NURS 661 Exam 3 Key Points

Feedback Loops (strategic)

Feedback loops are circular processes by which information about a system's output is continuously reintroduced back into the system, initiating a chain of subsequent events.

Give immediate and specific feedback.

Focus on effort over result. Reframe failures as opportunities for learning and growth. Make a plan for how to handle the next challenge.

Nuclear Family Emotional System

From Bowen, a fused family that is unstable and unable to cope with stress. Characterized by conflict and dysfunction which are transmitted across generations. Ineffective patterns used in fused families to cope with family problems & stress.

Know when to use trauma-focused cognitive behavioral therapy—CBT with pediatric patients

Trauma focused CBT- Trauma. Helps child and parent learn how to manage emotions, cope with stress, manage and process thoughts related to trauma, and enhance feelings of safety

family projection process (Bowen)

Undifferentiated parents project tensions and anxiety onto the most susceptible /sensitive child/ This causes triangulation, the child become symptomatic and the parents focus on the child, rather than on themselves. The child, serving as an emotional extension of the parents, is fused and triangulated to the parents, has a low level of differentiation, and has difficulty separating from the parents. Usually the child targeted is the most emotionally vulnerable and unprotected, regardless of birth order.

Encouraging Acceptance (EFFT)

When a family member begins to express deeper emotions and needs, the therapist encourages other family members to be supportive and receptive to this new openness. For example, a husband expresses deep sadness about a job loss. The wife perceives him in a new way, "I didn't know how sad you are, for I've only seen your anger. I see you need my caring."

concrete operational stage

in Piaget's theory, the stage of cognitive development (from about 6 or 7 to 11 years of age) during which children gain the mental operations that enable them to think logically about concrete events

formal operational stage

in Piaget's theory, the stage of cognitive development (normally beginning about age 12) during which people begin to think logically about abstract concepts

Softening (EFFT)

involves dominant or pursuing partners owning and expressing their primary vulnerability such as the experience of being unlovable or the shame that lies beneath the controlling behavior or critical demands.

Deescalation (EFFT)

of the conflict between the partners involves the progressive unfolding of the experience that each partner has in the relationship and the clarification of the interactive cycle between them

self-regulation techniques

Manage your own stress Keep end goal in mind Develop realistic expectations Stay calm and model self-regulation Be supportive and encouraging Ensure that children's resource pool for regulation is regularly replenished Reduce unnecessary demands Provide structure and consistency Collaborate and make learning about regulation fun Teach children about their brains Expand their vocabulary Enhance their self-awareness to help them self-monitor. Help them develop a toolbox of coping strategies to use when dysregulated. Help children identify opportunities to practice their skills. Give immediate and specific feedback. Use rewards, positive reinforcement, and praise. Hold back from punishing dysregulated behaviour

Enmeshed Family Structure

Members are grossly overinvolved in each other's activities, thoughts, and feelings.

Help them develop a toolbox of coping strategies to use when dysregulated.

Mental break (e.g., book, music, coloring, creativity, hobbies, games, movies) Physical break (e.g., dance, sports, walk, stretch) Spiritual break (e.g., yoga, meditation, mantra) Sensory experience (e.g., sound, taste, touch, movement) Grounding activity (e.g., deep breathing, slow counting, visual imagery) Positive self-talk (e.g., affirmations) Social support (e.g., ask for help, connect with a friend/ parent)

Know possible reasons you could terminate therapy

Mutually agreed on based on achievement of goals o Preplanned based on number of sessions o Forced termination b/c therapist graduates or changes clinical assignment o Forced termination b/c the patient moves o Forced termination b/c patient cannot afford fee or insurance will not pay o Patient terminates b/c he or she feels not helped o Therapist refers patient elsewhere b/c therapist feels there is no value in continuing o Setting ends the treatment for any reasons

EFFT Assessment

-first phase of therapy and usually takes two sessions. the therapist creates a comfortable and supportive environment for the couple to have an open discussion about any hesitations they may have about therapy. A strong therapeutic relationship is developed based on the patient-centered work of Carl Rogers, emphasizing empathy, congruence, and authenticity. The problematic interactional patterns that maintain attachment insecurity and relationship distress are identified as well as the primary emotions underlying these patterns. There is a reframing and summarizing of the problematic interactional patterns and the attachment needs so that the couple is no longer victim of the patterns but allies against them in the pursuit of positive attachment patterns

EFFT Key Concepts

1. Emotions 2. Attachment Styles a. secure b. insecure c. anxious d. vacillating

Strategic Family Therapy Techniques

1. Place the problem under the family's control 2. Paradoxical Technique 3. Pretend Technique 4. Ordeals 5. Rituals 6. Invariant Prescription

Stages of Change

1. Precontemplation 2. Contemplation 3. Preparation 4. Action 5. Maintenance

Systemic Family Therapy Techniques

1. Promote Self-statements 2. Transform Dysfunctional Generational Patterns 3. Decrease Anxiety and Interrupt Conflict 4. Detriangulate 5. Repair Cutoffs 6. Disrupt Nuclear Family Processes

Systemic Family Therapy Psychotherapeutic Interventions

1. Therapist assumes a neutral and objective role. 2. Genogram

Structural Family Key Concepts

Family Structure Subsystems Boundaries Enmeshed Family Disengaged Family Coalition Parentification

Piaget's stages of cognitive development

1. sensorimotor 0-2 2. preoperational 2-6 or 7 3. concrete operational 7-11 4. formal operational 12- adult

Systemic Family Therapy

A Milan-model therapeutic approach in which the family, as an evolving system, is viewed as continuing to use an old epistemology that no longer fits its current behavior patterns; the therapist indirectly introduces new information into the family system and encourages alternative epistemologies to develop.

Fusion

A blurring between self and other that occurs when two undifferentiated people form a dysfunctional interaction pattern and function as a single emotional system, such as overfunctioning/underfunctioning pattern.

Differentiation:

A person's sense of self, or degree of wholeness, is demonstrated by the ability to separate one's intellectual and emotional functioning. A differentiated person has a firm sense of self and is individuated from the family, yet in contact with them. He or she has clear values and beliefs, flexible, goal directed, secure, capable of handling stress, and less reactive to praise or criticism, and can decide important issues deliberately rather than with emotional reactivity and impulsivity. An undifferentiated person has little to no sense of self and is susceptible to family influence, dependent on others for approval, emotionally reactive, impulsive, vulnerable to stress, and has difficulty maintaining his or her emotional equilibrium.

Unbalancing

A structural technique designed to disrupt a dysfunctional sequence by lending greater support to one side of a conflict than the other. A 15 y.o. male patient requests an extended curfew and each time he begins to speak, the mother interrupts, attempting to convince the boy that his request is unreasonable, while the father sits there uninvolved. The therapist sets a 3-minute timer and tells the boy to argue his point for 3 minutes without interruptions. He is then asked to leave the room while the parents are instructed to come up with a solution together. After 10 minutes, the son returns to the session and the father is asked to inform the son of their decision. Two kids refuse to pay attention to their parent's requests to stay calm in session. The kids are asked to leave while the therapist works to strengthen the parental subsystem.

Boundary Making

A structural therapy technique in which the therapist establishes a functional semi-permeable (clear) boundary where either a rigid or diffuse boundary had existed previously. The therapist tries to change the distance between enmeshed or disengaged subsystems. Two examples are: An enmeshed father and daughter sit next to each other and frequently exchange looks and laughter, while ignoring the mother, who asks them frequently, "What did you just say?" The therapist asks the mother and father to change seats so that the mother is next to the daughter and the enmeshed father and daughter have more distance. A disengaged family attempts to deal with their 12 y.o. daughter who failed three courses by shrugging and saying, "What can we do? It's her life." The parents are challenged to come up with three solutions to the problems that would create conflict.

Attachment Injuries

An attachment injury is an emotional injury that is experienced in a couple relationship. The injury is generally characterized as abandonment, betrayal, or violation of trust

Pretend Techniques

Ask a symptomatic person to pretend to exhibit symptoms, reclassifying them as voluntary and not genuine. An example would be to ask an anxious patient to pretend to be anxious. This in turn alters the family's response, for they do not know whether the symptoms are real when the symptomatic person expresses them. Another pretend technique is to ask the patient to do something he or she would not ordinarily do. An example would be to ask someone very neat and compulsive to pretend that he or she is messy.

Develop realistic expectations

Assess children's skills to determine where they need support (e.g., instruction, self-awareness, practice, feedback). Remember that younger children have less developed brains and are less able to regulate themselves. Demand from children as much as they are able to handle, keeping in mind that success leads to more success. Expect setbacks to learning and growth.

Collaborate and make learning about regulation fun

Be creative when helping children develop, practice, and adapt coping strategies toward regulation. Listen to their ideas. Talk about 'learning to regulate' in ways they can understand. For example, if children like science, present this task to them as an experiment. If they like spy games, present it as a mission.

Mindfulness (Jon Kabat-Zinn)

Because those who have suffered significant trauma have decreased activation of the prefrontal cortex under stress, strategies such as mindfulness that activate this area are extremely important to enhance control over emotions. Mindfulness is described as internal and having external awareness in abundance Mindfulness is helpful for patients in developing dual awareness. Dual awareness means being able to maintain awareness of more than one experience at a time, allowing the person to maintain a sense of the present here and now while experiencing sensations from the past then and there

Structural Family Therapy (Salvadore Minuchin)

Believes the symptoms and family problems are embedded in a dysfunctional family organization. Framework to address structure and substructure A functional family is not the absence of problems, but the presence of an effective organizational structure to handle problems when they arise

Cybernetics (strategic)

Cybernetics is the theoretical study of control processes in a system, especially the analysis of the flow of information in a system through feedback loops and how it regulates a system.

Boundaries

Boundaries are physical or invisible emotional barriers that protect the integrity of individual members, subsystems, and families. They function to regulate contact, maintain individual identity, modulate emotional closeness, define rules of relating, and regulate the flow of resources and information within the family and the outside environment. Boundaries 507 should be clear and flexible, allowing members to attain a sense of personal identity and connection within the family, without undue interference

Invariant Prescription

Break up existing dysfunctional interactional sequences with a new sequence. For example, in a family with an unhealthy coalition, the parents are encouraged to form a secret alliance and sneak away, without informing the children of their departure or return. This new pattern unites the parents and helps the children relinquish inappropriate roles

Life Review

Chronological, 1:1, 4-6 weeks

Strategic Family Therapy Key Concepts

Cybernetics Homeostatis Feedback Loops Circular Causality First-Order changes Second-Order changes

EFFT techniques

Deescalation, reengagement, Softening Empathetic Attunement Reflective Statements Evocative Questions Creative Images & Metaphors Encouraging Acceptance Creating Intimate Attachments

Systemic Family Therapy Key Concepts

Differentiation of Self Triangles Multigenerational Transmission Process Nuclear family emotional system Family Projection Process Emotional Cutoff Sibling Position

Ordeals

Direct patient to engage in mildly noxious activities if they engage in the symptomatic or problematic behavior. The consequences for the behavior become more difficult and time consuming than they are worth. For example, a teenager who has a very disrespectful attitude will have to, after each episode of disrespect, engage in a lengthy process with the family, where everyone, in great detail, expresses how they feel about his or her behavior.

Paradoxical Technique

Do a seemingly illogical intervention that runs counter to common sense. The directive entails a maneuver that is in apparent contradiction to the goals of therapy, yet is designed to bring about positive change (Haley & Richeport-Haley, 2007). Major types include prescribing the symptom or problem, restraining change, and exaggerating the problem. An example of prescribing the symptom would be to ask the patient to do more of the symptom or problem such as to fight more or be more negative. In restraining change, an example would be for the therapist to ask the couple or family not to change. In exaggerating the problem, an example would be for the therapist to ask the patient to amplify the problem.

EFT believes

EFT believes that couples and families in distress are caught in negative interaction patterns (e.g., pursuing-distancing, attacking- withdrawing, dominance-submission, and rage-shame) that limit contact with one another and create emotional distance. Couples and families conceal their primary emotions (genuine, authentic) and rather display secondary emotions (defensive, reactive), which serve to create the negative interaction patterns. Over time, members fear revealing their primary emotions and attachment bonds are further weakened. In this approach, an empathically attuned therapeutic relationship is used to help couples access primary emotions, strengthen attachment bonds, and change their negative interactional patterns (G

Emotions (EFFT)

Emotion is an affective state of information processing that informs a person of important needs, prepares the self for action, and creates strong attachment bonds. Primary & Secondary Primary: fundamental, initial emotional reactions in response to a situation, such as sadness in response to a loss or anger in response to an attack Secondary: emotional reactions to thoughts or feelings, rather than to the situation itself, such as feeling guilty about feeling angry.

Structural Family Therapy Techniques

Enactments Structural Mapping Modifying Problematic Interactions

Manage your own stress

Get your own needs met so that you can support children and be a positive role model.

Guided imagery (veterans)

Guided Imagery promotes an altered state of awareness. It is a means by which a person can communicate with their subconscious, or unconscious, mind. Images can distract from pain, as people work with and even alter imagery related to their discomfort; a person may visualize a change in the pains color, or replace the pain with a different feeling, such as warmth. Imagery can also induce relaxation and help people cope more effectively with stress. As they are working with an image, a person is encouraged to be very descriptive and to use all their senses. They are also encouraged to note emotions that arise. Different people gravitate more to focusing on senses. Imagery can affect almost all major physiologic control systems of the body, including[3]: Respiration, heart rate, and blood pressure Metabolic rate Digestive system motility and secretion Cortisol (stress hormone) levels Cholesterol levels Immune system activity Mood, including levels of anxiety and depression

Place the problem under the family's control

Have the family control the problem rather than have the problem control the family. The therapist gives a specific directive as to how long family members are to discuss the problem, whom they are to discuss it with, and how long these discussions should last. As members carry out the directive, they develop a sense of control over the problem, which helps them deal with it effectively

Enactments

Having families act out dysfunctional transactional patterns. For example, if the family identifies a great deal of fighting in their structure, the therapist might ask the family to choose a recent issue they fought about at home and demonstrate how it unfolded in the session. With the enactment, the therapist may notice a weak parental hierarchy, a child with too much power, or a couple involved in a pursuer/distancer pattern.

Be supportive and encouraging

Help children feel cared about, valued, and understood as they learn to regulate. Show genuine interest and engage with them as a coach and mentor.

Enhance their self-awareness to help them self-monitor.

Help children rate their emotions and energy reserve on a scale from 1 (low) to 5 (high). Help them identify strategies to calm and ways to refill their resource pool.

Teach children about their brains

Help them understand the role of the downstairs brain in their stress response, as well as the upstairs brain in their regulation. You can read 'The Whole-Brain Child' listed in the resource section of this article for more information.

Homeostasis (strategic)

Homeostasis is a dynamic state of equilibrium or balance within a system. Families are believed to seek such a state in an effort to ensure a stable 511 environment.

Circular Causality (strategic)

In this view causality is nonlinear, occurring instead within a relationship context and by means of a network of interacting loops; any cause is thus seen as an effect of a prior cause. All families encounter difficulties, but whether they become problematic depends on the response of family members. Families often make cogent but misguided attempts to solve their problems, and when they persist they apply more of the same erroneous solutions. This produces an escalation of the problem and more of the same repeating cycles

three main characteristics of ADHD in children

Inattention Impulsivity Hyperactivity

DSM-5 Criteria for ADHD

Inattention: >/= 6 symptoms of inattention for children up to 16 >/=5 symptoms for ages 17 and older Symptoms must be present for at least 6 months Hyperactivity and impulsivity: >/= 6 symptoms of hyperactivity/impulsivity for children up to 16 >/=5 symptoms for ages 17 and older Symptoms must be present for at least 6 months ***must be present in 2 or more settings ***symptoms interfere with functioning and are not caused by another condition ***several inattention and hyperactivity-impulsive symptoms were present before age 12

Hold back from punishing dysregulated behaviour

Instead, use it as a starting point to understand where children need support. Remember that punishment will not teach children the skills they need to regulate

Provide structure and consistency

Let children know what to expect and what is expected of them (e.g., routines, clear rules, proactive planning). Predictability helps to decrease stress.

sibling hierarchy

Oldest tends toward leadership position and youngest child tends to follow. Bowen believes that the more closely a marriage duplicates one's sibling place in childhood, the more successful it will be. For example: an oldest child who marries a youngest will feel comfortable taking on more responsibility and decision-making, while two oldest children may be overly competitive because each will want to be in charge.

Anxious Attachment

People who are psychologically reactive exhibit anxious attachment and are inclined to demand reassurance in an aggressive and controlling way, frequently blaming and manipulating in 515 order to engage their partner.

Secure Attachment

People who are secure perceive themselves as lovable. They are able to trust self and others in relationships. They are able to be vulnerable and express their needs and feelings in relationships.

Vacillating Attachment

People who have been traumatized frequently fluctuate between attachment and hostility. They are typically reactive and they vacillate with frequency

Rituals

Perform a series of actions according to a prescribed order that gives members a sense of belonging and togetherness. For example, the family is directed to exaggerate a family ritual such as preparing and eating a meal together in a specific order

Reframing

Providing a different perspective

Stay calm and model self-regulation

Remember that when children are reacting in the moment, they are in survival mode. Their downstairs brains are in full swing. Do not try to talk to them because they cannot respond to logic or reason. Instead, stay calm, show empathy, help them become self-aware, and guide them through sensory experiences and calming strategies.

Undifferentiation

Results in emotional fusion, cutoffs, and transmission of dysfunctional patterns.

Differentiation of Self

Results in rewarding emotional contact within the family and across generations

Reduce unnecessary demands

Review children's routines to make sure they are not overloaded. Too many responsibilities will increase stress and decrease children's energy levels to regulate.

Use rewards, positive reinforcement, and praise

Rewards can include common everyday privileges (screen time, internet, video games, going to a friend's house, anything your child enjoys) or special privileges (movies, activities, buying an item). Help motivate children to learn and practice regulation. Celebrate small successes.

Ensure that children's resource pool for regulation is regularly replenished

Sleep, a balanced diet, and regular exercise are essential. Help children plan for activities they enjoy and in which they do well.

Help children identify opportunities to practice their skills.

Start by practicing in moments of calm. Once mastered, they will be more able to apply these skills during increasingly challenging situations.

Reminiscence Therapy

Story telling, group, no time frame

Structural Mapping

Structural Family Therapy (Genogram) to represent over-involvement,conflict or coalitions

Expand their vocabulary

Talk to children about their feelings. Teach them about their resource pool.

Creating Intimate Attachments (EFFT)

The couple recognizes and expresses their attachment and consolidates a new emotional position. In the example above, the husband states, "I do need your love and caring for I am going through a rough time." And, she states, "I am able to do this for I see I am needed by you." At times, the therapist needs to assist the couple in creating new attachment patterns.

Keep end goal in mind

The end goal is not to simply decrease children's challenging behavior. We want to teach skills. When children learn how to cope with stress, their behavior will improve. You will notice that they can handle changes in their environment better and respond to stress more calmly.

Goals of Strategic Family Therapy

The goal in strategic family therapy is to alter problematic patterns of behavior that maintain the family dysfunction by using strategic directives, also known as behavioral tasks. The belief is that the problem-maintaining sequences and cycles can be disrupted and extinguished by these strategic directives and replaced by functional sequences

Strategic Family Therapy (Bateson)

The strategic family therapy movement is derived from the work on feedback loops, double binds, cybernetics, homeostasis, and circular causality by Bateson and his colleagues at the Mental Research Institute focused on the study of pragmatics (the behavioral consequences of communication). They came up with a number of axioms regarding the interpersonal nature of communication including: (a) all behavior is communication; (b) communication occurs simultaneously at the metacommunication level (gesture, body language, tone of voice, posture, and intensity) and the content (surface) level; and (c) problems develop and are maintained within the context of dysfunctional interactive patterns and recursive feedback loops. The model emphasized that the solutions people use in attempting to alleviate a problem often contribute to the problem's maintenance or even its exacerbation.

Strategic Psychotherapeutic Interventions: Assessment

The therapeutic relationship in this approach is empathic and collaborative. The therapist poses questions to help define the problem completely. Each member is asked to articulate a description of the problem in great detail. The assessment stage demands a complete understanding of the problem by the therapist and the family members. The_therapist then determines how the family has attempted a solution, recognizing that the attempted solution more than likely has contributed to maintaining and worsening the problem. The therapist, in collaboration with the family, determines goals to solve the problem.

Tracking

The therapist follows a theme identified from communication and uses it deliberately in conversation with the family. An example is a phrase a 10 y.o. boy stated early in the assessment, which was, "I don't want to receive any low blows in here." Tracking the phrase, the therapist discovers that a common way the family communicates is by humiliating comments. The therapist closely tracks these undermining comments and when they occur, helps members communicate kindly

Shaping Competence

The therapist reinforces new, desirable patterns by praising the family members for their success. For example, the therapist states, "That was terrific that you were able to work together and present a united front to your child."

First-order Changes (strategic)

These changes are superficial behavioral changes within a system that do not change the structure of the system itself. For example, suppose the family makes a decision to stop shouting at each another. The underlying systemic rules governing the interaction between them have not changed, so the attempt to stop shouting will be violated sooner or later.

Second-order Changes (strategic)

These in-depth behavioral changes require a fundamental revision of the system's structure and function. An example would be changing the rules of the family system and reorganizing the system so that it reaches a different level of functioning rather than just calling a stop to shouting

Evocative Questions (EFFT)

These questions are used to evoke deeper, primary emotions that are not experienced directly. For example, a husband states, "She is never home. She always is working or out with her friends." The therapist comments, "What's happening now for you as you say that?" This draws attention to the deeper emotions

Creative Images & Metaphors (EFFT)

These representations are evoked to capture an elusive emotional experience. For example, a patient states that she cannot speak when her husband voices anger toward her. The therapist comments, "It feels like a noose around your throat that is strangling you."

Subsystems

These smaller units carry out necessary tasks for the functioning of the overall family system. They are determined by generation, age, sex, spousal relationship, interest, and function. They may include the spousal subsystem (wife and husband), parental subsystem (mother and father), sibling subsystem (children), and extended family subsystem (grandparents and other relatives). Family members belong to a number of different subsystems that help in the process of individuation and organize the way members relate to one another.

Reflective Statements (EFFT)

These statements reflect the deeper, primary emotions that a person possibly experiences based on a comment made by another. For example, a wife makes a comment, "A part of me wants a divorce." The husband is silent and looks afraid and the therapist comments to him, "It seems you are feeling terribly scared by the comment your spouse made. Is that correct?" This helps the husband access the primary emotion and for the wife to understand his emotional response.

Empathetic Attunement (EFFT)

Throughout therapy, the therapist attempts to empathically attune to each partner and connect on a deep personal level. The therapist is concerned not with evaluating the patient's comments as they relate to truth, but to make contact with the patient's subjective world. Each member's experience is closely followed empathically. The therapist speaks slowly, calmly, and patiently, checking frequently with the patient to make sure he or she is understood and engaged

Know how to take a strengths-based approach with pediatric patients

Where you praise them for doing something themselves and for maintaining that control. Giving positive praise. Praise them for doing something themselves/controlling their behaviors, and giving them positive praise.

Know how to promote self-statements during a family therapy session (systemic)

You try to help them use first-person pronouns; "I" statements. o Help them identify their own beliefs by using first-person pronouns. The therapist encourages family members to use self-defining "I-position" statements to help separate their own emotions and beliefs from the family

exhortation

a communication intended to urge or persuade the recipients to take some action

Coalition

a dysfunctional alliance between two family members against a third. There are several types of coalitions. A cross-generational coalition exists when a parent and child side against a third member of the family. A schism coalition exists when a child joins one parent of two warring spouses and the joined parent devalues the other parent to the child. A skewed coalition one spouse over functions for an under functioning spouse in order to preserve the marriage and family.

Undifferentiated Ego mass

a term used to describe a family unit whose members possess low differentiation and therefore are emotionally fused. a family system with members possessing low levels of differentiation who are "stuck together" in symbiotic relationships. Members have great difficulty individuating, for they are unable to function independently. Very codependent.

Family Structure

an invisible set of functional, recurrent patterns that organize the way family members relate to one another, structure defines and stabilizes the family. It includes This study source was downloaded by 100000808279353 from CourseHero.com on 08-17-2022 21:48:57 GMT -05:00 https://www.coursehero.com/file/159837864/Exam-4-Key-Pointsdocx/ aspects such as family roles and rules, hierarchy and power structures, communication patterns, and decision-making functions.

Grounding

bringing the person's level of awareness to the immediate therapeutic environment by noticing things in the present

Disengaged Family

families with too little cohesion, in which members have limited attachment or commitment to one another

Goal of Systemic Family Therapy

help family members increase their level of self-differentiation, especially the adult couple. Reduce emotional turmoil in the family as well as detriangulate three-person systems

preoperational stage

in Piaget's theory, the stage (from about 2 to 6 or 7 years of age) during which a child learns to use language but does not yet comprehend the mental operations of concrete logic

sensorimotor stage

in Piaget's theory, the stage (from birth to about 2 years of age) during which infants know the world mostly in terms of their sensory impressions and motor activities

ADHD brain structures

pre-frontal cortex - impulse control inhibition motor activity concentration

Structural Family Therapy Goals

restructure family organization; change dysfunctional transactional patterns

Parentification

role reversal in which a child assumes responsibilities usually taken care of by parents usually due to neglect or addiction The child willingly accepts the role because it brings with it power and status; however, it is very detrimental to the child. Ultimately, the child is unable to perform the role adequately, increasing his or her anxiety and guilt as well as lowering self-esteem. The child also cannot develop normal peer relationships, resulting in social deprivation

Emotionally Focused Family Therapy (Greenberg & Johnson)

short-term (10-15 sessions), experiential, evidence-based approach to couple and family therapy, rooted in the humanistic-existential school rom emotion-focused therapy, an individual approach to psychotherapy. Although it has many similarities to emotionfocused therapy, this therapy also includes systems theory and attachment theory and works predominantly with helping couples and families communicate from an in-depth emotional level and fully connect with each other

Treatment for ADHD

stimulant and therapy together (mod to sev) - Therapy only for mild. Behavioral and psychosocial therapies are very beneficial Cognition training is suitable for these kids because it helps with the working memory which is something they have difficulty with. Different techniques in training that helps them retain more.

Deep breathing

technique

Strategic Family therapy believes what?

that dysfunctional family patterns of behavior are deeply embedded within the family. Families maintain and perpetuate these patterns by their own actions, which are misguided attempts to solve the problem. The therapist identifies the sequence that keeps the repetitive patterns deeply entrenched within the system and uses provocative, strategic interventions to change the dysfunctional patterns

encouragement

the act of giving hope or support to someone

self-regulation

the exercise of voluntary control over the self to bring the self into line with preferred standards Self-regulation is a skill that needs to be supported in children because it is key to their overall success and happiness. Children who can cope with stress, anger, disappointment, and frustration are more able to do well in school, with friends, and at home. Remember that the more children practice regulating themselves, the easier it will become for them to cope with and adapt to change. You can help children by removing unnecessary demands and guiding them with loving support

EFFT belief

the premise that positive interaction patterns follow from the attainment of an experience of emotional bonding between the partners during therapy

Transmission Process

the transfer of dysfunctional family patterns occurs from one generation to the next. For example, the repeated message to a young girl, "You're just like your grandmother, irresponsible and unable to care for yourself," will transmit this behavioral p

Reengagement (EFFT)

the withdrawing or submissive partner in the relationship involves that partner identifying and owning, in the presence of the other, his or her primary emotional experience in the relationship

Emotional Cutoffs

this process involves reducing or cutting off emotional contact with family members in order to manage anxiety and conflict. The person may cut themselves off geographically or put up psychological barriers.

Triangulation/Triangle Family

three-person systems that manage tension between two people by bringing in a third person. Dyads are inherently unstable, as two people will vacillate between closeness and distance; a triangle can manage more tension. Example: A couple who has a highly emotional, unresolved argument. Afterward, one person calls their best friend to talk about the fight, blaming the partner. Tension is reduced through diversion, yet, the problem between the couple goes unresolved

Goals of Structural Family Therapy

to create an effective family structure with functional subsystems and clear boundaries. A strong parental hierarchy is stressed with parents having the necessary power and control. Communication is open and direct, rules are fair, roles are flexible, and decision-making is productive. In this way, the family has the capacity to handle problems when they arise focus is not on the presenting problem but on assessing dysfunction in overall structure, subsystems, boundaries, power structures, and communication patterns.

Goal of EFFT

to expand constricted emotional responses that create negative interaction patterns, restructure interactions so that partners become more accessible and responsive to each other, and foster 516 positive cycles of comfort and caring. Couples are helped to access their authentic emotions, transform negative interactional patterns, and strengthen attachment bonds. This is achieved within an empathically attuned therapeutic relationship

inspire

to motivate, guide, or influence; to give hope and courage.

Bowen Theory of Family Systems

triangles - intro new person, differentiation of self - family thinks alike and individual can still make own choices, nuclear family, emotional system - 4 relationships marital conflict- dysfunction spouse- impairment of 1 or more kid- emotional distance, Family Projection Process - parent projection of problem, Multigenerational Transmission Process - impact of parenting and result of differentiation, Emotional Cutoff - individual distances themselves from family, Sibling Position - birth order reflects tendencies, Societal Emotional Process - carryover of all the above systems into societal interaction

Insecure Attachment

—People who have a diminished ability to express their needs and feelings and tend to discount their need for attachment. They tend to adopt a position of safe distance and solve problems by themselves without understanding the effect they have on their partners.