programs emphasis is on the medical model. E. Mental Health Counselors ‒ Mental health counselors obtain either a master's or a doctorate in counseling from a counselor education program and complete internships in specialty areas such as school counseling; rehabilitation counseling; mental health counseling; career counseling; gerontological counseling; addiction counseling; or marriage, couple, and family counseling. ‒ They are usually certified by the National Board of Certified Counselors (NBCC) (the primary national agency that certifies counselors) as a National Certified Counselor (NCC) (the entry level of national credentialing). ‒ Often they are credentialed on a specialist level, such as school, mental health, or addiction. ‒ In addition, they are licensed to practice by individual states. ‒ Counselors treat mental health disorders from a strength-based and development emphasis. F. Social Worker ‒ Social workers usually earn a master's of social work degree (MSW) ‒ Regardless of their educational background, social workers on all levels have completed internships in social agency settings. ‒ Social workers link people to tangible services, provide counseling, help communities to provide and improve health and social services, and advocate for the inclusion of social work principles and values in relevant legislative processes. ‒ "Social work differentiates itself from counseling, psychology, and psychiatry in that its mission includes mandates to negotiate social systems and advocate for change, to understand clients' habitats (physical and social settings within cultural contexts) and niches (statuses and roles in community) and to provide social services". G. Marriage and Family Therapists ‒ Marriage and family therapy can be viewed as both a professional orientation and a specific vocation within the mental health professions. ‒ Marriage and family therapists are members of a distinct profession who diagnose and treat a wide range of human conditions, including individual psychopathology, parent-child problems, and marital distress and conflict, within the context of marriage and family systems. ‒ The presenting issues are viewed from a relational and systemic orientation. ‒ To be a licensed marriage and family therapist, the practitioner must have earned either a master's or doctoral degree in marriage and family therapy and have at least 2 years of clinical experience conducted under qualified supervision.

1. Which of the following types of tests measures an individual's degree of accomplishment or learning in a given subject or task? A. Achievement B. Aptitude C. Intelligence D. Interest/career

A. achievement

1. Effective goals in counseling are ________. A. agreed upon by both the client and the counselor B. broad C. relate to anything in the client's life D. qualitative and theoretical

A. agreed upon by both the client and the counselor

1. Effective contracts in counseling include all EXCEPT the following ______________. A. client con words ("try" and "maybe") B. a focus on change C. concreteness D. personal responsibility

A. client con words ( try and maybe)

1. The XYZ assessment instrument is consistent but it does not measure the construct that it purports to measure. Which of the following statements is accurate regarding the psychometrics of the XYZ assessment instrument? A. It is reliable but not valid B. It is valid but not reliable C. It has content validity but not test-retest reliability D. It has construct validity but not internal consistency

A. it is reliable but not valid

1. Which of the following is a question that usually begins with who, what, where, or how? A. probe B. open ended question C. summarization D. reinforcement

A. probe

1. "An objective and standardized measure of behavior" is an accurate definition of which of the following? A. psychological test B. interest test C. Diagnosis D. intelligence test

A. psychological test

1. The degree to which a test produces consistency of test scores is _____________. A. reliability B. validity C. correlation D. standardization

A. reliability

1. Functional fixity is _________. A. seeing things from only one perspective B. operating in a stereotyped interpersonal style C. a habit D. a breakdown in overall functioning

A. seeing things from only one perspective

1. A test that must be completed within a specific period of time, such as an achievement test, is known as a ______________ test. A. speed B. power C. criterion-referenced D. performance

A. speed

What are ACT programs? How have they been successful?

Acceptance and Commitment Therapy (ACT) is a mindfulness-based program that encourages clients to accept, rather than attempt to control or change, unpleasant sensations. Clients learn to recognize the operation of their contextualized self and put it aside, so they can give their real self full expression. ‒ ACT encourages people to embrace their thoughts and feelings rather than fighting or feeling guilty for them. ‒ Medical conditions such as anxiety, depression, OCD, addictions, and substance abuse can all benefit from ACT paired with Mindfulness-Based Cognitive Therapy (MBCT). ‒ ACT is an approach for dealing with difficult thoughts, emotions, memories, sensations, etc. Using a simple three-step process, ACT utilizes the fact that you can step away from the part of you that is feeling the way you do, noticing, accepting, and even embracing what that person is going through from an objective perspective. The ACT acronym may be used to remember the steps: Acceptance, Choosing a valued direction, and Taking action. ‒ This type of therapy encourages you to reach your full potential in living a meaningful life through learning various coping skills and in defining what is most important to you.

Which professional organization represents the interests of professional counselors in general?

American Counseling Association (ACA); founded in 1952; 20 divisions of ACA

Which focuses specifically on Mental Health Counselors?

American Mental Health Counseling Association (AMHCA)

1. When a counselor asks a client to comply with a minor request and then later follows the initial request with one that is larger, the counselor is employing which technique? A. challenge B. the foot in the door technique C. the door in the face technique D. confrontation

B. Foot in the door technique

The most successful candidates for traditional approaches to counseling are described by which acronym? A. SOLER B. YAVIS C. DUDS HOUNDs

B. Yavis

1. The "E" in the acronym SOLER stands for __________. A. elevate B. eye contact C. egalitarian relationship D. equality

B. eye contact

1. Those who are employed as specialists in the area of testing and appraisal are known as ________________. A. phrenologists B. psychometrists C. assessment counselors D. psychiatrists

B. psychometrists

1. Through the process of ________ the counselor offers the client another way to look at situation. A. leading B. reframing C. empathy D. functional fixity

B. reframing

1. If a client brings up new material at the end of a session, a counselor should __________. A. always deal with the material on an emergency basis B. work to make the new material the anticipated focus of the next session C. subtly ignore the new material D. call the client's attention to the inappropriate timing

B. work to make the new material the anticipated focus of the next session

Why is informed consent considered a process? What must be included?

Because informed consent is applicable to all stages of the counseling process. Informed consent is an ongoing part of the counseling process, and counselors appropriately document discussions of informed consent throughout the counseling relationship. The 2014 ACA Code of Ethics (ACA, 2014) requires that information be presented in both verbal and written forms. The following information should be included: · The nature of the treatment, including purposes, goals, techniques, and procedures · The limitations, potential risks, and/or side effects of treatment · Role of technology · The time parameters for the sessions · Fees, billing arrangements, and procedures for nonpayment · No-show/cancellation policy · The nature of and limitations on confidentiality · The qualifications, credentials, and relevant experiences of the counselor · Roles of supervisory or interdisciplinary treatment teams · Continuation of services if counselor becomes incapacitated or dies.

How does choice of counseling theory relate to the counselors personality?

Being intentional in developing your theoretical stance requires both knowledge of theory and an accurate awareness of your personality style and values.

When must a counselor break confidentiality?

Confidentiality must be breached when a risk of harm to clients or others exists. This circumstance includes suspected abuse or neglect of children, clients who pose a danger to themselves, clients who pose a danger to others, clients who have a communicable disease and whose behavior puts others at risk, and, in some states, suspected abuse of the elderly. The specific responsibilities of the mental health counselor in such situations include the duties to warn, to protect, and/or to report.

In a counseling relationship, the battle for structure involves ______. A. motivation for change B. client responsibility C. issues of administrative control D. the physical arrangement of the counseling room

C. issues of administrative control

What type programs are accredited?

CACREP accredits master's master's and doctoral-level counseling programs in the following areas: Addiction Counseling Career Counseling Clinical Mental Health Counseling Clinical Rehabilitation Counseling College Counseling and Student Affairs Marriage, Couple, and Family Counseling School Counseling Rehabilitation Counseling

What is case advocacy?

Case advocacy is speaking for, representing the interests of, or defending the rights of another person; it involves speaking on behalf of disadvantaged people and promoting ways of ensuring that their rights are respected and that their needs are taken care of through social action.

What are three general components of the curricular model?

Common Core Curriculum Standards for Specialization Professional Practice Experience

Which is involved in accreditation of graduate counseling programs?

Council for Accreditation of Counseling and Related Educational Programs (CACREP)

When there is a potential conflict between a counselor's employer and a counselor's client, what should the counselor do?

Counselors should check thoroughly the general policies and principles of an institution before accepting employment because employment in a specific setting implies that the counselor agrees with its policies, principles, and ethics. When counselors find themselves in institutions that misuse their services and do not act in the best interest of their clients, they must act either to change the institution through educational or persuasive means or find other employment.

Who can be certified?

Counselors who wish to become a National Certified Counselor (NCC) must have a minimum of 48 semester hours or 72 quarter hours of graduate study in counseling or a related field, including a master's degree in counseling from a regionally accredited institution of higher education. They must also have a minimum of two academic terms of supervised field experience in a counseling setting. In addition, they must pass the National Counselor Examination (NCE).

What is cultural encapsulation? What is confirmation bias?

Cultural encapsulation - Gilbert Wrenn (1962) described the culturally encapsulated counselor as one who disregards cultural differences and works under the mistaken assumption that theories and techniques are equally applicable to all people. There are four components of cultural encapsulation: a) Define and dogmatically cling to viewing reality according to their own sets of cultural assumptions to the exclusion of alternative interpretations b) Demonstrate insensitivity to persons of other cultural backgrounds who hold alternative perspectives c) Resist or simply not recognize the necessity of testing the validity of one's underlying assumptions d) Become trapped in what may be described as cultural tunnel vision Confirmation bias - refers to a human tendency to search for information that confirms one's preexisting conceptions.

How is culture defined?

Culture can be defined as "a way of living that encompasses the customs, traditions, attitudes, and overall socialization in which a group of people engage that are unique to their cultural upbringing". These are shared patterns of learned behavior and are transmitted across generations by members of the group.

1. The question "why" usually is not used in counseling because __________. A. it puts clients on the defensive B. it connotes disapproval C. it leads to self-disclosure D. "A" and "B" but not "C"

D. A and B but not C

1. A counselor being hostile, cold, or antagonistic toward a client is an example of __________. A. overidentification B. transference C. disidentification D. a blind spot

D. disidentification

Describe the stages of Transtheoretical Model of behavioral change.

Developed by Prochaska and DiClemente (1984) to provide an integrative framework for understanding, assessing, and facilitating behavioral change; it posits that clients move through five stages in making successful changes in their lives. The five stages of change are: 1. Precontemplation - Clients in this stage are unaware of their behavioral problem, unwilling to change, or discourages about making helpful changes in their lives; in this stage, counselors with conduct a cost/benefit analysis and create discrepancy 2. Contemplation - This stage occurs as clients acknowledge the existence of a problem and begin to consider making changes to resolve it; however, they may not fully understand the nature of the problem, its causes, or its implications; in this stage, counselors offer encouragement, support, and gentle prodding 3. Preparation - Clients in this stage have made an initial commitment to changing and are on the verge of acting on that commitment; they are now motivated to change, but they need a systematic plan and a firm commitment to its implementation; in the stage, counselors develop a systematic, step-by-step plan 4. Action - This stage is where clients implement the plan to modify their behavior; in this stage, counselors try to lower the clients risk for relapse by helping the client understand that initial change is not the same as goal attainment 5. Maintenance - This final stage consists of consolidation of gains made during the action stage and continued efforts to prevent relapse; counselors in this stage help the client consolidate gains and prevent relapse

How is the term ethnicity different from race?

Ethnicity - in a broad sense, ethnicity refers to a group of persons who identify with one another by virtue of sharing common ancestry, religion, language, skin color, and/or culture; when used in this manner, the term is interchangeable with race; the more narrow sense focuses on the setting apart of groups of persons on the basis of national origin and distinctive cultural patterns. Race - is a socially constructed classification system of people groups based on visible physical characteristics (e.g., skin pigmentation, facial features, texture of hair).

Superego?

Forms around the time the child reaches the age of 4 to 6; this structure is a reflection of the values of society and culture as represented to the child through the words and actions of the parents; the primary task of the superego is to block unacceptable impulses of the id and guide the ego in the direction of moral action rather than merely to do what works. The superego is the part of personality that deals with morality.

What is the fundamental attribution error? Illusory correlation? Availability heuristic?

Fundamental attribution error - is the general tendency for people to underestimate contextual influences and overestimate dispositional influences in explaining the behavior of others. Illusory correlation - refers to the concept of perceiving a relationship between two variables (typically people, events, or behaviors) even when no such relationship exists. Availability heuristic - also known as availability bias, is a mental shortcut that relies on immediate examples that come to a given person's mind when evaluating a specific topic, concept, method or decision.

Who was knows as the Father of Medicine

Hippocrates

What did Hippocrates think caused mental disorders?

Hippocrates insisted that abnormal behavior had natural causes like an imbalance of four bodily fluids.

What is mental retardation now called in the DSM-5?

Intellectual disability (intellectual developmental disorder)

How does the double standard of mental health depict adult females relative to healthy adults?

It depicted adult female behavior as less socially desirable and healthy, a perception that lowered expectations for women's behavior and set up barriers against their advancement in nontraditional roles.

While it is good to know group characteristics it is more important to realize that there are bigger differences within any group than between that group and another group.

It is crucial that counselors remind themselves that each individual, like each counseling session, is unique. There are more within-group differences than between-group differences in counseling people from specific cultural traditions.

What is transference?

It is the client's projection of past or present feelings, attitudes, or desires onto the counselor. It can be used to help counselors understand clients better, and as a way of resolving clients' problems. Counselors attempt to be "blank slates" that facilitate the development of transference in the relationship. In transference, the patient's thoughts and feelings from their past are "transferred" to the counselor. Transference is either negative or positive.

What did Community Mental Health Centers Act of 1963 do?

It was a major legislation in the 20th century that led to the development of comprehensive community mental health centers throughout the country.

Do LGBT people use mental health services more or less than others?

Lesbian, gay, bisexual, and transgender clients use counseling services at higher rates than their heterosexual counterparts.

What is the difference between moral anxiety and neurotic anxiety?

Moral anxiety - is experienced as guilt or shame resulting from a perceived threat of disapproval or punishment. Neurotic anxiety - is the emotional response to the threat that an unconscious impulse will emerge into one's awareness.

Who was Frank Parsons?

Parsons founded the Boston Vocational Bureau in 1908; he created the role of vocational counselor, which initiated an approach of interaction and facilitation that was a forerunner of the contemporary counseling process; he is known as the Father of Vocational Guidance.

What is Reciprocity?

Reciprocity is a system in which certain states have negotiated agreements with other states so that the license in one state would be automatically accepted in the others, as long as the appropriate fees are paid.

Describe the defense mechanisms mentioned in the text. Are they conscious or unconscious?

Repression - the involuntary removal of material from one's conscious awareness; ex. A child who was sexually abused at age 7 but has no conscious recollection of the abuse. Regression - reversion to forms of behavior characteristic an earlier age when the person was more secure; ex. A 6 yr-old child experiencing the divorce of parents and beginning nocturnal bed-wetting after 4 yrs of appropriate bladder control. Projection - attribution of one's unacceptable desires, motives, or characteristics to others; ex. A husband accuses his spouse of not loving him when, in fact, it is he who does not love his spouse. Displacement - discharging pent-up feelings or behaviors onto less threatening targets; ex. A father in unresolved conflict at work comes home and yells at his children for not cleaning their bedrooms. Rationalization - contrived "reasons" that explain away or mask personal failures or questionable motives; A person who is not hired for a position that she truly wanted states that she probably would have become bored with the job if it had been offered to her. Reaction Formation - defense against unacceptable impulses or desires by expression of a seemingly opposite behavior; ex. A college student who wants to drop out of his program signs up for an overload of classes for the semester. Denial - refusal to believe, accept, or face an unpleasant reality; ex. A parent whose child tragically dies in an automobile accident expresses disbelief at the funeral that the tragedy has actually happened. Sublimation - redirecting sexual or aggressive energies into a more socially acceptable alternative activity; ex. A recently divorced person diverts her anger and sexual energy by enrolling in college and immersing herself in studies. They are unconscious.

What did Carl Rogers think was necessary for growth?

Rogers was a humanistic psychologist who believed that for a person to "grow", they need an environment that provides them with genuineness (openness and self-disclosure), acceptance (being seen with unconditional positive regard), and empathy (being listened to and understood). Without these, relationships and healthy personalities will not develop as they should.

What did Tarasoff v. Board of Regents of the University of California establish?

That a therapist has a duty to protect the public that overrides any obligation to maintain client confidentiality.

What did "The Iowa Law Review Note of 1971" do?

That counselors were legally recognized as professionals who provided personal as well as vocational and educational counseling.

Describe the ecological perspective of Urie Bronfenbrenner?

The Ecological Theory is a multidimensional model that provides mental health professionals with a framework for viewing human functioning within a developmental and environmental context; Bronfenbrenner sees human development as consisting of a series of ongoing changes involving interactions between individuals and their immediate contexts. Bronfenbrenner identifies four different levels of environmental context in which development occurs: 1. The Microsystem Level is: the level of context in which face-to-face interactions takes place 2. The Mesosystem Level is: the level of context in which two or more of client's microsystems interact; e.g., the relations between home and school, school and work, etc. 3. The Exosystem Level is: the level of context in which two or more settings interact, one of which does not contain the client 4. The Macrosystem Level is: the level of context defined by the client's culture, encompassing that culture's roles, values, and expectations

What does HIPPA do?

The Health and Insurance Portability and Accountability Act (HIPAA) passed in 1996, was intended to: improve "efficiency in healthcare delivery by standardizing electronic data interchange," and protect "confidentiality and security of health data through setting and enforcing standards"; HIPPA provides national standards for the privacy of individually identifiable health​ information, outlined​ clients' rights, and established criteria for access to health​ records.

What is the ICD-10 and who uses it?

The ICD-10 has been the official system used across health care settings in the United States under the terms of the 1996 Health Insurance Portability and Accountability Act (HIPAA). Although DSM predominates in the US, 95% of professionals worldwide use the ICD-10. The ICD-10-CM is a clinical modification (i.e., CM) of the ICD-10 for use in the United States. It creates a uniform system, used worldwide, for reporting health information for the World Health Organization (WHO) and is readily adapted for use across a wide range of cultures

What does the National Board of Certified Counselors (NBCC) do?

The NBCC is the main national organization that certifies counselors. Certification specialties are available from NBCC in school counseling, mental health counseling, addiction counseling, and supervision.

The ACA was formed through the alliance of the following professional groups:

The National Vocational Guidance Association, American College Personnel Association, National Association of Guidance Supervisors, and Student Personnel Association for Teacher Education

What must a counselor do if child abuse is suspected but not proven?

The counselor must report the suspected abuse.

Id?

The deep, inaccessible component of personality that holds all instinctual urges; its goal is to obtain immediate fulfillment of basic needs; it operates according to the pleasure principle, which seeks to experience pleasure and avoid pain; nothing else matters; the personality of the neonate and the infant are almost entirely id.

Defense Mechanisms?

The ego's job is to satisfy the demands of reality, the moral demands of the superego, and the id's demands for immediate gratification. Through the use of ego defense mechanisms, impulses emanating from the id are blocked from reaching consciousness or distorted in such a way that the superego is fooled. Defense mechanisms are the unconscious distortion of reality in some way so that the impulses of the id are blocked from reaching consciousness or distorted in such a way that the superego is fooled. All ego defense mechanisms have several things in common. First, the person does not consciously choose to use them. Second, they involve at least some degree of denial or distortion of reality. Third, we all use them. They become pathological only when they are used in excess or to the extreme.

Define the different types of prevention.

The following approaches have been developed to enhance growth, promote crisis resistance, and limit crisis reactions: · Primary prevention - often comes in the form of education, consultation, and crisis intervention. Its goal is to reduce the likelihood of persons contracting the disorder. Programs and interventions are directed toward persons identified as being at risk for experiencing adverse situations or negative reactions. Approaches to primary prevention include modifying the hazardous situation, reducing exposure to hazardous situations, and increasing coping abilities; ex. Teen pregnancy prevention programs. · Secondary prevention - refers to programs and interventions that seek to limit the negative impact of disorders in persons already affected. The goal is to shorten the duration of the condition. · Tertiary prevention - aims to reduce the long-term consequences for persons recovering from mental disorders. For example, relapse prevention programs for recovering alcoholics provide skills that decrease the likelihood of falling back into the former dysfunctional pattern of thinking and drinking.

Know Erickson's stages and what relevance they have for elderly?

The stages before late adulthood have a deep impact on how this time of life is handled. Gender, ability, ethnicity, health, physiology, environment, and drive all affect the stage of late adulthood and the ones that come before it. Erikson views middle and late adulthood as a time when the individual must develop a sense of generativity and ego integrity or become stagnant and despairing. The developmental demands of older adults are probably second only to those of young children. Older adults must learn to cope successfully with (a) the death of friends and spouses, (b) reduced physical vigor, (c) retirement and the reduction of income, (d) more leisure time and the process of making new friends, (e) the development of new social roles, (f) dealing with grown children, and (g) changing living arrangements or making satisfactory ones.

What is the relationship between health and absence of illness are they the same?

The traditional medical model defines health as the absence of illness or disease and emphasises the role of clinical diagnosis and intervention. The WHO definition links health explicitly with wellbeing, and conceptualizes health as a human right requiring physical and social resources to achieve and maintain. 'Wellbeing' refers to a positive rather than neutral state, framing health as a positive aspiration. This definition describes health as 'a resource for everyday life, not the object of living'. From this perspective health is a means to living well, which highlights the link between health and participation in society.

What is the laws view of ethical codes?

There is a significant amount of overlap between ethics codes and the law. The underlying purpose of both is to encourage harmonious social relations. Ideally, they allow professionals to act autonomously while also protecting the rights of others. There are times, though, when ethics and the law conflict. Counselors may encounter such conflicts when subpoenaed by the court for copies of a client's clinical record. The counselor who refuses to release confidential information to the court in order to protect the best interests of a client can be found in contempt of court. Generally, all codes of ethics state that professional counselors are obligated to act in accordance with local, state, and federal law. And, in court, the law overrules codes of ethics.

What are self-schemas?

These are defined as "cognitive generalizations about the self, derived from past experience, that organize and guide the processing of self-related information contained in the individual's social experiences"; self-schemas serve as templates through which we organize our world.

What is a wounded healer?

Wounded healer refers to individuals who have been hurt and have been able to transcend their pain and gain insight into themselves and the world can be helpful to others who struggle to overcome emotional problems; coined by Rollo May.