PSY320 Exam II on Mon 12/5

regulation, distress tolerance

DBT teaches skills for other major behavioral changes related to emotional ___ (aka ___ ___,) which is how to regulate the intensity, duration, and frequency of forceful negative emotions like anger, anxiety, and depression.

consultative, supervisory

DBT therapists are required to participate in ___ and ___ groups to keep them from burning out from working with demanding and corrosive clients. DBT therapists are also required to engage in the dialectical process of accepting when needed & changing when possible

exposure, 1970, implosive

Directly confronting feared stimuli, such as the burglary, and activating intense emotions, such as Annique's crippling anxiety, are the distinctive characteristics of treatment approaches known as ___ therapies, which emerged in the ___s. Its precursor was ___ therapy, with the 2 main subtypes of prolonged exposure and eye movement desensitization and reprocessing (EDMR)

bibliotherapy workshops

Distinctive features of REBT are its widespread use of ___ and public ___. Ellis was an extraordinarily prolific author, writing more than 80 books on a multitude of topics, and almost all clients are expected to read one or more of these books relevant to their presenting complaints.

REBT, problematic thoughts

REBT and CBT overlap: both Ellis (___) and Beck (CBT) view the ___ ___ as the content to be addressed; whereas in other therapies thoughts are seen as a symptom

counterconditioning, contingency, modification

The 3 Cs of behavior therapy are: ___; ___ management; and cognitive-behavior ____

stress inoculation, stressful, medical

The 3 phases of Meichenbaum's CBM have been successfully applied to children and adults in ___ ___, a treatment wherein patients develop covert cognitive skills and overt behavioral skills that can inoculate them against stressors, instead of learning only to control anxiety in ___ situations. Previously anxiety-provoking events (such as school or work evaluations, public speaking, and interpersonal confrontations can be reevaluated as challenges and learning opportunities.) Stress inoculation is frequently employed to help young clients complete scary ___ procedures such as chemotherapy or surgery.

behavioral, cognitive, CBT

The 3 waves of psychotherapies are ___ therapy (first wave,) ___ therapy (second wave,) and ___ + mindfulness (third-wave.)

language, accepting

The ACT technique of cognitive diffusion (thoughts as hypotheticals) is taught using exercises and challenging conventions of ___. ___ is the healthy opposite of controlling and avoiding thoughts; and leads to committed actions which beget healthier behaviors

urine alarm

The most successful Behavioral treatment was the urine alarm, an old behavioral method of conditioning introduced in 1938 by Mowrer and Mowrer. A plastic pad underneath the child or a small sensor attached to the pajamas detects moisture from urination and starts an alarm to wake the child.

radical acceptance, mindfulness

The most unique set of skills DBT teaches concern ___ ___, which require much practice and teach clients to release control of the physical world. DBT therapists train clients in ___ via sensory awareness, retraining breathing,

counterconditioning, desensitization

The essential change process in EMDR is _____ via desensitization, distancing, and cognitive restructuring. For the traumatized, the healthy alternative is desensitization instead of hyperarousal, distancing instead of intrusive thoughts, and realistic thinking rather than fear-based reactions.

adaptive information processing, identity

The original conceptualization of EMD was one of desensitization according to the behavioral model; the evolved conceptualization of EMDR is that of ___ ___ ___, transforms traumatic memories and disturbing information but also concomitantly shifts feelings, thoughts, and sensations, creating changes in ___. Desensitization and cognitive restructuring are by-products of the adaptive reprocessing taking place on a neurophysiological level.

emotional, exposure, homework

Imaginal & in vivo exposure treatments in Behavior therapy emerged from conditioning theories, the recent conceptualizations believe that ___ processing to explain fear reduction during ___, which corrects false associations and evaluations. Exposure reduces symptoms by allowing patients to realize that, contrary to their mistaken ideas, being in objectively safe situations that remind them of trauma isn't dangerous. In Foa's treatment, in vivo exposure is carried out as ___ to be practiced between sessions. Clients are instructed to remain in the fearful situations for at least 45 minutes or until the anxiety decreases.

nonlinear

Critics of Systemic Therapies argue that systems theory is characterized by ___ dynamics, by change that is not amenable to the linear cause-and-effect models familiar to behavioral scientists. Instead, chaos and complexity theory provide the best ways to understand systems theory and to advance more sophisticated methods for studying complex human systems. Meta-analyses reflect Systemic therapies' effectiveness for couple and marital issues; internalizing and externalizing disorders in kids; and for OCD, schizophrenia, depression, EDs, etc. in adults

family system, hierarchically

A ___ ___ is comprised of the individuals within the nuclear & the extended family and the interrelationships between them and the entire context & rules (often unspoken) of the family. Generally organized ___; provides ongoing structure & stability for family; profoundly impacts the experience of individual members; is often resistant to change. Embedded within larger social systems that impact family and individual members.

ruminative, depressive

A ___ style of thinking is the tendency to focus passively on the causes & consequences of one's problems and is linked to more severe ___ symptoms and impaired problem solving. Cognitive reactivity combined with this thinking style strongly predicts depressive relapse. Studies of these linkages inform the third-wave approach of mindfulness-based cognitive therapy

origin

Bowen is a strong proponent of family of ___ therapy for psychotherapists, wherein they participate in lengthy personal therapy to differentiate themselves more fully from their own family of origin.

emotional, trauma, prolonged, homework

Stage 2 of DBT targets ___ exposure and experiencing; and ___-related symptoms. Techniques: individual therapy (exposure-based procedures for trauma/manualized ___ exposure,) Skills group: skill acquisition, role play, skill rehearsal, and ___

quality, reflection, normalizing

Stage 3 of DBT targets problems of everyday living, and ___ of life goals. Techniques involve history taking, goal/setting preparing for failure and reassessment; metaphors; and radical acceptance. 6 Levels of Validation in DBT: show interest, be awake; accurate ___; validate based on history; ___; radical genuineness

avoidance, extinction

Thomas Stampfl, founder of Implosive Therapy, was inspired by the learning theory processes of ___ conditioning and ___. His IT treatment integrated behavioral researchers to demonstrate the efficacy of implosion in the lab and apply it in the consulting room

mindfulness, cognitive, MDD

___-based cognitive therapy (MBCT) is a third-wave therapy that began with Beck's ___ therapy for depression and then added an adaptation of Kabat-Zinn's mindfulness-based stress reduction (MBSR,) with MBCT designed to prevent relapse of ___

depression, conduct

"Individual" disorders, including ___, are frequently best treated in couple and family systemic treatments. Effective outcomes of systemic therapies in treating ___ disorder, substance abuse, obesity, and schizophrenia

parenting

As therapy progresses, DBT therapists often shift from ___ and teaching to consulting, as clients progress from accepting emotional and interpersonal events without disruption to learning emotional & relational functioning skills

consciousness, expectations

Therapeutic processes in communication therapy (family/systems) include ___ raising and understanding the family's rules and ___ for functioning, as well as the roles each member plays

clarification, commit, respect

Throughout therapy, the ACT therapist transitions from initially being a coach to being a value ___ trainer. By bearing witness when clients ___ to action, they strengthen the client's actual commitment & hold clients responsible. ACT therapists have a unique, radical ___ for and acceptance of clients, and are there to facilitate but not lead the journey

avoidance, cognitive fusion, internal

Western culture and language reinforce the ___ of undesirable thoughts. External commands from teachers and parents can convince kids that any thoughts, feelings, or impulses to behave more expressively are bad or abnormal. This controlling context produces ___ ___, the domination of private events taken literally: becoming entangled with our thoughts rather than our sensory experience, leading us to make decisions and actions based on our ___ experience rather than our external reality.

eating, CBT, intent

While CBT proves more effective than no therapy, medication alone, and perhaps some other therapies for ___ disorders, its success rates are still rather low. CBT outperformed both no treatment and pharmacotherapy (mainly antidepressants) for binge eating disorder, and ___ should be recommended as a first-line treatment. Results are even more disappointing if considering in meta-analyses those patients who started therapy but dropped out (___-to-treat analysis)

stabilization, childhood, meaning

4 stages of DBT: pretreatment & orientation; Stage 1: behavior ___; 2: address ___ history, trauma; 3: quality of life; 4: deeper ___

Contingency management, operant, analysis

A behavioral approach is ___ ___, which uses ___ learning and idea that all behavior (both adaptive and maladaptive) is learned and maintained by its consequences. Begins with a functional ___ of behavior, which involves specifying the stimulus situations that set the occasion for maladaptive behavior (antecedents,) the behavior itself, and the consequences (ABC behavioral chain)

antecedents, consequences, behavior chain

A behavioral, or functional, analysis consists of specifying the stimulus situations that set the occasion for the maladaptive behavior (___), operationalizing the behavior itself (behavior), and detailing the reinforcement contingencies that follow (___). This A → B → C sequence is known as the ___ ___ and is the foundation for understanding and modifying contingencies. Behavioral analysis indicates three categories of frequent problems: behavioral excesses, deficits, and inappropriateness for the circumstances, time, personal learning history, etc.

stimulus control, cued, adaptive

A final counterconditioning technique of behavior therapy to be considered here is ___ ___: avoiding stimuli that elicit the problem behavior and inserting stimuli that cue the alternative, adaptive behavior. If you want to reduce fat in your diet, then avoid fast-food restaurants and snack foods, and instead insert healthy reminders and foods at home. Typically, stimulus control entails helping patients to avoid high-risk environments and people that historically have ___ their problem behaviors. People in recovery from drug dependence are trained to avoid places, people, and things that encouraged their drug use. Stimulus control also involves creating new cues and reminders for ___, nonproblem behavior.

ruminative, reactivity, relapse

A parallel line of research on people's styles of thinking also informs the MBCT model of depressive relapse. A ___ style of thinking is the tendency to focus passively on the causes and consequences of one's problems and is associated with more severe depressive symptoms and impaired problem solving. Combining cognitive ___ and a ruminating style produce high vulnerability to depressive ___

relapse, continuation, depression

A prevalent and costly problem in the treatment of depression is ___. Over half of patients—actually 54%—who respond to treatment will relapse into depression within 2 years of completing treatment. To prevent relapse, many cognitive therapists have begun offering ___ treatment: booster sessions spaced several weeks apart, following the more aggressive, acute phase of therapy. This continuation reduces relapse recurrence by 21-29%. Conclusively, cognitive therapy is superior to no treatment or placebo treatments for ___ among children, teens, adults, and older adults. Continued cognitive therapy reduces the probability of later relapse or recurrence

present moment, observing

ACT Hexagon: Openness is contact with the ___ ___ allows us to be aware of the here & now and approach the present with openness, interest and receptiveness (and not by shame/guilt/memories.) Self as context/the ___ self: "meta-awareness," awareness of one's awareness, noticing of one's noticing, consciousness of one's consciousness; there's a self outside of our experiences

psychopathology, experiential avoidance

ACT assumes instead that psychological processes of a normal human mind are often destructive; that ___ is the norm and it differs by only degree. All people have minds that produce troubling thoughts, especially when such thoughts are not processed effectively. ___ ___ is the attempt to alter unwanted private events (thoughts, feelings, impulses) even when decreasing their intensity, frequency, or duration causes behavioral problems; at the core of many psychological disorders. Immediately distracting oneself usually results in immediate reduction of distress, which is reinforcing

coaches, workability

ACT therapists are most like ___ in the therapeutic relationship. They initially help clients identify the private events interfering with effective ___ by creating cognitive avoidance. The therapist asks ___ questions, such as how such reactive behaviors work for the client, to make clients more aware of how maladaptive their avoidant behaviors are in creating long-term health

Beck, depressogenic assumptions

Aaron ___ founded cognitive therapy in 1970s from his origins in childhood illness and psychoanalysis; he almost died at age 7 from a blood infection, leading to years of abandonment and health phobias that he later mastered by exposure to feared situations. Beck's and Ellis's respective theories of psychopathology converge in most important respects, though the vocab differs. In place of Ellis's irrational beliefs, Beck describes maladaptive cognitions, dysfunctional attitudes, or in the case of his early research on depression, ___ (depression-causing) ___

Mindfulness

Acceptance & Commitment Therapy views thoughts, feelings, urges, and memories as potentially distressing because life has distressing moments. But these aren't the ONLY moments. ___ helps improve our awareness of our thoughts and emotions without evaluation or judgment. Mindfulness also helps us to be in the here and now, in contact with the present moment

Radical acceptance, counterconditioning

Acceptance & Commitment Therapy's Therapeutic Approach is in the ___ ___ of clients. Facilitate journey, don't determine destination. Teach and facilitate mindfulness practices; Values clarification exercises; Coach to set goals according to values and provide accountability for carrying them out; Skills training; ____ through diffusion, present focus, acceptance

psychological flexibility

Acceptance & Commitment therapy's Measure of Health is ___ ___ = the measure of health; the key to many life outcomes

Acceptance, Cognitive diffusion, Values

Acceptance & Commitment therapy: Awareness involves ___: noticing sensations, flashbacks, and feelings as they come and go in our consciousness without struggle and without trying to control or change them. ___ ___/defusion: noticing that cognitions and thoughts can be taken as hypotheticals that we don't have to directly respond to or attempt to change. CD is remaining with processes that alter how we interact with our internal experiences. Observe thoughts as product of busy minds that may or may not be true. ACT Hexagon: Engagement is driven by ___: what's most important to the true self. Committed action: setting goals (Specific achievements) according to values (broader directions) and carrying them out responsibly; behaving in service of chosen values.

communication, Hostility, transcend

According to Ellis' REBT, most of what are labeled ___ problems are, in reality, thinking problems. People who communicate boring, bizarre, repetitive, or contradictory messages are actually revealing the boring, bizarre, repetitive, or contradictory character of their cognitions. ___ is the irrational consequence of (1) an inborn, biological tendency to become aggressive; (2) some unpleasant or frustrating event; and (3) a tendency to think crookedly about the event and a persistent refusal to work against this crooked tendency. The hostile person demands the removal of injustice, unfairness, and frustration immediately. With such impossible demands, hostile persons upset themselves unnecessarily. Those convinced that they can ___ the restraints, injustices, and frustrations of society will inevitably make themselves neurotic. Ellis' REBT proposes adjustment vs. transcendence

Anxiety, negatively reinforces

According to behavioral approaches, ___ is a classically conditioned response behavior. Avoidance of the feared stimulus ___ ___ anxieties

Gottman, stability

Across clinical situations, couple therapy has enjoyed a resurgence in research and training. Many attribute that to the ___ approach, led by a researcher couple. Tried to discover reliable patterns of interactions that could discriminate happy from unhappy couples. Gottman and colleagues discovered that couples' interactions had enormous ___ over time and that about two-thirds of relationship problems never get resolved but pose "perpetual" problems.

Personality, environment

Albert Ellis' Rational Emotive Behavior Therapy (REBT) Theory of ___: Activating events --> Beliefs (either rational or irrational,) and Consequences (emotional, behavioral, psychophysiological.) We can make ourselves healthy or upset by how we think, not by the ___. Core irrational beliefs are rigid, dogmatic, powerful, illogical

groups, DBT

All 3 third-wave therapies are performed for both teens and adults; individually and in groups. Most mindfulness (MBCT) programs are only offered in ___ formats, whereas many ___ therapists don't provide the recommended skills group. Both ACT and DBT now have international institutes to nurture therapists, offer mindfulness for caregivers, and share evidence-based treatments for complex disorders.

cognitions, consequences

Although Cognitive-Behavioral Therapy lacks a consensual theory of pathology, CBT's theory of psychopathology is similar to contingency management: that psychopathology is due to deficits, excesses, or inappropriateness in ___. Deficits in cognitive activity include essential hypertension, tension headaches, and chronic anxiety. Excesses in cognitive responses include hypochondria, behavior disorders, etc. Inappropriate or ineffective cognitive responses include inappropriate labeling, such as a client who mislabels sex as dirty. From a cognitive perspective, these clients experience trouble because they are not responding to the actual stimuli and ___ that occur in their environments. Instead, the clients are responding primarily to the labels and expectancies used to process environmental events.

reciprocal inhibition, cognitive restructuring

Although Wolpe's ___ ___ remains the leading guide for assertiveness training, most trainers use techniques beyond counterconditioning. Many clients need to first reevaluate their attitude about what it means to be an assertive person. For some, this involves ___ ___ (literally, changing thinking), in which they realize their personal right to be assertive

history, preparation, validity, desensitization

Although the eye movement component garners strong attention, EDMR consists of multiple phases. First, taking client ___ and planning treatment. Second, clinician introduces the client to EMDR procedures, explains the rationale, and prepares the client for possible between-session disturbance. During this assessment phase, clients have to pull up a triggering memory and counters it with a positive thought, which they then assess on a 7-point ___ of Cognition (VOC) scale. Clients become proficient in self-soothing and relaxation before moving on to the (3rd phase,) ___ proper.

attribution, stability, internality, globality

An ___ is an explanation for an observed event or an account of what caused something to happen. ___ theory has introduced an alternative to challenging mistaken cognitions in the Behavior therapy tradition. Patients can be helped toward more accurate or benign attributions. Seligman et al. developed further the measurement and treatment of maladaptive attributions & have consistently identified the three attributional styles of ___, ___, and ___. Optimal performance and mental health are associated with a stable, internal, and global attributional style toward good events; that is, when positive events occur, we assign them a permanent, personal, and pervasive quality.

fusion, emotional, boundaries

Another contributor to pathology in Bowen's family systems therapy's theory is ___, the phenomenon that interferes with differentiation of self from family. Refers to two aspects of immaturity: the fusion of feeling and thinking when objective thinking is overwhelmed by emotionality and becomes its servant. What results then is rationalization or intellectualization to justify the acting out of ___ immaturity. Second, fusion refers to the absence of ___ or the lack of individuality between two or more individuals, as in the case of symbiotic relationships

behavioral parent, habit reversal

Another specific Behavior therapy method is ___ ___ training, which is used to educate parents on responding to children with conduct disorder and antisocial behavior. This training has certainly proven successful and transferrable to the real world, but less so with fathers than with mothers. ___ ___ therapy is another Behavioral method designed to reduce habit-based disorders, such as tics, nail biting, stuttering, Tourette syndrome, etc. Has 5 treatment phases: awareness training, relaxation training, competing response training (counterconditioning), motivation procedures, and finally, generalization training.

anxiety, suicidality, mindfulness

As both have grown in popularity, ACT and DBT have been successfully applied in treating conditions outside their initial parameters. ACT, initially for ___ and depression, is now used to treat body dysmorphia, PTSD, eating disorders, etc. DBT, initially for personally disordered and chronic ___ is now used to treat NSSI, substance dependence, bipolar, and eating disorders. Throughout all these new applications, both still centrally emphasize teaching the client & clinicians the requisite ___ skills

suicide, relationship, skill

Because most DBT clients are high-risk, Linehan created a structural protocol with three treatment priorities. First, focus on threats of ___ or other self-destructive behaviors. Second, focus on threats to the therapeutic ___, such as dropping out of or disrupting treatment. Third is ___ development, including behavior change (like assertiveness & interpersonal training,) and acceptance skills based on mindfulness

depression, activity scheduling, restructuring

Beck (cognitive therapy) is a leading expert on ___ and sequences treatment to prioritize reducing severe symptoms including suicidal impulses, insomnia, and weight loss. An intervention introduced early in therapy can be ___ ___, in which specific daily activities are selected and evaluated strictly on the basis of how effectively they elevate mood. These activities are also rated by clients in terms of mastery and pleasure. Three basic approaches to cognitive ___, or modifying the thinking process, are to ask, in various ways, (1) What's the evidence? (2) What's another way of looking at it? (3) So what if it happens?

cognitive triad, automatic

Beck's cognitive therapy holds that the basic ideation in depression has three themes, which Beck (1970) terms the ___ ___: (1) Events are interpreted negatively, (2) depressed individuals dislike themselves, and (3) the future is appraised negatively. Ie negative and unchanging thoughts about self, world, and future. Beck characterizes these as too absolute, too broad or extreme, or too arbitrary. Much of cognitive therapy involves unraveling ___ thinking and reevaluating faulty cognitions by testing them both logically and empirically

beliefs, evidence, manuals

Beck's therapy emphasizes the process of empiricism to a greater extent than does Ellis's REBT: clients in cognitive therapy are encouraged to treat their ___ as hypotheses to be tested by way of their own behavioral experiments. Beck encourages clients to rely on ___ to alter existing beliefs. Cognitive therapy also tends to be more structured and precise than REBT; eg cognitive therapy for depression lasts no longer than 20 hours, following strict treatment ___ for each disorder. In an early session, the therapist introduces the cognitive model to patients (influence of cognitions on affect and behavior) and later administers brief symptom checklists, including the Beck Depression & Anxiety Inventories

Counterconditioning, contingency management

Behavior therapies applied to disorder groups: ___ has been used most often with verbal adults who suffer from behavioral, health, and personality disorders. Cognitive-behavioral techniques are most often used with adults and adolescents, although problem solving and self-instruction are employed extensively with children. ___ ___ techniques have been applied to disorders that have been most difficult for verbal therapies, such as impulse-control problems, addictive disorders, children's dysfunctions, and the problems of developmentally disabled and psychotically regressed patients.

modeling, assertiveness, expressing

Behavior therapists must invoke ___: observational learning in which the behavior of the therapist (the model) acts as a stimulus for similar thoughts, attitudes, and behaviors on the part of the client. Occurs in desensitization and in ___ training, for example, where the therapist serves directly as a model who teaches clients more effective methods of assertion. Modeling is such a critical part of assertiveness training that therapists who are not genuinely assertive would probably not prove competent as assertion trainers. Modeling enables behavior change by inducing clients to perform behaviors that they are capable of performing but have not been performing in appropriate ways, such as ___ positive feelings toward a spouse after observing the therapist express similar feelings

Stimulus control, environments

Behavior therapy approach of ___ ___ tries to avoid stimuli that elicit problem behavior and exposing self to stimuli that cue alternative and adaptive behavior. Patient learns to avoid ___ and people that cue problematic behavior that's been conditioned

overt behavior

Behavior therapy approaches focus on ___ ___: the directive and active nature of treatments, and centrality of assessment and evaluation. Therapist as expert.

relationship, stimuli, contingency control

Behavior therapy tends to be technique-based as opposed to ___ based. Change processes focus on conditional ___ and ___ ___ as opposed to consciousness raising, catharsis, and choosing

anxiety, classical, generalization, gradient

Behavior therapy's theory of psychopathology is that ___ causes all behavior disorders, and that it's the primary learning problem in psychopathology. People can learn to respond with anxiety to any stimuli, including buzzers, dogs, people, sex, elevators, and dirt, even though these stimuli previously did not evoke anxiety. Through ___, or respondent, conditioning, a neutral stimulus, such as a dog, can be paired contiguously with a threatening stimulus. Through the process of ___, stimuli physically similar to the original conditioned stimulus, such as other dogs, can also evoke anxiety. Stimuli can be ranked on a gradient of similarity that constitutes a generalization ___, or an anxiety hierarchy, that goes from the original stimulus, which evokes maximum anxiety, to a very dissimilar stimulus that evokes minimal anxiety.

consequences, reinforcements, punishments

Behavior therapy's theory of psychopathology is that human behavior is controlled by its ___: most behavior can be explained by the same operant principles that account for most human behavior. Thus, maladaptive responses, such as painful head banging, are likely to increase in frequency if they are followed by ___, such as special attention given only when head banging occurs. Conversely, maladaptive responses are likely to decrease in occurrence if they are followed by contingent ___—for example, withdrawing a special treat or introducing a noxious chore

social skills training

Behavioral approach of assertiveness/___ ___ ___ for interpersonal problems is used for anxiety-related to interpersonal interactions, eg. people whose anxiety about expressing different opinions, standing up for themselves, etc. Also used for people with anger problems. Idea is that clients may lack the skill to be appropriately assertive and need to be taught. These skills can be taught thru rehearsal & role-play When client behaves assertively, this is inconsistent with anxiety. Reinforced by reduction in anxiety & improvements in social interactions

clients, technology, evidence

Behavioral practitioners continually test the limits of their techniques and consequently have worked with a wide range of ___, and also integrate ___ into treatment. Behaviorists are heavily involved in creating treatment manuals and documenting ___-based practice for the purposes of enhancing professional training and treatment selection. Treatment manuals operationalize therapeutic procedures, typically session by session, in such a way that other therapists can learn and replicate the procedures.

neurotic paradox, reinforced

Behaviorist Mowrer (Foa's student) coined the term ___ ___ to describe this phenomenon: the failure of maladaptive anxiety to extinguish despite its self-defeating nature. In the short term, obsessive thoughts and compulsive rituals actually relieve anxiety by avoiding confrontation with feared situations. The obsessive-compulsive who washes his or her hands five times in a row or checks the door locks five times is being ___ through anxiety reduction. But longterm, such washing and checking invariably lead to more intense avoidance and more intense anxiety. Avoidance of an anxiety-producing situation short-term creates long-term suffering

Behaviorists, counterconditioning, group

Behaviorists commit to time-efficient, evidence-based treatments. In one of our studies, behavior therapists reported seeing clients less frequently and for a shorter duration than psychotherapists of all other persuasions; only 7% of their clients, on average, were seen for more than a year. Therapists using ___ and cognitive-behavioral methods are most likely to work in an office setting. Treatment is typically conducted in an individual or, increasingly, a group or couple format. Many of the behavioral and cognitive-behavior techniques, including assertiveness training, relaxation training, and problem solving, are applied in a ___ format.

ego mass, differentiate

Bowen family systems therapy's theory of psychopathology holds that Fusion (emotion, lack of boundaries between individuals) in families results in an undifferentiated family ___ ___, or being enmeshed & stuck together. The more stressed or distressed individuals feel, the more they seek the security of oneness that results from family fusion. Chronic distress can produce emotionally ill individuals unable to ___ themselves from their family. They remain stuck forever in the family, and the family is stuck around them.

differentiate, emotionally, objectively

Bowen family systems therapy's theory of psychopathology is that emotional illnesses arise when people can't adequately ___ themselves from their families of origin. Differentiation of self is the ability to be ___ controlled while remaining within the emotional intensity of one's family. DOS reflects the extent to which one can think ___ about emotionally loaded topics within the family.

genogram, differentiation

Bower's family systems therapists eventually create a ___, or a family tree illustrating which family members are close, cut off, or conflicted, teaches clients about triangles and how they interfere with self-___

choosing, responsible

Bower's family systems therapy also creates therapeutic changes by encouraging clients to liberate themselves from the family system via ___ to respond more autonomously. Well-differentiated people embody the ___ I/self, who assumes accountability for one's experiences and comfort and leaves space for others to create their own happiness.

judge, accept, choose

By learning not to ___ internal and external events as good/bad or fair/unfair, clients in DBT learn to better ___ events they may have previously found emotionally or interpersonally disruptive. DBT also increases clients' ability to ___ and exercise agency over their consciousness

biofeedback, autonomic, neurobiofeedback, neural

CBT & Behavior therapies' therapeutic processes include ___ which communicate info about changes in their blood pressure, pulse rate, brain waves, dilation of blood vessels, and other biological functions to patients and enables an increase in cognitive control over ___ responses. techniques which and ___ which communicates info about brain wave activity to the patient and is useful for ADHD. Patients learn to alter brain activity by focusing on and manipulating the computer game, with the goal of training the individual to increase the ___ activity associated with paying attention, while decreasing the neural activity associated with distraction.

acceptance, collaboration, insight

CBT Therapeutic Alliance: Unconditional, full ___ & ___: Set agenda, summaries, elicit feedback, guided discovery. Helps client become more active; client activity is inherently promoted by collaboration. ___ gains are more long lasting. Enhances motivation

Structured, Collaborative, symptom

CBT Therapeutic Process is: ___, active, and directed. It's Collaborative, non-confrontational, involving ___ empiricism; Socratic questioning/guided discovery; and Feedback regularly solicited. Sequencing of treatment problem-oriented/___ relief initially, with later focus on schema modification and addressing the core belief via multiple techniques

Assessment, Activation, beliefs

CBT Treatment Sequence: begins with ___ & treatment rationale; Activity scheduling & Behavior ___; Noticing unhelpful thoughts; Addressing assumptions and core ___; Relapse prevention

homework, compliance

CBT ___ assignments definitely produced greater outcomes than did psychotherapy consisting entirely of in-session work. Homework assignments enhance therapy outcomes, and actual ___ with those assignments adds more benefit to treatment outcome

pain, dysmorphic, fatigue, batterers

CBT is also effective for chronic ___, body ___ disorder, chronic ___ syndrome, somatoform disorder (functional impairment due to physical symptoms + mental distress,) pathological gambling, psychotic disorders; personality disorders, and self-harm. However treatment effects on domestic violence ___ were in the small range, meaning that current treatments have a minimal impact on reducing recidivism beyond the effect of being arrested. There were no differences in effect sizes between CBT and other psychotherapies; none were particularly effective for this refractory population

anxiety, medications , OCD

Cognitive & CBT for ___ disorders have very large effect sizes, as well as for depression. These therapies both outperform ___ in the long run. While both therapies & pharmacotherapy helpsp in the short run, the success of meds is reduced once it's discontinued. Exposure therapy is very useful in treating ___ as well, and cognitive restructuring alone proved as effective as exposure alone

aware, substitute, feedback

Cognitive Therapeutic process takes the client through several stages: 1) becoming ___ of what he's thinking, 2) recognizing what thoughts are awry, 3) ___ accurate for inaccurate judgments, and finally 4) receiving ___ to inform whether changes are correct

language, language, present

Cognitive fusion, the over-enmeshment with our thoughts rather than our senses, is the root of psychopathology in the ACT theory and is believed to lead to overly-controlled ___, including loss of contact with the ___ and the tendency to make overly literal stances about the self.

directive, structured, homework, 12

Cognitive therapists generally endorse brief treatment due to their active, ___, and ___ style (ADS.) Problems are diagnosed, goals are identified, principles of the cognitive model are taught, and ___ experiments are designed in short order. Tapes, books, and handouts supplement the formal sessions. Manuals for Beck's cognitive therapy prescribe ___ or 16 sessions, spaced further apart as the patient recovers. Ellis's REBT offers not only quick change but also "better, deeper, and more enduring" change in 1 to 20 sessions

cognitions, counterconditioning, homework

Cognitive therapy Treatments involve consciousness raising about maladaptive ___ and their disruptive impact. Integrative in technique selection (including ____ & exposure-based approaches, contingency management) to replace maladaptive cognitions with more adaptive thought patterns. Problem-oriented, directive, psychoeducational, empirical, brief. Manualized, scripted. ___ as central, indispensable treatment feature

modification,

Cognitive-behavior ___ is the 3rd C of behavior therapy & represents those behaviorists who use cognitive explanations and cognitive techniques for producing behavior change. These therapists, known popularly as cognitive behaviorists, draw on a diversity of procedures, including cognitive restructuring, stress inoculation, and problem solving.

Implosive, prolonged exposure, phobias

Cognitive-behavioral treatments & exposure treatments have been the most thoroughly investigated psychotherapy in controlled research. ___ therapy is effective with clinical patients and superior to no treatment; it's also the most effective form of behavioral psychotherapy. ___ ___ is a behavior therapy technique particularly effective in treating PTSD, OCD, panic disorder, social anxiety disorder, and specific ___. PE creates temporarily high levels of arousal, as patients repeatedly confront the traumatic memory, but leads to permanent change in the traumatic memory and hence results in more durable gains.

commitment, punctuated, verbal, s

Communication therapists (a form of systems/family therapy) hold that communication has 5 components: it's necessary for functioning and includes silence; it implies a ___ and defines the nature of relationships; the nature of relationships are contingent on how a communication sequence is ___ (eg who speaks last getting to hold greater power;) humans communicate both verbally and nonverbally, with ___ communication providing the clearest content; and finally that all communication exchanges are either ___ (equal) or complementary (power imbalance)

substance.

Communication/strategic therapies are esp. useful in treating ___ abuse disorder

double binds, paradoxical

Communication/strategic therapists ingeniously liberate clients from double bind (lose-lose) situations and from symptoms by creating therapeutic ___ ___. When constructed correctly, these ___ techniques liberate clients by giving them two choices: to cooperate with the therapist's directives or to refuse to cooperate. The clients must either choose to follow the therapist's instructions or to rebel.

meaning, beliefs, analysis

Core principles of Cognitive Therapies: Our perception, interpretation, appraisal & attribution of ___ of events = key to our distress and key to therapy. People have adopted unhelpful/irrational ___ and thinking patterns that prevent them from experiencing optimal well-being. These thoughts = the problem to change. Lasting change can occur as a result of challenge, ___, and insight

suicidal, eating, anxiety

Compared to community treatment, DBT was associated with better outcomes: fewer suicide attempts, less treatment dropout, lower medical risk, and other indexes of success. Effectiveness of DBT isn't attributed to the common factors associated with expert therapy; something unique to DBT seems to be effective in reducing ___ behavior. DBT has been steadily adapted to disorders other than BPD, prominently including ___ disorders. For MDD MBCT proved at least as effective as (sometimes more than) maintenance antidepressant medication in preventing MDD relapse. Mindfulness and acceptance-based therapies have also been increasingly applied to ___ disorders.

avoidance, Symptom substitution

Conditioned anxiety frequently leads to ___. Physical avoidance, such as phobias, may be learned because avoidance leads to fear reduction. Thus, some patients complain of having to avoid doctors, airplanes, elevators, or social gatherings. Other patients learn to reduce anxiety by consuming alcohol, barbiturates, opiates, or other drugs. ___ ___ or symptom return is a theoretical myth of those who see all behavior as interconnected by a single, underlying dynamic conflict. What is common to most behavioral or mental disorders is conditioned anxiety that is highly specific in both the stimuli that elicit it and the consequences that result from it. Successful treatment thus calls for successful, and at times successive, elimination of specific anxiety responses. Because anxiety is learned through conditioning, it can be unlearned through counterconditioning

substance, incentive, antecedents, parents

Contingency management procedures have been applied with promising success to the treatment of ___ abusers, including alcohol and marijuana. Contingency management provides ___ for change, using positive reinforcement for abstinence and occasionally response costs for returning to drug use. Behavior therapists help clients restructure the ___ and consequences controlling their troubled responses. Importantly, ___ can be trained to manage contingencies more effectively by instituting a token economy, by contracting with their children, or by making social reinforcements contingent on positive responses from the child while avoiding reinforcement of negative behaviors.

token economies, control, contracting

Contingency management procedures in Behavior therapy can be categorized according to (1) institutional control, eg. the use of ___ ___ in hospital wards or classrooms where reinforcements are contingent on particular behaviors (2) self-___, (3) mutual control or ___, in which two or more people in a relationship share control over the consequences that each wants and each person in a relationship must specify the consequences that they'd like to have increased (4) therapist control, and (5) aversive control.

patterns, skills, current, persuasive

Core principles of CBT: Psychological challenges are based, at least in part, on unhelpful ways of thinking and learned ___ of unhelpful behavior. Through changing thinking patterns and developing ___ to better cope with challenges, people can become more effective in their lives and experience relief from unpleasant symptoms Emphasis is placed on ___ life and not past difficulties, with a focus on moving forward to develop effective ways of coping with life. Includes exposure techniques, body relaxation. Cognitive patterns are deeply entrenched and inform how we interpret situations. These core beliefs are often formed in childhood and solidified over time through repeated perception & experience. These core beliefs tend to be rigid, ___, and quite powerful

cognitive, groups, internet

Couples treated with ___ therapy improved significantly more than untreated couples but not more than couples receiving behavioral marital therapy or insight-oriented marital therapy. CBT is also most cost-effective when being administered in ___, and retains a decently high effect size even still. Even recent ___-based CBT for anxiety and depression in teens had a relatively high effect size

emotion regulation, Environment

DBT Theory of Challenges follow a Bio-Psychosocial-Emotional model of 1) Systematic dysfunction of the ___ ___ system due to a)Biological and constitutional predispositions, b) ___, and c) interaction/transaction our thoughts/behaviors and the environment, via processes of reciprocal influence

emotion dysregulation, eating, drugs

DBT includes a broad range of skills training that reduce vulnerability to ___ ___ and interpersonal disruption. The DBT PLEASE skills target PhysicaL illness, ___, Avoiding mood-altering ___, sleep, and Exercise

mood, radical acceptance, sensations

DBT PLEASE skills target: PhysicaL illness: seek treatment if sick; Eating healthily; Avoid ___-altering drugs that are not prescribed; Sleep, and Exercise This skills training is a form of counterconditioning. most unique set of skills taught in DBT concern ___ ___. These skills require practice, and run contrary to the human desire to control. DBT therapists thus train patients in mindfulness in and out of therapy sessions, in individual therapy and in group therapy. Dozens of training activities are used: becoming aware of bodily ___, such as taking five minutes to experience the sensual pleasures of a single grape; appreciating the moment; practicing mindfulness meditations; and retraining breathing

threatening, therapy

DBT Phased treatment targets: begin with life-___ behaviors; ___-interfering behaviors, and ___ of life behaviors. Then skills acquisition

commitment,

DBT Pre-Treatment and Orientation establishes treatment conditions and ___; describes treatment model and requirement; and can take several sessions.

limits, collaborative, therapy

DBT therapists help clients set effective ___ on their intense emotional reactions that can disrupt therapy & ruin relationships. This dialectic results in both warm & empathetic validation and, when needed, powerful & confrontational demeanor from the therapist. DBT is rooted in an open and ___ relationship, and therapists are often on call 24/7 for emergencies, making the relationship both a vehicle for clients and the ___ in and of itself

panic, cognitions

David Barlow's ___ control therapy (PCT) integrates elements of cognitive therapy, behavior therapy, and exposure therapy and educates clients about the nature and physiological aspects of panic, training in slow breathing, restructuring of negative ___ related to panic, and repeated exposure to feared physical sensations associated with panic. ___ is the most cost-effective treatment for both panic disorder and OCD

overgeneralizing, Selective Abstraction, responsibility

Depressogenic assumptions in Beck's Cognitive theory: ___ is drawing broad negative conclusions based on limited evidence from one situation. ___ ___ is a cognitive distortion that focuses on a single, decontextualized failureat the expense of other information. Excessive ___ is another source of psychopathology, wherein people put too much pressure on themselves to be working and achieving perfectly. Finally, dichotomous thinking is hyperbolic, catastrophizing, and black-and-white, effectively hopelessness

subjective units, desensitization, installation

During the (2nd) assessment phase of EMDR (Eye Movement Desensitization & Reprocessing) treatment, the client is asked to give an ___ ___ of distress (SUD) rating for how it feels right now. This leads to the ___ phase, the longest & hardest phase for the patient, wherein they bring up the traumatic image, negative cognition, and the associated feelings as they follow the therapist's hand with their eyes. The next phase of treatment is called ___ because the objective is to install and increase the strength of the positive cognition. Once the SUD rating reaches 0 or 1, the client has obtained sufficient relief to allow a more realistic and adaptive cognition to emerge.

integrative, anxiety, trauma, CBT

EMDR offers its recipients a couple of advantages over prolonged exposure treatment: Clients do not need to verbalize their painful memories, just think about them. Nor are EMDR clients asked to conduct between-session exposure homework. Therapists offering EDMR are typically ___ or cognitive/behavioral in orientation and that they used EMDR primarily for PTSD and other ___ disorders. Sessions are also 75-90 minutes to allow for emotional reprocessing. EMDR practitioners commit themselves to providing pro bono (free of cost) treatment and training in disaster areas, helping victims of civil wars, regional trauma, & natural disasters. Extensive base of controlled research consistently concludes that EMDR proves an effective, research-supported treatment for ___. EMDR was slightly superior to ___ (including exposure,) in particular, for decreasing intrusion symptoms and arousal severity compared to CBT.

breathing retraining, imaginal, emotional

Early Behavior therapy sessions begin with ___ ___, teaching clients to breathe calmly from the diaphragm. Before exposure begins, clients receive a clear rationale for the treatment method. Repeated exposure to the trauma then occurs in the office through ___ exposure, which enhances the ___ processing, and then through in vivo exposure, which enables the client to realize that the trauma-related situations are not dangerous

autistic, intellectual

Early, intensive behavioral interventions entails 20 to 30 hours a week of individualized, structured treatment based on behavioral principles, with several more hours per week of parent-led instruction and practice. The only intervention with established efficacy for ___ spectrum disorders and is the treatment of choice, enabling achievement of near-average ___ and educational functioning

exposure, conditioned, respondent, operant

Edna B. Foa is the most influential and systematic clinician behind prolonged exposure therapy. Foa found that behavior therapy had limitations for anxiety and mood disorders, including OCT, PTSD, and SAD. This led to the refinement of exposure therapy and the development of the emotional-processing theory. Exposure therapists in the behavioral tradition view anxiety as a ___ response controlled by ___ and ____ learning, which contribute to the acquisition of the fear.

irrational beliefs, Transference

Ellis' REBT Therapeutic Alliance: Therapists' only task is to help client identify and confront ___ ___, and replace them with rational ones. "Practically the polar opposite of person-centered therapy". ___ is encouraged as an example of clients demanding that the world be something other than it is

irrational, structured, contingency management

Ellis' REBT Therapy Process (ABCDEF): Intervening with B (___ beliefs) by D (disrupting irrational beliefs) → E (effective new philosophy) and F (new set of non-debilitating feelings). It's Short, ___, active-directive, Homework exercises in day-to-day life, and PYA-"Push your ass" and used ___ ___

conduct, cognitive, depression

Ellis' REBT is supported by research as equally effective as other psychological treatments in reducing symptoms. REBT and associated cognitive therapies also prove effective for older children and adolescents. REBT had its most pronounced impact on disruptive and ___ disorders. Over time, the apparent magnitude of ___ therapy's superiority over other treatments has declined. At this point, the benefits of cognitive therapy for ___ are approximately equal to the benefits of other tested, bona fide non-cognitive psychotherapies

person, unconditional acceptance

Ellis' REBT is the polar opposite of ___-centered therapy, and only concurs with the Rogerian idea that the therapist demonstrates ___ ___ of clients, even while challenging many of the clients' irrational beliefs. When patients do not complete homework or arrive late for sessions, the REBT clinician provides unconditional support of them as people.

expert, collaborative, problem

Ellis' Rational Emotive Behavior Therapy (REBT) is more therapist-as-___ whereas Cognitive therapies are more ___ and believe psychopathology emerges from maladaptive thought and behavioral patterns. Both cognitive & behavioral therapies are ___-oriented and present-focused. These therapies are also known for being BRIEF

rational emotive explanation

Ellis, a NYC native established ___-___ ___ therapy holds that personality emerges over time through ABCs: Activating events; Beliefs used to process the activating events; and the emotional and behavioral consequences.

contingency management, consequences

Ellis, a cognitive behaviorist, supplements his Rational-Emotive Behavior Therapy (REBT) with behavioral interventions, including ___ ___ if clients fail to follow through on HW assignments, such as sending money to a detested group if they fail to progress. The REBT therapist has clients confront the very ___ that seem terrible so that they can reevaluate them and no longer be controlled by them.

discriminative stimuli

Environmental control over maladaptive behavior results partly from the fact that certain stimuli signal that reinforcement is likely to follow a response when emitted in that particular stimulus situation, called ___ ___. Other stimuli signal that reinforcement will not follow a response when made under these particular stimulus conditions.

family, multisystemic, conduct

Evidence-based ___ therapies all grew out of empirical research in the 1980s, 1990s, and 2000s. They are the new generation that build on the rich heritage of preceding systemic therapies and that, as their title proudly proclaims, favor research evidence. Includes ___ therapy, a highly directive, intensive family-based treatment based on systems, social-ecological, and social-learning theories. constructed to treat families with serious clinical problems, typically youth with ___ disorders and substance abuse.

negatively reinforced

Exposure treatments and anxiety in Behavioral therapy: Anxiety causes most behavioral disorders and is learned through classical/respondent conditioning. Avoidance behavior of anxiety-provoking situations are ___ ___. Through generalization, stimuli similar to original conditioned stimulus can also come to evoke anxiety. Leads to avoidance which reduces anxiety. Can impair other behaviors and lead to secondary symptoms. Anxiety can be unlearned by counterconditioning

multisystemic, antisocial

Family members collaborate with ___ therapists in designing a tailored treatment plan. The plans build on the strengths in their lives. MST therapists utilize several core clinical strategies to enhance collaboration with families, which create a climate of engagement while behavioral and systemic interventions are implemented. The systemic and behavioral interventions target the adolescents' entire system—family, friends, school, and neighborhood—to break the cycle of ___ activities.

communications, structural

Family/Systemic therapy approaches include: ___/strategic family therapy; ___ family therapy, and multi systemic therapy.

eight, mindfulness, relapse.

Following the structure of Kabat-Zinn's MBSR, the formal MBCT program consists of ___ weekly sessions. The initial four sessions teach participants the ___ skills of paying attention, noticing mind wandering, and directing attention to a single, relatively neutral focus. The final four sessions concentrate on ways to skillfully handle negative mood shifts, cultivate sustained wellness, and protect against ___ into MDD etc.

OCD, panic, developmental

For adult ___, behavior therapy is the primary treatment: it was significantly more effective than antidepressants alone. The combination of behavior therapy and antidepressants was also more effective than the antidepressant medication alone. Behavior therapy was at least as effective as pharmacotherapy and, depending on the type of analysis, even significantly more effective in treating ___ disorder. Behavioral therapies are also effective in treating ___ disabilities, particularly in individual (non-group) settings

education, evidence,

For both Beck's CBT and Ellis' REBT, ___ and training in cognitive and cognitive-behavioral therapies is ideally grounded in science. Like cognitive therapy itself, training should prove ___-based and competency-based, with more than 12 affiliated training facilities throughout the US

CBT, exposure, processing

For treating PTSD, ___ and ___ therapy and EDMR have proved most effective. A variation, cognitive ___ therapy (CPT) and prolonged exposure have been the most frequently studied psychotherapies for military-related PTSD.

Relational frame, ACT

Foundation of ACT is the ___ ___theory: humans have a unique ability to understand language and cognition and create derived thoughts and relational networks among thoughts. Core ACT processes apply RFT to modify how clients relate to thoughts/memories/experiences. ___ Effectiveness: it's as effective as other cognitive & behavioral approaches. Helpful for chronic pain, tinnitus, depression, work stress, anxiety. There's a modest 0.42 effect size across meta-analyses

Dialectic, acceptance

Foundations of DBT are 1) ___: need for ___ for self-identity and for behavior change. Theoretical orientation of DBT: behavioral science, dialectical philosophy of holding multiple truths simultaneously, and Zen practice

eye movement desensitization, PTSD

Francine Shapiro established the new behavioral procedure of ___ ___ ___ (EMD), which entails simultaneous desensitization and cognitive restructuring of traumatic memories. Treatment for trauma and anxiety disorders. Can provide relief from ___ in just a few long sessions

suicidal, therapeutic, skill

Given the high-risk of disruptive events among suicidal and borderline clients, Linehan developed a structured protocol for DBT therapists with three treatment priorities: 1) address threats of ___ or other self-destructive behaviors, 2 ) focus on threats to the ___ relationship, such as dropping out or disrupting treatment, and 3) ___ development, including behavior change skills from behavior therapy, like assertiveness and interpersonal training, and acceptance skills based on mindfulness.

experiential avoidance, fusion

Hayes' Acceptance & Commitment therapy (ACT) views psychopathology as a function of ___ ___ of private events (thoughts, memories, beliefs) or cognitive ___, being controlled by them

catharsis, diffusion, distance

In ACT therapy, another therapeutic process is ___, the free-flowing expression of emotions and thoughts as they arise, without becoming attached, avoidant, or obsessive about them. Another tactic ACT uses to help clients counter ingrained habits of avoiding internal perspectives is cognitive ___ and focusing on the present. This method teaches clients how to relate to thoughts and emotions hypothetically rather than literally, giving themselves agency & control over their reactions & actions in the process. This counterconditioning process for cognitive fusion enables clients to ___ and observe their thoughts, and see them as products of a busy mind rather than inherently true

committed action, goals

In ACT, the therapeutic process of ___ ___ involves setting goals according to values and carrying them out responsibly. Therapists coach patients in distinguishing between their values and goals, which can be easily confused. ___ are specific achievements, while values are broader directions.

present moment, acceptance

In ACT, the therapeutic processes involve generating a ___-___ focus, experienced with openness, interest, and receptiveness. This mindful approach also spurs on the ___ process, which allows thoughts and feelings to come and go in consciousness with little resistance

values, clarification

In ACT, the therapeutic processes involve the client discovering their ___ as the basis for making future decisions. Techniques like values ___ help clients decide which values best provide a context for choosing, encouraging them to transcend their cultural and social contexts

group, reacting, behaviors, depression

In Beck's Cognitive therapy, once patients have the basic cognitive model down, they are often referred to ___ therapy to further refine and practice their cognitive-behavioral skills. Groups serve as a microcosm of the larger world in which clients can practice ___ to criticism, rejection, or pleasure in more rational ways. In therapy groups, clients can also practice new ___, such as assertion, that follow from more logical attitudes toward life. Cognitive and CBT have proven successful with children, adolescents, adults, and older adults. The area of best-documented achievement for cognitive therapies to date has been unipolar ___ and anxiety disorders. REBT and cognitive therapy have been applied to couples, to families, to sex therapy, and to organizations.

sensations, behaviors, exposure

In Beck's Cognitive therapy, the behavioral procedures for panic attacks include inducing feared ___ (for example, hyperventilating or focusing attention on the body) in order to demonstrate the true cause of the panic attack, stopping safety ___ (such as holding onto solid objects when dizzy), and practicing ___ to feared situations in order to allow patients to disconfirm their negative predictions about the consequences of their symptoms.

schemas, content specificity,

In Beck's cognitive therapy, Psychopathology originates in the client's preconscious or preattentive constructions of reality. These constructions reflect the operation of the client's underlying cognitive organization, called ___, in interaction with the current environment. As in REBT, life events are interpreted through cognitive lenses or structures. In cognitive therapy, the underlying cognitions are assumed to vary specifically with the behavioral disorder of clients, an idea known as the ___ ___ hypothesis. Different pathologies (disorders) are related to different cognitive content. A paranoid personality, for example, holds core beliefs that motives are suspect, that one must look for hidden

distancing, disattribution, sensations

In Beck's cognitive therapy, a key objective is to teach patients the method of ___. They learn to deal with upsetting thoughts objectively, reevaluating them rather than automatically accepting them. cognitive therapists teach the ___ technique, in which clients learn to not automatically attribute all bad events to themselves and to share the responsibility for outcomes. By raising awareness of depressogenic ___ and dysfunctional cognitions, clients begin freeing themselves debilitating expectations that they're doomed to depression and other forms of psychopathology. In the case of panic attacks, for instance, patients are taught to identify and modify their misinterpretations of bodily ___.

schemas, Homework, evidence

In Beck's cognitive therapy, a trusting relationship with a credible therapist is likely to improve treatment effectiveness, but the active ingredients of cognitive therapy are the identification of problematic ___ and their remediation, not the relationship between client and therapist. ___ assignments are, for the most part, mutual decisions in which the patient generates ideas to test out the logic or to gather ___

full family, insurance

In communication therapy, communication patterns are best observed and modified when the ___ ___ system is present. Most couple or family treatments are not covered by ___, which can pose a problem

catharsis, counterconditioning

In communications therapy, therapeutic processes in addition to the therapeutic double bind (paradox) and insights include encouraging ___ via feedback & interpretations of verbal + nonverbal communications, and ___ practices to deconstruct power tactics

social, refusal, communications

In Behavior therapy, Wolpe's original assertiveness training has inspired 3 counterconditioning applications to interpersonal behavior: ___ skills training includes but surpasses the behaviors originally taught in assertiveness training and has been extensively applied to individuals suffering from psychotic disorders and developmental disabilities. ___ skills training, routinely taught in treatment programs for addictive and consumptive disorders, enables patients to politely but persistently decline offers to partake of the troubling substance (Marlatt & Donovan, 2007). And ___ skills training consists of instruction, modeling, practice, role-playing, and homework in fundamental communication skills, such as active listening and constructive negotiation

reciprocal inhibition ,

In Behavior therapy, the principle of ___ ___ states that "if a response-inhibiting anxiety can be made to occur in the presence of anxiety-evoking stimuli, it will weaken the bond between these stimuli and anxiety.". In simplified terms, do the healthy opposite of the problem and the problem will disappear. Many healthy responses can inhibit anxiety, but the ones most frequently employed by behavior therapists are relaxation, assertion, exercise, and sexual arousal, all of which are associated with a predominance of parasympathetic nervous activity.

intensive, imaginal, vivo, desensitization

In Behavior therapy, the tactic of exposure can be a) either ___ or incremental/gradual, and b) presented either as ___ or in ___, in the real situation. Systematic ___ is at the extreme of imaginal & minimally

effective, collaboration, regard

In Behavior therapy, the therapeutic relationship focuses on being ___ not genuine. The therapist must engender trust and ___ for clients to cooperate in treatment and to tolerate repeating the fearful memories until anxiety is markedly reduced. Trust building starts at the beginning of the first evaluation session, as the therapist expertly communicates a desire to understand and to assist the client. Exposure therapists communicate positive ___ to clients via implicit and explicit convictions that clients are much stronger than they usually think. Exposure therapy generally entails 8-12 sessions, each 1-2 hours in duration, in a soundproof room to let clients emote fully. Homework assigned between sessions, including self-controlled exposure

learning, continuous, personality, maintenance

In Behavioral therapies, abnormal behavior is acquired and maintained based on scientific principles of ___, as is any behavior. Assessment is ___ and focuses on current determinants (reinforcers) of behavior. People are best described by what they do in specific life situations and not by ___ traits/internal mental events. Treatment is derived from theory and experimental findings in scientific psychology. Research evaluates effects of specific techniques on specific problems. Treatment outcome evaluated in terms of measurable behavior changes, generalization to real-world settings, and ___ over time

Fusion, triangulation

In Bowen's Family Systems theory of psychopathology, ___ between any two people, such as a husband and wife, relieves tension by involving vulnerable third parties who take sides. Fusion thus gives rise to ___. Dyads are inherently unstable because they inevitably result in periods of insensitivity, abrasiveness, or withdrawal. Triangles, on the other hand are much more stable relationships and are the building blocks of any emotional system.

multigenerational transmission, differentiation

In Bowen's family system theory, because triangles typically occur across generations, severe psychopathology can develop from a ___ ___ process. A child who has been triangulated can emerge from the family with a lower level of self-differentiation. This child will probably marry someone of a similar differentiation level, and their children are likely to have even lower levels of ___. After multiple generations of this process, a child will emerge with such a low level of differentiation that a severe pathology,

emotional cutoff

In Bowen's family systems theory, Fusion leads to triangulation. Rather than resolve triangles through self-differentiation, most people use ___ ___ to cope with their unresolved attachments to their families of origin. The cutoff consists of denial and isolation of the problems when living close to the parents, or physically running away, or a combination of the two.

family projection

In Bowen's family systems theory, the ___ ___ process pulls the parents together by creating a preoccupation with the child's problem.

hedonism

In Cognitive therapies, people can avoid emotional disturbances if they base their lives on logic and empiricism. We'd be less likely to engage in such self-defeating activities as the short-term ___ of smoking or overreacting, which provide immediate gratification at the expense of lessening our aliveness

bilateral stimulation, trauma, identity

In EMDR, eye movements represent only one form of ___ ___, but they're the most clinically effective. Hand taps and repetition of auditory cues are widely used as alternate stimuli. In EMDR, the patient is eye stimulated or hand tapped into a neutral SUD state within a few sessions, but the real work of psychotherapy remains. Following EMDR the therapist still needs to undertake the lengthy and laborious work of resolving ___ and gradually integrating the healing experience into the patient's ___.

impulse control, meaning

In Ellis' REBT theory of psychopathology, irrational thinking underlies all problems, including pervasive issues with ___ ___, from gambling to overeating to stealing, smoking, etc. In REBT, ___ is a value system that only exists when created by clients. If it means that which makes life more enjoyable, then we can agree it's best to maximize pleasures and minimize pains

beliefs, attitudes, catastrophizing

In Ellis' Rational-Emotive Behavior Therapy (REBT), the irrational ___ (iBs) and dysfunctional ___ (DAs) that constitute people's self-disturbing philosophies, then, possess two main qualities 1) possess core rigid, dogmatic, powerful demands, and 2) involve ___

surrender tactic, clarification

In communication therapy, the ___ ___ is the act of admitting defeat by becoming helpless in the face of authority, paradoxically almost always frustrating & defeating the opponent. CT tactics also include ___, reframing, and counterconditioning directives which restructure family interactions

symmetrical, complementary

In communications (family/systems) therapy, communication in relationships can either be ___ (equal, anyone can lead,) or ___ (unequal, one leads and one follows.) Psychopathology can emerge in either type of communicative relationship

irrational beliefs, Defense

In Ellis' cognitive-behavioral REBT, psychological problems are intrapersonal in origin: Individuals produce emotional problems within themselves by ___ ___. REBT usually begins, therefore, with individual sessions focusing on the client's demanding thinking. Anxiety is an inappropriate consequence of irrational beliefs. ___ mechanisms are examples of human irrational propensities. Projection is a clear example of people thinking that emotional upset is caused by external events. Repression is a reflection of the irrational belief that it is best not to think about unpleasant events. Probably the most common defense, rationalization reflects people's desire to convince the world that they have good reasons for behaving or feeling foolishly.

activating, absolute beliefs

In Ellis's cognitive Rational-Emotive Behavior Therapy, Processing ___ events (A) through ___ ___ (B) will inevitably produce dysfunctional emotional consequences (C). These irrational beliefs can produce excessive upsetting consequences such as self-pity over an unfair world, depression over parental disapproval, hostility, etc. Such emotional upsets unhealthy and unnecessary, but such emotions frequently interfere with performance

cognitive fusion, thoughts, language

In Hayes' ACT, the constant commands of teachers and parents to "be quiet, be still, be good, behave" can convince kids that any thoughts, feelings or impulses to behave more expressively must be bad, troubling, or abnormal. Such controlling contexts produce ___ ___, which is the domination of private events taken literally. In this state, we get entangled with our ___, the contents of our mind, rather than what we experience through our five senses. Cognitive fusion thus leads to over-control of ___, including loss of contact with the present moment and the tendency to take stances about the self literally

workability, value clarification, skill, behavior

In Hayes' ACT, therapists are like coaches who help clients identify private events interfering with effective action. The trainer asks ___ questions, such as, how do such reactive behaviors work for the client. Once aware of how avoiding private events produces ineffective responses, therapists become mindfulness trainers, taking skills of distancing and diffusion to accept private events that don't require judgment or avoidance. Eventually, ACT practitioners function as a ___ ___ trainer, helping clients identify values most significant to their true self. ACT therapists specifically address verbal behaviors as private events that retard effective action, but also recognize that ___ deficits, like social skills, can pose barriers. Here ACT therapists function as ___ analysts, who engage in skill training, using techniques from traditional behavior therapy

inquiry, sharing

In MBCT, ___ is the process by which the group therapist/leader engages participants in a conversation about the moment-to-moment experiences in mindfulness practice. "What do you find happening? This process is is collaborative, involving joint and interactive ___.

modes, inhabit, counterconditioning

In MBCT, the engrained habits of cognitive styles and reactivity need to be countered by MBCT trainers via mindfulness practice, exercises, and assignments. Treatment entails clients learning to distinguish the two ___ of mind (consciousness raising,) electing to ___ their being mind more often (choosing,) and acquiring the skills (___) to engage their attention more intentionally

family, directive

In Manuchin's structural therapy, the therapeutic processes include consciousness raising via dissecting their experiences in the ___ (social) context. The therapist is active and ___ and helps reframe presenting problems to create insight.

enactments, social liberation

In Manuchin's structural therapy, the therapist will encourage a family to enact family transactions rather than describe them. In ___, the therapist explicitly directs family members to engage in a particular activity, such as discussing a curfew time. Structural therapy also uses the change process of ___ ___, which occurs when a social system is changed to create more alternatives for healthy responding, giving people more freedom to choose adaptive responses and enhance growth & social justice.

boundaries, structure

In Minuchin's structural therapy, the ___ of a subsystem are the rules defining who participates in the subsystem and how. The rules that govern transactions within a family form the ___ of the family; this can only be changed if the family changes some of its fundamental rules for interacting.

enmeshed, autonomy

In Minuchin's structural therapy, the second potential pathological family structure is the ___ family, in which scant boundaries and diffuse relationships create a lack of individual ___ and individual subsystem formation. Neither the parental nor spousal subsystems can operate, and individual subsystems can't operate

disengaged, antisocial, enmeshed

In Minuchin's structural therapy, the two types of pathological family structures are 1) the ___ family, with overly rigid boundaries, little or no contact between family members, lack of structure or authority, and at least one passive parent. Children of this family structure are at high risk of developing ___ symptomology. The second type is the ___ family, whose boundaries are diffuse and whose family members lack boundaries and rules in their relations. These families' boundaries are often crossed in improper ways, such as incest, and individuals can't develop adequate autonomy

unconditional acceptance, should, required

In REBT, ___ self-___ (USA) is a logical and justifiable state, allowing stability & no dramatic rises & falls. Patients are held ___ for only their own actions, not their history, genetic makeup, early childhood, etc. Accepting responsibility for one's own problems does not involve blaming oneself. Blame is just another expression of the tyranny of the ___. REBT also encourages not seeing love, intimacy, and sex as ___ or or deified; it must be done for natural reasons without concern for parental or performance demands

extreme,

In communications therapy, another tool similar to prescribing the symptom is reductio ad absurdum, in which the therapist takes the complaint to an absurd ___ so that a client becomes aware of the relationship dysfunction

continuing, change

In communications therapy, therapeutic double binds require the therapist to create a paradox that will help liberate clients whether they follow or refuse the therapist's directive. The directive is structured so that it (1) recommends ___ the very behavior the patient expects to change, (2) implies that acting out the symptomatic behavior will produce ___, and (3) thereby creates a paradox because the patient is told to change by remaining unchanged.

homework, hypotheses, interpretation

In Rational Emotive Behavior therapy, clients soon become aware in the process of explaining their problems that they hold irrational beliefs that they cannot defend logically or empirically. They become aware that they are indeed upsetting themselves emotionally by insisting on convictions. REBT also uses ___ including reading books, listening to podcasts, or listening to & critiquing tapes of their therapy sessions, so that clients come to recognize their own absolute or demanding beliefs. HW also includes demands to test out their restricting thoughts as ___, so have them prove to themselves whether the belief is actually true or not. REBT therapists use cognitive, emotive, and behavioral techniques to teach clients to distinguish between mature, logical-empirical thought and irrational thoughts. Therapists can anticipate the nature of the underlying beliefs based on the activating events and inappropriate consequences and must be skilled in ___

boundaries, structure, psychopathology

In Structural Family therapy, healthy family systems have clear but flexible, ___ which are the rules for defining who participates in subsystems and how subsystems interact with one another. These rules, which aren't explicitly stated, form the ___ of the family and powerfully influence the experience of family members. Problems in boundaries between subsystems--in how family is structured--contributes to the origin and maintenance of ___

ordeal, severe

In addition to communication therapy for families, Haley developed ___ therapy, an extension of behavioral process of contingency management for very resistant clients. The strategic therapist imposes a situation more ___ than the actual problem on the client, causing equal or greater stress than they're actually experiencing, to reduce the stress they experience in some area of their life

refutations, homework, humor

In addition to providing interpretations and confrontations, REBT therapists raise the consciousness of clients to a more mature, rational level through ___. As effective debaters, therapists point out inherent contradictions between the clients' beliefs or between beliefs and actions. REBT therapists direct their clients to complete ___assignments designed to refute irrational hypotheses or to enable them to practice more rational thinking. REBT therapists use a multitude of techniques, including ___, to encourage clients to become more rational in their emotions and behavior. Humor is a comparatively safe method for helping clients become aware of some of their foolishness. In treating anxiety disorders, Ellis might assign a patient to sing one of his rational humorous songs, such as this one called "Perfect Rationality"

interpersonal, assertiveness

In addition to teaching emotion regulation & distress tolerance, there are DBT skills for ___ effectiveness, including ___ training and communications training.

anxiety hierarchy, relaxing

In behavior therapy, the tactic of systematic desensitization involves making an ___ ___ that ranks stimuli from the most anxiety-arousing to the least anxiety arousing. The stimulus situations are imagined by the client and ranked from the least to the most anxiety arousing. A typical hierarchy will have 10 to 20 scenes, spaced relatively equally along a 10- (or 100-) point scale from practically no anxiety elicited to intense anxiety elicited. The scenes are typically realistic, concrete situations related to the client's problem. Once the hierarchy is constructed, clients think of one or two ___ scenes, such as lying on the beach on a sunny summer day, that facilitate relaxation during the presentation of items in the hierarchy. A desensitization session typically lasts 15 to 30 minutes. Clients are frequently instructed to use in vivo desensitization, in which they approach previously feared stimuli in real-life situations.

assertiveness, anxiety, homework, punishment

In behavior therapy, whereas desensitization is the treatment of choice for specific phobias, ___ training is the choice for most anxieties related to interpersonal interactions. Candidates for assertiveness (or assertion) training include people with interpersonal problems, ranging from fear and avoidance to aggression and anger By learning to assert themselves in situations that previously evoked anxiety, patients decondition ___ by substituting an assertive response. To practice, therapists give graduated ___ assignments, beginning with less frightening situations that prove most likely to lead to successes for the client. Nevertheless, most clients and therapists desire to minimize the risk that patient assertion will evoke ___, especially hostility or violence. Using a minimally effective response reduces the probability that assertion will be met with hostility or other potentially punishing responses

Disputing, philosophy, irrational

In cognitive REBT, the ABC model of human disturbance is followed by D—the ___ of people's irrational Beliefs when they feel and act in a self-defeating way. This process leads them to E, an Effective new ___—a sound and rational set of preferential beliefs. The corresponding therapeutic process is to identify the ___ beliefs causing the presenting symptoms, to dispute them vigorously, and to replace them with more rational beliefs that constitute an effective new philosophy of life

straight, paradoxical

In communication therapy for families, therapists deliver 2 directives. ___ directives tell the family to do what the directive says, such as playing a fun game if they're too serious or disengaged. ___ directives are given when the goal is for the family to oppose the therapist, via the therapeutic double bind

control, directives, outcome

In communication therapy for family systems, the therapeutic relationship vests all ___ in the therapist, who gives ___ which change the rules of relating and communicating and intensify the relationship between the family and the therapist. Haley ultimately views therapy as a ___ struggle, where the outcome is important regardless of process

double bind

In communication therapy, a systems/family therapy version, ___ ___ communications are the most problematic patterns of communicating because they involve two incompatible patterns, such as one family member simultaneously communicating contradicting desires.

ordeals

In communications/strategic family therapy, ___ are directives aimed at making the problem harder to keep than to give up. These require clients to do something they don't want to do, but that would benefit them in some way. The therapist has to deliver them with sincerity & assertiveness to conceal the fact that it's designed to make them argue less.

directives, paradoxical

In communications/strategic family therapy, the therapist changes the rules of relating by giving ___, when they want the family to do as they say. ___ directives are used when opposing the therapist results in positive change. Family rebels against the therapist by changing

relating, symptoms, psychopathology

In communications/strategic family, the basic idea is that all families have rules of ___ that can be observed in their interaction & communication patterns. Who can talk to whom about what? Where does power to control the communicative flow reside? When communication patterns, ie the rules of relating, are unclear or threatened, the family system becomes disorganized & the individual may develop ___ to restore order. These patterns are resistant to change because ___ in family member often serves to stabilize the family

Socratic dialogue, collaborative empiricism

In contrast to Ellis' direct confrontational style in REBT, Beck uses a ___ ___ in cognitive therapy, where clients are lead to making personal discoveries through a tactful series of questions. This approach uses ___ ___: participants are on a shared mission to determine which thoughts may be dysfunctional and which avenues they might pursue to enhance those thoughts. Therapists structure interactions so that clients discover for themselves those thoughts that are inaccurate.

self instructional, control, statements

In creating ___-___ training, Donald Meichenbaum (1977, 1986) pioneered cognitive-behavior modification (CBM). Meichenbaum works with patients to reduce their self-statements that produce maladaptive emotions and, at the same time, to develop self-statements that facilitate adaptive self-control. Works particularly with treatments of childhood and adolescent disorders, especially attention-deficit, defiant, and impulsive disorders via developing self-___. Self-___ (even whispered to oneself, then gradually internalized) exert control over the individual's behavior in the same way as statements coming from another person.

habituation, response prevention

In exposure treatment in behavior therapy, ___ is a 50% reduction in anxiety to a fear-producing stimuli. ___ ___ blocks compulsive rituals, such as washing, by instruction, encouragement, direction, persuasion, and other nonphysical means. Because the rituals serve an anxiety-reducing function, the patient must learn that the feared catastrophic consequences do not occur if the rituals are not performed

Inquiry, instructors, mindfulness, relapse

In mindfulness-based cognitive therapy (MBCT), ___ is the process by which the group therapist/leader engages participants in a conversation about the moment-to-moment experiences in mindfulness practice. "What do you find happening?" "What are you experiencing now?" "Can you notice how your thoughts turn away?" By its nature, the inquiry is collaborative, involving joint and interactive sharing. MBCT practitioners often call themselves ___, as opposed to psychotherapists. They model spiritual leaders who enlighten people in modes of mind but they offer MBCT from a secular rather than spiritual perspective. Formal MBCT program consists of eight weekly sessions. The initial four sessions teach participants the ___skills of paying attention, noticing mind wandering, and directing attention to a single, relatively neutral focus. The final four sessions concentrate on ways to skillfully handle negative mood shifts, cultivate sustained wellness, and protect against ___

contingencies, response cost

In outpatient treatment, psychotherapists ordinarily have little direct control over the daily environmental ___ of their patients. Therapists can, however, control social reinforcers, such as attention, recognition, and praise, that occur in treatment. Effective Behavior therapists make a point of managing their own verbal and nonverbal reinforcements to ensure they are encouraging adaptive behaviors. The therapeutic contract can also include a provision for response cost, such as the client's paying $5 for each pound gained.

boundaries, homework, imitation

In structural therapy, Marking ___ is one technique to restructure the family. The structural clinician also keeps the therapeutic system functioning at home by assigning tasks for ___. The structural therapist may use an exaggerated ___ of the family's style to point out a dysfunctional pattern, such as yelling loudly to emphasize that a parent's yelling at a child is too harsh

identified patient, ambiguous

In systematic (family) therapy, symptoms of psychopathology may lead to a halt in dysfunctional family patterns as the family becomes concerned with the ___ ___ (IP,) while the entire system, not just the IP, should be the subject of concern. A breakdown in family functioning occurs when the rules of relating become ___ ; when this occurs, symptoms often develop to restore order to the family.

insight, interaction

In systemic (family) therapies, ___ isn't particularly important; rather focuses on reducing symptoms & improve functioning via changing ___ patterns

boundaries, subsystems, neighborhood

In systems therapies, systems are also organized by ___ around the system, which are delineated by the rules of relationships. Systems are often organized hierarchically and composed of component ___, such as partners, siblings, and parental groupings in the family system. The family system is also a component of a larger ___ system, which is hierarchically related to even larger social systems including the community, region, nation, etc.

values, flexibility

In the ACT theory of psychopathology, cognitive fusion can interfere with the ability to behave in accordance with one's ___. Psychological health is measured as a form of ___: changing or persistent as needed to adapt to environment

alter, experiential avoidance

In the ACT theory of psychopathology, the root of many disorders is the attempt to ___ unwanted private events (thoughts, feelings, impulses) even when decreasing their intensity, frequency, or duration. This struggle is a functional class of behavior called ___ ___, which persists because immediately distracting oneself usually results in immediate reduction of distress, which is reinforcing

contingencies, reinforcements

In the Behavioral approach of contingency management, typically think of ___ as being administered by others (eg token economies) but can also be self-administered. Client learns the contingencies & stimulus situations that maintain problematic behavior & alters them. Can make ___ (eg listening to music) contingent on engaging in desired behavior. Can enlist friends and family to provide social reinforcements

ABC, activating events, emotional

In the Rational-Emotive Behavioral Therapy, a cognitive therapy, psychopathologies of everyday life can be explained by the ___ model of human functioning. In emotional disturbances, ___ ___ are always processed through some irrational belief. A dozen of the most common irrational beliefs including equating needs with preferences; self-worth being determined by successes and failures; maintaining approval of parents & authorities; word should treat us fairly, etc. Ellis posited that demandingness (the shoulds, oughts, and musts) was the primary core of ___ disturbance.

multiple baseline, target behavior

In the ___ ___ design, several of the client's behaviors (not only the target behavior being modified) are measured initially. The therapeutic intervention is then introduced for one of the behaviors, while measurement of all the behaviors continues. If the intervention produces improvement in the ___ ___ but not in the other behaviors, then there is evidence that the intervention produced the improvement.

ABAB, reversal

In the ____ (___) design, the behavior of the person receiving treatment is measured repeatedly: before intervention (baseline, A); during the time when the intervention is in effect (B); during a subsequent period when the intervention is temporarily discontinued (return to baseline, A); and again under the influence of the therapeutic intervention (B). IF the client's behavior improves during the periods when treatment is administered and is worse during the initial period and at any other time when treatment is withdrawn, then the treatment itself is presumed to be causally responsible for the change.

therapy, being,

In the modes of mind metaphor underlying ___-based cognitive therapy (MBCT,) the ___ mind differs from the doing mind in that the focus is on welcoming and expressing the present moment rather than evaluating it in comparison to the he past and future. Rather than striving for a goal, this mode of mind accepts the present moment without trying to change it

bipolar, personality, medication.

Increasingly, cognitive therapy is applied to and evaluated on more disturbed patients. Beck's cognitive therapy has even been applied to ___ depression, ___ disorders, substance abuse, and psychotic conditions despite having been only applicable to mild-moderate disorders in the 1990s. Both cognitive treatments are amenable to combination with psychotropic ___ as indicated.

emotional, invalidate, abuse, reactions

Individuals with BPD have biologically heightened sensitivity & reactivity to ___ stimuli, and are esp. vulnerable to social environments that ___ them through punishing, ignoring, or trivializing. If any sort of emotional, sexual, or physical ___ is also present, these conditions can generate BPD. These people get intensely angry, hurt, rejected, jealous, depressed, or anxious quickly in response to stimuli that would evoke mild responses in others. These disruptive emotional ___ often disrupt interpersonal relationships, including the therapeutic relationship

treatment fidelity, pain,

Interestingly, the effectiveness of EMDR for PTSD appears to be stronger in rigorous studies that closely follow the specified treatment protocol (known as ___ ___.) EMDR may also be a promising treatment option in chronic ___ conditions and that more rigorous studies are needed.

counterconditioning, operant conditioning

Joseph Volpe's ___ or reciprocal inhibition therapy relies on presence of one emotional state inhibiting the occurrence of another, such as joy preventing fear or anxiety inhibiting pleasure. Builds on Pavlov's conditioning work & a respondent conditioning of anxiety-related problems. The 2nd C of Behavior therapy is behavior modification aka contingency management aka behavior analysis aka ___ ___. Follows from BF Skinner's work and changes the contingencies that follow and control behavior.

consciousness raising, choosing, counterconditioning

Like ACT and DBT, MBCT employs the therapeutic processes of ___ ___, ___ and ___ . To prevent relapse, MBCT therapists or instructors first guide clients in becoming aware of the different modes of mind. Clients can become conscious about when they are in the mode of doing mind or being mind.

choosing, counterconditioning, relapse

Like ACT and DBT, the third-wave approach of mindfulness-based cognitive therapy uses the therapeutic processes of consciousness raising, ___, and ___. To prevent ___, MBCT therapists guide clients in becoming aware of their different modes of mind (doing v. being)

accommodation , mimesis

Like anthropologists who join new social systems, systemic therapists initially accommodate themselves to the rules of the system. If the family is hierarchically structured across four generations, the therapist might address the great-grandmother first. This type of ___ involves maintenance of the family subsystems through planned support of the family structure. The therapist also accommodates to the family through tracking the context of the family's communication and behavior, by asking questions for clarification, making approving statements, or asking for amplification of certain points. Another accommodation technique is ___, which is imitating or miming important communication or behavior patterns of the family.

choices, emotional regulation, interpersonal

Like other third-wave therapies, DBT provides clients ___ that go beyond altering distressing behaviors. These therapies train clients to be mindful and accepting of distressing events. The first noble truth of Buddhism is that life is suffering—it entails pain, loneliness, frustration, disease, and ultimately death. This irrefutable fact becomes useful and therapeutic because Buddhism explains how suffering can be coped with: Choose to accept it. Attempting to avoid all pain or distress is usually the single biggest source of suffering. DBT includes training in a broad range of skills that reduce vulnerabilities to emotional dysregulation and interpersonal disruption. DBT teaches skill sets for other major behavior changes related to ___ ___ (or distress tolerance): how to better regulate the intensity, duration, and frequency of forceful negative emotions like anger, anxiety, and depression. Similarly, there are DBT skills for ___ effectiveness, including assertiveness training and communications training.

dialectic, change, acceptance

Linehan developed DBT to create a ___ between the behavioral therapy approach (client needs to change behaviors) and the antithesis (the therapist needs to accept the client for who they are.) The goal of therapy is for clients to achieve a synthesis, balancing ___ and ___

borderline, emotionally, mindfulness

Linehan's DBT views ___ personalities as products of genetic and social abnormalities. Individuals with BPD have a biological predisposition for heightened sensitivity and reactivity (quick and strong reactions) to ___ evocative stimuli, as well as delays in letting go of the emotional arousal. Individuals with such biological dispositions are especially vulnerable to social environments that invalidate them through punishing, ignoring or trivializing. To help clients accept and cope with their powerful emotions when challenging their habits or exposing themselves to upsetting situations, Linehan incorporated ___ and meditation derived from Eastern Zen Buddhist practices

instructors, groups

MBCT practitioners often call themselves ___, as opposed to psychotherapists. They model spiritual leaders who enlighten people in modes of mind but they offer MBCT from a secular rather than spiritual perspective. MBCT, like meditation, yoga, and other mindfulness methods, is usually provided to ___.

Counterconditioning, exposure

Major approaches to Behavior Therapy include ___ & ___ based approaches: based on classical conditioning, requires exposure to feared/avoided stimuli/situations, and used primarily in the treatment of anxiety

Skills, cognitive

Major approaches to Behavior Therapy include 1) ___ training approaches based on idea that maladaptive behavior often reflects fundamental skills deficits and that skills can be taught & learned and 2) ___ behavioral approaches that integrate focus on cognitive change w/ traditional behavior interventions

Contingency management, stimulus control

Major approaches to Behavior Therapy include ___ ___ & ___ ___ - based on operant conditioning and involves reducing maladaptive behavior & increasing adaptive behavior through consequences (operant conditioning) and avoiding stimuli that elicit maladaptive behavior (stimulus control)

validation, responses, change

Many behavior therapists prefer the operational term ___ to the person-centered empathy in describing their relationship goals. It occurs when the therapist communicates to the patient that her ___ make sense and are understandable within her current life context. There are multiple means of validating clients in session: listening and observing, accurately reflecting, articulating the unverbalized, reinforcing progress, validating as reasonable in the moment, and treating the person as important and valid. Validation is an end in itself, but it also facilitates client ___

suicidal, borderline, dialectic

Marsha Linehan (1943-) created DBT in the 1970s to more effectively treat chronically ___ or self-injurious patients, who often suffered from ___ personality disorders (BPD). DBT is an expanded behavior therapy that creates a ___ between the thesis of behavior therapy (the client needs to change behaviors) and the antithesis (the therapist needs to accept me for who I am). In the end, clients would achieve a synthesis (balancing change and acceptance).

dialectical behavior, acceptance, behavior

Marsha Linehan created ___ ___ Therapy (DBT) to treat chronically suicidal and self-injurious people, often with BPD. Supports simultaneous self-___ and behavior ___

DBT, group, consultation

Marsha Linehan created ___ for people with BPD, suicide attempts & suicidality; NSSI; Depression; PTSD, substance-use disorders; social adjustment/interpersonal functioning; anger and aggression; parent, couple, family distress. DBT components include skills training ___ (shaping, modeling, repeated practice, behavioral rehearsal, homework, reinforcement,) Individual therapy (motivation, acceptance, change,) Coaching skills between sessions; Parent, partner, family intervention, and Therapist ___ team

anxiety, MBSR

Mindfulness and acceptance-based therapies are increasingly used with ___ disorders. ___ is used to reduce stress, chronic pain, and outcomes in cancer patients, people with somatization disorders, and people with multiple disorders

emotion, relapse

More than 50 RCTs conducted around the world have shown family treatment proves effective for schizophrenia. A number of family treatments have been initiated, partly in light of the high relapse rates for schizophrenia and partly because of the success of expressed ___ in predicting relapse. Studies demonstrate that ___ is far more likely if schizophrenic patients live with or have extensive contact with relatives who are excessively critical, overinvolved, or hostile

aversive conditioning, punishment, schedule

On rare occasions, the stimulus control and contingency management of reinforcements fail to change the maladaptive behavior. At these times, the behavior therapist will carefully consider the use of aversive controls. When positive techniques have failed, "impulse control problems" such as sexual deviations, alcohol dependence, and repetitive self-abuse may respond to aversive controls when positive techniques have failed. Behavior therapists only attempt ___ ___ after multiple efforts at positive alternatives have failed. When aversive controls are applied within contingency management, the emphasis is generally on the contingent use of ___, which should be immediate, sufficiently intense, salient to that person, delivered early in the behavioral chain, and delivered on a continuous ___ because intermittent reinforcement makes a response even more resistant to extinction. Eg teaching a child to use restraint and assertive skills instead of smashing a younger sibling

general, specialized, educational, evidence

REBT has two major forms: ___, or inelegant, REBT, which is practically synonymous with cognitive-behavior therapy; and ___, or elegant, REBT, which adheres more precisely to Ellis's formulations. REBT uses consciousness raising as a therapeutic process. Because much of the consciousness raising in REBT is an ___ process, the work of clients frequently resembles that of students. In the process of explaining their problems, clients are quickly challenged to defend the beliefs that underlie their emotional upsets and then provide ___ for the belief, eg that they must be popular in order to be happy

schema, affective, reparenting

Recently, ognitive therapy has been extended and adapted for the treatment of personality disorders, with ___-focused psychotherapy. Personality disorders are no longer conceptualized as a collection of isolated symptoms and cognitive distortions, but rather as dysfunctional schemas and self-perpetuating, self-defeating behaviors. Rooted in cognitive therapy but drawing from attachment theory and emotion-focused therapies, Young's schema-focused therapy emphasizes ___ change methods, the therapeutic relationship, and limited reparenting more than standard cognitive therapy. Limited ___, paralleling healthy parenting, involves the establishment of a secure attachment through the therapist, and flows directly from the assumption that early maladaptive schemas arise when core needs are not met.

functional contextualism, Diffusion

Relational Frame Theory & ACT are both rooted in ___ ___: an ongoing act/interaction between self & context. Depending on our context, our thoughts/feelings/memories can function in a way that's harmful OR they can function in a way that has less power. ACT's Model of Psychological Flexibility is the hexaflex (6 components): Acceptance, Contact with the present moment, Values, Committed action, Self as context, ___

Medications, symptom exacerbation, OCD

Research proves the efficacy of prolonged exposure for the treatment of trauma (PTSD): it proves superior to psychoactive ___ alone as a first-line treatment for PTSD. But it remains a difficult treatment in terms of patient acceptability and leaves many patients improved but still suffering. A criticism of PE is that it might cause ___ ___, which, in turn, will lead to premature termination or to inferior outcomes. Prolonged exposure with response prevention leads to substantial improvement for 65% to 70% of patients with ___, in both children and adults

clinical representativeness

Research studies are particularly weak in ___ ___, or their similarity to the actual clients, therapists, and settings in real-life clinical practice (Weisz et al., 2004). In particular, certain nonbehavioral forms of child therapy, such as play therapy and psychodynamic therapy, are not adequately represented in the research studies. All methods of Behavior therapy (Rehearsal & self control; Covert behavioral, relaxation, desensitization, reinforcement, modeling, social skills training) produce large effect sizes & are superior to those found for no treatment and placebo treatment.

structural, structure, maintains

Salvador Minuchin founded ___ therapy to address delinquency problems for low-income boys & families. Focuses on changing the ___ of families, and concerns what ___ psychopathology rather than what causes it.

learned optimism, CBT

Seligman et al. introduced adopting ___ ___ to modify pessimistic attributions into __ field, based on the notion that attributions are learned behaviors, and can thus be unlearned

suicidality, dialectic

Stage 1 of DBT treatment targets ___, self-harm, life-threatening acts, and therapy-interfering behaviors. Introduces ___ strategy of balancing validation and change. Techniques: diary card; behavioral chain analysis; teaching skills; reinforcement; coaching calls. Can take 12 months

operationalize, baseline, observations

Steps of contingency management to induce behavior change in Behavior therapy: 1) ___ the target behavior by stating the general problem in behavioral terms, including the maladaptive responses and the situations in which they occur. 2) Identify target behaviors and behavioral objectives, and whether the behaviors should be increased, decreased, or reinforced only when emitted in more appropriate situations. 3) Develop behavioral measures and take ___ measures to determine whether treatment is effective. Baseline measures show the rate of responses prior to the initiation of treatment. 4) Conduct naturalistic ___, which involves observing patients in their natural environments in order to determine the existing contingencies and therefore the effective reinforcements for a particular patient. 5) Modify existing contingencies, which involves specifying the conditions under which reinforcements are or are not to be given. 6) Monitor results using behavior assessment

acceptance commitment, distancing

Steven Hayes' third-wave ___ and ___ therapy (ACT) focused on one treatment component, cognitive distancing, because it overlapped with Eastern traditions and behavior analysis. The process of mining thoughts objectively is called ___. Any technique that facilitates a client's ability to hold thoughts as hypotheses (distancing) rather than literal truth is considered useful in CT

restructuring , commitment, joining

Structural therapists emphasize ___of family systems as the means by which family subsystems become freer to respond and relate in healthier patterns. The client's ___ to liberate the system from pathogenic rules begins with a formal or informal contract to participate in structural therapy, specifying how often the family will meet, who will attend, how long sessions will last, and the initial goals of therapy. Minuchin uses the common term ___ to denote a host of techniques for entering a family system by engaging its members and subsystems. The therapist must speak the language of the family, using its own metaphors and idioms.

restructure, metachange

Structural therapy constitutes an active, short-term treatment that initiates the change process that helps ___ families. By releasing family members from their stereotyped positions, restructuring enables the system to mobilize its underutilized resources and to improve its adaptability. As a result of structural intervention, the family may not only change but also ___; that is, in addition to overcoming its current crisis, the family will enhance its ability to deal with future events without external help

Systematic desensitization

Subset of the behavioral approach of counterconditioning is ___ ___, which was Developed by Joseph Wolpe based on conditioned anxiety studies done with cats. Idea is to find response that is incompatible with anxiety and that can be paired with stimuli that evoke anxiety. Deep muscle relaxation is often used When relaxation response occurs in presence of anxiety provoking stimuli, bond between the stimulus and anxiety response is weakened

modality, content

Systemic therapies are modern approaches to family functioning which can either refer to 1) a therapy ___ or format, denoting meeting with a couple or family, or to 2) treatment ___ or goal, aimed at improving the family system

gradient, anxiety

The Behavioral (counterconditioning) process of systematic desensitization begins by developing a ___ of scenes/situations that evoke progressively more ___ (ie an anxiety gradient). Begin counterconditioning process w/ stimuli low on the anxiety gradient so as not to generate a level of anxiety that disrupts the counter-conditioned response. Client asked to imagine relaxing scene while engaging in muscle relaxation, then asked to imagine scene that evokes low level of anxiety. After imagining scene without experiencing anxiety for ~10 seconds, return to imagining relaxing scene. Process repeats until scene no longer provokes anxiety. Repeat process with next level in hierarchy. Imaginal exposure can be followed by in-vivo exposure out of the office. Diminishes strength of classical conditioning bond between anxiety & stimulus

Contingency management, remain

The Behavioral method of ___ __ is effective in reducing use of opiates, cocaine, other drugs, and to a lesser extent tobacco. Contingency management clearly improves the ability of clients to ____ abstinent, thereby allowing them to take fuller advantage of other treatment components. That includes benefiting from pharmacotherapy, which seems to act synergistically

acceptance, diffusion, committed action

The Third-Wave therapy's Acceptance & Commitment therapy says we can be open to our experiences related to our feelings, even painful ones, and how they impact us (___.) We can notice our thoughts and not directly respond to them (___.) The perspective from which we observe our thoughts and feelings is referred to as self-as-context/observing self. The values which are important to us in our lives can guide us in working through problems via behavior change, or ___ ___. When behaviors are connected to values, it's easier to commit to change.

differential activation, relapse

The ___ ___ hypothesis holds that sad moods have the power to reactive patterns of negative thinking. Even after depressive episodes have resolved, the links between sadness & negative thinking can persist and eventually initiate a depressive ___

differential activation, reactivity

The ___ ___ hypothesis posits that sad moods have the power to reactivate patterns of negative thinking. Undergirds goals of mindfulness-based cognitive therapy in preventing MDD relapse. Even after the resolution of depressive episodes, the links between sadness and negative thinking persist and can lead to a downward spiral that initiates a depressive relapse. Research on this model has examined the construct of cognitive ___ and has demonstrated the tendency of formerly depressed people to react to mild changes in mood with large changes in thinking.

modes, being

The construct that guides mindfulness-based cognitive therapy centers on the metaphor of ___ of mind. The doing mind strives toward a particular goal, such as avoid this sad mood. If a solution cannot be readily found, the mind can be trapped in an endless loop of mental problem solving, such as ruminating about the past or worrying about the future. This mode of constant hyperactivity is sometimes known as the monkey mind or the foraging squirrel mind. The ___ mind represents a wholly different way of interacting with experience. In this mode, the focus is on welcoming and expressing the present moment rather than evaluating it in relation to the past and future. Instead of striving for a goal, the being mind takes in the present moment for exactly what it is and does not try to change it.

modes, doing, ruminating

The construct that guides mindfulness-based cognitive therapy is the metaphorical ___ of mind. The ___ mind strives toward goals, such as avoiding a sad mood. If the goal can't be achieved or a solution can't be found, the mind can be trapped in an endless loop of mental problem solving, namely ___ about the past or worrying about the future.

Behavioral activation, activities

The healthy opposite and counterconditioning technique for such depression is ___ ___, a combination of improving daily activity, increasing pleasurable events, and enhancing feelings of personal mastery. BA breaks the cycle of depression by increasing the patient's daily ___. Patients complete graduated exercises to promote activities and people that are reinforcing

shame attacking, Shame, easy

The origins of Ellis's infamous ___-___ exercises involve therapists asking clients to intentionally commit in public a foolish or shameful act, such as walking a banana down the street or breaking out in a show tune in the middle of a city block. Experiments typically prove to clients that they don't need to feel shame or embarrassment. ___ is essentially a self-conscious thinking error, an irrational belief. When patients complain that the work of counterconditioning is hard, Ellis responds with 1) agreement, 2) challenging the expectation that psychotherapy should be ___, and 3) push your ass (PYA) - hard, persistent work

homeostasis, open, info

The process of maintaining a balanced or constant internal state, supported by the biological, neuroendocrine, and autonomic nervous systems. Living systems are ___ systems, meaning that energy can be freely transported into, within, and out of the system. ___ is the most important type of energy exchanged in living systems, because it reduces uncertainty. When conveyed well, it increases a system's ability to function in a highly complex & organized manner.

validation, disclosure, normalize

The series of DBT ___ strategies include responsiveness, self-___, warm engagement, and genuineness. As a result, DBT therapists often relate to clients like healthy parental figures. Therapists must ___ and accept clients; in that client behavior, no matter how disruptive or destructive, always makes sense in the context of their subjective world.

generalization, conditioned, extinction

The stimuli that were conditioned to elicit anxiety can become pervasive through the process of ___. Feature of implosive therapy. If the cause of psychopathology is ___ anxiety and avoidance, then the implosive solution is to apply the most effective methods of extinguishing both avoidance and anxiety responses. ___ is the gradual disappearance of conditioned anxiety because it is no longer reinforced—in this case, no longer reinforced by avoidance

joining, authoritative

The structural therapist has a unique way of relating to clients. The ___ process certainly includes empathy, warmth, and caring. But once a therapeutic system has been created, the therapist relates as an ___ leader. The therapist acts like a psychopolitician, advocating for the benefit of each family member against a destructive social system

psychopathology, interactional

The systemic therapy theory of psychopathology notes that decreases in one family member's ___ are linked with increased symptoms in another. STs see psychopathology as a fundamentally ___ process among family members, rather than an intrapersonal problem.

homeostatic, family, symptomatic

The systemic therapy theory of psychopathology sees psychopathology as a ___mechanism to maintain an internal balance for ___ functioning. Becoming ___ is family members' way of communicating concern over problems or conflicts

sensate focusing

The technique that these sex therapists use for reducing anxiety involves ___ ____—literally, focusing on the sensations instead of the sexual act itself. In these exercises, partners take turns pleasuring each other, beginning with sessions in which the genitals and breasts are avoided and the rest of the body is caressed. The theory behind this realm of Behavior therapy uses counterconditioning of sexual arousal to inhibit anxiety

information, processed, avoidant

The theory of psychopathology in Shapiro's Eye Movement Desensitization & Reprocessing holds that psychopathology occurs when humans' inherent, physiological ___-processing system is blocked. Traumatic life experiences set in motion a pathological pattern of affect, behavior, cognitions, sensations, and consequent identity structures. The pathological structures occur because the information is not ___; instead, the traumatic information is static, unresolved, fixed at the time it was stored during the disturbing event. Lack of adequate processing or resolution means the client reacts emotionally and behaviorally in ways consistent with the trauma. Being held in a distressing, excitatory state-specific form, the trauma continues to be triggered by ongoing events and is expressed in nightmares, flashbacks, intrusive thoughts, and ___ behavior.

parental, acceptance, genuineness, validation

The therapeutic alliance in DBT is therapist as a healthy ___ figure, since so many borderline and psychotherapy patients have so often been invalidated by abusive or neglectful parents. Strive for radical ___ and ___. Series of DBT ___ strategies are responsiveness, self-disclosure, warm engagement, and genuineness. DBT therapists also help patients set effective limits on their intense emotional reactions that can disrupt therapy and destroy relationships

structural, systemic, restructuring

The therapeutic process in Structural Family Therapy (SFT) involves the goal of identifying ___ problems in family & work towards promoting a healthier structure. Structural challenges are identified through observing family interactions, how families discuss problems, and enactments. Process reframes individual problems as ___ problems to change families' understanding of the problem. Often prescribes assignments with the explicit goal of ___ the family to create more appropriate boundaries

communication, therapist

The therapeutic process in communications/strategic family therapy focuses on influencing the family to change problematic ___ & interaction patterns through direct & active problem solving. These are assessed through history-taking and observing the family engage. Power taken by the therapist & therapy are sometimes viewed as a power struggle between the therapist & family. Haley called his approach strategic because it's a therapy where the therapist initiates what happens and directly influences people. Responsibility for change rests with the ___

choose, counterconditioning, precondition

The therapeutic processes of change in multisystemic therapy include consciousness raising, freedom to ___, ___ and contingency management. The therapeutic relationship serves as both a ___ of change and a process of change. That relationship is distinctive in that the youth, the family, and the entire system are recipients of services. It is more accurate to speak of multiple collaborations rather than the therapeutic alliance.

disengaged, enmeshed

The two problematic family structures in Structural Family therapy are the ___ family: excessively rigid boundaries that inhibit needed interactions across subsystems; and the ___ families: boundaries are overly diffuse resulting in inappropriate interactions across subsystems. These structures can give rise to what appears to be individual psychopathology, even though the basic problem is family organization

classical, respondent, operant

The two-factor theory of learning within the behavioral tradition is ___ or ___ conditioning through which animals learn to fear an unconditioned stimulus because it's been paired with a negative, unconditioned stimulus. The unconditioned stimulus becomes a conditioned stimulus capable of eliciting an automatic and autonomic conditioned response similar to fear. The second is ___ or instrumental conditioning because it's instrumental in minimizing the reactionary anxiety & motivates or drives the avoidance response, whereas the anxiety reduction reinforces instrumental avoidance

behavior, operant, social reinforcers

The value and nature of the therapeutic relationship in ___ therapy depends upon the particular method and clinician. With systematic desensitization, for example, the relationship is not nearly as consequential as in CBM or ___ methods; the former has been successfully applied in large groups and with computers, whereas the latter requires the active collaboration of patient and therapist. Behavior therapists can indeed be ___ ___, leading clients to perceive them as empathic and warm. The educational and collaborative nature of the therapeutic relationship leads to patient ratings on therapist empathy, understanding, and warmth generally comparabl

differentiation, observation

Therapeutic processes in Bowen's family systems theory involve increasing ___ of self (because psychopathology is conceptualized to arise from an inadequate differentiation of self from the family emotional system.) This process involves detriangulation of family members. Another therapeutic process is consciousness raising, via ___, which involves the ability to step back from an emotional interaction & view the events from an emotional distance; it helps control automatic & autonomic reactions.

committed action, catharsis, counterconditioning

Therapeutic processes in Hayes' ACT also include 4) ___ ___, or the process of setting goals according to values and carrying them out responsibly. Goals are specific achievements; values are broader directions. 5) ___, or letting thoughts flow up and out, allows for reflection on core values that reflect fundamental self-identity. 6) Learning cognitive diffusion (or defusion) methods helps clients shift from the context that takes thoughts and emotions literally, as facts that must be followed, to a context where such experiences can be taken as hypotheticals that need not control our behavior.) Diffusion is a ___ remedy for cognitive fusion, enabling clients to distance from and observe their thoughts.

consciousness raising, acceptance, choosing

Therapeutic processes in Hayes' ACT include 1) ___ ___, engendering a present-moment focus which enables full awareness of the here and now, experienced with openness, interest, and receptiveness. Present-focus reduces the influence of shame, guilt, or anger on behavior and also drives the 2)___ process, which allows thoughts and feelings to come and go in our consciousness without struggle. 3) ACT also uses the freedom to ___ as a therapeutic process, encouraging them to make decisions based on values: what's important to their true self. Techniques like values clarification help decide which values create the best context for choosing, rather than being controlled by roles & cultural expectations

metacommunication, strategic

Therapeutic processes in communication therapy (family/systems) include ___, or discussing communication styles to improve patterns of relating. ___ mechanisms in families may make family systems resistant to change, which is when ___ therapists are needed to disrupt the family's rigid resistance

coach, regard

Therapists operating in Bower's family systems theory are like a ___ or consultant. They use the autonomous "I" to refer to themselves and remain differentiated (not triangulated) from family members. This autonomy allows them to relate in a genuine, calm, and communicative style; they do NOT exhibit the unconditional positive ___ that may be conducive to family fusion & self-differentiation

management, contingency

These interventions include many of those reviewed earlier in this and the behavior therapy chapter: parent ___ training, conjoint family sessions to improve relations, tutoring and vocational counseling, involvement with friends who do not participate in criminal behavior, network therapy with extended family and friends to help the parents/caregivers maintain the changes, and ___ management to reward all of these positive behaviors.

acceptance, commitment, dialectical

Third wave of behavior therapies, like ___ and ___ therapy (ACT) and ___ behavior therapy (DBT), help people accept challenging experiences and to commit themselves to act on their fundamental values. Patients learn to accept what can probably not be changed—in their psychopathology, in their body shape, in their physiological arousal

values, insight, CBT

Third-Wave therapies consist of ACT, CBT, and mindfulness interventions and help people accept challenging experiences & commit themselves to act on their fundamental ___. These therapies help clients gain ___ (awareness) of what can and should be changed. Third-Wave therapies are ultimately a contemporary manifestation of ___, incorporating acceptance and mindfulness into standard therapies

philosophy, reframing, Eastern

Third-wave therapies like ACT, CBT, and mindfulness interventions combine Eastern & Western ___, science, and practice. They build on CBT, including skill building, cognitive ___, and fear exposure; and draw on ___ traditions of noticing, accepting, and enhancing private events.

ACT, DBT, mindfulness

Third-wave therapies like ___, ___, and several variants of ___ interventions represent a combination of Western and Eastern philosophy, science, and practice. From the West, they build on behavioral and cognitive therapies, including skill building, cognitive reframing, and exposure to fears. Draw from the Eastern traditions of noticing, accepting, and enhancing private events, especially previously unwanted experiences.

relapse, depression

Third-wave therapy MBCT is designed to reduce or delay the ___ of chronic ___

stress, pain, cancer

Third-wave therapy MBSR is also quite effective at reducing ___ for practitioners and patients, chronic ___, improved mental health in ___ patients, and in people with somatization disorders and multiple disorders

group, skills, mindfulness

To meet the 3 structured priorities of treatment, DBT is divided into individual and ___ sessions, where clients can learn and practice functional behavior. The ___-based group therapy helps clients practice many skills learned throughout DBT. As with ACT, DBT uses ___ as a core skill to increase self-consciousness without judging or rejecting one's experience. Clients learn to observe their internal and external environments non-judgmentally, describe it, and participate by focusing on what they're doing and experiencing.

relaxation desensitization, counterconditioning

Under Joseph Wolpe, the use of deep ___ to inhibit anxiety became the basis for systematic ___; the use of assertive responses to inhibit social anxiety became the basis for assertiveness training; and the use of sexual arousal to inhibit anxiety became the basis for new approaches to sex therapy. Volpe's ____ approaches to treating behavioral disorders reported success with 90% of more than 200 clients.

borderline, genetic, reactivity

Unlike ACT's view that psychopathological thoughts & emotions are normal; DBT views ___ personalities as product of ___ and social abnormalities. People with BPD have a biological predisposition for heightened sensitivity and ___ to emotionally evocative stimuli, as well as delays in releasing emotional arousal.

shaping

Using the process of ___, Behavior therapists reinforce clients' successive approximations to the finished goal of assertion to reduce anxiety. In the early stages, for instance, merely an increase in eye contact or an escalation in voice volume will be reinforced.

normality, psychopathology

Western psychology operates under the "healthy ___" assumption, that humans are at baseline psychologically healthy. ACT instead assumes that psychological processes of a "normal human mind are often destructive, making ___ the norm that differs only by degree

behavior exchange

What some people dislike about contracting, an element of contingency management in Behavior therapy, is that it makes explicit in relationships the ___ ___theory, which holds that we interact in order to exchange reinforcements (eg a man desiring more sex and a woman desiring more connection or vice versa)

investigator alliance

When a researcher examining the effectiveness of a given branch of psychotherapy in a meta-analysis happens to conclude that their branch of expertise is the most effective this illustrates the ___ ___, which is unintentional

cognitive interweave, looping

When the information processing gets blocked or otherwise stops progressing during EMDR, the dysfunctional material will fail to reach resolution. When this occurs, the clinician employs the ___ ___: a proactive version of EMDR that deliberately interlaces clinician-derived statements with client-generated material, instead of relying solely on the client's spontaneous processing. Clients frequently require the clinician-initiated processing in 4 situations: ___ (repetitive thoughts that do not move and that block processing); insufficient information; lack of generalization; and time pressures.

behavior, genuineness, mindfulness

When working with strongly reactive clients as in DBT, Linehan recognized simultaneous need for principles of ___ change and radical ___ and unconditional regard. Linehan incorporates ___ and mediation to help people cope with powerful emotions, challenging their habits, or exposing themselves to upsetting situations

covert sensitization, relaxation

__ ___ is an aversive technique in Behavior therapy is a self-control approach to modifying behavior. In covert sensitization, conditioning is done through the use of covert stimuli and responses, such as thoughts and images. The client is first taught deep-muscle ___ and then encouraged to imagine a scene that the therapist describes. Eg getting a pedophile to imagine propositioning a young boy he's attracted to, then imagining vomiting, then actually making himself vomit

Acceptance, commitment, process

___ & ___ Therapy (founded by Dr. Steven Hayes) is interested in area of cognitive distancing: taking greater objectivity with our thoughts, seeing them as possibilities but not necessarily true. ACT is a ___-oriented approach; Process-based therapy is an extension as well

Cognitive, Beck

___ Behavioral Therapy was est. by Aaron ___ in the 1960s

structural, systems, homeostasis

___ Family Therapy was developed by Salvador Minuchin in the 1960s, who was trained as a psychoanalyst but worked with low-income, delinquent youth from multi-problem families. He recognized the need to address problems of these youth using a systemic approach and developed SFT at the Philadelphia Child Guidance Clinic. SFT assumes that a family is a social ___ comprised of different subsystems, including the spousal, parental, and sibling subsystems, plus grandparents & other extended family. Embedded within neighborhood & larger social systems. Like all systems, family systems are organized to maintain ___ and are often resistant to change, even in the face of problems and when change is required

Eye Movement Desensitization Reprocessing

___ ___ ___ and ___ (EDMR) is a form of implosive therapy, the precursor to exposure therapy, which desensitizes via directed eye movements or taps

virtual reality exposure

___ ___ ___ therapy integrates real-time computer graphics, visual displays, and other sensory input devices to immerse patients in computer-simulated environments that they find anxiety-producing, such as heights, public speaking, and air flight. Provides controlled, individualized, and repeatable exposure to anxious situations that might otherwise prove difficult or impossible in real environments

cognitive distortions, reasoning

___ ___ are dysfunctional, automatic, thoughts that CBT tries to disrupt. Include all-or-nothing thinking, mind reading, fortune telling (catastrophizing,) emotional ___, and labeling (a fixed generalization on ourselves,) magnification/minimization, mental filter, overgeneralizing, personification, should/must statements

cue exposure, extinction

___ ___ is a Behavior therapy method used in treating addictive disorders to counteract the ability of stimuli linked to substance use to elicit actual use. In substance abusers, cues related to alcohol use, such as the smell of beer or the sight of a vodka bottle, elicit conditioned responses, such as anticipated pleasure or physiological cravings. Repeated exposure to preingestion cues in the absence of substance use can lead to ___ of conditioned responses and maladaptive cognitions, thus reducing the likelihood of substance abuse in the future.

prolonged exposure, contingencies

___ ___ is a CBT therapeutic process in Behaviorism which activates the patient's pathological structure and, at the same time, introduces corrective information that can be incorporated into a new, more adaptive structure. The therapeutic strategy is to reverse the reinforcement ___ or the neurotic paradox. It's a form of implosive therapy, a precursor to modern exposure therapies, and offers both imaginary and actual consideration of fears.

cognitive reactivity, MBCT

___ ___ is the tendency of formerly depressed people to react to mild changes in mood with large changes in thinking. The third-wave ____ approach is designed to interrupt this thinking to prevent relapses

behavioral marital, publication

___ ___ therapy (BMT) includes communication skills training, problem-solving training, and modifying dysfunctional relationship expectations and attributions. BMT produced significant changes in behavior, as compared with control couples. But ___ bias exists in the BMT literature, whereby small sample studies with small effects are systematically missing compared with other studies.

Behavioral Activation, mood

___ ___ therapy for depression: Depressed people withdraw from environment and experience fewer pleasurable events. Depressed mood increase as opportunities for positive reinforcement reduce. Depression isn't just a state of mind, but also behavioral withdrawal and social isolation. Behavioral activation focuses on increasing daily activity and exposure to pleasurable events. Breaks cycle of depression by increasing daily activities, without focusing on client's cognitions. Has clients rate their ____ as they're engaging in different activities

dialectical behavioral therapy

___ ___ therapy is a third-wave treatment for suicidality and NSSI, often suffering from borderline personality disorder, that involves exposing the client to stressors in a controlled situation, as well as helping the client regulate emotions and cope with stressors that might trigger suicidal behavior. Created by Marsha Linehan in the 1970s.

Response prevention, conditioned, repressed

___ ___, on an animal level, extinguishes anxiety by forcing the animal to remain in the presence of the ___ anxious stimuli. Likewise, on a human level, response prevention entails extinguishing pathological anxiety by preventing clients from avoiding the anxiety-eliciting stimuli. Following a few evaluation sessions, the implosive therapist constructs stimulus scenes that evoke the maximum anxiety. Stimuli most directly related to the client's symptoms will be first in the series of anxiety-eliciting cues, such as bugs for a person with a morbid dread of bugs. Implosive therapist constructs scenes that have been ___ or cognitively avoided. These repressed stimuli are similar to what psychoanalysts refer to as the dynamics of psychopathology, such as repressed feelings of rage

Rational Emotive, Ellis

___ ___/Rational Emotive Behavior Therapy est. by Albert ___ (1950s)

acceptance commitment, destructive

___ and ___ therapy (ACT) is a third-wave therapy introduced by Steven Hayes which assumes that psychological processes of a normal human mind are often ___: that psychopathology is the norm and it differs only by degree.

Systemic, interactional, symptoms

___ and family therapies believe that humans must be understood within their social context & that ___ is the most important context. See psychopathology as fundamentally an ___ process among family members, not an intrapersonal problem within one member. Problematic interaction patterns in family must be identified & altered. Changing interaction patterns changes experience & can both reduce ___ and enhance functioning.

Patient, externalizing, age, bulimia

___ characteristics can drive the selection of optimal psychotherapies; in this case, cognitive therapy is particularly valuable with ___ coping styles and LOW-resistance patients. To conclude this section, the evidence base for CBT is very strong across dozens of disorders and all ___ groups. The strongest research support exists for CBT of unipolar depression, anxiety disorders, somatoform disorders, ___, and general stress. Couple, group, and internet-based CBT proves effective plus cost efficient.

ACT, DBT, eating

___ consistently outperforms no-treatment controls and performs as well as other psychotherapies. It's useful in treating chronic pain, tinnitus, and depression. It's not superior to traditional CBT for pain, but is a treatment alternative. ___ is an effective & efficient treatment for BPD, outperforming no-treatment and usually outperforming other treatments. It's also effective in treating depression & ___ disorders

relabeling, symptom

___ is a therapeutic process technique used in communication (systems/family) therapy to make family rules explicit and to describe them more positively. Another tool used to make a family aware of their dysfunctional rules is to produce a runaway in the system by prescribing the ___, such as encouraging overly harsh parents to be even more harsh to force the system to breakdown

distancing, cognitive, ACT

___ is the process of mining thoughts objectively, facilitating one's ability to hold thoughts as hypotheses rather than literal truth. Useful in ___ therapies and recapitulated in ___ to help clients gain greater objectivity when evaluating thoughts.

REBT, transference, precondition

___ practitioners frequently behave in a genuine and open manner, directly revealing their own beliefs and philosophies of life. They are more willing than most to reveal some of their own foibles in order to dispute the client's belief that anyone, even a psychotherapist, can be more than human. ___ feelings are challenged, not encouraged, because these represent yet more examples of clients' demanding that the world be something other than what it is. A combination philosopher/teacher/scientist, the REBT therapist views the therapeutic relationship primarily as a ___for effective education. As long as the client remains willing to relate, the therapist can use hard-headed reasoning to teach

clinical, statistical, Dismantling

___ significance is the degree to which research findings have useful and meaningful applications to real problems while ___ significance only reflects how likely it is that an obtained result occurred by chance. Relying on SS alone inflates small, insubstantial treatment gains; while using a measure of CS ensures the magnitude of treatment gains is substantial and meaningful. ___ studies—research designs to break down a psychotherapy into its constituent ingredients to determine which prove the active ingredients, are greatly needed.

systemic, system, relations

___ therapies hold that people can only be understood within their social context, most often a family. In the 1950s-60s, General Systems Theory (GST) emerged in biology and cybernetics in CS. In psych, a ___ is a set of units or elements in a consistent relationship with one another. It comprises the separate elements as well as the ___ among those elements.

communication, videos

___ therapy is a systemic therapy approach from the 1950s that attempts to modify human behavior via conflicting communications. Uses ___ of family interactions to analyze breakdowns

behavior, assessment, acquired

___ therapy is a treatment process that focuses on changing unwanted behaviors through rewards and reinforcements, and denotes conceptual and/or methodological behaviorism. Proliferated during the 1970s & 80s. Concerns the primacy of overt behavior, the importance of learning, the directive and active nature of treatments, and the centrality of ___ and evaluation. Holds that most abnormal behavior is ___ and maintained according to the same principles as normal behavior. Outcome is evaluated in terms of the initial induction of behavior change, its generalization to real-life settings, and its maintenance over time. Encompasses a vast array of clinical techniques, a set of conceptual assumptions, and many possible methods for testing treatment success.

Implosive, 1970 avoid

___ therapy is intensive exposure: Developed by Thomas Stampl in the ___s to help people face frightening thoughts, feelings, and memories. Clinician works with client to construct scenes that evoke maximum anxiety. These include scenes that evoke memories/images that client is highly motivated to ___. As the client imagines those scenes, therapist looks for visible signs of fear/anxiety and then trieds to intensify the anxiety producing aspects of the scene Client is encouraged/required to STAY in the scene

implosive

___ therapy is the precursor to exposure therapies of the 1970s and presents. fantastic form of imagery

relaxation, panic, autogenic

___ training is a specific Behavioral therapy method, which produces a medium effect size for generalized anxiety (GAD) and large effect in reducing symptoms of ___ disorder. Another specific Behavioral method is ___ training, used in Germany, which treats physical disorders, such as tension headaches and hypertension, as well as psychological disorders, such as anxiety and functional insomnia.

empathy, trust, desensitization, stop

___, ___, and safety are crucial to the clinician-client relationship in EMDR. Although empathic, the EMDR therapist shouldn't provide empathic or supportive statements during the trauma processing itself, as they can inhibit the patient's ___ and inhibit tendency toward psychological self-healing. SAFETY includes building rapport, screening patients, teaching relaxation, preparing clients, reviewing a "___ signal" for them to suspend processing, and being available as necessary between sessions all create a safe haven for client and clinician alike.

ACT, CBT, depression

___, initially created for anxiety and depression in individual adults, has now been applied to children, adolescents, couples, body dissatisfaction, PTSD, eating disorders, and a host of other problems. ___, initially created as an intensive outpatient treatment for personality disordered and chronically suicidal individuals, has been increasingly applied to such complex problems as deliberate self-injury, substance dependence, bipolar disorder, and eating disorders. ACT has comparable effectiveness to established psychotherapies of cognitive or behavioral treatments. ACT was more clinically effective than control conditions and significantly better on ___ and anxiety than MBSR or MBCT.

mindfulness, cognitive, MDD

___-based ___ therapy (MBCT) is a third-wave therapy that began with Beck's cognitive therapy for depression and then added an adaptation of the MBSR program developed by Kabat-Zinn in 1990. MBCT was created to prevent relapse of ___. Individuals experiencing their third or greater episode of MDD have a 90% chance of a relapse or recurrence of MDD. When medications discontinue, relapse is likely to occur relatively quickly.

mindfulness,

___-based cognitive therapy is a third-wave approach that combines elements of CBT with mindfulness meditation to help people with depression learn to recognize and restructure negative thought patterns

exposure, Systematic desensitization, antagonistic

___-based therapies are based in respondent (classical) conditioning, and include 1) Implosive therapy: all-at-once therapy and 2) ___ ___ (counterconditioning) which is often done via imagination, rather than in-vivo. SD is not just pure extinction: you're trying to condition a response that's ___ to the feeling of anxiety

problem solving, alternatives

f a patient's problem stems from inadequate skills in confronting life's routine challenges, then ___-___ therapy. Therapists begin by educating clients in a philosophy that encourages independent problem solving. Clients learn to define problems operationally in terms of the A, B, Cs (antecedents, behaviors, consequences) and then formulate the problem more abstractly. Once the problem is formulated, the next step is to generate ___, or a range of possible responses to a situation. Step 3: stage of decision making.

learned avoidance, conditioned

the symptoms and defense mechanisms that characterize psychopathology represent ___ ___ that reduce anxiety in the short term. Phobics avoid stimuli including dogs, elevators, or heights; obsessive-compulsives may avoid dirt, disorder, or anger; hypochondriacs avoid disease. People learn to avoid particular stimuli to avoid ___ anxiety