Theories and Interventions

Bowen Family Systems Therapy

* healthy families have clearly differentiated family members * balance of intellectual and emotional forces * multigenerational transmission process * goal of treatment is differentiation and analysis of emotional triangles, balance individual and family * TOOLS: genogram detriangulate I-positions process question relationship experiments Healthy individual functioning based on family healthy functioning Uses attachment theory 8 interlocking theories: 1. differentiation of self 2. triangulation 3. nuclear family emotional system 4. family projection process= parent project onto kids 5. emotional cutoff- unreolved emtional conflict w/parents 6. multigenerational transmission process 7. sibling position 8. societal emotional process- sexism, classism, racism, et

Cognitive Therapy for Depression

- Developed by Aaron Beck -Identify cognitive patterns/schemes, distorted reality of self, experiences, the future - Involves trying to get clients to engage in pursuits that will bring them success. This will alleviate the depression while also identifying and challenging the irrational ideas that cause unhappiness. - Beck explains depression using the cognitive triad: people's beliefs about themselves, their world, and their futures. - People suffering from depression often have irrationally negative beliefs about all three of these areas. Cognitive therapy aims to make these beliefs more positive. When a person's stream of automatic thoughts is very negative you would expect a person to become depressed (I'm never going to get this essay finished, my girlfriend fancies my best friend, I'm getting fat, I have no money, my parents hate me - have you ever felt like this?). Quite often these negative thoughts will persist even in the face of contrary evidence. Beck (1967) identified three mechanisms that he thought were responsible for depression: 1. The cognitive triad (of negative automatic thinking 2. Negative self schemas 3. Errors in Logic (i.e. faulty information processing) The cognitive triad are three forms of negative (i.e helpless and critical) thinking that are typical of individuals with depression: namely negative thoughts about the self, the world and the future. These thoughts tended to be automatic in depressed people as they occurred spontaneously. As these three components interact, they interfere with normal cognitive processing, leading to impairments in perception, memory and problem solving with the person becoming obsessed with negative thoughts. Negative schemas: Experiences that might contribute to negative schemas include: Death of a parent or sibling. Parental rejection, criticism, overprotection, neglect or abuse. Bullying at school or exclusion from peer group. People with negative self schemas become prone to making logical errors in their thinking and they tend to focus selectively on certain aspects of a situation while ignoring equally relevant information Common cognitive distortions: - Arbitrary interference: Drawing conclusions on the basis of sufficient or irrelevant evidence - Selective abstraction: Focusing on a single aspect of a situation and ignoring others - Magnification: exaggerating the importance of undesirable events - Minimisation: underplaying positive events/outcomes - Overgeneralization: drawing broad negative conclusions - Personalisation: Attributing the negative feelings of others to yourself It was also found that the therapy was more successful than drug therapy and had a lower relapse rate

Reality Therapy (Glasser)

- Focus on present behaviour, human behavior is purposeful and generates from within, behavior aimed at survival, belonging, power, or fun, tries to control our perceptions of the external world to satisfy the inner world view. - Realistic/rational process - Importance of making a plan-Five needs: survival, love and belonging, power, freedom, and fun -Quality world contains pictures in our mind of people, things, and beliefs most important to meeting our needs -Choices we make based on these pictures can be bad or good -Caring, nonblaming language reflects positive choices, negative blaming language reflects poor choices -Can reevaluate behaviors, thoughts, feelings and physiology and make new choices a. face reality without excuses b. identify goals and evaluate methods of achieving goals c. Two needs: need to love and be loved and need to feel worthwhile to self and others Therapist helps client make a plan to gain control over the enviornment Good for: help people to function better, challenge clients with consequences of their actions, use self-help, Used for: originally youth with behavior issues, education settings, military setting, SUD, can be used w/wide range of clients, can be used by parents/teachers/counselors Not good for: past trauma, dealing w/unconscious, downplays social backgroud and culture, sometimes blaming Autonomy, internally oriented, responsibility, value judgments, REALITY THERAPY - HERE-AND-NOW Here-and-Now: 1. The content involves immediate events in the session, not past occurrences or even current outside events.2. The process is cognitive, a self-reflective loop determined by the nature of the relationship between interacting individuals.3. The content process includes abstract, specific, generic, and personal information as guided by the needs of the group at any given time. Here-and-Now Tasks of the Therapist: 1. First stage: activating phases aim to move group into the here-and-now. As an example, it is the leader who sets the norms for interpersonal confrontation, emotional expression, and self-monitoring, and who demonstrates the value placed upon the group as a source of good information.2. Second stage: process illumination is employed.3. The counselor acts as observer-participant and group historian. In this role, the therapist should comment on the process, eventually helping members to process as well.4. Uncovering should not be used to understand the past, but toward understanding the present.5. Here-and-now (content) and process should overlap.

ACT Acceptance And Commitment Therapy

1. Acceptance: notice and allow space for one's experiences- thoughts, feelings, behaviors without judgment 2. Cognitive diffusion- get distance from thoughts 3. Committed action- make life changes based on values 4. Committed dialogue- self conversation used to claify values 5. Confronting the agenda- feeling stuck w/no way out, hopelessness, despair 6. Experiential Avoidance- avoid/suppress the uncomfortable, i.e. numb feelings via alcohol 7. Exposure- confront what they are avoiding 8. Flexible action- shift focus away from unpleasant toward values 9. Metaphors- 10. Mindful acceptance- notice w/o judgment 11. Observe the self 12. Perspective taking 13. Psychological flexibility

narrative family therapy approach

1. life stories serve as what? Correct answer: Filters 2. Narrative therapists attempt to first understand the clients' perspectives on their lives and the problems they confront. This is called: Correct answer: Dominant plotExplanation: Narrative therapists think in terms of stories--dominant stories and alternative stories; dominant plots and alternative plots; events being linked together over time that have implications for past, present, and future actions; stories that are powerfully shaping lives. Narrative therapists are interested in joining with people to explore the stories they have about their lives and relationships, those stories' effects, their meanings, and the context in which they have been formed and authored. 3. Deconstruction in the narrative therapy process means: Correct answer: Questioning assumptionsExplanation: Deconstruction is the focus on questioning assumptions, which is part of the work that narrative therapists see as political, in that they are freeing people from oppressive cultural assumptions and empowering them to be in charge of their lives 4. When it comes to truth, narrative therapists believe: Correct answer: There are no absolute truths, only those constructed by the client 5. Preference questions are questions that: Your answer: Make sure unique outcomes represent preferred experiences 6. One of the main underlying premises of the narrative family therapy approach is that personal experience is: Your answer: Ambiguous 7. At the outset of counseling, narrative therapists encourage clients to describe the concerns that have brought them to counseling. This is done to: Correct answer: Understand the dominant plots clients have constructedExplanation: As more and more events are selected and gathered into the dominant plot, the story gains richness and thickness. Throughout this process, the story thickens and becomes more dominant, and it is increasingly easy to find more examples of events that fit with the meaning. 8. In the narrative approach, questions are asked to: Correct answer: Separate the client from the influence of the problem storyExplanation: Narrative approaches to counseling and community work center people as the experts in their own lives and views problems as separate from people. Narrative approaches assume that people have many skills, competencies, beliefs, values, commitments, and abilities that will assist them to reduce the influence of problems in their lives. The word 'narrative' refers to the emphasis that is placed upon the stories of people's lives and the differences that can be made through particular tellings and retellings of these stories. 9. Externalizing problems serves to: : Externalizing problems cuts down on guilt and blame by framing the problem in a social construction. This empowers people to take on the problem, since it shifts the problem away from being about them. 10. Which is a ritual technique of narrative therapy? Letter writing from therapist to client. Letter writing from therapist to client is a powerful technique to summarize key points of a session and, with the advent of e-mail, is not excessively time- consuming. Documents, such as certificates, awards, and diplomas specifically created to commemorate significant client developments, are also meaningful The dominant story is the one told by the client that he or she accepts as truth, while subjugated stories are alternatives that offer a different view of the truth.

family systems therapy

4 draws on systems thinking in its view of the family as an emotional unit. When systems thinking—which evaluates the parts of a system in relation to the whole—is applied to families, it suggests behavior is both often informed by and inseparable from the functioning of one's family of origin. Structural family therapy, designed by Salvador Minuchin, looks at family relationships, behaviors, and patterns as they are exhibited within the therapy session in order to evaluate the structure of the family. Employing activities such as role play in session, therapists also examine subsystems within the family structure, such as parental or sibling subsystems. Strategic family therapy, developed by Jay Haley, Milton Erickson, and Cloe Madanes, among others, examines family processes and functions, such as communication or problem-solving patterns, by evaluating family behavior outside the therapy session. Intergenerational family therapy acknowledges generational influences on family and individual behavior. Identifying multigenerational behavioral patterns, such as management of anxiety, can help people see how their current problems may be rooted in previous generations. EIGHT INTERLOCKING CONCEPTS OF FAMILY SYSTEMS THEORY 1. Differentiation of self, 2. An emotional triangle 3. The family projection process, 4. The multigenerational transmission process 5. An emotional cutoff 6. Sibling position 7. The societal emotional process 8. The nuclear family emotional process

Contextual Family Therapy

A theory and therapeutic model developed by Boszormenyi-Nagy based on the ethical dimension of family relationships. The family maintains invisible, intergenerational loyalties, which members hold in their personal ledgers. Problems in relationships are thought to result either from an attempt to maintain or change the balance sheet of what members owe to one another. Focuses on ethical dimensions of family, trust, mutual support, loyalty, fairness, accountablitiy, symptoms caused by breakdown in trust, focus on motives of family Based on psychodynamic model, includes multi-generations 4 dimensions: 1. Facts- genetic input, physical health 2. individual psychology 3. systemic transactions 4. relational ethics Interventions: encourage open dialogues, be more considerate, give freely, fact gathering, genomes. emphasize dialogue and empathy

psychoanalytic theory

A theory developed by Freud that attempts to explain personality, motivation, and mental disorders by focusing on unconscious determinants of behavior. Theorizes that people are selfish, irrational, driven by sexual instincts Id: pleasure Ego: reality based, mediates the Id and Super ego Super egoz; moral principle Libido: sexual energy Neurosis: super ego imposes guilt on ego to limit id's impulses. Dreams: manifest is literal content and latent is the hidden meaning Treatment techniques: 1. Free association: spontanious thoughts to uncover the unconscious 2. Catharsis: entales a burst of emotion and a collapse of defenses 3. Transference: project feelings onto others or therapist; types of transference: positive, negative, ambivilent, counter-transference

Functional Family Therapy

A therapeutic approach based on systems theory, cognitive theory, and behavioral principles in which clients are helped to understand the function or interpersonal payoff of certain of their behaviors as a prelude to substituting more effective ways to achieve the same results. USED for: high risk youth, cultrually sensitive, develop family goals, Flexibility highlighted to make decisions in the moment of therapy Assessment is ongoing Multi level interventions include: treatment system, individual functioning, therapist is major component Phases of therapy: 1. engagement and motivation 2. behavior change phase 3. generalization phase Techniques: reframing, minimize distractions, maximize perception that positive change is possible, build respect, coping strategies, parenting, communication

Aaron T. Beck's cognitive theory of depression

Aaron T. Beck's cognitive theory of depression proposes that persons susceptible to depression develop inaccurate/unhelpful core beliefs about themselves, others, and the world as a result of their learning histories

script in transactional analysis

According to Transactional Analysis (TA), we all create a script between the ages of zero and five. This is called our "life-script" and it contains a beginning, a middle and an ending. It is a script based on the perception that, in order to be safe or loved, we need to "be" a certain way

Narrative Therapy

An approach to treatment that emphasizes the role of the stories people construct about their experience. Techniques: 1.Tellings one's story: develop their story gives them an opportunity to discover meaning, find healing, and establish or re-establish an identity to find alterations to their story or make a whole new one 2. Externalization technique: viewing their problems or behaviors as external, instead of an unchangeable part of themselves it is easier to change a behavior you do, than to change a core personality characteristic. 3. Deconstruction tehcnique: makes the issue more specific and reduces overgeneralizing; it also clarifies what the core issue or issues actually are. Our problems can feel overwhelming, confusing, or unsolvable, but they are never truly unsolvable 4. Unique outcomes technique: changing one's own storyline, construct a storyline to their experiences that offers meaning, or gives them a positive and functional identity. 5. Existentilism: existentialists believe in a world with no inherent meaning; if there is no given meaning, then people can create their own meaning. encourages individuals to find their meaning and purpose rather than search for an absolute truth 4 realities: reality is socially constructed, reality is communicated thru language, a narrative can help organize or reality, there is no absolute truth

Analytical Psychology (Jung)

An elaborate explanation of human nature that combines ideas from history, mythology, anthropology, and religion. focuses on helping people integrate and make aspects of the psyche/personality more conscious to the individual. Like Freud, Jung centered much of his theory around the psyche and unconscious, but Jung's concept is more complex and resides in three main areas; the conscious mind, the collective unconscious, and the personal unconscious. Jungian therapy begins with establishing the therapeutic alliance, focusing on the conscious, and building a foundation for exploring the unconscious. Jungian treatments typically utilize 4 stages: 1. Catharsis and Emotional Cleansing- The beginning process of coming to terms with strong negative (repressed) emotions, and releasing them to make clients present and future more positive. 2. Elucidation- The process of making meaning out of symptoms, and working through childhood origins of emotional difficulties. 3. Education- In this stage the clinician works to bridge any gaps in development or maturation, and supports/encourages the client to take risks to improve their life. (end of treatment for many). 4. Transformation- Some clients go into this stage. Transformation involves the client utilizing their new-found. - Clinicians strive to understand the underlying psychological meanings of the symbols often found in client's dreams, symptoms, fantasies, etc. - Clinicians help to find patterns and meaning in symbolic thoughts, feelings, and emotions. - Dream interpretation: Jungian dream interpretation involves recalling dreams, and exploring the impact on the consciousness, looking at events that may be triggers, and investigating any potential archetypal images - Word Association tests: The clinician reads one word at a time to the client, and the client responds with the first word that comes to mind. By recording, hesitations, unusual responses, repeated responses, physiological responses, etc; the clinician is able to make connections -individuation: process of becoming whole/true self -Animus (hostility) - Archetypes ) images, figures, character types, settings, and story patterns) - Collective unconscious (part of the unconscious mind which is derived from ancestral memory and experience and is common to all humankind) - personal shadow (the sum total of all negative aspects of the persona that have been disowned from the personal self) Theorists: carl Jung

CBT (cognitive behavioral therapy) Meichenbaum

An umbrella term for several types of therapy. The goal is to help clients overcome problems by learning to think more rationally and logically. CBT is based on the idea that how we think (cognition), how we feel (emotion) and how we act (behavior) all interact together. Specifically, our thoughts determine our feelings and our behavior. negative and unrealistic thoughts can cause us distress and result in problems. USED for: depression, anxiety, adjustment, eating disorders, personality disorders, low to mod. functioning clients. Techniques: analysis of disfunctioning, desentitization, homework, psychoeducation, reframing, thought stopping, affirmations - Replaces self defeating thoughts with coping - Stress inoculation: practice positive self talk - Self talk: change underlying assumptions - Cognitive therapy helps people to develop alternative ways of thinking and behaving which aims to reduce their psychological distress. - Cognitive behavioral therapy is, in fact, an umbrella term for many different therapies that share some common elements. - The clients learn to discriminate between their own thoughts and reality. They learn the influence that cognition has on their feelings, and they are taught to recognize observe and monitor their own thoughts. Strengths of CBT: 1. Human cognitive abilities have been responsible for our many accomplishments so may also be responsible for our problems. 2. Cognitive theories lend themselves to testing. When experimental subjects are manipulated into adopting unpleasant assumptions or thought they became more anxious and depressed 3, Many people with psychological disorders, particularly depressive, anxiety, and sexual disorders have been found to display maladaptive assumptions and thoughts 4. ognitive therapy has been very effective for treating depression and moderately effective for anxiety problems Limitations: 1. It is not clear whether faulty cognitions are a cause of the psychopathology or a consequence of it 2. The cognitive model is narrow in scope - thinking is just one part of human functioning • Albert Ellis views the therapist as a teacher and does not think that a warm personal relationship with a client is essential. In contrast, Beck stresses the quality of the therapeutic relationship Two of the earliest forms of Cognitive behavioral Therapy were Rational Emotive Behavior Therapy (REBT), developed by Albert Ellis in the 1950s, and Cognitive Therapy, developed by Aaron T. Beck in the 1960s. Differences between REBT & Cognitive Therapy Albert Ellis views the therapist as a teacher and does not think that a warm personal relationship with a client is essential. In contrast, Beck stresses the quality of the therapeutic relationship Meichenbaum focused on replacement thoughts 'self talk' or changing unerlying assumptions, practice positive self talk CBT is an evidence-based intervention for Intermittent Explosive Disorder. The focus is on relaxation and coping skills and changing the client's thought patterns. Stress inoculation is the practice of making positive self-statements. The client keeps a daily journal of dysfunctional thoughts, noting situations and emotions that trigger the irrational beliefs and learning to counter irrational beliefs with rational responses. Techniques: 1. Socratic dialogue - involves the use of questions to point out the client's maladaptive thoughts and stuck points. Primary categories of questions are: clarification, probing assumptions, probing reasons, or evidence, questioning viewpoints or perspectives, analyzing outcomes, and questions about questions. 2. Self-monitoring - sometimes called "diary work" and is used to document the degree and amount of targeted thoughts and behaviors occurring between sessions or during a given event or timeframe. 3. Behavioral rehearsal and role-playing - client imagines a target situation, and the therapist guides the client through a step-by-step process of successfully coping with the situation. The client then practices the steps in a 'mental rehearsal' in a variety of ways. 4. Problem solving - counselor teaches the client problem-solving skills, and an identified problem (described in clear, concrete, goal-oriented terms) is explored by generating solutions to the situation, evaluating each potential alternative for short and long-term consequences, and finally selecting a course of action and following up on that course of action after implementation. 5. Modeling - involves demonstrating something for the client and having the client replicate the desired behavior. 6. Decatastrophizing ("what if") - therapist has the client state his/or her feared consequence of a situation and then identify strategies for coping. 7. Redefining - assisting the client in making the problem more specific, concrete, and individual to the client's behavior. 8. Decentering - helpful with anxious clients who believe they are the focus of others. The technique is to set up experiments to challenge client's belief and assist him/or her to see that others are not focused upon the client. 9. Cognitive restructuring - involves identifying, challenging, and changing faulty beliefs and distortions in thinking through examining logic, testing the truth of the thought or belief, and finding alternative explanations. 10. Systematic desensitization - pairing of relaxation with exposure to something the client reports as stressful. 11. Homework - clients are given homework to reinforce learning through monitoring automatic thoughts and/or behavioral activation, reviewing the previous therapy session or preparing for the next session. 12. Psychoeducation - this provides the client with information, education, or skills training on specific areas to facilitate change, such as parenting, obesity, smoking, or medication management.

REBT, cont

ELLIS (RATIONAL EMOTIVE BEHAVIOR THERAPY) ABCDE Model Therapists practicing rational emotive behavior therapy (REBT) believe that individuals have the potential for rational thinking. Self-talk is the source of emotional disturbance. Rational emotive behavior therapy, developed by Albert Ellis in the 1950's, envisions emotional consequences as being created by an individual's belief system, rather than by significant causal events, with individual intrapersonal and interpersonal life being the source of growth and happiness. Each of us is born with abilities to create or destroy, to relate or withdraw, to choose or not choose, to like or dislike, all affected by our individual culture and environment, family, and social group. The counselor's aim is to use rational emotive methods to help the client to desire rather than demand, positively change those parts of himself/or herself that the client wants to change, and accept what cannot be changed. Ellis proposed the "ABCDE" mnemonic to describe the basics of his theory: A - Activating event (induces the stress)B - Belief (what the client thinks about the event)C - Consequences (how the individual responses to the event)D - Disputing of the irrational belief (attempting to replace negative irrational beliefs with positive rational ones)E - Effect (the new beliefs if REBT has been effective) According to Ellis, people possess innate capacities for self-preservation and self-destruction, rationality and irrationality. Since others' influence is strongest during the early years, individuals' early family environments are of major importance. Individuals can and do perceive, think, emote, and behave at the same time, meaning that cognitive, connotative, and motoric behaviors co-exist. Perceptions, thoughts, emotions, and actions (from which spring both normal and abnormal behaviors) are all key elements in the rational emotive client/counselor relationship. The counselor also must remain accepting of the client, and at the same time critical of that client's negative behavior, when necessary illustrating deficiencies, and, if the client remains dependent, emphasizing independent self-discipline. Because of its cognitive core, rational emotive therapy does not require a "warm" relationship between counselor and client. Rational emotive behavior therapy employs various methods to help clients achieve basic cognitive changes that can mean changes in an individual's belief system and values. Among these techniques are didactic discussion, behavior modification, bibliotherapy, audiovisual aids, activity-based homework, role-playing, assertion training, desensitization, humor, operant conditioning, suggestion, and emotional support. Usually, general rational emotive therapy (learning appropriate behaviors) is included in preferential rational emotive therapy (learning to internalize logic and empirical thinking to counter irrational ideas and behaviors). Since in this model the true cause of an individual's problems is adherence to dogmatic and irrational beliefs, he/or she needs to see that the difficulty results from those beliefs (instead of antecedent causes and conditions), that problems will not go away by themselves, and that those problems can be eliminated or minimized through rational emotive thinking and action. The active-directive approach of rational emotive therapy treats the client holistically, with emphasis on the biological factors of personality development. In order to help the client replace self-defeating outlooks with a realistic and acceptable worldview, rational emotive therapists identify and strongly challenge those clients' irrational beliefs.

attachment theory

Early attachment seems to affect subsequent development. By ages four to five, children who were securely attached as infants are usually more curious, more popular with peers, and less dependent on adults. As adults, they have high self-esteem and a strong sense of personal identity, although it does not appear that insecure attachment in infancy is necessarily linked with poor social adjustment or adulthood psychopathology. Those separated at nine months exhibit moderate to extreme reactions including: feeding and sleeping problems, social withdrawal, increased stranger anxiety, and either physical rejection or extreme attachment to the new mother. Early institutionalization has the most negative impact when separation of the mother and child occurs in the second half of the first year. In this case, the infant may develop anaclitic depression, a syndrome involving developmental delays, unresponsiveness, and social withdrawal Stages of Prolonged Separation (Bowlby): 1. Protest - refuses to accept separation, demonstrated by crying, kicking and screaming2. Despair - gives up all hope and withdraws3. Detachment - seems less unhappy, accepts attention from others and may react with disinterest when visited by the caretaker

Interpersonal and social rhythm therapy (IPSRT) use w/B-I

Explanation: IPSRT would help this client understand patterns which lead to mood episodes. It would also help develop better sleep hygiene and has a strong evidence base for reducing the length of time clients with Bipolar I Disorder spend in the depressive phase of the disorder.

REBT (Rational Emotive Behavior Therapy)

Field: cognitive behavioral therapy, developed by Albert Ellis, that vigorously challenges people's illogical, self-defeating attitudes and assumptions. ABC(DE), Can be considered confrontational. Rational Emotive Behavior Therapy (REBT) is a type cognitive therapy first used by Albert Ellis which focuses on resolving emotional and behavioral problems. The goal of the therapy is to change irrational beliefs to more rational ones. REBT encourages a person to identify their general and irrational beliefs (e.g. I must be perfect") and subsequently persuades the person to challenge these false beliefs through reality testing. some people's assumptions are largely irrational, guiding them to act and react in ways that are inappropriate and that prejudice their chances of happiness and success. Albert Ellis calls these basic irrational assumptions. Some people irrationally assume that they are failures if they are not loved by everyone they know - they constantly seek approval and repeatedly feel rejected .common irrational assumptions: • The idea that one should be thoroughly competent at everything. • The idea that is it catastrophic when things are not the way you want them to be. • The idea that people have no control over their happiness. • The idea that you need someone stronger than yourself to be dependent on. • The idea that your past history greatly influences your present life. • The idea that there is a perfect solution to human problems, and it's a disaster if you don't find it. ABC Technique of Irrational Beliefs? A- activating event or antecedent B- Belief C- Consequences Ellis believes that it is not the activating event (A) that causes negative emotional and behavioral consequences (C), but rather that a person interprets these events unrealistically and therefore has an irrational belief system (B) that helps cause the consequences (C). the therapist will often work with the client in challenging the negative thoughts on the basis of evidence from the client's experience by reframing it. The counselor's aim is to use rational emotive methods to help the client to desire rather than demand, positively change those parts of himself/or herself that the client wants to change, and accept what cannot be changed. Ellis proposed the "ABCDE" mnemonic to describe the basics of his theory: A - Activating event (induces the stress)B - Belief (what the client thinks about the event)C - Consequences (how the individual responses to the event)D - Disputing of the irrational belief (attempting to replace negative irrational beliefs with positive rational ones)E - Effect (the new beliefs if REBT has been effective) Works well on anxiety and fears Techniques: - Bibliotherapy: creative arts therapy that involves storytelling - Activity based homework: science based activities - Dialetectic discussion: acceptance and change - Role playing - Problem-solving skills - Assertiveness - Social skills - Decision-making skills - Conflict resolution skills - Guided imagery and visualization - Reframing - Using humor and irony - Exposing yourself to whatever you fear - Disputing irrational beliefs - Imagin the worst- face that fear by envisioning it - Blown Out of All Proportion-guide them in visualizing it to an extreme -didactic discussion, - behavior modification, - bibliotherapy, - audiovisual aids, - activity-based homework, - desensitization, - humor, - suggestion, and - emotional support. - problems can be eliminated or minimized through rational emotive thinking and action. - replace self-defeating outlooks with a realistic and acceptable worldview, rational emotive therapists identify and strongly challenge those clients' irrational beliefs.

Dialectical Behavioral Therapy (DBT)

Helpful in learning how to manage his emotions, tolerate frustration and regulate his affect. This is especially a good choice for a client who has little insight into their problem (either from a maturity standpoint, age, cognitive ability, or to help with personality disorder) and needs help controlling their bodily reactions immediately without necessarily understanding the underlying reasons why they react the way they do. Cognitive behavioral therapy (CBT) approaches will also be useful for Avery but focus on identifying and changing negative beliefs and thought patterns that contribute to maladaptive behaviors, which is critical for long term change. Applied Behavior Analysis (ABA) is the preferred intervention for autism, and holistic therapies can be considered to provide additional support but are not all clinically evidence-based and do not directly apply to the interventions listed in the question. Dialectical behavior therapy is a skill-based approach that includes both individual and group therapy. It teaches mindfulness and acceptance skills, such as the ability to experience moment-to-moment thoughts, emotions and their accompanying physical sensations from an observer's stance, without negative judgment. It also teaches distress tolerance, emotion regulation and interpersonal effectiveness.

CONJOINT FAMILY THERAPY - HOW PEOPLE GET IN TROUBLE AND HOW TO HELP PEOPLE

How People Get In Trouble: 1. Self-esteem is lowered when the family does not respect its members' needs. 2. Family members adopt defensive stances for coping with stress (e.g. placating-enabler, acting out, entertainer, people pleaser, or rescuer). 3. When family members start operating under unspoken, absolute rules that are impossible in nature (e.g. always look happy, never be mad at your mother, etc.), a child will adhere to these rules to survive within the family, yet he/or she becomes burdensome as an adult. 4. When members in a family begin to act, think, and feel the same way due to dysfunction; this can also stem from family members being controlled by punishment, guilt, fear, or dominance. 5. Family members are considered "dysfunctional" when the poor self-esteem of the parents leads to closed communication and when members become incapable of establishing autonomy from one another. Family members' relationships become strained with little room for individuality or intimacy; the establishment of rigid patterns emerges. 6. There are three parts to every communication: me, you, and context; dysfunctional communications only account for two at a time. How to Help People: 1. Encouragement of growth by acknowledging differences 2. A goal of therapy is to enhance the self-esteem of family members by basing family decisions on individual needs. 3. Transform extreme family rules into useful and functional rules 4. Focus on enhancement and validation of self-esteem 5. Assess, strengthen, and enhance coping skills 6. Identify family roles, then help transform family roles into relationships, and family rules into guidelines 7. The overall goal is to liberate the family, so they adhere to the 5 freedoms:a. To see and hear what is here instead of what should be, was, or will beb. To say what one feels and thinks, instead of what one shouldc. To feel what one feels, instead of what one oughtd. To ask for what one wants, instead of always waiting for permissione. To take risks in one's own behalf, instead of choosing to be "secure" by not rocking the boat

interpersonal and social rhythm therapy

IPSRT is an individual therapy in which the person with BD keeps daily records of their bed times, wake times, and activities, and the effects of changes in these routines on their moods. The clinician coaches the person on how to regulate their daily routines and sleep-wake cycles as a way to stabilize moods. The person and his/her therapist identify one or more interpersonal problem areas (e.g., conflicts with coworkers; difficulty sustaining friendships) and discuss potential solutions to prevent similar problems from emerging in the future.

Behavior Therapy

Operant conditioning: BF Skinner: focuses on the effects of behavior, positive and negative reinforcers are used. Positive adds something in, negative takes something away. Positive punishment adds unpleasant consequence, negative punishment removes something desirable. Techniques include: shaping, token, extinction. USED FOR: disfunctional behavior issues-low to moderate functioning ability, CD, SUD, impulse control disorders, sexual dysfuntion, phobias, sleep disorders. Techniques: establish baseline, rewards, homework, record keeping, charts/diaries, imagery, reinforcement, role play, assertive or other skills training, acting 'as if' Classical conditioning: Pavlov: focuses on antecedent of behavior, unconditional stimulus produces unconditional response and neutral stimulus doesn't produce anything. To affect behavior pair unconditional with neutral stimulus, causing the neutral stimulus to be conditioned and produces the desired response.

Behavioral Parent Management Training approach

Parent behavior management training is an evidence-based treatment teaching parents how to manage difficult childhood behaviors (defiance, outbursts, noncompliance). Validating and encouraging a parent like in answer a) is positive, a positive attitude to have however dismissing the behavior or the parent's role in reinforcing the behavior is not clinically best practice when you are responsible for treating the child conducting those behaviors. Answer b) is an aggressive response to a parent who is actively seeking advice and support, however the need for stricter boundaries may be something the parent should consider. Negative reinforcement and CBT (cognitive behavioral therapy) techniques are also appropriate to teach the parent, but this response assumes the parent understands these terms. It is also best practice to collaborate with the parent on what interventions they have already tried already, and work towards empowering them to select their own options as this approach tends to be the most effective.

Psychodrama

Psychodrama focuses on the life situation of one individual, with group members taking on roles as needed. A session is typically executed in three phases: the warm-up phase, the action phase, and the sharing phase

Adlerian Therapy

Relationship based on mutual respect and identifying, exploring, and disclosing mistaken goals and faulty assumptions and collaboration between therapist/client. This is followed by a reeducation of the client toward a useful side of life. The main aim of therapy is to develop the client's sense of belonging and to assist in the adoption of behaviors and processes characterized by community feeling and social interest. popular in family therapy. Goals: - Performing a lifestyle assessment- a. Family constellation interviewUsed to find out relevant information about childhood experiences b. The Question' how might your life be different if... c. Earliest recollections Rather than reflecting on the past, the "earliest recollections" questions are there to forecast the future - Identifying and disclosing faulty assumptions in the client's lifestyle - Foster and grow social interest - Overcome feelings of inferiority and discouragement - Change their lifestyle by modifying their views and goals - Challenge faulty motivation - Recognize equality among people - Become contributing members of society recognizes the demands placed on the client by the world as six interrelated life challenges: 1.work 2. socia, 3. love & marriage 4. self 5. spirituality 6. parenting/family Reorientation of the client toward a more meaningful lifestyle The client is not considered sick or in need of healing One approach is to ask the client to visualize a happy event, re-experience the associated feelings, then an unhappy event, and finally to return to the happy event, re-experiencing the happier feelings. USED FOR: issues of goal or directions No clear set of procedures (use the ones right for client) Focuses on: birth order, life scripts, natural consequences 1. Oldest: responsible, achievement oriented, may be insecure, unsocial 2. Second: ambitious, competative 3. Middle: feels left out 4. Youngest: spoiled, creative, rebellious 5. Only child: does not learn to share or cooperate, interacts well with adults Adlerian therapy is a brief, psychoeducational approach that is both humanistic and goal oriented. It emphasizes the individual's strivings for success, connectedness with others, and contributions to society as being hallmarks of mental health Techniques: 1. The future autobiographyThe client is asked to write a story about how the rest of their life might look. 2. Creating new imagesAnalyzing the client's early recollections and basic mistakes makes it possible to produce a new visual 3. Acting as ifClients may wish for traits they don't currently possess -identifies faulty beliefs, whole-ism (integrated beings, not personality traits), attempts to compensated for imaginged and real, friendship, intimacy, work, etc

Reading previous notes may help with outcomes measures

Review therapy notes for a given time period Explanation: Contemporaneous client notes are an accurate manner of determining client outcomes

Study heavily:

SFT and DBT questions In like 4 narratives back to back. A lot of theory questions, Adlerian, gestalt, as well. And CBT CBT techniques, SFT, REBT, and counseling skills (rapport building, reflection of meaning, paraphrasing, summarizing, etc.) I found Narrative Mapping

Solution Focused Therapy

Short-term, strengths-based treatment model that emphasizes empowerment to allow client to take action him or herself -Describing the problem - Developing well-formulated goals - Working cooperatively to idetify solutions to problems - End of session feedback - Evaluation of client progress Techniques: miracle question, exception-finding, presuppositional questions, compliments, listening skills, empath, scaling questions Good for: trauma abuse, SUD, spouse abuse The solution-focused therapy model often uses reflection by the therapist near the end of the session. With this technique: The therapist gives the client a bridging statement that ties together the content of the session with a rationale for homework exercises, behavioral changes, etc.Reflection gives clients something to think about. The therapist reflects on what seems to be working and the strengths of the family and perhaps even gives them a powerful metaphor to consider. This sets the stage for the suggestion of homework that the family or individual can undertake before the next session. SFBT is generally not recommended is that of the more extreme mental health issues, such as schizophrenia or major depressive disorder Techniques: -Coping question: "How do you manage, in the face of such difficulty, to fulfill your daily obligations?" Designed to help client identify their resiliency -Miracle question: "Imagine that a miracle has occurred. This problem you are struggling with is suddenly absent from your life. What does your life look like without this problem?" -Best hopes question: :What are your best hopes for today's session?" or "How will you know things are "good enough" -Exceptions questions: "Tell me about the times when you felt the happiest" or "Can you think of times when the problem was not present in your life?" -Scaling question: "rate their experiences" or "On a scale from 0 to 10, how would you rate your progress in finding and implementing a solution to your problem?" -presupposing change: recognize the good things happening in your life when you are struggling with a problem -Do One Thing Different: Step 1: Think of a time that things did not go well for you. When does that happen? What part of that problem situation will you do differently now? Step 2: Think of something that you or somebody else does that works to make things go better. What is the person's name and what do they do that you will try? Step 3: Feelings tell you that you need to do something. Your brain tells you what to do. Understand what your feelings are but do not let them determine your actions. Let your brain determine the actions Step 4: Change what you focus on. Focus on what you want and not what you don't want Step 5: Imagine a time in the future when you aren't having the problem you are having right now. Work backward to figure out what you could do now to make that future come true Step 6: Change your story.. Control what you can control. You can't control other people, but you can change your actions Step 7: Talk about how you will seek help from your god

Existentialism Frankl

Since there are no set techniques, the existential therapist can use any approach that meets the needs of the client; therefore, therapists show wide latitude in techniques employed. Humor and paradox are both used. Best considered as an approach to understanding humans, existential therapy is basically experiential. An authentic relationship between client and therapist is necessary, and the therapist's authenticity is considered the crucial quality in building an effective therapeutic relationship. Techniques are secondary in the therapeutic process, and subjective understanding of the client is primary. The central theme running through the works of Viktor Frankl is the will to meaning. According to Jean-Paul Sartre, existential guilt is the consciousness a person has of evading commitment to make personal choices. As a reaction against both psychoanalysis and behaviorism, the existential approach views humans as being free and responsible. According to the existential view, anxiety is a part of the human condition. A limitation of the existential approach in working with culturally diverse client populations is the focus on personal responsibility rather than on social conditions.

person-centered therapy

Therapy method in which the client, rather than the counselor, primarily directs the course of discussion, seeking self-discovery and self-responsibility. based on the idea that people are inherently good and have a natural propensity for growth and development. Central to this theory is understanding, relating to, and appreciating others in positive ways Best used for: high functioning, minor concerns, looking for presonal growth, self esteem, self confidence, goal oriented, has become the third force in psychology. In person-centered therapy, the counseling process is determined by the client instead of the therapist. Based upon the belief that individuals are rational, good and responsible, Rogerian therapy is humanistic. Self-acceptance is a basic construct of this approach. Congruence occurs when what a person would like to be is in accord with the perception of how he/she actually is. "Counseling and Psychotherapy" is the most influential book in counseling. To be effective the therapist must possess: 1. Empathy2. Genuineness3. Unconditional positive regard Goals of person-centered therapy: 1. Deal with the here-and-now2. Help clients grow so they can better cope with present situations and future problems. Rather than looking to solve the client's problems, the person-centered therapist wants to encourage the client to move towards self-actualization. Characteristics of a person progressing towards self-actualization: 1. Openness to experience2. Self-trust3. Internal source of evaluation4. Willingness to continue growing5. Since the process is ongoing, one is never completely self-actualized. Techniques of person-centered counseling: 1. Since it is the client/therapist relationship that brings about the growth, there is no set of techniques. Techniques: 1. EMPATHY:Empathy is less a technique and more a way of being for clinicians. By temporarily putting oneself in another persons shoes, a person is able to understand where that person is coming from and what they are experiencing. 2. CONGRUENCE:The clinicians' ability to be genuinely authentic, well integrated and cognizant of who they are on the inside 3. UNCONDITIONAL POSITIVE REGARD:This is the concept of respecting, liking, and accepting people for exactly who they are. A central component of this technique is to practice in such a way that does not make the client feel as if they are required to act, feel, or think in any specific way in order to please the clinician 4. GENUINENESS 5. SELF ACTUALIZATION is the goal 5. ACCEPTANCE 6. Genuiness 7. Modeling 8. Reflection of feeling 9. Exploration 10. Self disclosure Therorist: Carl Rogers

Assertiveness training

This therapy intervention focuses on communication

Schema-focused therapy

This treatment is founded on the principles of cognitive-behavioral therapy and then expanded to include techniques and concepts from other psychotherapies. Schema therapists help clients change their entrenched, self-defeating life patterns (schemas) by using cognitive, behavioral, and emotion-focused technique

Transcational Analysis (Eric Berne)

Transaction is a basic unit of communication and developed for group therapy. There are 2 levels of communication; 1.Overt Social Level 2. Covert Psychological Level 3 Different ego states: A. parent B. Adult C. Child Strokes are a unit of recognition, when one person recognizes another person A stroke can be physical, verbal or non-verbal and so could be a hand shake, a compliment or a nod of the head. It could also be a "Hello", "Go away!" or a dismissive wave of the hand. All of these acknowledge that the other person exists. Techniques: 1. Contracts, 2. Teaching concepts 3. Diagnosis 4. Confrontation 5. Empty chair 6. role play 7. family modeling

Existential Therapy (Viktor Frankl)

Type of therapy in which reflection on life and self-confrontation are encouraged. Emphasizes an individual's accepting freedom and making responsible choices. Goals: to live authentically and to focus on the present and on personal responsibility - healting through discovery of meaning - major themes include freedom, isolation, death, meaninglessness - Mitwelt: relationship with others - Umwelt: relationship with environment - eigenwelt: relationship with self - Uberwelt: ideal world Dimensions of the human condition: 1. Each person has the capacity for self-awareness.2. Freedom is given for responsibility.3. Discovering one's identity and establishing meaningful relationships with others is possible.4. The search for meaning, purpose, values and goals is part of life.5. Anxiety (normal) is part of life and has the ability to promote growth.6. An awareness of death exists within each person. Goals of existential therapy: 1. Increase the client's awareness and understanding of goals, purposes, and responsibility for personal actions2. Acceptance of freedom3. Use of normal anxiety to promote growth

psychodynamic therapy (Frued, Erikson, Muller- current)

a newer and more general term for therapies based on psychoanalysis with an emphasis on transference, shorter treatment times, and a more direct therapeutic approach. primarily used to treat depression, emotions, especially in those who have lost meaning in their lives and have difficulty forming or maintaining personal relationships, social anxiety disorder, eating disorders, problems with pain, relationship difficulties. This therapy is used with children and adolescents; it is also useful in cases of borderline personality disorder.Best with those who have capacity to be self-reflective and are looking to obtain insight into themselves and their behavior, psychodynamic therapy is more focused on problem-solving and outcomes rather that the client's history. Dream analysis, free association. The theories and techniques that distinguish psychodynamic therapy from other types of therapy include a focus on recognizing, acknowledging, understanding, expressing, and overcoming negative and contradictory feelings and repressed emotions to improve the patient's interpersonal experiences and relationships. This includes helping the patient understand how repressed emotions from the past affect current decision-making, behavior, and relationships. Id- demanding (child), ego- balancer, super ego- moral unconscious plays a big part, look to the past for clues to the present (id psychology) make subconscious- conscious transference, counter transference at center of relationship by having client transfer onto therapist to Defences Takes years in therapy Not useful for: wide range, limited in crisis use, expensive stages: oral, anal, phallyc, latent, genital catharsis, boarderline personality, self destructive, estreme mood shifts, counter transference, transference, fixation, narcissism, Beneficial: anxiety, depression, personality disorders, targets teh unconscious, explore disfunctional habits, process childhood memories, highly functioniong clients Therapists: Feud

behavior therapy

a treatment process that focuses on changing unwanted behaviors through rewards and reinforcements. Skinners' work is essential to the development of Behavior Modification and Behavior Therapy, Skinner developed a procedural model for evaluation (diagnosis) and intervention: "The functional analysis of behavior" - Operant conditioning: where the consequences of a response determine the probability of it being repeated. behavior which is reinforced (rewarded) will likely be repeated, and behavior which is punished will occur less frequently. Focus is on observable behavior rather than internal mental events. behavior which is reinforced tends to be repeated (i.e., strengthened); behavior which is not reinforced tends to die out-or be extinguished (i.e., weakened) Strengths: 1. This method is goal oriented, which helps the client see his progress, and help the clients better control his or her undesirable behavior, such as anger 2. it can be tailored for each specific client and their specific needs 3. People are more aware of how to control behavior for parenting and school settings Weaknesses: 1. Does not work with everyone 2. Too little emphasis on cognition Therorists: Pavlov, Skinner

Gestalt (Perls)

an organized whole that is perceived as more than the sum of its parts. Works with anxiety, behavior issues, depression, self-esteem, relationship issues, addictive behaviors. emphasizes personal responsibilit, here and now, unfinished business. Uses dreams/dreamwork, subconscious, focus on the present. Layers of neurosis: phony layer, phobic layer Techniques: 1. Paradoxical change. The theory of paradoxical change focuses on the need for self-acceptance 2. "Here" and "now". This technique enables individuals to appreciate past experiences and how they influence their present thoughts and behavior 3. Empty chair technique: visualize yourself opening up to a particular person 4. Exaggeration technique: exaggerate a specific behavior or emotion 5. Role play: speaks as both the top dog, which is the more demanding side of their personality and the underdog, which is the more submissive and obedient side 6. Dream work: take the part of various characters/symbols in their dream Strengths: - increased self-awareness - Improved self-confidence - Ability to make peace with the past, and an improved sense of acceptance - increased ability to deal and cope with stressful situations - Being more responsible Limitations: - may not help with the psychological effects of hereditary behaviors - does not help with factors that are not influenced by an individual's thoughts Anxiety. Gestalt therapy helps people focus on the present. This allows individuals to discover what immediate thoughts, feelings, or behavior may make them feel anxious. Behavioral health issues. Gestalt therapy can help people with behavioral conditions like bipolar disorder. It's also an effective therapeutic method for treating substance abuse, compulsive gambling, and PTSD. People struggling with these conditions may develop a new view on life through gestalt therapy and may see a positive change in their lifestyles. Depression. Since gestalt therapy focuses on self-awareness, it can help people with depression become aware of possible stressful situations that trigger their depression. Relationship difficulties. Gestalt therapy can help couples recognize underlying destructive behaviors that may be negatively impacting their relationships. This can help them work toward making positive changes in their relationship and individual lifestyles. Self-esteem issues. Gestalt therapy helps people with low self-esteem identify and overcome underlying factors that contribute to their low self-esteem. enefits of Gestalt Therapy Gestalt therapy is a comprehensive therapeutic method that gives long-lasting benefits to an individual's mind, emotions, body, and spirit. Common benefits of gestalt therapy include but are not limited to: Increased self-awareness Improved self-confidence Ability to make peace with the past, and an improved sense of acceptance Increased ability to deal and cope with stressful situations Being more responsible, improved ability to own up for mistakes and behaviors without placing blames Treats: Anxiety. Gestalt therapy helps people focus on the present. This allows individuals to discover what immediate thoughts, feelings, or behavior may make them feel anxious. Behavioral health issues. Gestalt therapy can help people with behavioral conditions like bipolar disorder. It's also an effective therapeutic method for treating substance abuse, compulsive gambling, and PTSD. People struggling with these conditions may develop a new view on life through gestalt therapy and may see a positive change in their lifestyles. Depression. Since gestalt therapy focuses on self-awareness, it can help people with depression become aware of possible stressful situations that trigger their depression. Relationship difficulties. Gestalt therapy can help couples recognize underlying destructive behaviors that may be negatively impacting their relationships. This can help them work toward making positive changes in their relationship and individual lifestyles. Self-esteem issues. Gestalt therapy helps people with low self-esteem identify and overcome underlying factors that contribute to their low self-esteem. Good for treating: Anxiety3 Attachment issues Attention-deficit/hyperactivity disorder (ADHD) Depression3 Eating disorders Grief Post-traumatic stress disorder (PTSD) GESTALT - RESISTANCE Gestalt counselors view resistance as a way that one tries to hold onto his/or her psychological functioning. Five Major Channels of Resistance: 1. Introjection:a. The tendency to uncritically accept others' beliefs and standards without assimilating them to make them congruent with who one isb. To passively incorporate what the environment provides, spending little time on becoming clear about what one personally needs or wants 2. Projection:a. Disown aspects of self by assigning them to the environmentb. Trouble distinguishing between inside and outside worldc. Disown attributes of one's self that are inconsistent with self image and put them onto other peopled. Avoid taking responsibly of feelings and the person one really is 3. Deflection:a. A way of avoiding contact and awareness by the process of being vague and indirectly using distractionb. Makes it difficult to sustain a sense of contact with realityc. May lead to overuse of humor, abstract generalizations, and questions rather than making statements, ultimately resulting in emotional depletiond. May also lead to diminished emotional experience as one seeks to live vicariously through others 4. Retroflection:a. One may do something to one's self that he/or she really wanted to do or would have done to someone else 5. Confluence:a. Blurring the boundaries between self and environmentb. Fitting in, which alleviates all conflictc. The belief all people feel and think the same wayd. The high need for acceptance and approvale. Stay safe, never express one's own feelingsf. Therapist uses "W" questions, "the who, what, where, and why" to get the client to open up Other Forms of Resistance: 1. Control of environment:a. Resistance to contactb. Boundary disturbance 2. Blocks to energy manifested by:a. Tension in part of bodyb. Posturec. Keeping body tight and closedd. Not breathing deeplye. Looking away from people when speakingf. Numbing feelingsg. Speaking with a restricted voice 1. Clients:a. Are manipulativeb. Avoid self-reliancec. Avoid taking on personal responsibilityd. Have to stand on their own two feet to deal with life problems themselves- Move the client from environmental supports to self-support- Help the client reintegrate disowned parts of his/or her personality Therapist's Goals: 1. Create experiments for clients to assist their self-awareness of what they are doing and how they are doing it2. Help clients with the development of skills necessary to satisfy their needs without violating rights of others or personal moral standards3. Assist clients with acquisition of morals4. Help clients with the development of willingness to help others and to ask for help when needed Therapy Process: 1. Promote awareness in client through:a. Insightb. Self acceptancec. Knowledge of the environmentd. Responsibility for choices, actions, and behaviorse. Paradoxical theory of changef. Ability to make contact with others Theorist: Perls

DBT Techniques

decatastrophising: the "what-if" technique which helps clients prepare for feared consequences. This is helpful in decreasing avoidance. Reattribution: a technique which tests automatic thoughts and assumptions by considering alternative causes of events. This particularly helps when clients perceive themselves as the cause of problem events. Redefining: helps clients mobilise when they believe problems are beyond personal control; these techniques may make problems more concrete, stating them in terms of the client's own behaviour. Decentring: used chiefly to help clients who erroneously believe that they are the focus of everyone's (usually negative) attention. Behavioural techniques are also used to modify automatic thoughts and assumptions. These employ behavioural experiments designed to challenge specific maladaptive beliefs and promote new learning. A client might, for example, (1) predict that a certain outcome will obtain, based on automatic thoughts, (2) carry out the agreed behaviour, and then (3) evaluate the evidence in light of the new experience. Some of the chief behavioural techniques used to foster cognitive change are: Homework: opportunities to apply CBT principles between sessions. Assignments typically focus on self-monitoring, structuring time effectively, and implementing procedures for dealing with actual situations. Hypothesis testing: with both cognitive and behavioural components, this technique must make the hypothesis both specific and concrete. Exposure therapy: thoughts, images, bodily symptoms, and levels of tension are experienced by, say, an anxious client. Exposure to the anxiety triggers provides data for the client, who can examine specific thoughts and images for distortions. Behavioural rehearsal and roleplaying: used to practice skills or techniques which are later applied in real life. Role-playing may be taped in order to provide objective feedback with which to assess performance. Diversion techniques: Activities such as social contact, work, play, visual imagery, and physical activity are used to reduce strong emotions and decrease negative thinking.

Feminist family therapy

focuses on inferior status of women, validates women and gender roles in family system, interpersonal relationships, and relationship with society, Complementary Neutrality Circularity Socialized gender differences: masculine/feminine Men: task oriented, Women: relationship oriented

Jungian

he focus of this therapy is to help clients live authentically, as who they are intended to be, bringing internal struggles (opposites) into harmony, and to fully individuate in the archetype of wholeness. Techniques: 1. Analysis of transference - four stages are addressed:a. The client's personal history projections onto the therapistb. The client differentiates his/or her own unconscious from the collectivec. The therapist's reality is differentiated from the superimposed imagesd. The achievement of greater knowledge and insight within the self having worked through the transference and into an authentic relationship with the therapist 2. Active imagination - one identifies an entity (i.e. shadow figure, anima, maternal figure, male) through a dream or other scene, and he/or she activates attention to the figure through meditation. The client is invited to enter the scene and dialogue with the entity, usually one that has qualities opposite the ego, thereby accessing rejected elements and availing them to the conscious mind. This may be done in writing, art, sculpting, dance, or other medium. 3. Dream analysis - Jung believed that images are a reflection of something within the person, and that the dream world could allow the individual access to the unconscious within the self, specific to the dreamer. 4. Individuation - involves the development of the individual's personality via making conscious the individual's unconscious and the collective unconscious tendencies. It is considered to be both a goal and something to develop throughout the lifespan. 5. Sandplay - involves the use of a tray of sand for free expression, often used with figures, symbols, avatars, or other miniature objects. This engages both children and adults in free expression and has been used successfully in a variety of trauma work. 6. Shadow work - addresses the qualities that do not fit our image of ourselves - anger, hatred, jealousy, greed, lust, and shame. It also address behaviors that are not culturally acceptable such as aggression, addiction, and dependency. The goal is to integrate parts of ourselves that we try to hide from. 7. Journaling - allows the client to keep track of thoughts, feelings and behaviors so they can see their progress during therapy. 8. Rituals - involves a series of actions involving the entire family in a sequence of steps, forming a play that is to be enacted under specific circumstances. An example of a ritual is a family sitting together daily, each getting equal time to speak well of the family, with no negative opinions allowed.

Family-focused therapy (FFT)

includes both the person with BD and their parents, spouse, or other family members. FFT typically lasts about 12 sessions (depending on the family's needs) given by a single therapist. Early sessions focus on education about the condition: its symptoms and how they cycle over time, its causes, how to recognize the early warning signs of new episodes, and what to do as a family to prevent the episodes from getting worse. Later sessions focus on communication and problem solving skills, especially to address family conflicts. In many randomized trials conducted by my labs at University of Colorado and UCLA, we have found that people with BD who get FFT and medication after an episode have less severe mood symptoms and better functioning over 1-2 year periods than those who get medications and briefer treatments or case management.

defense mechanisms

the ego's protective methods of reducing anxiety by unconsciously distorting reality 1. Repression: force painful feeings into subconscious 2. Regression: retreat to earlier developmental age 3. Rationalization: assign socially acceptable behavior to unacceptable behavior 4. Displacement: transfer emotion to a less threatening person 5. Projection: Assing unacceptable thought onto another 6. Sublimation: channel inappropriate iimpulses into socially acceptable behavior 7. Reaction formation: express the opposite of whats desired

Family therapy

therapy that treats the family as a system. Views an individual's unwanted behaviors as influenced by, or directed at, other family members - family is psychological unit - changes in individuals affect entire family functioning - family is multi-generational network, sensitive to cultureand stereotypical beliefs - homeostasis may create problems for the famly Social considerations: - multicultluralism -race - Classism - Gay and lesbian rights - spiritaulity - home based services Types of family therapy 1. family systemsA Bowen 2. experiential: satir, whitaker 3. narrative: epston, white 4. strategic: haley, madanes 5. structual: minuchin 6. brief solution focused therapy: de Shazer 7. psychodynamic: Scharff Communication models: Jackson and Haley