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Tx Interventions
CSPE exam
| Question | Answer |
|---|---|
| Autism Spectrum Disorder general overview | -Use multidisciplinary approach to evaluate, monitor-Early age Tx using: a) Ed & vocational intervention focused on social & function skills -Behavior intervention: Reduce undesirable acts -Psychotherapy: Structured, directive can improve social skills |
| ADHD general overview | -Assess through use of client, parents, teachers, using Dx interview, questionnaire, rating scales, measures of cognitive, emotional, social, academics. Treatment w/: -Pharmacotherapy -Behavior Tx improves academics -Neurofeedback -Parent ed/training |
| Specific Learning Disorder general overview | -I.D. w/ consideration of performance on IQ & academic tests, & evaluate other areas (memory, attention, social, comorbids) Use of multidisciplinary approach to Tx: -Instructional intervention -Behavioral intervention -Family intervention |
| Tourette's Disorder general overview | -Assess w/ clinical interview, clinician-, self-, and parent-rating scales, & evaluate impact on academic/vocational, & social environment -Tx includes help thru: --Pharmacotherapy: Antipsychotic meds --Behavioral: Relaxation, self-monitor, habits |
| Schizophrenia general overview | Assess w/: -Info on specific Sx, social, occupational/ vocational, self-care functions -Structured clinical interview Tx: -Hospitalize -Pharmacotherapy: 1st & 2nd G -Psychosocial Tx (CBT, Skills, Family, Assertive Community Tx, supported employment) |
| Bipolar I Disorder general overview | Assess w/: -Thorough, structured Dx interview, scales, MSE, safety eval Tx: -Pharmacotherapy: Mood stabilizer, anti-seizure, anti-psychotic -Psychotherapy: CBT, Family Tx, Interpersonal & Social Therapy |
| Major Depressive Disorder general overview | Assess w/: -Instruments: BDI, Inventory of Dep Sx, Zung Self-Rating Dep Scale, etc. -Eval of current function, suicide risk, & quality of life Tx: -Pharmacotherapy: SSRI, TCA, MAOI -Psychotherapy: CBT, Interpersonal -Phototherapy -ECT |
| Separation Anxiety Disorder general overview | Assessment: Self-reports, ratings, structured interviews Tx: -Variety of interventions: in vivo exposure, systematic densitization, contingency mgt, modeling -CBT: I.D. & replace anxiety thoughts -Parent support, guidance -Immediate return to school |
| Specific Phobia: Assessment | Assesses w/ clinical interview, self-report measures, I.D. situations with their associated cognitions, physiological Sx. |
| Social Anxiety Disorder: Assessment | Assessment: Clinical interview, self-report measures, & behavioral role-plays observing reactions |
| Panic Disorder: Assessment | -Evaluating suicide risk, degree of impairment, co-existing conditions -Formal anxiety inventories and scales |
| Generalized Anxiety Disorder: Overview | Assessment: Clinical interview, self-report questionnaires, substance use, comorbid disorders, stressors, daily functioning. Tx: CBT, applied relaxation, & pharmacotherapy |
| Obsessive-Compulsive Disorder: Overview facts | Assessment: Scales and checklists quantify severity and determine extent to which Sx of this anxiety disorder interfere, I.D. Tx setting. Tx: Empirically supported Tx includes Exposure w/ Response Prevention, CBT, & Pharmacotherapy (SSRIs) |
| Posttraumatic Stress Disorder: Overview facts | Assessment: Clinical interview, PTSD Checklist, evaluate risk for danger, coping skills, supports, MSE. Tx: CBT and pharmacotherapy (non-combat trauma Px = SSRI) |
| Somatic Symptom Disorder: Assessment | -Clinical interview -Screening instruments (Screening for Somatoform Disorders) -Measures of illness behavior to determine attitudes, responses to own Sx, precipitating stresses |
| Body Dysmorphic Disorder: Assessment | -Clinical interview -Screening instruments (Screening for Somatoform Disorders) -Measures of illness behavior to determine attitudes, responses to own Sx, precipitating stresses |
| Anorexia Nervosa: Brief overview | Assessment: -Structured interview, informant ratings, self-reports -Danger to self, nutrition, body image, personality, comorbid symptoms, family factors Tx: -Inpatient -CBT -Family therapy -Pharmacotherapy |
| Bulimia Nervosa: Assessment | Assessment: -Structured interview, informant ratings, self-reports -Danger to self, nutrition, body image, personality, comorbid symptoms, family factors |
| Enuresis: Assessment | -Complete history, precipitating & complicating factors, nature of Sx, I.D. parent attitudes, efforts to change, parent willingness & ability to follow thru on Tx -Sx checklists to detect comorbid conditions -No Dx until medical and/or substance use R/O |
| Sexual Dysfunctions: Assessment | Take medical, psych, sexual history (past & current functioning, attitudes) and R/O these first, otherwise no Dx of Sexual Dysfunction |
| Conduct Disorder: Assessment | -Rating scales clarify nature & extent -Individual’s danger to self, others -Family factors -Effect on life functioning (school, family) |
| Substance Use Disorder: Assessment | -Brief screen (CAGE, Drug Abuse Screening Test, etc.) initially I.D. problem -Follow with questionnaires, other measures (Substance Dependence Severity Scale, Addiction Severity Index) -Assessment including history -Evaluation of risks: suicide, homi- |
| Delirium | Assessment: I.D. Delirium (Folstein Mini-Mental State Exam, Delirium Rating Scale, Confusion Assessment Method) Tx: Two primary targets -Underlying cause of disorder & reduce agitated behavior -Environment and psychosocial intervention -Meds as needed |
| Major Neurocognitive Disorder: Assessment | -I.D. with Dementia Rating Scale, Alzheimer's Disease assessment Scale -Evaluate IQ, memory, other cognitives -MSE -Behavioral, psychosocial, psychiatric issues -Assessment is an ongoing process due to progressive nature of neurocognitive disorders |
| Antisocial & Borderline Personality Disorders: Assessment | -Structured Dx interview and MMPI-2 -Evaluation of history & risk future violence, stressors, coping, & relationships. -For BPD also use MSE, functional abilities, and support. -Use collateral sources of info (family, medical records, etc.) |
| Antisocial Personality Disorder: General treatment overview | APD usually remanded reluctantly for Tx -Milieu/Residential Tx: token economies & TCs, promoting prosocial attitudes -CBT: relapse prevention skills -Pharmacotherapy: Tx of specific Sx, i.e. mood stabilizers, antidepressants, antipsychotics |
| Paraphilic Disorders: General overview | Assessment: Clinical interview for comprehensive history, course of disorder, triggers, thoughts, consequences, lifestyle, risk of danger; MMPI-2; family reports Tx: -CBT: Alter beliefs, justifications, & eliminate pleasure responses -Pharmacotherapy |
| Older Adults: Overview of assessment | -Is complex -Seeks to I.D. elder abuse -Decisional capacity: particularly Re: dementia, depression, psychosis --5 Step Model: referral, assessment planning, assessment, synthesis, & follow-up eval -Depression: Complete biopsychosocial -Suicide risk |
| American Indian Clients | Guidelines: -Be familiar w/ history -Reaffirm own culture's values Tx: -Focus on building trust -Collaborate -Incorporate elders -Use spirituality -Extended family/tribe -Time = personal/seasonal rhythms -Network (home) therapy |
| African American Clients | Awareness guidelines: -Interconnectedness of all things, group over individual -Extended kinship family -Flexible, non-hierarchical roles (egalitarian) -Presenece of healthy cultural paranoia Tx: -Structured -Time-limited -Problem-solving |
| Asian American Clients | Guidelines: -Group over individual -Restraint of emotions -Modesty is good -Somaticization of psych Sx -Passivity = respect, formality is good -Tx is to provide immediate, meaningful benefit Tx: -Use behavioral or action Tx -Concrete info -CBT |
| Hispanic/Latino American Clients | Guidelines: -Family welfare over individual, patriarchal roles -Concrete, tangible approach to life -Physical = mental health, somaticization of psych -Keep business within the family -Formal at first, then "personalismo" Tx: -Active, directive |
| Lesbian, Gay, and Bisexual Clients: Guidelines | -Some seek help accepting themselves -Coping with stigma, internalized homophobia -Don't assume all problems are related to sexual orientation |
| Victims of Child Abuse: Initial Identification | -Interview guidelines for child: separate and together with other family members --provide safe place --use understandable language --reassure child --avoid leading questions, etc -Interview guidelines for parent/caregiver --Nonjudgmental |
| Victims of Intimate Partner Abuse: Identification of Abuse Interview Guidelines | -Conduct interview in private -Open-ended questions -Avoid leading questions -Convey interest, non-judgmental -Avoid advice-giving -Avoid rushing -Clarify unclear words, verify you each understand descriptions of abuse |
| Content of a Case Formulation | -ID info (name, age, gender, etc.) -Problem list -Psych Dx -Precipitating, predisposing factors -Working hypothesis -Strengths -Tx expectations |
| Case Formulation & Use of DSM 5 in Assessing Client's Cultural Background | -Use DSM 5 "Outline for Cultural Formulation" -Incorporates culture into assessment & case concept |
| Five Components to Case Formulate a Client's Cultural Background: | -Cultural ID -Cultural concept of distress -Pschosocial stress, cultural features of vulnerability, resilience -Cultural features of client & clinician relationship -Overal cultural assessment |
| Intervention Strategies | -Client characteristics: psych, med history, expectations ,motivation, social support, finances, diversity (race/ethincity, gender, religion, age) -Treatment factors: includes theoretical orientation and clinician experience |
| Psychoanalytic (Freudian) Psychotherapy | -Psychopathology stems from unconscious, unresolved conflict during childhood -Reduce or eliminate Sx, bring unconscious into awareness, integrate repressed material in personality -Primary technique: analysis using free associations, resistance, transf |
| Person-Centered Therapy | -"Self" disorganized by inconruence between self & experience. Occurs when exposed to conditions of worth -Help client achieve congruence between self and experience, self-actualize -Provide genuineness, unconditional positive regard, empathy, understa |
| Gestalt Therapy | -Neurotic behavior = growth disorder, involves abandonment of self for a self-image, results in lack of integration -Help client be integrated, unified whole -Bring awareness of thoughts, feelings, actions here-and-now |
| Interpersonal Psychotherapy (IPT) | -Symptoms = problems in social roles, relationships traceable to lack of early attachments -Reduce Sx by improving interpersonal function in 1+ domains (grief, conflict, roles, relational deficits) -Variety of CBT, encouragement of affect, communication |
| Solution-Focused Therapy | -Understanding etiology, attributes of problem is irrelevant -Focus on solutions -Assist in recognizing, using strengths, resources for goals -Incorporate variety of techniques to I.D. solutions, ask miracle, exception, scaling questions. |
| Behavior Therapy | -Problems result from classical or operant conditioning, or social/observational learning -Achieve desired, realistic changes in observable behaviors -Use variety of behavioral interventions (exposure, counterconditioning, reinforcement, modeling, skill |
| Cognitive Therapy | -Dysfunctional cognitive schemas develop early in life, subsequently activated by stressors -I.D., reality-test, correct dysfunctional schemas -Use variety of cognitive, behavioral techniques (Socratic dialogue, homework, activity schedules, relaxation) |
| Structural Family Therapy | -Dysfunction results from inflexible family, prohibits healthy adaptation to stressors -Help Sx by restructure of family, change relationships -Focus on behavior change, leads to modification of family structure thru enactment, reframing, joining |
| Strategic Family Therapy | -Sx are strategies for control of relationships -Alleviate problem thru use of strategies that alter communication & interpersonal behavior -Include use of directives, paradoxical techniques (ordeals, reframing, positioning, prescribe the Sx) |
| Bowenian Family Systems Therapy | -Multigenerational transmission produces progressively lower levels of differentiation -Reduce anxiety, increase self-differentiation -Achieve greater intellectual, emotional differentiation (therapeutic triangle, questioning, take an "I" stand) |
| Stages of Generic Treatment Plan | -Early Stage: Immediate concerns -Early Stage: Assessment, Goal-Setting, Initial intervention -Middle Stage -Late Stage -Termination Stage |
| Overview of treatment implementation steps | -Work toward achieving Tx goals, objectives -Monitoring effectiveness of Tx -Work with other professionals -Prepare for termination |
| Monitoring Effectiveness of Treatment | -Provides validation of initial case coneptualization -Informs clinician, client, 3rd parties of progress -Helps clinician determine when to modify Tx plan -Helps clinican, client know when to terminate |
| Specific Phobia: Treatments | -Exposure via Response Prevention (in vivo feared object/situation, prevents avoidance, provides applied tension), -Cognitive Interventions: In vivo & self-control |
| Social Anxiety Disorder: Treatment | -CBT: psychoeducation, cognitive restructuring, exposure w/ response prevention, social skills, relaxation -Pharmacotherapy w/ antidepressants (SSRIs and MAOIs) |
| Panic Disorder: Treatment | 1) Tailored to circumstances, nature, and frequency of Sx 2) CBT 3) Panic-Control Treatment 4) Pharmacotherapy: SSRIs, SNRIs, benzodiazepines (drug Tx alone not as effective without CBT) |
| Somatic Symptom & Body Dysmporphic Disorder: Treatments | -For Somatic Sx Disorder, an eclectic approach w/ strong therapeutic alliance, education of client, -For Body Dysmorphic, CBT to I.D., evaluate, modify thinking, cognitive restructuring, exposure, maybe antidepressants |
| Bulimia Nervosa: Brief treatment overview | -CBT -Interpersonal Psychotherapy (IPT) -Nutritional Counseling: adjunctive intervention to correct beliefs of food, exercise -Pharmacotherapy |
| Enuresis: Treatment | 1) Urine alarm 2) Pharmacotherapy (imipramine 85% effective in short term, 30% effective in long-term) 3) Most kids relapse within 3 months after D/C of imipramine or desmopressin |
| Sexual Dysfunctions: Treatment | -Sex therapy: Sensate focus, start-stop & squeeze techniques, Kegel exercise -Couples therapy: Address poor communication, conflicts over children, finances -Pharmacotherapy: Address low serotonin for premature ejaculation, sildenafil for ED |
| Conduct Disorder: Treatment | -Family intervention -Cognitive Problem-Solving Skills Training -Multisystemic Therapy -Pharmacotherapy -Out-of-home placement |
| Substance Use Disorder: General Treatment | -Multimodal & multidisciplinary -Prochaska and DiClemente's transtheoretical model -Level of Care: Least restrictive setting (safe & effective) -Dual Diagnosis treatment approaches: Sequential, parallel, integrated -CBT -Motivational interviewing |
| Substance Use Disorder: Additional Treatments | -Relapse prevention -Self-help groups -Group therapy -Family and Couple therapy -Pharmacotherapy |
| Substance Use Disorder: Psychosocial Treatments | -CBT -Behavioral interventions -Motivational interviewing -Relapse prevention -Self-help groups -Group therapy -Family and couple's therapy |
| Substance Use Disorder: General Treatments | -Level of care: least restrictive setting that's both effective and safe -Dual diagnosis treatment: --sequential approach --parallel approach --integrated approach -Pharmacotherapy: treat acute intoxication, overdose, withdrawal, or block "high" |
| Mild Neurocognitive Disorder: Assessment | -I.D. with Dementia Rating Scale -Evaluate IQ, memory, other cognitives -MSE -Behavioral, psychosocial, psychiatric issues -An ongoing process |
| Mild Neurocognitive Disorder: Treatment | -Psychosocial interventions -Environmental manipulation -Pharmacotherapy -Family/caregiver interventions |
| Major Neurocognitive Disorder: Overview of treatment | -Psychosocial interventions -Environmental manipulation -Pharmacotherapy -Family/caregiver interventions |
| Borderline Personality Disorder: Treatment | BPD sufferes have distress, usually seek Tx using: -Dialectical Behavior Therapy (Linehan, 1987) -Transference-Focused Psychotherapy -Mentalization-Based Therapy (MBT) -Interpersonal Psychotherapy -Pharmacotherapy: Fluvoxamine, olanzapine |
| Older Adults: Recommendations for Treatment | -Determine views of the problems, impact of education, race/ethnicity, etc. -Presume competence -I.D. meds and conditions impacting mental state -Accommodate age-related changes in cognition -Plenty of time for rapport -Decisions w/ client & family |
| Older Adults: General Interventions for Treatment | -Brief psychodynamic therapy -Behavior therapy -CBT -IPT -Tx tailored to their needs -Reminiscence therapy -Validation therapy |
| Lesbian, Gay, and Bisexual Clients: General overview of treatments | -Affirmative psychotherapy: Encouragement of healthiness, awareness of hetero-sexism -Sexual identity therapy (SIT): synthesize sexual I.D., integrate thru 4 phases -Phase-specific psychotherapy --Sensitization --I.D. confusion --I.D. assumption, etc |
| Victims of Child Abuse: Treatment Planning | Multistage process -Start w/ impressionistic data -> specific needs -I.D. general problems -I.D. parental strenghts & problems -I.D. child strengths & problems -Evaluate parent-child relationship -Use clinical interviews, report measures, observatio |
| Victims of Child Abuse: Treatment | -Abuse-Focused CBT -Parent-child interaction therapy -Trauma-focused CBT |
| Victims of Intimate Partner Abuse: Assessment for I.D. Screening Questions | -Have you been hit in the past year? -Do you feel safe in your current relationship? -Is there a partner from a previous relationship who is making you feel unsafe? |
| Victims of Intimate Partner Abuse: Assessment for I.D. Risk Assessment | -Evaluate the risk of further assault, homicide, suicide, harm. -Discuss immediate options if safety concerns are revealed -Contact the police if needed -Develop a safety plan & discuss referral resources |
| Victims of Intimate Partner Abuse: Assessment for Treatment Planning | -Session 1 general psychosocial obtaining demographic info, referral source, living situation, recent events, etc. -Session 2 obtain info on developmental history, previous relationships, other history -Session 3 MMPI-2, measures of anger, others |
| Victims of Intimate Partner Abuse: Treatment | -Individual therapy: May use "Survivor Therapy" -Group therapy: Women-only groups, perpetrator-only groups -Couples therapy: Avoid this until --No incidents for 5+ months --Abuser accepts responsibility --Both partners active in Tx groups --Contract |
| Treatment implementation: single phase vs. series of phases | 1) For clients w/ less complex or severe problems 2) addresses relatively circumscribed problems 3) For more complex & severe problems, Tx is a series of phases addressing limited # of problems in each phase |
| Identifying treatment goals and objectives | 1) Goals & objectives of Tx are derived from case formulation 2) They represent desired outcomes of psychotherapy |
| Treatment goals and objectives defined | 1) Goals are broad, comprehensive, & long-term 2) These are aimed at reducing core symptoms, achieving satisfactory level of functioning 3) Objectives are specific, short-term, & measurable 4) They specify changes in behavior, affect, cognition |
| Treatment planning and selecting intervention strategies | This is based on consideration of the client's characteristics & circumstances, Tx options, & other Tx-related factors |
| Client characteristics directly impacting choice of Tx intervention strategies | 1) Who the client is (an individual? couple? family?) 2) Client's psych & med history 3) Characteristics relevant to Tx (psych mindedness, expectations, motives) 4) Environmental circumstances (social or financial resources) 5) Diversity issues |
| Treatment factors directly impacting choice of Tx intervention strategies | 1) Clinician's theoretical orientation & experience; 2) relevant level of care, Tx mode & format; 3) criteria used to validate Tx plan, monitor Tx progress, & when to end Tx |
| Theoretical orientation as a treatment factor directly impacting choice of Tx intervention strategies | 1) Clinician's theoretical orientation provides a systematic framework for Tx planning & implementation. 2) There are 10 major theoretical approaches to psychotherapy currently in use in California and much of the Western world |
| Ten major theoretical approaches to psychotherapy for use in Tx intervention | 1) Psychoanalytic (Freudian) 2) Person-centered 3) Gestalt 4) Interpersonal Psychotherapy 5) Solution-focused 6) Behavior 7) Cognitive 8) Structural Family 9) Strategic Family 10) Bowenian Family Systems |
| Empirically supported treatments (ESTs) as a treatment factor impacting Tx intervention strategies | 1) AKA "empirically validated & evidence-based Txs" 2) "Specific psychological Txs that have been shown to be efficacious in controlled clinical trials" 3) There are 15 efficacious Txs for adults 4) There are 8 efficacious Txs for kids/adolescents |
| Nine of fifteen efficacious treatment interventions for adults | 1) CBT 2) Exposure therapy 3) Exposure w/ response prevention 4) Interpersonal psychotherapy 5) Environmental behavioral interventions 6) Social-learning programs 7) Social skills training 8) Behavioral family therapy 9) Supportive long-term family Tx |
| Six of twelve efficacious treatment interventions for adults | 1) Community reinforcement 2) Motivational interviewing 3) Dialectical behavior therapy 4) Behavior therapy 5) Multicomponent CBT 6) Behavioral marital therapy |
| Eight efficacious treatment interventions for children and adolescents | 1) Behavioral parent training 2) Behavioral modification in the classroom 3) Parent training programs 4) Cognitive problem-solving skills training 5) Multisystemic therapy 6) Behavior modification 7) Participant modeling 8) Reinforced practice |
| Intervention strategies: Selecting level of care & mode of treatment | 1) Appropriate level of care (inpatient, partial day Tx, outpatient, etc.) 2) Primary consideration when choosing is severity of Sx, risk for harm to self/others 3) Clinician must I.D. mode(s) of Tx (med, therapy, ed, groups) 4) Multimodal Tx is effective |
| Intervention strategies: Selecting format of treatment | 1) Requires decision among individual, group, marital/family therapy 2) Several factors help to I.D. correct Tx format for a client (Clarkin, 1998) |
| Intervention strategies: factors to I.D. indicated treatment format for a client (Clarkin, 1998) | 1) Nature of client's problems & symptoms; 2) way client's problems are manifested; 3) clinician's theoretical orientation; 4) goals & objectives of Tx; 5) client's preferences; & 6) efficiency & effectiveness of Tx format for symptoms/disorder |
| Selecting intervention strategies and treatment factors: Treatment monitoring | 1) Tx plan identifies methods used to monitor Tx progress 2) Methods include self-reports, therapist observations, structured Sx checklists administered at onset of therapy & thereafter to assess progress, adjust Tx plan, & evaluate outcomes at end of Tx. |
| Selecting intervention strategies and treatment factors: Treatment termination | 1) Tx plan includes criteria to determine when it's time for Tx termination 2) Criteria stated in concrete, measurable terms |
| Selecting intervention strategies and stages of a generic treatment plan | 1) Early stage: immediate concerns 2) Early stage: assessment, goal-setting, & initial intervention 3) Middle stage 4) Late stage 5) Termination stage |
| Tx intervention stages of a generic treatment plan: Tasks for the Early Stage: Immediate concerns | 1) Evaluate risk factors 2) Create therapeutic framework via presenting problem 3) Address clinical, legal, & ethical issues 4) Conduct preliminary assessment & make provisional diagnosis |
| Tx intervention & stages of a generic treatment plan: Tasks for the Early Stage: Assessment, goal-setting, & initial intervention | 1) Conduct thorough assessment 2) Make appropriate referrals 3) Educate client about problem & Tx options 4) Integrate assessment info to confirm diagnosis, develop case conceptualization 5) Construct Tx plan 6) Begin addressing client's Sx & problems |
| Tx intervention & stages of a generic treatment plan: Tasks for the Middle Stage | 1) Reduce core symptoms 2) I.D. & strengthen client's ability to cope 3) Decrease isolation/mobilize social support 4) Increase client's self-esteem, sense of efficacy 5) Address family, environmental problems 6) Interpret client's defenses |
| Tx intervention & stages of a generic treatment plan: Tasks for the Late Stage | 1) Help client understand developmental roots of problems 2) Prepare client to cope successfully w/ future problems 3) Connect client to appropriate resources & community services 4) Encourage client to assume responsibility for own behavior |
| Tx intervention & stages of a generic treatment plan: Tasks for the Termination Stage | 1) Review client's progress 2) Express confidence in client's ability to cope independently 3) Schedule added sessions several weeks after termination for assessment 4) Ensure support system in place 5) I.D. & address feelings about termination |
| Tx implementation: Three Tx phases (Howard et al., 1986) | 1) Remoralization 2) Remediation 3) Rehabilitation |
| Tx implementation, use of assessment data, and 3 of 4 ways to evaluate assessment results (Maruish, 2002) | 1) Compare client's performance/status to the outcomes identified in the Tx objectives; b) compare client's performance/status to normative data; c) use statistical techniques to determine if a change in behavior is significant |
| Tx implementation and evaluating assessment results with profiles (1 of 4 ways) (Maruish, 2002) | Compare client's profile (course of recovery) to an expected course of recovery. |
| Tx implementation and use of assessment data for inadequate progress: Reducing resistance | 1) I.D. strategies for addressing the problem. 2) Clinician clarifies rationale of the Tx strategies for the client; 3) Provide client w/ choices to empower client; 4) review advantages & disadvantages of maintaining the status quo; 5) use Socratic dialog |
| Tx implementation and use of assessment data for inadequate progress: Increasing motivation | 1) Give advice, 2) remove obstacles, 3) provide choices, 4) communicate empathy, 5) use active techniques for client change |
| Tx implementation and use of assessment data for inadequate progress: Addressing non-adherence | 1) Establish collaborative relationship w/ client; 2) cultivate positive expectations Re: Tx outcomes; 3) give client a range of options to choose from; 4) integrate actions into daily schedule; 5) provide clear instructions; 6) provide feedback of prog |
| Tx implementation and 6 indications for making referrals | 1) Client's problems exceed therapist's expertise; 2) dual relationship or conflict of interest; 3) significant problems in therapeutic alliance; 4) clinciian unable to resolve client's resistance; 5) relocating; 6) request for 2nd opinion |
| Tx implementation and 2 indications for making adjunctive or termination referrals | 1) Client needs adjunctive services (e.g., a neurological, medication, or nutritional evaluation); or 2) at termination, clinician determines it would be appropriate to refer the client for continuing services from another professional |
| Tx implementation and preparing for termination via specific criteria | 1) Tx plan should specify criteria for determining client's readiness for termination, strategies to be used during final phase of therapy. 2) Clinician to help ensure that client maintains changes made during therapy. 3) Use relapse prevention strategies |
| Tx implementation and preparing for termination: Relapse prevention strategies (Gordon, 1985) | 1) Enhancing client's coping skills & self-efficacy, 2) I.D. sources of support & ways to make lifestyle changes, & 3) I.D. methods for managing lapses. 4) Discuss booster sessions, phone calls, other minimal therapist contacts to support successful close |
| Autism Spectrum Disorder useful parent/family interventions | 1) Include parent training, 2) parent/sibling support groups, 3) family therapy, & 4) referral to community services & advocacy groups for the autistic |
| Autism Spectrum Disorder & pharmacotherapy | 1) Meds not generally considered effective Tx for core Sx of Autism. 2) May be useful for Tx of depression, anxiety, other Sx contributing to impairment/distress |
| Attention-Deficit/Hyperactivity Disorder & pharmaco-therapy | 1) This involves use of Concerta, Metadate, & other stimulants, 2) 85% of ADHD kids benefit, 3) side-effects such as dysphoria, < appetite, insomnia, > heart rate & B.P., 4) drug holidays minimize growth suppression, confirm need for drug |
| Attention-Deficit/Hyperactivity Disorder & behavioral interventions | 1) These are used to improve academic performance, social functioning, reduce behavioral problems, 2) they have + effects on core Sx of ADHD & academics, 3) includes self-instruction, self-eval, self-reinforcement, other self-control techniques |
| Attention-Deficit/Hyperactivity Disorder & neurofeedback | 1) This has been found to be effective for Tx of core Sx of ADHD. 2) Studies say neurofeedback has + effects for 70-80% of those with ADHD, 3) has effects similar to those of stim meds (methylphenidate) |
| Attention-Deficit/Hyperactivity Disorder & parent education/training | 1) Interventions are best w/ parental involvement, 2) when consistent rules provided 3) structured environment, predictable routines, 4) psycho-ed for parents should be provided, including cause & effect |
| Specific Learning Disorder & instructional interventions | 1) These interventions are specified in an IEP, 2) designed to remediate processing deficits, 3) improve cognitive skills, 4) teach skills to compensate for learning issues, 5) includes cognitive strategy training & phonological awareness training |
| Specific Learning Disorder & behavioral interventions | 1) These are used to alleviate co-existing behavioral problems, 2) may include use of behavior mod at home & school. 3) reduce disruptive, oppositional behavior via behavioral contracting, & increase on-task behavior |
| Specific Learning Disorder & family interventions | 1) These are useful for modifying parents' expectations, responses to child or adolescent with LD. 2) Can be used to help parents structure household & other activities to enable child to succeed more often |
| Tourette's Disorder & pharmacotherapy | 1) Use of haloperidol, pimozide is frequent for this disorder when moderate-to-severe, 2) has disadvantage of intolerable side effects. 3) Antihypertensive drugs may be alternative. 4) Clonidine or desipramine sometimes prescribed to control tics |
| Tourette's Disorder & behavioral interventions | 1) These interventions include self-monitoring, relaxation training, & habit reversal training, 2) Has 3 components. 3) Comprehensive behavioral intervention for tics (CBIT) is empirically supported Tx for this disorder |
| Tourette's Disorder & 3 components of behavioral interventions | 1) Awareness training to increase awareness of habit & feelings immediately before it; 2) competing response training to teach how to disrupt the habit chain; & 3) social support to teach parent to praise for correct implementation of competing response |
| Tourette's Disorder & Comprehensive behavioral intervention for tics (CBIT) | 1) Empirically supported, 2) incorporates habit reversal training, psycho-ed, relaxation training, & other strategies. |
| Schizophrenia & when to hospitalize | 1) When the individual at risk for suicide or aggressive behavior; 2) when decompensating, noncompliant, resistant, not improved with outpatient care; 3) when Sx stabilization needed due to medication regimen changed or re-established; 4) psychosis |
| Schizophrenia & pharmacotherapy: Choosing a med to treat schizophrenia | Is based on consideration of factors including past med history, nature & severity of current Sx, presence of co-existing conditions, & preferences of client. |
| Schizophrenia & traditional (first-gen) antipsychotics | 1) Includes phenothiazine/chlorpromazine, haloperidol. 2) These meds are good for + Sx, less so for - Sx. 3) Side-effects include anticholinergic effects, extrapyramidal Sx, & neuroleptic malignant syndrome (NMS) |
| Schizophrenia & anticholinergic effects of traditional (first-gen) antipsychotics | 1) Dry mouth, 2) blurred vision, 3) tachycardia, 4) urinary retention, 5) constipation, 6) delayed ejaculation |
| Schizophrenia & extrapyramidal symptoms of traditional (first-gen) antipsychotics | 1) Parkinsonism, 2) akathisia, 3) acute dystonia, 4) tardive dyskinesia |
| Schizophrenia & neuroleptic malignant syndrome of traditional (first-gen) antipsychotics | 1) Involves rapid onset of motor, mental, & autonomic Sx that include muscle rigidity, tachycardia, hyperthermia, altered consciousness. 2) Such drugs must be stopped ASAP when Sx develop in order to avoid potentially fatal outcome. |
| Schizophrenia & psychosocial interventions | 1) Psychosocial interventions enhance meds' effects on core Sx. 2) Such interventions are useful for maintaining med adherence, improving functioning & quality of life, 3) reduce risk & - consequences of relapse. |
| Schizophrenia & CBT psychosocial interventions | 1) CBT is beneficial for schizophrenics w/o response to meds, or who have comorbid conditions (anxiety, moody). 2) CBT focuses on ed Re: the disorder, on testing beliefs Re: delusions, & on teaching skills & problem-solving |
| Schizophrenia & skills training psychosocial interventions | 1) This is used to improve social skills & other aspects of daily living. 2) Includes behaviorally based instruction, modeling rehearsal, corrective feedback, & contingent reinforcement |
| Schizophrenia & family psychosocial interventions | 1) Includes crisis management, psycho-ed, supportive counseling, support groups, behavioral family therapy. 2) Primary goal is to reduce risk for relapse |
| Schizophrenia & assertive community treatment (ACT) psychosocial interventions | 1) This is a community-based multidisciplinary team approach designed to prevent relapse, improve functioning. 2) Services are tailored to needs of persons, available 24 hours a day, & include a host of services. |
| Schizophrenia & assertive community treatment (ACT) services | 1) Available 24 hours a day, 2) case management, 3) assessment, 4) crisis management, 5) med Px, 6) mental health services, 7) housing & employment assist, 8) family ed & support, 9) A & D abuse programs |
| Schizophrenia & supported employment as a psychosocial intervention | 1) This improves vocational functioning & involves I.D. or development of job opportunities that suit the schizophrenic, 2) provides ongoing support following job placement, and 3) integrates vocational & mental health services. |
| Bipolar I Disorder & pharmacotherapy | 1) Tx includes use of a mood stabilizer. 2) Lithium effective in 60 to 90% of classic Bipolar Disorder cases. 3) Rapid cycling or dysphoric mania use anti-seizure drug (carbamazepine, divalproex sodium). 4) Antipsychotics may help (risperidone) for mania |
| Bipolar I Disorder & psychotherapy | 1) This helps with med Tx compliance and effectiveness, 2) relapse risk is reduced |
| Bipolar I Disorder & CBT psychotherapy | 1) Focuses on I.D. of & altering of - thoughts. 2) Versions of CBT are specifically for bipolar Dx. 3) One version is Basco & Rush's (2007) five goals. |
| Bipolar I Disorder, Basco & Rush's (2007) 5 goals of CBT psychotherapy | 1) Educate client Re: disorder, available Tx; 2) instruct on methods for monitoring manic & depressed Sx; 3) facilitate adherence to med regimens; 4) teach mood coping strategies; 5) teach strategies to I.D. & cope w/ stressors that lead to mood episode |
| Bipolar I Disorder, Miklowitz (2008) Family-Focused Treatment (FFT) | 1) Integrates the individual's family into Tx 2) Focuses on teaching family members Re: Bipolar Disorder & effects on patient & family members. 3) Involves three phases a) Psychoed, b) communication enhancement training, & c) problem solving |
| Bipolar I Disorder, Frank (2005) Interpersonal & Social rhythm therapy (IPSRT) | 1) Is a modification of interpersonal therapy & incorporates strategies for improving interpersonal relationships & stabilizing daily routines. 2) Based on the assumptions that abnormalities in the body's circadian rhythms underlie Bipolar Disorder |
| Bipolar I Disorder, Precipitants of rhythm dysregulation according to Interpersonal & Social rhythm therapy (IPSRT) | 1) Interpersonal events can be precipitants of rhythm dysregulation 2) These interpersonal events can also be sources of distress |
| Major Depressive Disorder treatment factors | 1) Stage of the disorder (acute, continuation, maintenance) 2) Severity of symptoms 3) Presence of co-occurring disorders, and 4) Individual's preferences |
| Major Depressive Disorder pharmacotherapy treatment approaches | 1) SSRIs, 2) Tricyclics (TCAs) 3) Monoamine Oxidase Inhibitors (MAOIs), 4) Serotonin norepinephrine reuptake inhibitors (SNRIs), 5)These are comparable to TCAs & SSRIs, but differ in side effects |
| Major Depressive Disorder pharmacotherapy treatment using selective serotonin reuptake inhibitors (SSRIs) | 1) Include fluoxetine, fluvoxamine, paroxetine, sertraline 2) Considered first-line drug Tx for mod-to-severe depression 3) Fewer side effects, lower risk for overdose than tricyclics 4) Side effects = GI, insomnia, anxiety, headache, dizzy, anorexia, sex |
| Major Depressive Disorder pharmacotherapy treatment using tricyclics (TCAs) | 1) Include amitriptyline, nortriptyline, doxepin, imipramine, & clomipramine 2) Effective for "classic" depression 3) Side-effects = anticholinergic, confusion, drowsiness, weight gain, tremor, paresthesia, blood dyscrasia 4) Cardiotoxic |
| Major Depressive Disorder pharmacotherapy treatment using tricyclics (TCAs) anticholinergic side-effects | 1) Dry mouth, 2) blurred vision, 3) urinary retention, 4) constipation, 5) sexual dysfunction |
| Major Depressive Disorder pharmacotherapy treatment using tricyclics (TCAs) and cardiotoxicity | 1) Produce cardiovascular symptoms 2) Tachycardia 3) Palpitations 4) Hypertension 5) Severe hypotension 6) Cardiac arrhythmia |
| Major Depressive Disorder pharmacotherapy treatment using monoamine oxidase inhibitors (MAOIs) | 1) Include isocarboxazid, phenelzine, tranylcypromine 2) Px for those who don't respond to TCAs or SSRIs, or atypical Sx 3) Side-effects = anticholinergic effects, insomnia, agitation, confusion, skin rash, weight gain, headahce, tremor, blood dyscrasia |
| Major Depressive Disorder pharmacotherapy treatment using monoamine oxidase inhibitors (MAOIs) atypical symptoms | 1) Anxiety, 2) increased appetite, 3) hypersomnia, & 4) mood worsening late in day. |
| Major Depressive Disorder pharmacotherapy treatment using monoamine oxidase inhibitors (MAOIs) and occurence of hypertensive crisis when taken with: | 1) barbiturates, 2) amphetamines, 3) antihistamines, 4) foods containing the amino acid tyramine |
| Major Depressive Disorder pharmacotherapy treatment using monoamine oxidase inhibitors (MAOIs)and hypertensive crisis with tyramine foods | 1) aged cheese, meat 2) beer 3) red wine 4) chicken liver 5) avocados, 6) bananas |
| Major Depressive Disorder pharmacotherapy treatment using other antidepressants that are SNRIs | 1) Venlafaxine (Effexor) 2) desvenlafaxine (Pristiq), 3) duloxetine (Cymbalta) 4) these all increase norepinephrine & serotonin 5) are comparable to TCAs & SSRIs |
| Major Depressive Disorder psychotherapy treatment of various intensities of depression | 1) Depression-focused psychotherapy alone (CBT or IPT) is most effective for mild depression 2) when antidepressant added = best for mod to severe depression, chronic depression, psychotic depression |
| Major Depressive Disorder psychotherapy treatment using CBT | 1) Primary goal: Help to I.D. & alter dysfunction & distorted cognitions underlying Sx using combo of behavioral & cognitive techniques. 2) Behavioral strategies and cognitive strategies |
| Major Depressive Disorder behavioral strategies of psychotherapy treatment | 1) Activity scheduling, 2) behavior rehearsal 3) social skills training, 4) relaxation |
| Major Depressive Disorder cognitive strategies of psychotherapy treatment | 1) The downward arrow ("If so, then what?"), 2) questioning the evidence, 3) decatastrophizing, 4) mental imagery, 5) cognitive rehearsal |
| Major Depressive Disorder psychotherapy treatment using interpersonal psychotherapy (IPT): description of IPT | 1) Manual-based brief therapy based on the assumption that depression is due to problems in social roles & interpersonal relationships traceable to lack of strong attachments in early life. |
| Major Depressive Disorder psychotherapy treatment using interpersonal psychotherapy (IPT): Focus & goals | 1) focused on current social relationships 2) primary goals are a) symptom reduction, b) improved interpersonal functioning. |
| Major Depressive Disorder psychotherapy treatment using interpersonal psychotherapy (IPT): Symptoms reduction | 1) Achieved through education, 2) instills hope 3) achieved through use of pharmacotherapy |
| Major Depressive Disorder psychotherapy treatment using interpersonal psychotherapy (IPT): interventions improving interpersonal functioning | 1) These target 1+ of 4 problem areas 2) Problem areas are a) unresolved grief, b) interpersonal role disputes, c) role transitions, d) interpersonal deficits 3) Includes encouragement of affect, communication analysis, modeling, & role-playing |
| Major Depressive Disorder psychotherapy treatment using phototherapy | 1) Involves the use of exposure to artificial bright light, 2) Has been found to be effective Tx for MDD w/ seasonal pattern 3) also effective for nonseasonal MDD |
| Major Depressive Disorder psychotherapy treatment using electroconvulsive therapy (ECT) | 1) Rarely used Tx, 2) can be effective for severe, endogenous depressions 3) non-responsive to antidepressants 4) can include delusions, suicidal ideations 5) produces transient disorientation, confusion & memory loss |
| Major Depressive Disorder psychotherapy treatment and reducing side effects while using ECT | 1) Administer ECT unilaterally 2) administer ECT only to the right (nondominant) hemisphere of the brain |
| Separation Anxiety Disorder inventories and interviews | 1) State-Trait Anxiety Inventory for Children, 2) Self-Report for Childhood Anxiety Related Disorders, 3) Revised Children's Manifest Anxiety Scale 4) These confirm Dx, 5) Clarify nature & severity of Sx, 6) Determine degree people aggravate/reduc anxiety |
| Separation Anxiety Disorder: Treatment | 1) Incorporates variety of behavioral interventions 2) Cognitive therapy for more mature children, adolescents 3) Parent support & guidance to help them manage the child's emotional & behavioral Sx |
| Separation Anxiety Disorder: Behavioral treatment includes: | 1) In vivo exposure 2) systematic desensitization, 3) contingency management, 4) modeling |
| Separation Anxiety Disorder: Cognitive treatment includes: | Identifying and replacing automatic & illogical thoughts associated w/ the child's anxiety |
| Specific Phobia assessment measures and approaches | 1) Spider Phobia Beliefs Questionnaire, 2) Dental Anxiety Scale, 3) Blood-Injection Symptom Scale 4) a behavioral approach test involving observation of how person reacts to feared object or situation |
| Panic Disorder: Panic-focused Cognitive-Behavioral Therapy | 1) This form of CBT is an empirically supported Tx, 2) integrates a) self-monitoring b) cognitive restructuring c) breathing retraining d) applied relaxation, d) in vivo exposure e) relapse prevention |
| Panic Disorder: Exposure and cues in panic-focused Cognitive-Behavioral Therapy | 1) Exposure to internal & external cues that trigger panics is essential to Tx, 2) internal cues are addressed by interoceptive exposure 3) involves exposing individual to bodily sensations associated w/ panic, 4) cardiovascular exercise, spinning chair |
| Panic Disorder: Panic-Control Treatment (PCT) as a specific CBT Tx | 1) A brief CBT intervention, 2) incorporates 4 components a) Psychoed; b) cognitive restructuring; c) breathing retraining exercises to eliminate hyperventiliation; d) interoceptive conditioning to reduce fear of body sensations associated w/ anxiety |
| Panic Disorder: Pharmacotherapy medications and challenges | 1) TCAs (imipramine), 2) SSRIs, 3) SNRIs, 4) benzodiazepines 5) risk for relapse is high when used alone 6) CBT & meds maybe not more effective in long-term than CBT alone! |
| Generalized Anxiety Disorder (GAD) assessment instruments | 1) Hamilton Anxiety Rating Scale, 2) Beck Anxiety Inventory, 3) Generalized Anxiety Disorder Severity Scale |
| Generalized Anxiety Disorder (GAD) CBT interventions | 1) Incorporates techniques to learn tolerance of uncertainty 2) to I.D. & replace maladaptive cognitions, 3) reduce anxiety 4) using psychoed, self-monitoring, relaxation training, cognitive restructuring, worry exposure |
| Generalized Anxiety Disorder (GAD) CBT primary target of cognitive restructuring Tx | 1) catastrophic thinking (CT) 2) where CT is characterized by unrealistic worry Re: future events 3) therapist can use decatastrophizing ("what if" scenarios) |
| Generalized Anxiety Disorder (GAD) and applied relaxation Tx (Ost, 1987) | 1) This Tx involves teaching client to control anxiety in stressful times 2) Client learns several versions of progressive muscle relaxation 3) regular practice of muscle relaxation while imagining feared situation, just before, or during feared situation |
| Generalized Anxiety Disorder (GAD): condition in which to use pharmacotherapy and types of meds to use | 1) Includes medication for those whose anxiety causes impairment in functioning 2) Includes use of benzodiazepines, buspiron, antidepressants venlafaxine & imipramine |
| Obsessive-Compulsive Disorder (OCD) and instruments for assessment | 1) Yale-Brown Obsessive Compulsive Scale 2) Compulsive Activity Checklist 3) Quality of Life enjoyment & Satisfaction Questionnaire 4) All help confirm Dx, quantify severity of Sx, extent of interference w/ ADLs & life quality, & I.D. right Tx setting |
| Obsessive-Compulsive Disorder (OCD): required to assess to check for these types of harm | 1) Risk for suicide, 2) self-injurious behaviors, 3) harm to others, 4) mental status exam |
| Obsessive-Compulsive Disorder (OCD) and Exposure with Response Prevention (ERP) | 1) A Tx that combines prolonged exposure to objects, situations that trigger obsessions, w/ procedures to block the ability to perform compulsions 2) Benefits of exposure enhanced when exposure is combined w/ social skills training, cognitive restructure |
| Obsessive-Compulsive Disorder (OCD) and CBT | 1) Evidence supports CBT as effective for Tx of OCD 2) especially when including exposure w/ response prevention 3) group & individual formats have similar benefits |
| Obsessive-Compulsive Disorder (OCD) and pharmacotherapy treatments | 1) tricyclic clomipramine in combo w/ exposure 2) antidepressants (only moderate effects) 3) both of these have high relapse rates when antidepressants are discontinued |
| Posttraumatic Stress Disorder: Cognitive-Behavioral Therapy strategies | 1) psychoed 2) cognitive restructuring 3) breathing retraining 4) relaxation training 5) exposure to trauma event (in vivo, in imagination, via virtual reality) 6) stress inoculation training |
| Posttraumatic Stress Disorder: CBT stress inoculation training | 1) Teaches coping skills 2) includes 3 phases a) cognitive prep/education, b) skills acquisition & rehearsal, c) skill application & follow-through |
| Posttraumatic Stress Disorder: Pharmacotherapy strategies | 1) SSRI useful as adjunctive Tx 2) SSRI reduces certain symptoms 3) particularly useful for those with NON-COMBAT-related PTSD |
| Anorexia Nervosa: Interviews, inventories, rating scales | 1) Eating Disorders Examination 2) Eating Disorder Inventory-3, 3) Questionnaire for Eating Disorder Diagnosis 4) Evaluation of danger to self, nutrition, body image, personality, comorbid Sx, family factors |
| Anorexia Nervosa: Purpose & methods for inpatient treatment | 1) Priority to get them to gain weight 2) May require hospital 3) Individual, family, & group therapy 4) Nutritional counseling 5) contingency management linking privileges to gaining of weight |
| Anorexia Nervosa: Indicators for inpatient care | 1) When weight is 20-25% below normal 2) patient doesn't see the problem 3) patient expresses belief of no gain in outpatient care setting 4) when family has significant dysfunction 5) when family not supportive of Tx goals |
| Anorexia Nervosa: Indications for use of CBT | 1) When they have started to gain weight 2) when need to modify erroneous beliefs Re: weight & food |
| Anorexia Nervosa: The Garner et al. (1997) CBT stages for treatment | 1) establish pos. therapy alliance & enhance motivation 2) normalize eating patterns, body weight via self-monitoring eating, thoughts, etc. 3) I.D., evaluate, modify beliefs Re: weight & food 4) prepare for termination & develop a relapse prevention plan |
| Anorexia Nervosa: Family therapy Tx | 1) Used in conjunction w/ other Txs 2) ensures weight gain maintained 3) Structural family therapy focusing on boundaries, alliances, interactions between members that maintain anorexia 4) uses "family lunch" to change interactions |
| Anorexia Nervosa: pharmacotherapy | 1) Not useful as routine Tx 2) SSRI might be useful to reduce relapse, Tx of co-occurring depression or OCD Sx following successful weight gains |
| Bulimia Nervosa: CBT treatment | 1) Outpatient 2) primary goal to gain control over eating habits 3) develop healthy attitude to food eating, body weight/shape 4) incorporates techniques during periods of high-risk for binging |
| Bulimia Nervosa: CBT techniques for addressing binging and bulimia | 1) self-monitoring 2) stimulus control 3) cognitive restructuring 4) problem-solving 5) self-distraction |
| Bulimia Nervosa: Interpersonal Psychotherapy (Agras & Apple, 2008) | 1) Focuses on I.D. & resolution of the interpersonal context that maintains maladaptive eating 2) Based on assumption that faulty handling of relationships causes emotional upset that, when combined with chronic dieting, triggers binging |
| Bulimia Nervosa: Nutritional counseling | 1) This is often provided as an adjunctive intervention in bulimic situations 2) focuses on correcting maladaptive beliefs Re: a) food and exercise b) replacing unhealthy eating w/ healthy habits c) helps maintain a healthy weight |
| Bulimia Nervosa: Pharmacotherapy | 1) Antidepressants imipramine & fluoxetine are effective for reducing binging & purging, improve dysphoria 2) However, CBT alone has lower relapse & Tx dropout rates than pharmacotherapy |
| Enuresis: Assessment using symptoms checklists | 1) Child Behavior Checklist 2) Conners Parent Rating Scale 3) detect for associated depression, anxiety, other problems 4) must R/O med conditions or substance use as etiological factors prior to settling on this Dx |
| Sexual Dysfunctions: Assessment using interviews, questionnaires | 1) Semistructured interviews 2) Sexual Desire Inventory 3) Derogatis Interview for Sexual Functioning 4) Golombok-Rust Inventory of Sexual Satisfaction |
| Conduct Disorder Assessment: rating scales and sources of info | 1) Adolescent Anger Rating System 2) Child Behavior Checklist 3) Behavior Assessment System for Children 4) collect from parents, teachers, court, other collateral sources |
| Conduct Disorder: Overview of common family interventions | 1) an essential component of Tx 2) includes parent management training (PMT) 3) functional family therapy (FFT) |
| Conduct Disorder: Parent management training (PMT) | 1) a treatment based on social learning theory 2) targets inconsistent discipline & negative, coercive interactions 3) Parents are taught to set rules, negotiate compromises, develop Tx contracts, reward positive behavior, replace physical punishment |
| Conduct Disorder: Functional family therapy (FFT) | 1) a Tx emphasizing functions that behaviors serve 2) begins w/ a functional behavioral assessment 3) primary goal of this therapy is to improve interactions between parents & child 4) consists of 3 intervention phases |
| Conduct Disorder: The three intervention phases of functional family therapy (FFT) | 1) engagement & motivation 2) behavior change 3) generalization |
| Conduct Disorder: Cognitive Problem-Solving Skills Training (CPSST) | 1) This incorporates cognitive & behavioral strategies to teach new skills for approaching situations that have previously elicited problematic behaviors 2) Includes multiple techniques to achieve problem-solving skills |
| Conduct Disorder: Techniques for Cognitive Problem-Solving Skills Training (CPSST) | 1) I.D. & replace maladaptive interpretations of situations 2) therapist modeling of positive behaviors 3) provide reinforcement for engaging in desirable behaviors |
| Conduct Disorder: Multisystemic therapy | 1) A comprehensive Tx targeting factors within the individual, family, school, peer group, community that maintain CD problems 2) Considered useful for youth in mid- to late-adolescence exhibiting serious Sx of CD, 3) those at-risk for out-of-home placing |
| Conduct Disorder: Interventions for multisystemic therapy | 1) academic support 2) social skills training 3) parent management training 4) individual psychotherapy 5) family therapy 6) peer and school interventions 7) pharmacotherapy |
| Conduct Disorder: Pharmacotherapy | 1) Meds are not recommended for CD 2) meds may be of limited use when behaviors are escalating, pose high risk for danger 3) when sincere desire for change exists & previous Tx has failed 4) in presence of co-occurring ADHD, MDD, or other mental disorder |
| Conduct Disorder: Out-of-home placement | 1) Residential Tx when exhibiting marked noncompliance, persistent involvement w/ deviant peers, family has severe dysfunction 2) hospitalization for those at risk for suicide, homicide, or severe impairment by substance abuse or behavior, thoughts, moods |
| Substance Use Disorder: Prochaska & DiClemente's (1994) stages of the transtheoretical model | 1) Precontemplation 2) Contemplation 3) Preparation 4) Action 5) Maintenance 6) Termination |
| Substance Use Disorder: Prochaska & DiClemente's (1994) precontemplation stage of the transtheoretical model | The person has little insight into the need for change and does not intend to change |
| Substance Use Disorder: Prochaska & DiClemente's (1994) contemplation stage of the transtheoretical model | Person is aware of the need for change, intends to take action within the next 6 months, but is not committed to change |
| Substance Use Disorder: Prochaska & DiClemente's (1994) preparation stage of the transtheoretical model | Person plans to take action in the immediate future (usually in the next month) and has a realistic plan of action for modifying his/her behavior |
| Substance Use Disorder: Prochaska & DiClemente's (1994) action stage of the transtheoretical model | The person takes concrete steps to change behaviors, often begins with making a public commitment to change |
| Substance Use Disorder: Prochaska & DiClemente's (1994) maintenance stage of the transtheoretical model | The person has maintained a change in behavior for at least 6 months and is taking steps to prevent relapse |
| Substance Use Disorder: Prochaska & DiClemente's (1994) termination stage of the transtheoretical model | The person feels they can resist temptation and are confident there is no longer a risk for relapse |
| Substance Use Disorder: Levels of care in treatment | 1) The general rule for choosing a level of care is to select the least restrictive setting 2) this setting needs to be likely to be effective & safe |
| Substance Use Disorder: Deciding upon a level of care for treatment | 1) Level of care may be chosen using the decision tree from the American Society of Addiction Medicine 2) The tree distinguishes between four levels of service |
| Substance Use Disorder: The four levels of care indicated by the American Society of Addiction Medicine's decision tree | 1) outpatient care, 2) intensive outpatient & partial hospitalization care, 3) residential/inpatient care, & 4) medically managed intensive Tx |
| Substance Use Disorder & the three approaches for dual diagnosis treatment | 1) Sequential approach, 2) Parallel approach, 3) Integrated approach 4) Research indicates integrated is most effective |
| Substance Use Disorder & the sequential approach of dual diagnosis treatment | 1) Involves treating the most acute disorder first and the less acute disorder next 2) Treatment provided by either the same or different provider(s) |
| Substance Use Disorder & the parallel approach of dual diagnosis treatment | Treating the two disorders simultaneously by different providers |
| Substance Use Disorder & the integrated approach of dual diagnosis treatment | Involves treatment of the two disorders simultaneously by the same provider. |
| Substance Use Disorder: psychosocial interventions | 1) These interventions for substance use problems include individual, family, & group approaches 2) typically the approaches are combined into a comprehensive treatment program tailored to the individual's needs and circumstances |
| Substance Use Disorder: Cognitive-Behavioral Interventions | 1) These interventions use a combo of cognitive & behavioral strategies to reduce, replace dysfunctional thoughts & maladaptive behaviors 2) Includes coping skills training, social & problem-solving skills training, stress management, & behavioral control |
| Substance Use Disorder: Behavioral Interventions | 1) This intervention assumes excessive substance use is learned & acquired thru experience 2) the goal of interventions is to alter environmental stimuli triggering substance use |
| Substance Use Disorder: Techniques for behavioral interventions | 1) Behavioral contracting 2) Stimulus control 3) Cue exposure & relaxation 4) Aversion therapy |
| Substance Use Disorder: Community reinforcement approach (CRA) for behavioral interventions | 1) A broad-based behavioral intervention 2) Utilizes social, recreational, familial, & vocational reinforcers to aid clients in recovery 3) Begins w/ functional behavioral assessment 4) incorporates use of naturally occurring reinforcers |
| Substance Use Disorder: The role of training in the community reinforcement approach (CRA) for behavioral interventions | 1) training in substance refusal 2) training in communication & social skills |
| Substance Use Disorder: Motivational interviewing as a psychosocial intervention | 1) This intervention focuses on enhancing intrinsic motivation to change 2) it helps patients examine & resolve ambivalence about changing 3) it includes 4 general principles to guide the selection of the strategies used in motivational interviewing |
| Substance Use Disorder: The four principles of motivational interviewing | 1) Expression of empathy 2) Development of discrepancies between current behavior & personal goals & values 3) Rolling with resistance, rather than opposition to resistance 4) Support of self-efficacy |
| Substance Use Disorder: Relapse prevention as a psychosocial intervention | 1) These interventions focus on helping persons recognize internal & external cues that increase risk for substance use 2) teach alternative ways for responding to cues |
| Substance Use Disorder: Reducing relapse with relapse prevention interventions | 1) Potential for relapse is reduced when person is shown that episodes of drinking were mistakes resulting from specific, external & controllable factors 2) Therapy involves I.D. of circumstances that increase risk for relapse 3) Implement strategies |
| Substance Use Disorder: Self-help groups as a psychosocial intervention | 1) These increase the likelihood of ongoing abstinence 2) AA is premised on disease-control model, not a curative model 3) Recovery is a life-long process 4) Abstinence and 12-step work are essential 5) SMART Recovery alternative based on CBT principles |
| Substance Use Disorder: Secular Organization for Sobriety self-help groups as psychosocial intervention | 1) Focuses on individual responsibility 2) does not invoke a "higher power" 3) Otherwise similar to AA |
| Substance Use Disorder: Group therapy as a psychosocial intervention | 1) This intervention is represented by a variety of theoretical orientations 2) Participation in this therapy mode provides members w/ opportunity to address problems w/ others w/ similar problems 3) reduces feelings of shame & guilt, provides role models |
| Substance Use Disorder: Family & couple therapy as a psychosocial intervention | 1) This is inadequate by itself when an individual has a serious Substance Use Disorder 2) It is often essential adjunctive Tx as addiction affects entire families 3) resolving family problems increases odds patient will remain sober |
| Substance Use Disorder: Primary goal of family & couple therapy as a psychosocial intervention | A primary goal of this therapy is to promote a living environment that helps prevent relapse & reduces enabling behaviors |
| Substance Use Disorder: Pharmacotherapy | 1) Meds are used to treat acute intoxication, overdose, & withdrawal syndromes 2) In conjunction w/ psychosocial interventions, promote abstinence 3) Disulfiram, naltrexone are examples 4) Coexisting mental disorders may be treated w/ meds, but caution! |
| Delirium: Medications that can help | 1) Px of haloperidol or other antipsychotics can help to reduce agitation, delusions, & hallucinations 2) No sedatives allowed, due to side effects and masking effects of afflicted person's Sx 3) Benzodiazepines for alcohol withdrawal delirium only |
| Major Neurocognitive Disorder: Psychosocial Interventions include | 1) Behavioral-oriented Tx to reduce disruptive, agitated, other undesirable behaviors & improve functional skills 2) Emotion-oriented therapies 3) cognitive training & rehabilitation 4) stimulation-oriented interventions |
| Major Neurocognitive Disorder: Emotion-oriented psychosocial Interventions | 1) Reminiscence therapy 2) validation therapy 3) supportive psychotherapy |
| Major Neurocognitive Disorder: Stimulation-oriented psychosocial interventions | 1) Exercise therapy 2) music and art therapy 3) animal-assisted therapy |
| Major Neurocognitive Disorder: Environmental manipulation treatments | 1) Treatment for those w/ moderate to severe cognitive impairment 2) Used to enhance memory & increase safety 3) Includes providing structured daily routine, installing safety measures, maintain familiar, calming environment & objects, adequate lighting |
| Major Neurocognitive Disorder: Pharmacotherapy treatments | 1) May include antipsychotics to reduce agitation 2) SSRIs or other antidepressants to reduce depression 3) cholinesterase (donepezil, rivastigmine, galantamine) inhibitor to slow rate of cognitive impairment/decline |
| Major Neurocognitive Disorder: Family/caregiver interventions | 1) Family & other caregivers delay out-of-home placement for the patient 2) provide quality of life & emotional well-being 3) Includes psychoed programs, stress management, support groups, family therapy, adult daycare for patient & other respite services |
| Antisocial & Borderline Personality Disorders: Collateral sources for assessment | 1) Because antisocial and borderline personality persons are not always reliable sources of info 2) Use family members, med records, other collateral sources |
| Antisocial Personality Disorders: Milieu/Residential treatment effectiveness | 1) When they target moderately high-risk individuals 2) When addressing issues associated w/ criminal behavior, including antisocial attitudes, substance dependence, relationships w/ other criminals, & ed & vocational deficits |
| Antisocial Personality Disorders: Focus of milieu/residential treatment effectiveness | 1) focus on teaching interpersonal skills 2) promotion of prosocial attitudes |
| Antisocial Personality Disorders: Cognitive-behavioral interventions (Gacono, 2000) | 1) Residential program that establishes & enforces clear rules & consequences for violating rules 2) teaches cognitive & life skills 3) modifies lifestyle patterns associated w/ antisocial behavior 4) promotes tolerance of affect 5) continuity of care |
| Antisocial Personality Disorders: Relapse prevention in cognitive-behavioral interventions (Meloy, 2007) | 1) An essential component of CBT 2) focuses on teaching the individual adaptive cognitive & behavioral responses to events that otherwise trigger antisocial behavior |
| Antisocial Personality Disorders: Pharmacotherapy | 1) Avoid drugs that can be avoided 2) Meds useful for Tx of specific Sx, such as mood stabilizers, antidepressants, antipsychotic (low dose) for cognitive-perceptual abnormalities |
| Borderline Personality Disorders: Dialectical Behavior Therapy (DBT) (Linehan, 1987) | 1) Empirically supported Tx 2) Describes cause of BPD as a dysfunction of emotion regulation attributable to combo of bio abnormalities & an invalidating environment 3) Combines 3 Tx strategies to help them achieve control over their behaviors |
| Borderline Personality Disorders: Three strategies for behavioral control in Dialectical Behavior Therapy (DBT) (Linehan, 1987) | 1) Group skills training to help regulate emotions, improve social & coping skills; 2) individual outpatient therapy to strengthen motivation & new skills; 3) telephone consults to provide added support & between-session coaching |
| Borderline Personality Disorders: Transference-Focused Psychotherapy | 1) This combines ego psychology, object relations theory, & attachment theory 2) It views BPD as a result of poorly defined, fragmented representations of self & others leading to primitive defense mechanisms, identity diffusion |
| Borderline Personality Disorders: Primary goal of Transference-Focused Psychotherapy | 1) Goal is to integrate fragmented representations 2) Achieved by therapist focusing on interactions between therapist & client here-and-now 3) Utilizes techniques of clarification, confrontation, & interpretation |
| Borderline Personality Disorders: Mentalization-Based Therapy (MBT) | 1) A form of psychodynamic therapy developed as Tx for BPD 2) Views BPD as resulting from early trauma that led to disorganized attachment, interferes w/ development of social & cognitive abilities required for mentalization |
| Borderline Personality Disorders: Focus of Mentalization-Based Therapy (MBT) | 1) Focuses on increasing mentalization capacities 2) involves helping them to identify & understand their own emotions |
| Borderline Personality Disorders: Interpersonal Psychotherapy (IPT) | 1) A brief Tx for depression, also effective for BPD 2) Effective as this involves disturbed interpersonal relationships & is often associated w/ depressive Sx 3) Duration of therapy is extended & between-session phone contacts are used for crises |
| Borderline Personality Disorder: Pharmacotherapy | 1) Symptoms-focused pharmacotherapy & psychotherapy may enhance Tx outcomes for these persons 2) Fluvoxamine is useful for reducing fast mood changes 3) Olanzapine effective for alleviating depression, impulsive aggressive acting out typical of this type |
| Paraphilias: Combined Cognitive-Behavioral Interventions | 1) Interventions are aimed at altering maladaptive beliefs, justifications 2) Aim to eliminate undesirable sexually arousing, pleasurable responses to individuals, objects, situations |
| Paraphilias: Exclusively Cognitive Interventions | Cognitive strategies aim to educate Re: sex, restructure cognitively, provide empathy training, & relapse prevention. |
| Paraphilias: Exclusively Behavioral Interventions | Aversion therapy, covert sensitization (aversive conditioning in imagination) & orgasmic reconditioning |
| Paraphilias: Orgasmic reconditioning in behavioral interventions | Involves having the individual replace the unacceptable sexual fantasy with a more acceptable one while masturbating. |
| Paraphilias: Combination interventions | 1) Necessary because those w/ Paraphilic Disorder lack motivation to change, have high relapse rates 2) Often combine family therapy, group therapy, social skills training, 12-step programs, and/or relapse prevention with CBT, cognitive, or behavioral |
| Paraphilias: Pharmacotherapy | 1) Medroxyprogesterone acetate (DepoProvera) reduces behaviors in men 2) Drawback: benefits stop as soon as D/Cd 3) Antidepressants useful for reducing paraphilic fantasies & behaviors, associated depression & anxiety |
| Older Adults & elder abuse | 1) I.D. of abuse may involve seeing physical signs of abuse, common behavioral signs. 2) Indications may be apparent in caregivers |
| Older Adults & physical signs of elder abuse | 1) unexplained injuries 2) poor hygiene |
| Older Adults & behavioral signs of elder abuse | 1) fear 2) depression 3) helplessness 4) anxiety 5) withdrawal 6) confusion 7) contradictory statements 8) nonresponsiveness |
| Older Adults & caregiver signs of elder abuse | 1) indifference or anger toward elder, 2) unwillingness to let elder speak, 3) aggressive behavior, 4) alcohol or drug problems 5) social isolation 6) conflicting explanations for injuries 7) lack of cooperation 8) "blaming-the-victim" |
| Older Adults & decisional capacity | 1) This becomes a concern when an elder has signs of dementia, depression, or psychosis 2) Baker et al. (1998) 5-step decisional capacity model helps to determine legal competency |
| Older Adults & Baker et al. (1998), 5-step decisional capacity model | 1) referral clarification 2) assessment planning 3) assessment 4) synthesis of data & communication of results 5) follow-up evaluation |
| Older Adults & the assessment step of the Baker et al. (1998) 5-step decisional capacity model | 1) Includes administering a clinical interview 2) administering performance-based measures of cognition & functional or decisional capacity, 3) administering measures of mental health |
| Older Adults & factors associated with increased risk for depression | 1) social isolation 2) recent loss of a loved one 3) recent major illness or chronic disabling illness 4) persistent sleep problems 5) Dx of Neurocognitive Disorder 6) recent placement in long-term care |
| Older Adults & biopsychosocial assessment for depression | 1) includes obtaining info on nature & severity of Sx 2) medication & substance use 3) current stressors & life situation 4) level of functioning 5) personal & family history of Mood Disorder 6) mental status 7) social support & strengths 8) suicide risk |
| Older Adults & important aspect of diagnosing depression | Must distinguish between depression and Neurocognitive Disorder |
| Older Adults & factors associated with increased suicide risk | 1) suicidal behavior & ideation 2) mental illness 3) substance use 4) certain physical disorders 5) negative life events 6) lack of social support 7) functional impairment |
| Older Adults & measures for evaluation of suicide risk | 1) Scale for Suicide Ideation 2) Geriatric Hopelessness Scale 3) Direct questioning of elder Re: suicidal thoughts/intent 4) obtain collateral info from family, caregivers, & health providers |
| Older Adults, purpose of & properties to use for Reminiscence Therapy (RT) | 1) Uses old photographs 2) mementoes 3) music 4) cues to stimulate memory, reduce depression, help integrate life experiences |
| Older Adults & when to use Validation Therapy (VT) | 1) Used to reduce a patient's distress 2) To improve communication by validating beliefs and feelings, even when not based in reality |
| Culturally Diverse Clients: General overview of assessment | 1) When working w/ these clients, determine degree to which culture & language impact assessment & Tx planning 2) I.D. relevant assessment tools, 3) consider impact of culture & language on testing |
| Culturally Diverse Clients: Improving accuracy of assessment (Grieger, 2008) | 1) Use the Cultural Assessment Interview Protocol (CAIP) 2) CAIP is primary means of data collection 3) Obtains information about numerous aspects of the client's life 4) Also use DSM-5's Cultural Formulation Interview 5) Use self-report questionnaires |
| Culturally Diverse Clients: Cultural Assessment Interview Protocol and client info obtained (Grieger, 2008) | 1) Info about problem conceptualization & attitudes about being helped 2) cultural I.D. 3) acculturation 4) family structure 5) racial/cultural I.D. development 6) experiences w/ bias 7) immigration issues 8) existential/spiritual issues |
| Culturally Diverse Clients: Improving accuracy of assessment via use of self-report questionnaires | 1) Abbreviated Multidimensional Acculturation Scale 2) General Ethnic Discrimination Questionnaire 3) Multigroup Ethnic Identity Measure |
| Lesbian, Gay, and Bisexual Clients: Affirmative Psychotherapy | 1) This refers to individual, couple, & group therapies 2) encourages acceptance of sexual orientation 3) based on a number of assumptions about homosexuality 4) This approach reflects APA's stance on the subject |
| Lesbian, Gay, and Bisexual Clients: Assumptions of Affirmative Psychotherapy | 1) Homosexuality is a normal/healthy variation of sexuality 2) It is not the cause of pathology in itself 3) clinicians must be aware of the impact of heterosexism on LGB persons & must be reasonably free of these biases |
| Lesbian, Gay, and Bisexual Clients: APA Guideline 1 related to Affirmative Psychotherapy | Psychologists are to "understand that homosexuality & bisexuality are not indicative of mental illness" |
| Lesbian, Gay, and Bisexual Clients: APA Guideline 4 related to Affirmative Psychotherapy | Psychologists are to "strive to understand how inaccurate or prejudicial views of homosexuality or bisexuality may affect the client's presentation in Tx and the therapeutic process" |
| Lesbian, Gay, and Bisexual Clients: Sexual Identity Therapy (SIT) by Throckmorton & Yarhouse (2006) | 1) Developed as an alternative to affirmative psychotherapy & sexual reorientation therapy 2) For clients experiencing conflicts between their sex I.D. & personal attitudes, beliefs, values |
| Lesbian, Gay, and Bisexual Clients: Goal of Sexual Identity Therapy (SIT), Throckmorton & Yarhouse (2006) | "The synthesis of a sexual identity that promotes personal well-being & integration w/ other aspects of personal identity (cultural, ethnic, relational, spiritual, worldview, etc." |
| Lesbian, Gay, and Bisexual Clients: The four phases of Sexual Identity Therapy (SIT) | 1) Assessment 2) advanced informed consent 3) psychotherapy, and 4) sexual identity synthesis |
| Lesbian, Gay, and Bisexual Clients: Phase 1 of Sexual Identity Therapy (SIT) | Assessment: evaluating the client's motivation for seeking therapy |
| Lesbian, Gay, and Bisexual Clients: Phase 2 of Sexual Identity Therapy (SIT) | Advanced informed consent: obtaining informed consent after providing the client w/ complete & accurate info Re: sexual identity & orientation & alternative Tx & identifying Tx goals |
| Lesbian, Gay, and Bisexual Clients: Phase 3 of Sexual Identity Therapy (SIT) | Psychotherapy: providing interventions & referrals that match the client's goals |
| Lesbian, Gay, and Bisexual Clients: Phase 4 of Sexual Identity Therapy (SIT) | Sexual identity synthesis |
| Lesbian, Gay, and Bisexual Clients: Phase-Specific Psychotherapy (Ritter & Terndrup, 2002) | a) addresses the developmental needs of LGB individuals b) Phase 1 - Sensitization, c) Phase 2 - Identity Confusion d) Phase 3 - Identity Assumption/Tolerance e) Phase 4 - Identity Acceptance/Commitment f) Phase 5 - Identity Pride/Synthesis |
| Lesbian, Gay, and Bisexual Clients: Phase 1 of Phase-Specific Psychotherapy (Ritter & Terndrup, 2002) | Sensitization: Empathize w/ and destigmatize client's feelings of alienation & isolation; address depression & suicidal ideation; and address impulsivity, anger, & other behavioral problems. |
| Lesbian, Gay, and Bisexual Clients: Four elements of Phase 2 from Phase-Specific Psychotherapy (Ritter & Terndrup, 2002) | Identity Confusion: 1) Empathize & explore the client's confusion Re: sexual I.D. & related fears & anxiety; 2) help client I.D. & acknowledge same-sex feelings; 3) dispel myths & stereotypes Re: homosexuality; 4) reframe being gay or lesbian as positive |
| Lesbian, Gay, and Bisexual Clients: Three elements of Phase 2 from Phase-Specific Psychotherapy (Ritter & Terndrup, 2002) | Identity Confusion: 1) Empathize w/ feelings of loss & facilitate the grieving process; 2) Expose the client to positive role models & I.D. sources of support; 3) assess for & address substance abuse |
| Lesbian, Gay, and Bisexual Clients: First three elements of Phase 3 from Phase-Specific Psychotherapy (Ritter & Terndrup, 2002) | Identity Assumption/Tolerance: 1) Validate client's self-perception of probable I.D. & provide info on I.D. development; 2) facilitate decision-making Re: self-disclosure & rehearse self-disclosure in therapy; 3) provide education on human sexuality |
| Lesbian, Gay, and Bisexual Clients: Three more elements of Phase 3 from Phase-Specific Psychotherapy (Ritter & Terndrup, 2002) | Identity Assumption/Tolerance: 4) help client develop a new personal & social I.D. 5) reframe rejection by others as an external problem; 6) refer client to community resources for LGB individuals |
| Lesbian, Gay, and Bisexual Clients: Three self-I.D. elements of Phase 4 from Phase-Specific Psychotherapy (Ritter & Terndrup, 2002) | Identity Acceptance/Commitment: 1) Encourage client to adopt temporary sexual I.D. label & refer to client as gay, lesbian, or bisexual; 2) support client's involvement in the LGBT community; 3) continue to discuss self-disclosures |
| Lesbian, Gay, and Bisexual Clients: Two relational elements of Phase 4 from Phase-Specific Psychotherapy (Ritter & Terndrup, 2002) | Identity Acceptance/Commitment: 4) address issues related to intimacy in initial gay or lesbian relationships; 5) provide couple counseling if so requested |
| Lesbian, Gay, and Bisexual Clients: Two elements of Phase 5 from Phase-Specific Psychotherapy (Ritter & Terndrup, 2002) | Identity Pride/Synthesis: 1) Validate client's pride in being gay or lesbian; 2) acknowledge existence & impact of heterosexist oppression & address the client's negative feelings & conflicts related to heterosexism |
| Lesbian, Gay, and Bisexual Clients: Three personality or relational elements of Phase 5 from Phase-Specific Psychotherapy (Ritter & Terndrup, 2002) | Identity Pride/Synthesis: 1) examine dimensions of client's personality, help to develop integrated sense 2) help client's reintegration into dominant culture 3) help client redefine former relationships |
| Indicators of Child Abuse: Physical abuse and child's physical condition | 1) Unexplained bruises, welts, burns, lacerations, fractures, abdominal injuries; 2) multiple injuries at various stages of healing; 3) wears clothes to hide injuries |
| Indicators of Child Abuse: Physical abuse and six relational, explanatory, and affective signs found in child's behavior | 1) child attributes injuries to improbable cause 2) reports injury by parent or other caregiver; 3) frightened of parents or of going home; 4) displays extremes in behavior; 5) exhibits "frozen watchfulness"; 6) has history of depression, acting-out |
| Indicators of Child Abuse: Physical abuse and two interaction signs found in child's behavior | 7) avoids physical activity (due to soreness); 8) is clingy & develops indiscriminant attachments |
| Indicators of Child Abuse: Physical abuse and three attitudinal and evasion signs found in parent/caregiver's behavior | 1) Seems unconcerned Re: child's condition; 2) offers an implausible explanation or no explanation for injuries; 3) tries to hide injuries or I.D. of person who inflicted the injuries |
| Indicators of Child Abuse: Physical abuse and three interactive signs found in parent/caregiver patterns | 4) has sought Tx for the child at different medical facilities to avoid detection; 5) uses harsh discipline that is inappropriate for the child's misbehavior and/or age; 6) has unrealistic expectations of the child |
| Indicators of Child Abuse: Physical abuse and two psychological or self-report signs found in parent/caregiver's behavior | 7) exhibits signs of severe psychopathology, emotional immaturity, poor impulse control, social isolation, and/or alcohol or drug abuse; 8) reports being maltreated as a child |
| Indicators of Child Abuse: Sexual abuse and signs found in child's physical condition | 1) Child has bruising in the genital area and/or venereal disease; 2) child is pregnant; 3) has sleep or appetite disturbances 4) complains about lower abdominal pain or painful urination or defecation |
| Indicators of Child Abuse: Sexual abuse and 5 signs found in child's behavior | 1) the child states they've been sexually assaulted; 2) child appears to mistrust or fear adults; 3) has had a sudden, unexplained change in behavior or mood; 4) has night terrors, psychosomatic illness, or eating disorder; 5) exhibits regressive behavior |
| Indicators of Child Abuse: Sexual abuse and 4 signs found in child's behavior | 6) exhibits regressive behaviors or withdrawal into a fantasy world; 7) has experienced recent decline in academic performance; 8) exhibits antisocial behavior; 9) engages in self-mutilation or other self-destructive behavior |
| Indicators of Child Abuse: Sexual abuse and 5 more signs found in child's behavior | 10) has overly-sophisticated knowledge about sex; 11) is promiscuous or overly sexualized; 12) is unwilling to participate in physical activities; 13) has attempted suicide; 14) abuses alcohol or drugs |
| Indicators of Child Abuse: Sexual abuse and 3 signs found in parent/caregiver behavior | 1) extremely protective, jealous, or disinterested in the child; 2) has a distorted perception of the chld's role in the family; 3) has inadequate coping skills and extremely low self-esteem |
| Indicators of Child Abuse: Sexual abuse and 3 more signs found in parent/caregiver behavior | 4) reports marital problems that would cause one parent to seek physical affection from the child; 5) describes a home situation in which one parent is often home alone w/ the child; 6) lacks social & emotional contacts outside the home |
| Indicators of Child Abuse: Sexual abuse and 2 signs found in parent/caregiver behavior | 7) abuses alcohol or drugs; 8) reports being sexually abused as a child |
| Indicators of Child Abuse: Emotional maltreatment and signs found in child's physical condition | 1) child has delays in physical, speech, social, and/or intellectual development; 2) has a habit disorder (thumb-sucking, nail biting, rocking) |
| Indicators of Child Abuse: Emotional maltreatment and 4 signs found in child's behavior | 1) child displays extremes in behavior (passivity or aggression); 2) has sleep problems, phobias, or obsessions & compulsions; 3) is verbally abusive, hostile, or provocative; 4) exhibits pseudomaturity or regressive behaviors |
| Indicators of Child Abuse: Emotional maltreatment and 2 signs found in child's behavior | 5) child often makes derogatory remarks Re: their own behavior & has low self-esteem; 6) is overly worried Re: conforming to directives from parents or other adults; has attempted suicide |
| Indicators of Child Abuse: Emotional maltreatment and 4 signs found in behavior of parent/caregiver | 1) parent offers inappropriate explanations for the child's behaviors; 2) disinterested in the child's problems; 3) blames, ridicules, and denigrates the child; 4) is cold and rejecting; 5) withholds love from the child |
| Indicators of Child Abuse: Emotional maltreatment and 3 signs found in behavior of parent/caregiver | 6) treats children in the family unequally; 7) abuses alcohol or other drugs; 8) reports being abused or neglected as a child |
| Indicators of Child Abuse: Physical neglect and signs found in child's physical condition | 1) child is constantly hungry & has signs of malnutrition (pallor, weakness, low weight, chronic fatigue) 2) has poor hygiene & inappropriate dress; has untreated medical problems |
| Indicators of Child Abuse: Physical neglect and signs found in child's behavior | 1) child says there is no one to care for them; 2) steals or begs for food; 3) often falls asleep at school, in therapy, or during other activities; 4) frequently absent from school; 5) uses alcohol, drugs; 6) history of delinquent behavior, suicidality |
| Indicators of Child Abuse: Physical neglect and signs found in behavior of parent/caregiver | 1) parent is disinterested in child; 2) expresses futility & low motivation for change; 3) describes chaotic, unsafe conditions at home; 4) chronic physical illness 5) mental illness, below-ave. IQ; 6) alcohol, drug abuse; 7) history of neglect as child |
| Victims of Child Abuse: Abuse-Focused Cognitive-Behavioral Therapy (AF-CBT) | 1) a short-term Tx for physically abused children & family; 2) targets characteristics associated w/ abuse, family context, and consequences of the abuse |
| Victims of Child Abuse: Therapy method in Abuse-Focused Cognitive-Behavioral Therapy (AF-CBT) | 1) Consists of individual sessions w/ child & parent, joint parent-child sessions, & interventions to teach parents discipline techniques 2) enhancing interactions 3) I.D. & alter parental reactions to triggers 4) train child coping skills |
| Victims of Child Abuse: Role of community in Abuse-Focused Cognitive-Behavioral Therapy (AF-CBT) | The community and social systems surrounding the abused child and the child's family are enlisted to help, support, and monitor recovery from the abusive state of functioning |
| Victims of Child Abuse: Elements of Parent-Child Interaction Therapy (PCIT) | 1) This therapy is based on recognition that negative, coercive relationships between parent & child are major risk factor for abuse 2) PCIT provides structured parent training 3) Therapist acts as coach by prompting parent from hidden observation |
| Victims of Child Abuse: More elements of Parent-Child Interaction Therapy (PCIT) | 4) parents are taught specific strategies designed to improve parent-child relationship & increase child compliance 5) parents can be taught five basic relationship-building skills 6) parents coached to use skills during relationship-enhancing activity |
| Victims of Child Abuse: Five basic relationship-building skills of Parent-Child Interaction Therapy (PCIT) | 1) praise, 2) reflection, 3) imitation, 4) description, and 5) enthusiasm |
| Victims of Child Abuse: Target behaviors and Parent-Child Interaction Therapy (PCIT) | 1) During this therapy, target behaviors are coded, recorded on chart by therapist during each session 2) parents are provided w/ feedback about their mastery of skills |
| Victims of Child Abuse: Definition & purpose of Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) | This is a short-term Tx for reducing PTSD Sx, depression, & behavioral problems in kids who have been sexually abused, or have been exposed to other traumas |
| Victims of Child Abuse: Six core components of Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) | 1) Psychoeducation & normalization of reactions 2) Stess management 3) affective expression and regulation 4) gradual exposure through verbal, written, or symbolic recounting of the abuse, 5) cognitive reprocessing, 6) personal safety skills training |
| Victims of Child Abuse: Two core components of Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) | 7) parent training in behavioral management skills, and 8) joint parent-child therapy sessions |
| Posttraumatic Stress Disorder & CBT stress inoculation training: Definition of cognitive prep/education | Helping the client understand their behavioral and cognitive responses to stressful situations |
| Posttraumatic Stress Disorder & CBT stress inoculation training: Definition of skills acquisition and rehearsal | Helping the client acquire and rehearse a variety of coping skills |
| Posttraumatic Stress Disorder & CBT stress inoculation training: Definition of skills application and follow-through | Having the client apply the coping skills to imagined, filmed, and in vivo stress-producing situations |
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