Comp Exam New

Question 1

Narrative (Family) (12)

Answer 1

1. No objective reality, we attempt to label people to control things, this is a fiction
2. We live in a story of our own making; we can shift understanding, change the story
3. Power of language-control our speech, control the future
4. present/future focus
5. Focus on ways society oppresses people- look for lessons we are taught, make them conscious
6. Most stories start thin “I am bad at math”- thicken it with context
7. Externalize the problem to de-fuse with it: examples given in class- instead of “he’s sneaky”, we say “when does this sneakiness happen?” “it’s us against the sneakiness”
8. Look for sparkling events: times the family has been able to avoid/overcome the problem- we want to shine these times up and make them seem more important in order to change the narrative
9. Engage each member in the story
10. Bring in external influences- not all our fault we turned out this way- understand the big picture of how dysfunctional patterns are created
11. Ask how each family member spends their time- focus on talents and strengths.
12. Write a letter after therapy to each family member detailing their strengths, what you believe is possible for them

Question 2

9 Steps of EFT ACE RIA ESC

Answer 2

1. Alliance 2.Cycle 3.Emotions. 4. Reframe the problem in terms of the cycle and attachment related emotions. 5. Promote identification with disowned needs and aspects of self; integrate these into relationship interactions. 6. Promote acceptance of the partner’s experience and creating new interaction patterns. 7. Facilitate the direct expression of needs and wants to create emotional engagement. 8. Facilitate the emergence of new solutions to old relationship problems. 9. Consolidate new positions/cycles of attachment behaviors.

Question 3

EFT Interventions (5)

Answer 3

1) Empathic reflection. 2) Validation of client realities & emotional responses. 3) Evocative questions and prompts that call up emotion through open ended questions about stimuli, bodily responses, desires, meanings, or action tendencies. 4) Heightening: Expand and intensifies emotional experience through repeating, re-enacting, focusing, refocusing, and using imagery. 5) Empathic conjecture, interpretation and inferences.

Question 4

EFT assesses relationship factors: (7)

Answer 4

a) Strengths b) Cycle – c) Behaviors d) Perceptions e) Secondary Emotions f) Primary Emotions g) Attachment Needs

Question 5

EFT Therapy Goals (5) CEDSA

Answer 5

Cycle/emotions/de-escalate/safety/attach 1. ID cycle 2. ID attachment emotions 3. Use in session enactments to de-escalate 4. Establish new ways of relating (safer) 5. Form healthy attachments

Question 6

Contraindications for EFT:

Answer 6

ongoing violence, substance abuse, ongoing affairs- no trust

Question 7

Methods of Assessment (EFT):

Answer 7

Dyadic adjustment scale, attachment hx (parents), family environment scale

Question 8

DV main points- 1. what must we know (2. and how?) and 3. when is couples counseling okay?

Answer 8

1. Assess individually for violence/risk/suicide/affairs- 2. Use written assessment: Partner Violence Scale (has gender bias) 3. Couples counseling okay iff: violence has stopped, violence is only mild, perpetrator takes responsibility for abuse and agrees to nonviolent tx

Question 9

Safety Planning Steps:

Answer 9

1. Identification that the risk is increasing 2. Identification of specific steps survivor can take once they’ve realized risk is increasing 3. Methods for maintaining safety once survivor leaves

Question 10

Psychoanalytic Terms (3)

Answer 10

1. behavior determined by unconscious factors/patterns early in life/developmental drives 2. Id- pleasure principle ego- reality principle superego- perfection principle/concience & standards 3. anxiety- reality (danger), neurotic (instincts will get you in trouble), moral (fear of one’s own conscience getting you in trouble)

Question 11

defense mechanisms (11) RRRFR CIPIDDS

Answer 11

rrrfr cipidds 1. repression, 2. regression 3. reaction formation (express opposite of true impulse), 4. rationalization 5. compensation (focus on accomplishments to avoid shortcomings) 6. Introjection (swallowing others’ values), 7. projection 8. identification 9. displacement 10. denial 11. sublimation

Question 12

Stages of development (Freud)

Answer 12

Erikson (see below) vs freud psychosocial (Oral (trust), anal (independence), phallic (sexuality, approval), latency (socialization), genital (sex energy channeled into achievement))

Question 13

Goal of psychoanalytic:

Answer 13

make unconscious conscious and strengthen the ego so behavior is based on reality not instinctual cravings/irrational guilt

Question 14

Therapist Role (psychoanalytic)/Client experience/What I’m looking for:

Answer 14

Blank screen, transference relationship, notice areas of resistance/interpret for client Client experience- free association, dream interpretation, explore past and present My interests: early childhood lessons, messages received; transference relationship (who am I to him, what can I learn from it); countertransference from me; developmental tasks mastered/not and attachment style/wounds

Question 15

Individual Assessments: Depression Anxiety Trauma Substance Use Suicide Career Couples DV

Answer 15

Intake: Intake Assessment, cultural formation interview, adult plan of care, NEO FFI Depression: BDI Anxiety: BAI Trauma: TSI Substance Use: CAGE-AID Suicide- SAFE-T; assess risk/protective factors, intent, plan Career- Strong Inventory (Interest- highly researched), ONET (Values) Couples: Dyadic Adjustment Scale, Attachment hx, Experience in Close Relationships Scale, DV: Partner Violence Scale

Question 16

Terminology to Describe Assessments

Answer 16

Reliability (consistency), Validity (accuracy), Bias (culture, error, instructor), Compare with Z/T scores

Question 17

Depressive Sx (9)

Answer 17

Depressed mood (sad, tearful) Loss of interest/pleasure Feelings of worthlessness Suicidal thoughts/ideation/plan/attempt Increased/Decreased appetite/weight Insomnia or hypersomnia Fatigue or loss of energy Diminished ability to think or indecisiveness Psychomotor agitation or retardation

Question 18

MDD PDD R/O

Answer 18

MDD- 5+ sx for at least 2 weeks PDD- 2+ sx for 2 years R/O: PMDD (monthly), Substance/Medically induced (Triggers), Bipolar (Manic Ep), DMDD (Temper, Kids, 1yr)

Question 19

Anxiety Sx (6)

Answer 19

1. Restlessness or feeling keyed up or on edge.
2. Muscle tension.
3. Being easily fatigued.
4. . Sleep disturbance (difficulty falling or staying asleep, or restless, unsatisfying sleep).
5. Difficulty concentrating or mind going blank.
6. Irritability.

Question 20

1. Separation D/O
2. Mutism
3. Specific Phobia
4. Social anxiety D/O
5. Panic D/O
6. Agoraphobia,
7. GAD

Answer 20

1. Separation D/O (4 weeks in kids, 6mos in adults),
2. Mutism (1mo),
3. Specific Phobia (6mos),
4. Social anxiety D/O (6mos),
5. Panic D/O (4 panic sx + 1mo avoidance/fear),
6. Agoraphobia,
7. GAD (3+ sx, 6mo)

Question 21

R/O for Anxiety

Answer 21

OCD (1hr/day, 6mos), Body Dysmorphic D/O, Hoarding, Substance/Medical

Question 22

PTSD

Answer 22

An event 1 or more intrusion symptom 1 or more avoidance symptom 2 or more cognitive and mood symptoms 2 or more arousal and reactivity symptoms Duration of symptoms for longer than a month. Specifiers: Dissociative symptoms, Delayed expression

Question 23

Acute Stress D/O

Answer 23

(1-30 days) Intrusion Negative mood Dissociative sx Avoidant sx Arousal sx

Question 24

1. Oppositional Defiant
2. Intermittent Explosive
3. CD
4. Autism
5. ADHD

Answer 24

1. ODD (4sx, 6mo, Angry/Argumentative/Vindictive)
2. Intermittent Explosive (2 outbursts/week, 3mos)
3. CD (3 criteria in past year) Aggression to people/animals Destruction of property Deceitfulness/Theft Serious rule violation
4. Autism- social defecits, rigidity of interests/behaviors
5. ADHD- 6 sx each of inattention & hyperactivity for at least 6 mos

Question 25

Personality D/O 1. ASPD 2. BPD 3. Histrionic 4. Narcissistic

Answer 25

1. ASPD- 3sx, since age 15 2. BPD- instability of interpersonal relationships, self-image and affects, and marked impulsivity, beginning by early adulthood and present in a variety of contexts, (5+sx) 3. Histrionic- attention seeking, 5+ sx (seductive) 4. Narcissistic- Need to be admired, 5+ sx, lack of empathy

Question 26

Psychotic D/O 1. Delusional D/O 2. Brief Psychotic 3. Schizophreniform 4. Schizophrenia 5. Schizoaffective 6. Cyclothymia R/O

Answer 26

1. Delusional D/O (1 mo) 2. Brief Psychotic (1 day-1mo, 1+ sx) Delusions. Hallucinations. Disorganized speech (e.g., frequent derailment or incoherence). Grossly disorganized or catatonic behavior. 3. Schizophreniform (2+sx, 1-6 mo)/ 4. Schizophrenia (6mo+)/ 5. Schizoaffective (6mo+, +mood sx) Delusions. Hallucinations. Disorganized speech (e.g., frequent derailment or incoherence). Grossly disorganized or catatonic behavior. Negative symptoms (i.e., diminished emotional expression or avolition). R/O: Substance/Medical, OCD, Bipolar Bipolar 1 (manic ep, 3 manic sx, 1wk+)/Bipolar 2 (hypomanic ep, 4 days, less severe impairment, no psychotic sx) 6. Cyclothymia (1yr kids, 2 yr adults; hypomanic/depressive sx ½ the time, fail to meet criteria for bipolar)

Question 27

Erikson Stages

Answer 27

Infancy: Hopes — Trust vs. Mistrust Toddlerhood: Will – Autonomy vs. Shame and Doubt Preschool Years: Purpose – Initiative vs. Guilt Early School Years: Competence – Industry vs. Inferiority Adolescence: Fidelity – Identity vs. Role Confusion Young Adulthood: Love – Intimacy vs. Isolation Middle Adulthood: Care – Generativity vs. Stagnation Late Adulthood: Ego Integrity vs. Despair

Question 28

Stage Salient Tasks

Answer 28

Attachment (0-12mos) Emotion regulation (1-3) Identity/Autonomy Peer Relations Externalizing Behaviors/Internalizing Behaviors

Question 29

Yalom Curative Factors

Answer 29

Mike’s Acronym: 4I’s, 2C’s, GUD, A&E 4I’s: Instillation of Hope, Imparting Information, Imitative Behavior, Interpersonal Learning 2C’s: Catharsis, Corrective Recapitulation of the Primary Family Group GUD: Group Cohesion, Universality, Development of Socializing Techniques A&E: Altruism & Existential Factors

Question 30

Couples Ethical Issues (7) MAC RT CV

Answer 30

Multiple Relationships Avoiding Harm Confidentiality/Disclosures Clarifying Therapist Role Testimonials Competency Personal Values/Biases

Question 31

Thorough Assessment of DV includes

Answer 31

Written/Verbal, Couple/Individual ID severity & Safety, ask about a gun

Question 32

Risk Assessment of DV (4):

Answer 32

Dispositional RF (impulsive, hostile) Contextual RF (esp pregnancy, end of relationship) Historical RF Clinical RF (Substance Abuse, BPD, ASPD, NPD)

Question 33

Safety Plan

Answer 33

ID Risk is increasing Specific steps to get to safety Ways to stay safe

Question 34

Four Main Duties (DV):

Answer 34

Duty to Care- Do no harm, assess, refer, competence Duty to Protect- safety planning Duty to Warn- Tarasoff Duty to Report- child abuse Individual/Couple/Group tx

Question 35

Subpoena

Answer 35

Check for Validity Contact Client/Atty

Question 36

Retain Records:

Answer 36

10 yrs from termination

Question 37

Tarasoff:

Answer 37

Duty to protect and predict only when a.) patient has communicated w/psychotherapist b.) serious threat of physical harm c.) against a reasonable identifiable victim. Communicate to victim and police.

Question 38

DSM Cross-Cutting Measure Domains

Answer 38

1. Depression 2. Anxiety 3. Anger 4. Mania 5. Somatic Sx 6. Suicidal Ideation 7. Psychosis 8. Sleep 9. Memory 10. Repetitive Thoughts & Behaviors 11. Dissociation