1
Q
The Four Steps in an Enactment are?
A
- Set Up
- Initiating
- Facilitating
- Ending/Punctuating
2
Q
The 5 stages of loss are?
A
- Denial and Shock
- Anger
- Bargaining
- Depression
- Acceptance
3
Q
The 7 stages of couple development are?
A
- Romance: creating a shared vision
- Power Struggle: shifting from family of origin to new commitment
- Stability: Provisional Marital Commitment
- Productivity: Balancing Children, Work, Friends and Marriage
- Summing Up: evaluating successes and failures; creating future goals
- Long Haul: resolving conflict and stabilizing
- Old Age: supporting/enhancing each other’s struggles for fulfillment
4
Q
8 Stages of Family Life Cycle Development
A
- Between Families: establishing self
- Couple before Children: forming Marital relationship
- Child Bearing Years: replenishment versus Turning Inward
- Child Rearing Years: Individualism versus Mutual Organization
- Families with Teenagers: Companionship versus isolation
- Launching: Regrouping verses isolation
- Beyond Parenting: Rediscovery verses despair
- Retirement: Mutual aid versus Uselessness
5
Q
8 Stages of Individual Development
A
1. Infancy (0 -1) Trust versus Mistrust 2. Toddler (1-3) Autonomy versus Shame and guilt 3. Pre-school (3-6) Initiative versus Guilt 4. Middle Years (6-11) Industry versus Inferiority 5. Adolescence (12-20) Identity versus Identity Confusion 6. Young Adult (20-30) Intimacy versus isolation 7. Adulthood (30-65) Generatively versus Stagnation 8. Mature Age (65+) Integrity versus Despair
6
Q
6 Components of Family Based Services are?
A
- In Home/ In Community
- Intensive
- Comprehensive
- Coordinated
- Team Delivered
- 60 % Team / 40% individual
7
Q
7 Principles of Family Based Services are?
A
- Child centered and family focused
- Strength Based
- Collaborative
- Eco-Systemic
- Structural
- Trauma Informed Care
- Cultural competent
8
Q
Stages of Family Based Therapy
A
Stage One: building a Theraputic Alliance; joining
Stage Two: Restructuring
Stage Three: Termination
9
Q
Shapes of Families
A
- Grandparents raising grandchildren
- Blended families
- Single parent families
- Interracial families
10
Q
Developmental tasks for Single Parents
A
- Aftermath
- Realignment
- Re-establishment
- Stabilization
11
Q
Developmental stages for stepparents
A
- Entering
- Conceptualizing
- Remarriage
12
Q
Developmental tasks for grandparents raising grandchildren
A
- Role confusion
- Rule confusion
- Generational boundaries
- Hierarchy
13
Q
5 Triadic Relationships in Families
A
- Detour the Conflict
- Double Bind
- Odd Person Out
- Disengaged
- Functional
14
Q
The “Family Shape”: Common Characteristics
A
- Hierarchy
- Roles
- Rules
- Boundaries
15
Q
What is First Order Change?
A
- Addresses the problem
2. Behavioral Change
16
Q
What is Second Order Change?
A
- Addresses dynamics of the family
- Adapts to changes impacting the family
- Involves not only Behavior, but changes of the rules of the system itself.
17
Q
Cooccurring Disorder Interventions
A
- Multi Family Group Therapy
- Multidimensional Family Therapy
- Strategic Family Therapy
- Multi systemic Therapy
- Skill building (In Groups)
- Big: 12 Step Programs, Prevention Groups
- Treatment for COD, psychiatric care, etc.
18
Q
Is Eco Systemic Family Based Therapy Considered Evidence Based?
A
Yes
19
Q
Stages of Change when dealing with Substance Abuse
A
Contemplation Preparation Action Maintenance Relapse
These stages tend to overlap and tend to go back and forth.
20
Q
Stages of Abuse (Substances)
A
- Use
- Misuse
- Abuse
- Dependence/Addiction
21
Q
Stages of Recovery for Substance Abuse
A
- Stabilization
- Engagement/Motivational Enhancement
- Prolonged Stabilization
- Recovery and Rehabilitation
22
Q
Types of Boundaries
A
Ridged
Clear
Diffuse
23
Q
“3” Areas in identifying an Hypothesis
A
- Meaning
- Orientation around the problem
- Patterns of Interactions
The goal of the hypothesis is change not truth
24
Q
4 areas of Structural Change
A
Hierarchy: help the parent be successful/effective
Boundaries: what should/should not happen
Roles/Rules: how, what, where, when, why; expose alliances and coalitions
Relationships: enhance through enactment
25
Three stages of Change in therapy
Joining
Restructuring
Termination
26
General DSM V Symptoms of autism
1. Socialization problems
2. Communication and language difficulties
3. Restrictive and repetitive behaviors, interests, and/or activities. Ie., lining up objects, echolalia-repetitive behaviors, repeating things over and over again, excessive smelling or touching.
27
Detailed Autism Spectrum Disorder Symptoms
1. Repetitive Behaviors
2. Intense interest in certain topics
3. Resistance/struggles with routine changes
4. Little or inconsistent eye contact
5. Confusion with reading emotions and/or affect of others
6. Sensory sensitivity: light, textures, noises, temperature
7. Difficultly with reciprocal conversation
8. Echolalia: repeating words/phrases
9. Displaying affect that is inconsistent with emotions
10. Unusual voice tones
11. Difficultly understanding other points of view.
12. Self-stimulation behaviors
13. Need for order and routine
14. Social skills deficits
28
One of the main tools used to diagnose autism is ?
ADOS: the Autism Diagnostic Observation Schedule through Western Psych
29
Difficulties faced by autistic children
- Lack of concept of meaning
- Excessive focus on details, with limited ability to prioritize the relevance of details
- Distractibility
- Concrete Thinking
- Difficulties with combining or integrating ideas
- Difficulties with organization and sequencing
- Difficulties with generalization
- Strong impulses
- Excessive Anxiety
- Sensory/Perception abnormalities
30
Themes seen in families affected by Autism
- Grief and Loss
- Disengagement
- Enmeshment
- Triangles
- Blurred Roles/Rules
- Protection
- Family Development
- Couple Development
- Distraction due to Trauma
- Fear of Failure/Judgement
- Dependency/Insecurity (Cut Off)
- Family Life Cycle Transition and/or Developmental “Stuckness”
31
Families are impacted on various ways due to Autism
```
Emotionally
Maritally
Sibling relationships
Extended Family Support
Financially
Community relationships
```
32
Systemic Hypothesis Pattern
```
Problem/Behavior:
Child Acts Out
Because:
If he or she is the focus, it changes family dynamics or pattern
Rational/meaning:
Child is attempting to do what
```
33
A systemic hypothesis is
Taking the problem from an individual and reframing it in the context of a family system issue. This the meaning behind the problem changes.
34
Pattern Interruption process
1. ID the patterns of interaction
2. Expose the usefulness of the pattern of interaction
3. Discuss the consequences, either positive or negative if the part of interaction changes
4. Create a plan for action
5. Maintain the pattern interruption through intervention through competency by family members as part of an interactive system
35
The parent can take various positions regarding the families perspective regarding dynamics with in the home from accommodating to...
Challenging
36
An Honorable mission service various purposes such as ...
- To connect or bond
- To define a “Position”
- To Repair or mend
- as a form of healthy self-striving
- To negotiate or problem solve
- To change the dynamics of the relationship
37
Everyone has an honorable mission, it is what that causes the problem?
The Metod
38
Three types of enactments?
Spontaneous
Diagnostic
Change Inducing
39
Another name for Behavioral Health Rehabilitation Services (BHRS) is?
WRAPAROUND
40
WRAPAROUND services, also known as Behavioral Health Rehabilitation Services (BHRS) generally consist of?
A Behavioral Specialist Consultant (BSC)
A Mobile Therapist (MT)
A Theraputic Staff Support (TSS)
41
A Behavioral Specialist Consultant is and provides?
- a masters level clinician
- Develops a Special Behavior management program with family and other clinicians
- Can work in the home, school or community
42
A Mobile Therapist is a masters level clinician responsible for?
- Providing counseling to child/adolescents and his/her family
- Provided in the home or community
- An alternative to outpatient therapy
- Based on individual needs, bus focuses on thought, emotions, and behaviors
- Active child participation is required
43
A Theraputic Staff Support is a bachelor level clinician. They provide the following:
- one on one work with the child
- work with child and parents
- implements Behavioral interventions outlined in the child’s treatment plan
- help parents and child develop coping skills
- model appropriate parenting skills
- may work in the school setting
44
List 2 DSM V diagnostic criteria for ODD
1. 6 months of the same behavior
2. Inconsistent with developmental level
3. Negatively impacts work, school, family etc.
4. Prior to age 12
5. Occurs in more than one setting
6. Not due to another diagnosis
45
List 3 coping strategies that individuals with ADHD may develop.
```
Self medicate
Stealing
Drugs
Violent Behaviors
Who Cares Mentality
Withdraw
Bad is better than stupid
Blaming
Learned helplessness
```
46
List 3 secondary symptoms of ADHD.
```
Difficulties following directions
Inconsistency
Impulsively
Self centered
Emotional deregulation
Demanding
Poor attention
Fixation
Low self esteem
Problems in school
Can’t stay seated
```
47
ADHD impacts Executive Functioning in the following ways:
Don’t consider consequences
Difficulties stopping behaviors
Disorganization
Problems setting goals
48
Strategies for parents who have a child with ODD
- it is not the result of being a bad parent
- Simple commands are better
- Have short term/simple goals
- Positive reinforcement
49
Three primary tenets when working with families in family based therapy
1. Focus on the strengths the family brings to the situation
2. By the time the family gets to family based they already know what they are doing does not work
3. It is a family issue, regardless of who has the diagnosis
50
In system focused therapy the focus is on ... and not on...?
The system and not on the individual.
51
The Family Life Cycles consists of the follwing 7 stages:
```
Couples before Children
Child Bearing Years
Child Rearing Years
Families with Teenagers
Launching: Child Leaves Home
Beyond Parenting
Retirement
```
52
The Structural Map does the following four things:
Presents a visual representation of the family
Depicts hierarchy, power, proximity, distance, boundaries, subsystems. As well as the position of the team in the family.
Shows bonding and connections between family members
Assesses both strengths and weaknesses for meeting the clients needs.
53
The Timeline provides…
A Chronological History of Events
Strengths and resiliency in the family
A lense to view “Stuckness”.
Empathizing with each person’s emotional experience
Validates efforts to Cope
Reveals themes and patterns from a historical context.
54
A Family theme defines the family in context. A theme is a presentation of the family across time, and what is normal for the family. There are two types. They are…
Situational and Transitional
55
Four types of Service Networks demontrate who is in collaboration with the family.
Conflicted: parties in disagreement
Rejected: Team against the family
Blind: collaborative failures
Absent of key resources: isolated/cut off
56
Types of Hypothesises are …
Linear- casual: linking the individual to their problem
| Systemic:
57
Major tasks during the Restructuring phase of Family Based Services consist of…
Components:
Reframing: Alternative Meaning
Enactments: “Neccessary Conversations”
Creation of Boundaries: Dyadic, Triadic, and sub systems.
Desired Outcomes:
Reorganize structure
Empowerment/Competency
Team:
Directors
Flow between Central and Decentral position
58
Calls for structural changes in families are directed at…
Hierachy: helping Hierarchy be effective
Boundaries: clarifying
Roles and Rules: make explicit and expose Alliances and coalitions.
Relationships: Enhance through Enactments
Family Based Therapy
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