1
Q
What theory involves prescribing the symptom?
A
Strategic family therapy
2
Q
What theory has the intervention of honoring the pain?
A
Existential
3
Q
What type of family therapy involves enactments?
A
Structural family therapy
4
Q
What is an enactment?
A
Clients enact a typical fight in a session
5
Q
Prescribing the symptom is an intervention in what theory?
A
Strategic family therapy
6
Q
What is Prescribing the Symptom and how does it work?
A
The therapist asks the client to deliberately engage in or exaggerate the very behavior or symptom that is problematic to disrupt unhelpful patterns, create insight, or reduce resistance to change.
7
Q
Deconstructing problem-saturated stories is what type of therapy?
A
Narrative Therapy
8
Q
Narrative therapy was developed by:
A
Michael White and David Epston
9
Q
Narrative therapy is
A
A form of psychotherapy that helps people separate their identity from their problems by re-authoring their life stories
10
Q
Differentiation is..
A
the ability of an individual to maintain their sense of self while remaining emotionally connected to others, particularly in the context of relationships and family dynamics. It is a concept rooted in family systems theory, developed by Murray Bowen.
11
Q
What are the key aspects of differentiation?
A
- Emotional Regulation
- Sense of Self
- Balance of Connection and Autonomy
12
Q
What is the difference between High vs. Low Differentiation?
A
High Differentiation: Individuals can stay calm and thoughtful in emotionally intense situations, make decisions based on personal values, and maintain healthy boundaries while staying connected to others.
Low Differentiation: People are more likely to react emotionally, struggle with independence, and may become overly fused or disconnected in relationships.
13
Q
What is Solution-focused therapy (SFT)?
A
A goal-oriented approach to therapy that focuses on the present and building solutions rather than analyzing problems.
14
Q
What are the key points about Solution-focused therapy?
A
- Client-centered
- Future-focused
- Positive orientation
- Brief interventions
- Focus on exceptions
15
Q
What therapy are scaling questions most commonly used?
A
Solution-Focused Therapy
16
Q
“Ordeals” are considered a therapeutic technique primarily associated with which therapy model?
A
Strategic Family Therapy model
17
Q
In Strategic Family Therapy model, Ordeals focus on…
A
Quickly changing behavioral patterns within a family system by using sometimes challenging or paradoxical interventions to disrupt dysfunctional interaction patterns.
Eg: Before one can emotionally eat to soothe emotions, they clean a room first.
18
Q
Who developed Strategic Family Therapy model?
A
Jay Haley
19
Q
What interventions are used in Strategic Family Therapy?
A
Ordeals
reframing
paradoxical directives
joining
20
Q
Coping questions are commonly used in which therapy model?
A
Solutions-focused Therapy
21
Q
Family sculpting was developed as part of what family therapy model?
A
Satir’s Transformational Systemic Therapy (STST)
22
Q
What is family sculpting?
A
A technique that reveals family dynamics through non-verbal expression. One family member is chosen to be the “sculptor” and directs the other family members to pose in a way that represents a specific event. The sculptor may consider aspects like body language, physical proximity, and eye gaze.
For example, a therapist might ask a child to position their family as they remember it after a loss. The child’s positioning might show that they felt emotionally distant from their parents and siblings after the loss.
23
Q
Establishing a “holding environment” is primarily associated with therapy model?
A
Psychoanalytic / Psychodynamic / object relations theory
24
Q
Who developed object relations theory?
A
Donald Winnicott
25
What is establishing a holding environment?
A therapeutic space that allows an emotionally fragile or insecure person to deal with affects that might potentially be overwhelming. In therapy, the "holding environment" is created through the therapist's consistent presence, empathy, and ability to tolerate a client's difficult emotions without judgment.
26
Structural family therapy (SFT) is
a type of therapy that focuses on how family members interact with each other to improve relationships and mental health. It is based on the idea that families are capable of solving their own issues, and that rigid boundaries can prevent growth.
27
Structural family therapy (SFT) interventions include:
1. Joining and Accommodating
2. Family Mapping
3. Enactment
4. Restructuring
5. Boundary Making
6. Unbalancing
7. Reframing
28
Structural family therapy (SFT) was developed by:
Salvador Minuchin
29
Gestalt therapy is
A type of psychotherapy that helps people become more aware of themselves and their present experiences. It focuses on the whole person and what is happening in the present (what is actually happening versus what is being talked about).
The goal is to help people accept and trust their feelings and experiences, and learn to deal with life's challenges in healthier ways.
30
Key aspects of Gestalt therapy:
Focus on the present
Personal responsibility
Therapeutic relationship
Techniques
Holistic
31
Empty chair technique is common with what therapy model?
Gestalt
32
Some interventions in Gestalt therapy include:
1. Empty chair technique
2. Exaggeration
3. Dream work
4. Body awareness
5. Experimentation
33
Some interventions used in solution-focused therapy (SFT) include:
1. Scaling
2. Miracle questions
3. Exception questions
4. Reframing
5. Focus on strengths
6. Presupposing change questions
7. Develop a plan
8. Focus on problem-solving
34
The solution-focused intervention of scaling involves:
Clients rating their problem on a scale, such as 1 to 10, to help visualize and measure their progress.
35
The solution-focused intervention of Miracle questions involves:
Therapists ask questions like, "If a miracle occurred while you were asleep tonight, what changes would you notice in your life?" to help clients set goals.
36
The solution-focused intervention of Exception questions involves:
Therapists ask questions to help clients identify when they were able to overcome their problems.
37
The solution-focused intervention of Reframing involves:
Therapists help clients see their situation from a different perspective by highlighting positives and challenging negative interpretations.
38
The solution-focused intervention of Focus on strengths involves:
Therapists help clients build on their strengths and resiliencies to create solutions.
39
The solution-focused intervention of Presupposing change questions involves:
Therapists ask questions to encourage clients to think about positive changes, no matter how small.
40
The solution-focused intervention of Developing a plan involves:
Therapists help clients develop a plan to maintain their gains.
41
The solution-focused intervention of Focusing on problem-solving involves:
Therapists focus on helping clients find solutions rather than dwelling on problems.
42
Milan systemic therapy is also known as
Long-term brief therapy
43
Milan therapists closely attend to...
how client language shapes family dynamics.
44
Systemic therapies are based on
general systems theory and cybernetic systems theory.
45
General systems theory and cybernetic systems theory (systemic therapies) propose that families are...
Living systems characterized by certain principles, such as homeostasis and self-correction.
46
Homeostasis in system therapies is..
The tendency to maintain a particular range of behaviors and norms.
47
Self-correction in system therapies is...
the ability to identify when the system has gone too far from its homeostatic norm and then self-correct to maintain balance.
48
Reframing is a central technique found in most forms of systemic family therapy such as...
structural therapy and experiential family therapy.
49
The basic component in reframing in systemic family therapies is...
finding an alternative yet equally plausible explanation (categorization) for the same set of facts.
50
Reframing in systemic family therapies typically involves...
considering the role of the symptoms in the broader relational system, highlighting how it helps maintain balance (homeostasis) in the relationship.
51
True or False:
Unlike in CBT, clients are not expected to literally believe or adopt the proposed reframe.
True: it is hoped that the reframe will be "news that makes a difference." If it does not land, one should look for other potential reframes.
52
What are circular questions?
A technique used in systemic therapy to asses and make overt the overall dynamics and interactive patterns in the system without requiring the therapist to specifically name the reframe.
53
What are the five (5) forms of circular questions in systemic therapy?
1. Behavioral sequence questions.
2. Behavioral difference questions.
3. Comparison and ranking questions.
4. Before-and-after questions.
5. Hypothetical circular questions.
54
What are Behavioral sequence questions in systemic therapy?
A form of circular questions therapists use to trace the entire sequence of behaviors that constitute the problem.
55
What are behavioral difference questions in systemic therapy?
A form of circular questions therapists use when clients begin labeling people and assuming a particular behavior is part of a person's inherent personality.
56
What are comparison and ranking questions in systemic therapy?
A form of circular questions to reduce labeling and other rigid descriptions in the family. (eg. who is the most upset with Jackie has an episode? Least upset?)
57
What are before-and-after questions in systemic therapy?
A form of circular questions that help determine how a particular event affected the family dynamic. (Eg. Did you and your mom fight more or less?)
58
What are hypothetical circular questions in systemic therapy?
A form of circular questions to offer a scenario and have family members describe how each is likely to respond.
59
Circular questions are the most useful in systemic therapy. What is the most basic strategic technique?
Directives.
60
What are directives in systemic therapy?
Directives are non-linear and usually illogical directions for the family to complete a specific task, between sessions or during session, to "perturb" the systems's interaction patterns to create new interactions.
61
Systemic and strategic therapies focus solely on...
resolving the presenting problems with the therapist imposing no other goals or agendas.
62
Systemic and strategic therapists see the presenting problem as...
a relational problem, not an individual problem, specifically an interactional problem.
63
What is the general flow of systemic or strategic therapy?
1. Assess the interactional sequence and associated meanings.
2. Intervene by interrupting the interactional sequence.
3. Evaluate outcome and client response.
4. Interrupt the new pattern.
64
Describe the therapeutic relationship in systemic and strategic therapy?
1. Respecting and trusting the system
2. Adapting to client language and viewpoint
3. Neutrality
4. Irreverence
5. Manueverability
6. The one-down stance, or helplessness
7. Social courtesy
8. Collaboration
65
What is respecting and trusting the system as part of the therapeutic relationship in systemic and strategic therapy?
The therapist trusts that the system can reorganize itself without the therapist forcing change. Symptoms are never seen as indicators of individual pathology.
66
What is adapting to client language and viewpoint as part of the therapeutic relationship in systemic and strategic therapy?
The therapist tries to establish a positive trusting relationship by adapting to the clients language, communication style, and worldview.
67
What is neutrality as part of the therapeutic relationship in systemic and strategic therapy?
Therapists do not become attached to particular meanings, descriptions, or outcomes. Therapists have a pragmatic effect on the family system and does not pick sides. Neutrality is a form of irreverence.
68
What is irreverence as part of the therapeutic relationship in systemic and strategic therapy?
Irreverence refers to the relationship between the therapist and the problem (not the client). The therapist is comfident and fearless in the fact of any presenting problem which allows for the therapist to remain open, creative, and flexible in treatment.
69
What is maneuverability as part of the therapeutic relationship in systemic and strategic therapy?
Maneuverability refers t the therapist's freedom to use personal judgement in defining the therapeutic relationship such as choosing to be in an expert position or one-down stance, depending on what the client needs.
70
What is the one-down stance, or helplessness, as part of the therapeutic relationship in systemic and strategic therapy?
The therapist takes on a hopeless stance, such as "I'm not sure I can handle such a problem", to increase client's motivation and counterbalance hopelessness. When one is down, the other goes up.
71
What is social courtesy as part of the therapeutic relationship in systemic and strategic therapy?
It is the initial stage of therapy where a therapist engages i casual social conversation to make clients comfortable and reduce sense of shame.
72
What is collaboration as part of the therapeutic relationship in systemic and strategic therapy?
Reflective questions designed to facilitate client self-healing and co-create new meanings and action.
73
What steps are taken to identify the interactional sequence in systemic and strategic therapy?
1. Identify homeostasis
2. Identify the start of tension.
3. Identify the escalation and symptoms.
4. Identify the return to homeostasis.
74
Systemic and Strategic therapies are also referred to...
MRI or Milan therapies
75
What are more-of-the-same solutions in systemic and strategic therapy?
Solutions that perpetuate the problem.
76
More-of-the-same solutions in systemic and strategic therapy can be described as mishandling the problem in one of three ways.
1. Terrible simplifications (action is necessary but none is taken)
2. The utopian syndrome (action taken when it is not necessary).
3. Paradox (action is taken at the wrong level).
77
More-of-the-same solution "terrible simplifications" in systems and strategic therapy is when...
A family attempts to solve problems by denying them.
Common in addiction, marital problems, and problematic family dynamics.
78
More-of-the-same solution "the utopian syndrome" in systems and strategic therapy is when...
The family tries to change something that is unchangeable or non-existent.
Common ins depression, anxiety, procrastination, or unrealistic demands on a relationship or child.
79
More-of-the-same solution "Paradox" in systems and strategic therapy is when...
Either a first-order solution is attempted for a problem that necessitates a second-order solution (parents need to adjust parenting techniques as child ages) or second-order solution is attempted for a first-order problems (people demand attitude or personality change and are not content with behavioral change).
Common with schizophrenia, relational impasses, domestic violence, and abuse.
80
What is the tyranny of linguistics in systemic and strategic therapy?
The use of negative and positive labels that the clients take on themselves or assign to others, such as "I am depressed", "He is angry", or "The relationship is good." They leave little room for flexibility to identify times when the person is not depressed, or less depressed; the person is not angry; or there are difficult times in the relationship.
81
What are 5 ways to think about a problem in strategic therapy?
1. Involuntary versus voluntary
2. Helplessness versus power
3. Metaphorical versus literal
4. Hierarchy versus equality
5. Hostility versus love
82
True or false: Strategic therapists emphasize increasing the family's ability to love and nurture rather than dominate and control.
True. Case conceptualization focuses on a family's unsuccessful attempts to show love rather than their attempts to control.
83
What is the four-step procedure in developing goals for systemic/strategic/MRI therapy?
1. Define the problem in behavioral terms.
2. Identify attempted solutions.
3. Describe the desired behavioral change. Goals must be realistic, specific, and time-limited.
4. Develop a plan.
---Target a change is the attempted solution
---Tactic of change is to use client's own language
84
What is "joining" in structural therapy?
The crucial initial process where the therapist builds rapport, gains trust, and becomes a part of the family's system to understand its internal rules, hierarchies, and patterns from the inside out, rather than as an outsider
85
What are three different types of structural therapy?
1. Ecosystemic structural therapy
2. Intensive structural therapy
3. Functional family therapy
86
What are boundaries in structural family therapy?
Boundaries are rules for managing physical and psychological distance between family members and for defining the regulation of closeness, distance, hierarchy, and family roles.
87
What are the 3 basic types of boundaries in structural therapy?
1. Clear boundaries
2. Enmeshment and diffuse boundaries
3. Disengagement and rigid boundaries
88
What are clear boundaries structural therapy?
Clear boundaries are "normal" boundaries that allow for close emotional contact while simultaneously allowing each person to maintaining a sense of identity and differentiation.
89
What is enmeshment and diffuse boundaries in structural therapy?
Diffuse or wear boundaries allow for enmeshment. Diffuse boundaries doe not make a clear distinction between members, creating a strong sense of mutuality, and connection at the expense of individual autonomy.
90
What is disengagement and rigid boundaries in structural therapy?
Rigid boundaries lead to disengagement. Autonomy and independence are emphasized at the expense of emotional connection, creating isolation that may be more emotional than physical.
91
Name the three phases that enactments occur.
1. Observation of spontaneous interactions: use tracking or mapping of interactions.
2. The invitation: Therapist elicits a transaction/enactment
3. Redirecting alternative transactions: therapist redirects enactments to redirect behavior.
92
What are the three phases of structural therapy?
1. Join the family and accommodate to its members style (build alliance).
2. Map the family structure, boundaries, and hierarchy (evaluate and assess).
3. Intervene to transform the structure to diminish symptoms (address the problems they identified in the assessment).
93
What are the three basic principles of structural family therapy?
1. Joining - an attitude of respect, empathy, and curiosity
2. Assumptions - families assume there are no alternatives to their problem
3. The enemy - the family's certainty in their view is ultimately their enemy.
94
What are the five techniques in structural family therapy?
1. Challenge certainty - challenge repetitive patterns or take one-down stance.
2. Explore alternatives - often done with enactments
3. Content versus process - use content of communication to identify underlying process
4. Humor and metaphor - can be used to facilitate joining and challenging certainty
5. Knowledge - introduce specific topics at different levels
95
What are they key factors assessed in structural family therapy?
1. Role of symptoms in the family
2. Subsystems
3. Cross-generational coalitions
4. Boundaries
5. Hierarchy
6. Complementarity
7. Family Development
8. Strengths
96
What are three possible relationships between the symptom and the family system in structural therapy?
1. Family as ineffectual challenger of symptom -family is passive and enabling to maintain enmeshed or disengaged family structure
2. Family as "shaper" of individual's symptoms - family shapes the individuals experience and behaviors
3. Family as "beneficiary" of the symptoms - the symptoms performs a regulatory function in maintaining the family structure
97
What are subsystems in structural family therapy?
The family as a whole is considered the system where smaller groups are considered subsystems within the larger system, such as parents and children.
98
What are cross-generational subsystems in structural family therapy?
Cross-generational subsystems are when a parent and child form a subsystem against the other parent. Common in divorce. Often covert. Can includes other family members, such as grandparents.
99
What are the three basic forms of parental hierarchy in structural therapy?
1. Effective - can set clear boundaries while still maintaining emotional connection with children
2. Insufficient - often adopt permissive parenting style with enmeshed boundaries
3. Excessive - rules are developmentally too strict and unrealistic with consequences being too severe to be effective
100
What are complementary patterns in structural therapy?
Family members develop complementary roles to counterbalance each other, such as logical/emotional, overachiever/underachiever, good/bad child.
101
What are the four major stages in family development according to Structural Family Therapy?
1. Couple formation
2. Families with young children
3. Families with school-age or adolescent children
4. Families with grown children
102
What are structural therapists goals for all families?
1. Clear boundaries between all subsystems that allow connectedness and differentiation congruent with the family's cultural contexts.
2. Clear distinction between the married/couple subsystems and the parental subsystem.
3. Effective parental hierarchy and the severing of cross-generational coalitions.
4. A family structure that promotes the development and growth of individuals and the family.
103
What is the intervention "Joining and Accommodating" in structural therapy?
The therapist builds trust and rapport with the family, then adapts to their style to gain entry into the system and understand it from within.
104
What is the intervention "Family mapping" in structural therapy?
The therapist creates a visual representation of the family's structure, highlighting hierarchies, roles, boundaries, and subsystems to identify patterns of interaction.
105
What is the intervention "Enactment" in structural therapy?
The therapist prompts family members to act out their interactions in session, providing real-time observation and opportunities for immediate guidance and restructuring.
106
What is the intervention "restructuring" in structural therapy?
This involves changing the family's organization by altering interaction patterns, roles, and power dynamics to create healthier ways of relating.
107
What is the intervention "Boundary Making" in structural therapy?
The therapist helps establish clear, appropriate boundaries, either by strengthening diffuse boundaries (e.g., between parents and children) or diffusing rigid ones.
108
What is the intervention "Unbalancing" in structural therapy?
The therapist deliberately disrupts the existing family equilibrium, often by temporarily supporting one member (scapegoat) more than another or shifting alliances, to promote change.
109
What is the intervention "Reframing" in structural therapy?
The therapist offers a new, more constructive perspective on a problem or behavior, helping the family shift away from blame and toward problem-solving.
110
What are intensity and crisis inductions in structural therapy?
Intensity and crisis inductions are interventions that use affect to create structural shifts in hierarchy and boundaries with a family having trouble "hearing" the therapist with other interventions.
Intensity involves turning up the emotional heat by using voice, pacing, and word choice to break through rigid and stuck interactional patterns.
Crisis induction is used with families who chronically avoid a conflict or problem such as at dinner time with an anorexic daughter.
111
What are the four basic stages of Ecosystemic structural family therapy (ESFT)?
1. Constructing a therapeutic system
2. Establishing a meaningful therapeutic focus
3. Creating key growth-promoting experiences
4. Solidifying change and termination
112
What does the first stage of Ecosystemic Structural Family Therapy, Constructing a therapeutic system, involve?
Therapist identifies relevant parties who need to be part of treatment, including family, extrafamilial persons, caregivers, school personnel, social workers, etc.
Importance is places on joining on all the levels of hierarchy, meaning, and emotional experience at the outset of treatment.
113
What does the second stage of Ecosystemic Structural Family Therapy, establishing a meaningful therapeutic focus, involve?
The therapist generates a comprehensive assessment and develops a meaningful focus of treatment by gathering descriptions of the child from all relevant parties and asses the child's function across all social contexts.
Similar to structural therapy, the assessment and intervention processes overlap: asses, hypothesize, intervene, and then reassess.
The focus is reframing the presenting problems as "something between people" and not "something embedded in the permanent identity of the symptom-bearer" (often the child).
114
What does the third stage of Ecosystemic Structural Family Therapy, Creating Key Growth-Promoting Experiences, involve?
Creating interactional experiences for the family that challenge and dilute the power of the core negative interaction pattern, such as through enactments, boundary making, and continued reframing.
115
In Ecosystemic Structural Family Therapy, what are the essential pillars of health family functioning?
1. Increasing parental executive skills
2. Strengthening the caregiver/parental alliance
3. Increasing emotion regulation or distress tolerance individually and as a family
4. Creating age-appropriate secure attachment between parents and children.
116
What does the fourth stage of Ecosystemic Structural Family Therapy, Solidifying Change and Termination, involve?
Therapists help families develop an understanding of how these new behaviors enable them to make desired changes and help them practice new behaviors in sessions and between sessions until termination.
117
What are the five interrelated constructs Ecosystemic Structural Family Therapists use to organize their case conceptualizations?
1. Family structure
2. Core negative interactional patterns
3. Affective proximity and attachment
4. Family and individual emotional regulation and trauma
5. Individual differences and development and family development
118
What are core negative interactional patterns in Ecosystemic Structural Family Therapy?
Cyclical transactional patterns that sustain the presenting problem.
119
What do Ecosystemic Structural Family Therapists assess for in family structure?
1. Complementary roles
2. Mutual expectations with regard to daily operations and routines
3. Proximity: affective closeness and distance between members
4. Organization and regulation: boundaries, parameters, etc.
5. Power differentials between members and generations (hierarchy)
120
What are the 4 overarching goals of Ecosystemic Structural Family Therapy?
1. Resolve presenting problems and eliminate the core negative interactional pattern that sustains the presenting problems.
2. Shift developmental trajectories of children toward greater capacity for emotional self-regulation and socio-emotional intelligence.
3. Recognize patterns of interactions that promote health attachment bonds.
4. Enable family to reorganize in such a way as to increase positive and productive engagement with nurturing and growth-promoting community systems.
121
What are the four fundamental concepts of Intensive Structural Therapy?
1. Social environment - powerful change is possible by working with key people in the family's social environment
2. Isomorphism - Dysfunctional structural patterns tend to be similar in dynamic replicated at multiple levels in the social system
3. Homeostatic maintainer - Some people serve to maintain unhealthy family homeostasis through specific interaction patterns
4. Crisis induction - can be used to create more rapid change, similar to traditional structural therapy
122
What is the 5 step treatment model of Intensive Structural Therapy?
1. Gathering the members of the system
2. Generate goal and planning treatment
3. Addressing dysfunctional patterns
4. Establishing and maintaining a new organization
5. Ending therapy
123
What is the four-dimensional model of assessment in Intensive Structural Therapy?
1. Contemporary developmental pressures - identify developmental pressures and challenges on the family using the family life cycle
2. Structure - assess famil structure, focusing on boundaries, hierarchies, complementary patterns and coalitions
3. History of the system - important family events (births, deaths, losses, illnesses, etc), notice changes they may be stuck in, history of presenting problems, attempted solutions.
4. Process - identify homeostatic maintainer and transactional patterns
124
What is measured on the Intensive Structural Therapy scorecard to measure change?
1. Objectives and goals
2. Plans, such as specific interventions
3. Measures, objective and relevant psychometric scale and inventory
4. Targets: specific score or achievement within timeframe
5. Homeostatic maintainer: identify person, which is the main barrier to change
125
What is Functional Family Therapy?
An intensive, short-term family therapy model that addresses behavioral and emotional problems in youth by focusing on the family as a whole
126
In Functional Family Therapy, behavior is viewed as adaptive to serve a particular function in the system. Behaviors are viewed as attempts to achieve two basic functions:
1. Relational connection: the relative balance of closeness and independence
2. Relational hierarchy: defining who has influence and control
127
What is the primary task of the Functional Family Therapist?
Identify the function of the problem behaviors - how the behaviors maintain connection and define hierarchy - and find more effective behaviors that achieve the same basic function.
128
What are the 4 stages of development in Piaget's Cognitive development theory?
1. Sensorimotor stage (Birth to 2 years)
2. Preoperational stage (2 to 7 years)
3. Concrete operational stage (7 to 11 years)
4. Formal operational stage (12 years and up)
129
Describe the Sensorimotor stage in Piaget's Cognitive development Theory?
(Birth to 2 years): Infants learn about the world through their senses and motor skills, developing concepts like object permanence.
130
Describe the Preoperational stage in Piaget's Cognitive development Theory?
(2 to 7 years): Children begin to think symbolically and use language, but their thinking is egocentric and not yet logical.
131
Describe the Concrete operational stage in Piaget's Cognitive development Theory?
(7 to 11 years): Thinking becomes more logical and organized, but is limited to concrete events. Children understand concepts like conservation.
132
Describe the Formal operational stage in Piaget's Cognitive development Theory?
(12 years and up): Individuals can think abstractly, use deductive reasoning, and solve problems systematically.
133
What is Triangulation?
The tendency to divert conflict or anxiety by involving a third party
134
What are the 3 phases in Functional Family Therapy?
Engagement
Behavior change
Generalization
135
Who are the developers of Functional Family Therapy?
James Alexander and Bruce Parsons
136
What is the first phase of Functional Family Therapy?
Engagement and Motivation
137
Describe the first phase of Functional Family Therapy: Engagement and Motivation:
The first phase aims to:
1) develop connection with all family members
2) assess the function of problem behaviors
138
Describe the middle phase of Functional Family Therapy: Behavioral Change:
The middle phase aims to modify cognitive sets, attitudes, expectations, labels, and beliefs so the family can see how their actions are interrelated to interrupt negative interaction patterns and introduces new skills.
139
Describe the late phase of Functional Family Therapy: Generalization:
The late phase helps families generalize the skills learned in therapy to other situations and maintain positive changes.
140
In Functional Family Therapy, what is alliance?
Alliance is the personal connection between the therapist and the family that includes feeling understood and having trust in each other while in agreement on therapy goals.
141
How does a therapist use alliance in Functional Family Therapy?
Through strong alliance, the therapist helps inspire all family members to see how they can be a part of the solution and be willing to do so.
142
How do therapists facilitate engagement in Functional Family Therapy?
By using humor, demonstrating respect, sincerely attempting to understand and bringing therapeutic presence into the room by bringing non-blaming and strength-based perspectives into the conversation.
143
What two essential functions of behaviors do Functional Family Therapists focus on?
1. Relational Connection
2. Relational hierarchy
144
What is relational connection in functional family therapy?
Relational connection describes how families balance a sense of interdependence and independence.
145
What are the three ways families balance relational connection in functional family therapy?
1. High independence
2. High interdependence
3. Midpointing
146
Describe high independence as a relational connection in functional family therapy?
Families that value high independence support autonomy and independence but may risk distance and disengagement.
147
Describe high interdependence as a relational connection in functional family therapy?
Families that value high interdependence may enjoy closeness and connection but also risk enmeshment and dependency.
148
Describe midpointing as a relational connection in functional family therapy?
Families strive for a balance between high independence and high interdependence.
149
What is relational hierarchy in functional family therapy?
Relational control and influence in the relationship.
150
What are the three general patterns of relational hierarchy do families fall into in functional family therapy?
1. Parent up/adolescent down
2. Adolescent up/parent down
3. Symmetrical
151
Describe the parent up/adolescent down relational hierarchy in functional family therapy?
The parent-child relationship can have a traditional hierarchy, in which the parent has more power than the child.
152
Describe the adolescent up/parent down relational hierarchy in functional family therapy?
The adolescent has ore influence over outcomes than the parent. Rarely an appropriate arrangement.
153
Describe the symmestrical relational hierarchy in functional family therapy?
Strong democratic structure in which parents and child have similar levels of power.
154
What are the goals during the initial phase, Engagement, of functional family therapy?
1. Reduce within-family risk factors
2. Reduce blame and negativity in the family
3. Increase family alliance and family-focused view of problem
155
What are the goals during the in working phase, Behavior change, of functional family therapy?
1. Increase behavioral competencies (eg. parenting, communication, problem solving) that fit the family
2. Match these competencies to family's relational function
156
What are the goals during the closing phase, generalization, of functional family therapy?
1. Increase within context protective factors
2. Generalize
3. Support and maintain gains
157
What is cognitive restructuring in functional family therapy?
A change in the interpretations and meanings about the problem.
158
What is relational reframing in Functional Family Therapy?
Moving families from blaming one family member for the problems to helping them understand how the problem is relational; everyone plays a part in maintaining the problem behaviors.
159
What is the three-phase process for relational reframing in Functional Family Therapy?
1. Acknowledgement
2. Reattribution
3. Assess the impact of the reframe and build on it
160
Describe the acknowledgement phase for relational reframing in Functional Family Therapy?
Each person's initial position, view, understanding, and feelings are acknowledged. Therapist focuses on the client's personal experience.
161
Describe the reattribution phase for relational reframing in Functional Family Therapy?
Therapist offers a reattribution for the problem.
1. Alternative explanation
2. Metaphor
3. Humor
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Describe the assess the impact phase for relational reframing in Functional Family Therapy?
Therapist listens to the family's response to assess the "fit" and will modify as needed. Goal is to find a mutually agreeable explanation.
163
What are organizational themes in Functional Family Therapy?
They describe how the problematic behaviors are motivated by positive but misguided intentions.
164
What are Process Comments in Functional Family Therapy?
A form of diverting to draw the family's attention to the immediate interactions in the room.
165
What 2 purposes do Process Comments serve in Functional Family Therapy?
1. Interrupt the problem behavior patterns
2. Help the family become more consciously aware of the patterns.
166
What are three Parent Skill Training areas Functional Family Therapists focus on?
1. Clear expectations and rules
2. Active monitoring and supervision
3. Consistent and enforcement of behavioral contingencies.
167
What is a subset of parenting skills in Functional Family Therapy?
Mutual problem solving - helping parents and children work together to address concerns to strengthen the relationship.
168
What are the 5 typical problem solving steps in Functional Family Therapu?
1. Identify the problem (in relational terms)
2. Identify the outcome desired (in specific behavioral terms)
3. Agree on how to accomplish the goal (each person's role)
4. Identify potential obstacles
5. Reevaluation of outcomes
169
What are the commonly used strategies of conflict management in Functional Family Therapy?
1. Remaining focused on a specific issue
2. Adopting a conciliatory mind-set and willingness to talk
3. Staying oriented to the present
170
What are some issues a therapist may focus on in communication skill building in Functional Family Therapy?
1. Responsibility - each person takes responsibility for their words and communication
2. Directness - comments are directed at the intended recipient
3. Brevity - messages are kept short
4. Concrete and specific - avoid generalizations
5. Congruence - verbal and nonverbal messages match
6. Active listening
171
How do Functional Family Therapists introduce new behavior skills that fit for a particular family?
1. Matching to the problem sequence
2. Matching to the relational functions
3. Matching to organization theme
172
What are three experiential therapies?
1. The Satis Model
2. Emotionally Focused Therapy
3. Symbolic-experiential Therapy
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Who developed The Satir Model?
Virginia Satir
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What are communication/survival stances in the Satir Model?
Communication survival or coping stances developed in childhood which influence how one communications during stress
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What are the 4 communication/survival stances in Satir's Model?
1. Placator
2. Blamer
3. Superreasonable
4. Irrelevant
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What three basic realities acknowledged or minimized by communication/survival stances in Satir's Model?
1. Self
2. Other
3. Context
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In Satir's Model, what is the goal in regards to communication/survival stances?
To move people toward congruent communication to balance the needs of self and other while responding appropriately within and acknowledging context.
178
What basic reality(ies) are minimized by Placators communication/survival stance in Satir's Model?
Self - people-pleasers
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What basic reality(ies) are minimized by Blaming communication/survival stance in Satir's Model?
Other
180
What basic reality(ies) are minimized by Superreasonable communication/survival stance in Satir's Model?
Self and Other
181
What basic reality(ies) are minimized by Irrelevant communication/survival stance in Satir's Model?
Self, Other, Context
182
How can therapists connect with client's who take the Placating communication/survival stance in Satir's Model?
Through their feelings, using less directive therapy methods, requiring them to voice their own opinion
183
How can therapists connect with client's who take the Blaming communication/survival stance in Satir's Model?
By addressing their expectations through direct confrontation and helping them learn to communicate their perspectives in a respectful way.
184
How can therapists connect with client's who take the Superreasonable communication/survival stance in Satir's Model?
Logic and rules first, then somatic sensations and expectations, then feelings.
185
How can therapists connect with client's who take the Irrelevant communication/survival stance in Satir's Model?
Create safety in the therapeutic relationship so there is less need for distracting communication and utilize somatic work, touch, and physical activities.
186
Which communication stance/survival is the most difficult with slower progress?
Irrelevant
187
What are the six stages in the Satir Model?
1. Status quo
2. Introduction of foreign element
3. Chaos
4. Integration of new possibilities
5. Practice
6. New status quo
188
What is "Status Quo" stage in the Satir Model?
Stage 1: It is homeostasis that includes at least one symptomatic member
189
What is the "Introduction of foreign element" stage in the Satir Model?
Stage 2: A foreign element, such as life crisis, tragedy, or therapeutic intervention, throw the system off balance.
190
What is the "Chaos" stage in the Satir Model?
Stage 3: A new perspective creates a positive feedback loop that throws the system into a state of chaos leading to the feeling of discomfort with the family system trying to return to status quo
191
What is the "Integration of new possibilities" stage in the Satir Model?
Stage 4: The family system in interprets the new information in a meaningful way
192
What is the "Practice" stage in the Satir Model?
Stage 5: The family system develops a new set of interaction patterns
193
What is the "New Status Quo" stage in the Satir Model?
Stage 6: The state of new homeostasis does ot include a symptomatic member and allow all members to grow and flourish.
194
What are the four primary assumptions of the Satir Model?
1. People naturally tend toward positive growth
2. All people possess the resources for positive growth
3. Every person and every thing or situation impacts and is impacted by everyone and everything else.
4. Therapy is a process that involves interactions between a therapist and a client - each person is responsible for themselves.
195
What role does a therapist play in Satir's Model?
Guide
196
Who is the leader in humanistic, experiential therapies?
Carl Rogers
197
Carl Rogers based his client-centered approach on what three therapist qualities?
1. Congruence or genuinness
2. Accurate empathy
3. Unconditional positive regard
198
What is "quality of being"?
Therapeutic presence
199
What is "making contact" in the Satir Model?
Making contact refers to a series of connections both within the therapist and between the therapist and client using physical, intellectual, emotional, spiritual and spiritual resources.
200
What does "making contact" involve in Satir's model?
1. Making direct eye contact
2. Touching clients (handshakes)
3. Sitting or standing at same physical level
4. Asking each person's name and how they prefer to be called
201
What is "empathy" in Satir's model?
An accurate understanding of another's emotional reality
202
What are the central tenets of Satir's Model?
1. Making contact
2. Empathy
3. Conveying hope
4. Establishing credibility
203
What is the role of the symptoms in the system according to Satir's Model?
The symptoms always have an emotional function in the family system, even if they are consciously and logically unwanted.
204
What are problematic family dynamics in Satir's Model?
1. Power struggles
2. Parental conflicts
3. Lack of validation
4. Lack of intimacy
205
What are the family roles in Satir's Model?
1. The Martyr
2. The victim or helpless one
3. The rescuer
4. The good child/parent
5. The bad child/parent
206
What is the family life chronology in Satir's Model?
A timeline that includes major events such as births, deaths, family events, and historical events.
207
What is the survival triad in Satir's Model?
The child, mother, and father - and the quality of the relationship between all three.
208
What areas are assessed of the family functioning in Satir's Model?
1. Role of the symptom
2. Family dynamics
3. Family roles
4. Family life chronology
5. Survival triad
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What areas are assessed of the individual functioning in Satir's Model?
1. Communication/survival stances
2. Six level of experience
3. Self-worth and self-esteem
4. Mind-body connection
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What are the six-levels of experience in Satir's Model?
1. Behavior
2. Coping
3. Feelings
4. Perceptions
5. Expectations
6. Yearnings
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Which level of experience is the only visible layer in Satir's Six-levels of Experience?
Behavior
212
How do Satir therapists help clients achieve intra-psychic congruence?
Helping clients identify contradictions between the 6 levels of experience
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At the most general level, the goal of Satir's Model is transformation which is...
to achieve optimal realization of a person's full potential
214
In Satir's Model, Transformation translates into what two broad sets of practical goals for treatment planning?
1. Relational, family, or systemic goals
2. Individual goals
215
What is congruent communication in Satir's Model?
the ability to communicate authentically while responding to the needs of both self and others.
216
In Satir's Model, what are 2 examples of relationally focused goals?
1. Increase congruent communication in relationships with spouse, parent, child, etc
2. Change family rules and shoulds to general guidelines
217
In Satir's Model, what are 2 examples of individual focused goals?
1. Increase sense of self-worth and self-compassion
2. Reduce defensiveness and use of survival stances
218
What are the interventions of Satir's Model?
1. Therapist's self
2. Ingredient of an interaction
3. Facilitating emotional expression
4. Softening family roles
5. Communication enhancement
219
In the Satir Model, how do therapist's use themselves as an intervention?
Being authentically who they are provides a role model for how to communicate congruently, show the effects of increased self-actualization, and creates safe relationship.
220
What are the "ingredients of an interaction" in Satir's Model?
7 questions that provide the details of the internal communication process
221
What are the 7 questions of the "ingredients of an interaction" in Satir's Model?
1. What do I hear and see?
2. What meanings do I make of what I hear and see?
3. What feelings do I have about the meanings I make?
4. What feelings do I have about these feelings?
5. What defenses do I use?
6. What rules for commenting do I use?
7. What is my response in the situation?
222
What is "softening family rules" in Satir's Model?
Softening rigid family rules by changing them into guidelines.
223
What are the common areas of communication coaching in Satir's Model?
1. Ask clients to start statements using "I" rather than "you"
2. As client to take full responsibility for their feelings rather than blaming others (instead of "you made me feel"..."When X happened, I felt..."
3. Encourage clients to be direct and honest rather than expecting the other to read between the lines
4. Identify double binds
224
Who developed Emotionally Focused Therapy?
Sue Johnson and Les Greenberg
225
Which four theories are integrated to create Emotionally Focused Therapy?
1. Attachment
2. Experiential (Carl Jungs Person-centered)
3. Systems
226
Describe the first stage of Emotionally Focused Therapy.
The therapist identifies the couple's behavioral interactional patterns and the perceptions, emotions, and underlying attachment needs which fuel the problematic behavioral interactions.
227
Describe the middle stage of Emotionally Focused Therapy.
The therapist helps couples fundamentally restructure their interactions so that each partner is able to experience a sense of safety and connection.
228
Describe the last stage of Emotionally Focused Therapy.
The therapist helps the couple solidify the new patterns.
229
How many stages and steps are in Emotionally Focused Therapy?
3 stages and 9 steps
230
What is Stage 1 of Emotionally Focused therapy?
De-escalation of Negative Cycles
231
What are the four steps in Stage 1 of Emotionally Focused Therapy?
1. Create an alliance and delineate conflict in the attachment struggle.
2. Identify the negative interaction cycle.
3. Access unacknowledged emotions and underlying interactional positions.
4. Reframe the problem in terms of the negative cycle and attachment needs, with the cycle being the common enemy.
232
What is stage 2 of Emotionally Focused therapy?
Change interactional patterns and creating engagement
233
What are the three steps in Stage 2 of Emotionally Focused Therapy?
1. Promote indeitification of disowned attachment needs and aspects of self, integrating these into relational interactions.
2. Promote acceptance of the partner's experience along with new interaction sequences.
3. Encourage direct expression of needs and wants while strengthening emotional engagement and attachment bonds.
234
What is stage 3 of Emotionally Focused Therapy?
Consolidation and Integration
235
What are the two steps in Stage 3 of Emotionally Focused Therapy?
1. Facilitate new solutions to old problems
2. Consolidate new positions and new cycles of attachment
236
Which partner in a couple does stage 2 typically begin with?
First with the withdrawing partner and then repeated with the pursuing partner
237
What are the three primary therapeutic tasks in Emotionally Focused Therapy?
1. Creating and maintaining alliance
2. Assessing and formulating emotion (most critically attachment emotions)
3. Restructuring interactions
238
What is empathetic attunement in Emotionally Focused Therapy?
Empathetic attunement requires listening to clients, connecting what they say with the therapist's personal experience, and then staying within the client's subjective perspective.
239
What does RISSSC stand for in Emotionally Focused Therapy?
R = Repeat
I = Images
S = Simple
S = Slow
S = Soft
C = Client's words
240
Describe "Repeat" is RISSSC in Emotionally Focused Therapy.
Repeat key words and phrases that the client says.
241
Describe "Images" is RISSSC in Emotionally Focused Therapy.
Use images to capture emotion in a way that abstract words cannot
242
Describe "Simple" is RISSSC in Emotionally Focused Therapy.
Use simple words and phrases
243
Describe "Slow" is RISSSC in Emotionally Focused Therapy.
Maintain a slow pace that enables an emotional experience to unfold.
244
Describe "Soft" is RISSSC in Emotionally Focused Therapy.
Use a soft voice to soothe and encourage deeper experiencing and risk taking
245
Describe "Client's words" is RISSSC in Emotionally Focused Therapy.
Adopt client's words and phrases in a validating way
246
What is the therapist's role in Emotionally Focused Therapy?
1. Process consultant who helps the couple reprocess their emotional experiences
2. Choreographer who helps the couple restructure their relationship dance
3. Collaborator who follows and leads the therapeutic alliance
247
What is intrapsychic in Emotionally Focused Therapy?
How individuals process their experiences, particularly their key attachment-oriented emotional responses.
248
What is interpersonal in Emotionally Focused Therapy?
How partners organize their interactions into patterns and cycles.
249
What are primary emotions in Emotionally Focused Therapy?
The initial reactions to a given situation, which typically represent attachment fears and needs, such as abandoned, alone, helpless, unloved
250
What are secondary emotions in Emotionally Focused Therapy?
Emotions about the primary emotions, not the actual situation. Often takes the form of anger, frustration, or withdrawal, to avoid feeling vulnerable
251
What is the Negative Interaction Cycle in Emotionally Focused Therapy?
Typically pursue/withdraw in which the pursuer protests the separation and distance and the withdrawer creates distance to protect themself from the perceived lack of safety in the relationship
252
What are the four basic pursue/withdraw patterns in Emotionally Focused Therapy?
1. Pursue/Withdraw
2. Withdraw/Withdraw
3. Attack/Attack
4. Complex cycles
253
Describe the Pursue/Withdraw cycle in Emotionally Focused Therapy.
The most common cycle which one partner pursues and the other withdraws.
254
Describe the Withdraw/withdraw cycle in Emotionally Focused Therapy.
Couples may appear as two withdrawers. Oftentimes one partner is a burned out pursuer who has given up trying to connect due to repeated failures.
255
Describe the attack/attack cycle in Emotionally Focused Therapy.
The withdrawer turns, erupts into anger and fights when pursued and reverts back to withdrawn position.
256
Describe the complex cycle in Emotionally Focused Therapy.
Trauma survivor couples often present with complex, multiple-move cycle that involves both high levels of anxiety and avoidance.
257
What is ARE in Emotionally Focused Therapy?
Are you there for me?
A = Accesible
R = Responsive
E = Engaged
258
What are attachment injuries in Emotionally Focused Therapy?
A specific type of betrayal, abandonment, or violation of trust in a couple's relationship. One partner is in high need and the other partners fails to offer support and nurturance.
259
Describe the structure of the initial sessions of Emotionally Focused Therapy.
A joint session, followed by individual sessions with each partner and then return to regular conjoint sessions.
260
What are contraindications to Emotionally Focused Therapy?
1. Different agendas for the relationship and therapy
2. Separating couples
3. Abusing relationships
4. Untreated addiction
261
What are the goals of Emotionally Focused Therapy?
1. Create secure attachment for both partners
2. Develop new interaction patterns that nurture and support each partner
3. Increasing direct expression of emotions, especially those related to attachment needs
262
What interventions are used in the early-phase: Deescalating and Identifying the Cycle of Emotionally Focused Therapy?
1. Validation
2. Reflecting emotions
3. Tracking the cycle
4. Evocative responding
5. Empathic conjecture
263
What interventions are used in the working-phase: Restructuring Interactions the Cycle of Emotionally Focused Therapy?
1. Evocative responding
2. Empathic conjecture
3. Heightening
4. Reframing
5. Restructuring interactions (enactments)
264
What interventions are used in the Closing-phase of Emotionally Focused Therapy?
1. Validation
2. Evocative responding
3. Reframing
4. Restructuring interactions (enactments)
265
What is evocative responding in Emotionally Focused Therapy?
Phrased as reflections or questions to bypass superficial issues and identify unexpressed emotions and needed.
266
What is empathetic conjecture in Emotionally Focused Therapy?
An interpretation that addresses defensive strategies, attachment longings, and attachment fears.
267
What is heightening in Emotionally Focused Therapy?
Involves repetition, metaphors, images and enactments to heighten key emotions and interactions that play a crucial role in maintaining the couples negative cycle.
268
What are two factors that best predict heightening levels of client emotions and a successful softening event in Emotionally Focused Therapy?
1. The therapist's emotional presences
2. The therapist's corresponding evocative vocal quality.
269
What are the six key therapist content themes in the mini-theory of blamer softening events in Emotionally Focused Therapy?
1. Possible blamer reaching
2. Processing fears of reaching
3. Actual blamer reaching
4. Supporting the softening blamer
5. Processing with engaged withdrawer
6. Engaged withdrawer reaches back with support
270
What is the most critical these in the softening event in Emotionally Focused Therapy?
Processing fears of reaching
271
What are the five common obstacles to successful blamer softening in Emotionally Focused Therapy?
1. Absence of attachment base in emotional reflections
2. Attachment-related affect distance
3. Overlooking attachment-related fears
4. Internal views of self and other unacknowledged
5. Interpersonal enactment failure; no softening reach
272
What is AIRM in Emotionally Focused Therapy?
Attachment Injury Resolution Model
273
What are the three phases of AIRM in Emotionally Focused Therapy?
Phase 1. Steps 1-4: Cycle Deescalation Related to Injury
Phase 2. Steps 5-6: New Cycles of Emotional Engagement
Phase 3: Steps 7-8: Reconsolidation of Frayed Bond
274
Describe the four steps in Phase 1: Cycle Deescalation Related to Injury in Emotionally Focused Therapy.
1. Injured partner provided account of incident, including description of secondary emotions.
2 Offending partner provides account of the same incident with their description of secondary protective responses.
3. Injury partner, with the help of the therapist, unpacks the negative models of self and partner and the attachment significant of the event.
4. Offending partner, with help of the therapist, unpacks secondary emotions, negative models of self and partner, and attachment significance of event.
275
Describe the two steps in Phase 2: New Cycles of Emotional Engagement
1. Injured partner shared primary vulnerable attachment related emotional expression; this process includes an injury-specific blamer-softening process.
2. Offending partner is emotional accessible and provides vulnerable expressions of responsibility, apology, and own desire to attachment.
276
Describe the two steps in Phase 3: Reconsolidation of Frayed Bond
1. Injured party accepts apology and is receptive to the offending partner's accessibility and expression of partner's attachment needs.
2. Offending partner provides responsiveness to the injured partner's expression of attachment needs. However, even if there is forgiveness at this point, reconciliation often requires the injured party to witness behaviors that show the intention to restore trust and maintain the relationship.
277
Which two steps of AIRM in Emotionally Focused Therapy is most critical of the model?
Step 1 of Phase 2: Injured partner shares primary vulnerable attachment related emotional expression
and
Step 2 of Phase 3: Offending partner provides responsiveness to the injured partner's expression of attachment needs.
278
Who developed Symbolic-experiential therapy?
Carl Whitaker
279
What are the two battles Whitaker identified in Symbolic-experiential therapy?
1. Battle for structure
2. Battle for initiative
280
What needs to win the Battle for structure in Symbolic-experiential therapy?
The therapist, who needs to ensure the necessary structure for change is in place.
1. The necessary people attend therapy
2. Therapy occurs frequently enough to produce progress.
3. The session content and process will produce change.
281
Who needs to win the Battle for Initiative in Symbolic-experiential therapy?
The client, who must have the most investment and initiative to pursue change.
282
What is a trial of labor in Symbolic-Experiential Therapy?
An observation of how a family responds to the therapist's interventions and interactions.
283
What does the therapist try to understand during the trial of labor in symbolic-experiential therapy?
Each person's preferred family roles, beliefs about life, values within relationships, developmental and family histories, and interactional patterns.
284
What is Bowen Intergenerational Therapy?
also known as Bowen Family Systems Therapy, is a form of psychotherapy that views the family as an emotional unit and analyzes patterns of behavior, anxiety, and coping mechanisms across multiple generations to improve family relationships
285
What is Differentiation of self in Bowen's Intergenerational Therapy?
The ability to maintain a sense of self while remaining emotionally connected to the family. Higher differentiation leads to better emotional and social functioning.
286
What are Triangles in Bowen's Intergenerational Therapy?
A three-person relationship system that is formed to reduce anxiety in a two-person relationship, like a couple with a child.
287
What are the Nuclear family emotional process in Bowen's Intergenerational Therapy?
Four patterns of emotional functioning that can cause dysfunction:
1. marital conflict
2. dysfunction in one spouse
3. impairment in a child
4. emotional distance between family members
288
What is the Family projection process in Bowen's Intergenerational Therapy?
How parents transmit their emotional states and problems to their children.
289
What is the Multigenerational transmission process in Bowen's Intergenerational Therapy?
The passing of emotional issues and levels of differentiation from one generation to the next.
290
What is an Emotional cutoff in Bowen's Intergenerational Therapy?
An individual's choice to cut off emotional contact with family members to manage unresolved issues.
291
What is the Sibling position in Bowen's Intergenerational Therapy?
The impact of birth order on personality traits.
292
What is Societal emotional processes in Bowen's Intergenerational Therapy?
The impact of emotional systems on society as a whole, as families are seen as a microcosm of the larger society.
293
How does Bowen's Intergenerational Therapy work?
1. Focus on patterns
2. Use of a genogram
3. Promote self-awareness
4. Improve communication
5. Manage anxiety
294
What is the primary intervention of Bowen's Intergenerational Therapy?
Viewing, because the therapist's level of differentiation is critical to the ability to accurately "See" what is going on.
295
What are the goals of Bowen's Intergenerational Therapy?
1. Increase each person's level of differentiation
2. Decrease emotional reactivity to chronic anxiety in the system
296
What are process questions in Bowen's Intergenerational Therapy?
Questions that help clients see the systemic process or the dynamics that they are enacting.
297
What are relational experiments in Bowen's Intergenerational Therapy?
Behavioral homework assignments designed to reveal and change unproductive relational processes in families by interrupting triangulation and increasing direct communication.
298
What is Psychoanalytic family therapy?
A treatment approach that analyzes the unconscious patterns and early childhood experiences that affect current family relationships
299
What are the Core principles of psychoanalytic family therapies?
1. Unconscious influences
2. Interpersonal dynamics
3. Transference
4. Insight and correction
300
What is Unconscious influences?
Based on psychoanalytic theory, this therapy assumes that unconscious thoughts, feelings, and past experiences—particularly from childhood—drive current family dynamics and conflicts.
301
What is Transference psychoanalytic family therapy?
The therapy analyzes how past relationship patterns are projected onto current family members and the therapist, a concept known as transference and countertransference.
302
What is Interpersonal dynamics in psychoanalytic family therapy?
It examines both the individual psychic structures within each family member and the system of relationships between them.
303
What is Insight and correction in psychoanalytic family therapy?
The process involves helping family members gain insight into the roots of their problems and then using this insight to change their behavior and interactions.
304
What are the goals of psychoanalytic family therapy?
1. To help family members understand and acknowledge their conscious and unconscious dysfunctional behaviors.
2. To identify how family members project their own inner issues onto each other.
3. To promote separation-individuation, allowing family members to be healthy individuals within the family unit.
4. To uncover inner barriers that may prevent emotional support and trust between members.
5. To foster a more empathetic and supportive family environment by strengthening emotional bonds.
305
What is a holding environment in psychoanalytic family therapy?
A caring therapeutic relationships between therapist and client
306
What does contextual holding refer to in psychoanalytic family therapy?
The therapists handling of therapy arrangements: conductions session competently, expressing concern for the family, and being willing to see the entire family.
307
What does centered holding refer to in psychoanalytic family therapy?
Connecting with the family at a deeper level by expressing empathetic understanding to create a safe emotional space.
308
What is multidirectional partiality in psychoanalytic family therapy?
The guiding principle for relating to clients, that is, being partial with all members of the family.
309
What are defense mechanisms in psychoanalytic family therapy?
Automatic responses to perceived psychological threats and are often activated on an unconscious level.
310
What is splitting in psychoanalytic family therapy?
Black and white thinking; "all good" or "all bad".
311
What is projection in psychoanalytic family therapy?
Falsely attributing one's own unacceptable feelings, impulses, or wishes onto another, typically without being aware of what one is doing.
312
What is repression in psychoanalytic family therapy?
The unconscious process that occurs when the superego seeks to repress the id's innate impulses and drives.
313
What is suppression in psychoanalytic family therapy?
The intentional avoidance of difficult inner thoughts, feelings, and desires.
314
What is minimizing in psychoanalytic family therapy?
Used to reduce the intensity of a situation, protecting the person from painful and difficult-to-accept realities.
315
What is displacement in psychoanalytic family therapy?
Unconsciously redirecting intense emotion from a threatening object to a less-threatening object, such as being angry at boss and taking it out on family at home.
316
What are self-object relations in psychoanalytic family therapy?
How people relate to others based on expectations created by early experiences with primary attachment objects.
317
What are ideal objects in psychoanalytic family therapy?
An internal mental representation of the primary caretaker that is de-sexualized and de-aggressivized and maintained as distinct from its rejecting and exciting elements.
318
What are rejecting objects in psychoanalytic family therapy?
An internal mental representation of the caregiver when the child's needs for attachment were rejected, leading to anger.
319
What are exciting objects in psychoanalytic family therapy?
An internal mental representation of the caretaker formed when the child's needs for attachment were overstimulated, leading to longing for an unattainable but tempting object.
320
What are parental introjects in psychoanalytic family therapy?
the internalized negative aspects of parents, such as hearing parents critical comments in partners neutral comments
321
What are Ledger of Entitlements and Indebtedness in psychoanalytic family therapy?
Also known as ledger of merits; an internal accounting of what you believes is due to you and what you owe others.
322
What are entitlements in psychoanalytic family therapy?
"Ethical guarantees" to merits that are earned in the context of relationships, such as parents expecting children to take care of them when they are old or sick.
323
What are destructive entitlements in psychoanalytic family therapy?
When children do not receive the nurturing to which they are entitled and later project this loss onto the world, which they see as their "Debtors".
324
What is a revolving slate in psychoanalytic family therapy?
A destructive relational process in which one person takes revenge (or expects entitlements) in one relationship based on relational transactions in another relationship.
325
What are invisible loyalties in psychoanalytic family therapy?
Ties or loyalties to family of origin which may block commitment in a current relaitonship.
326
What are split loyalties in psychoanalytic family therapy?
When a child feels forced to choose one parent over another due to mistrust between caregivers
327
What are transgenerational legacies in psychoanalytic family therapy?
A transgenerational mandate that links the endowments of the current generation to its obligations to future generations
328
What are the common interventions in psychoanalytic family therapy?
1. Listening Interpreting, and Working through
2. Eliciting
3. Detriangulating
4. Family-of-origin therapy
329
What is Integrative Behavioral Couples Therapy (IBCT)?
IBCT is an evidence-based couples therapy that integrates traditional behavioral interventions with strategies that promote emotional acceptance between partners.
330
Who developed IBCT?
Andrew Christensen and Neil S. Jacobson.
331
What are the two primary therapeutic goals of IBCT?
Acceptance of unresolvable differences and behavior change where possible.
332
How does IBCT differ from Traditional Behavioral Couples Therapy (TBCT)?
IBCT emphasizes emotional acceptance in addition to behavior change, focusing more on how partners respond to and understand each other’s vulnerabilities rather than just solving problems.
333
What is empathic joining in IBCT?
A technique that helps partners share painful emotions in a way that promotes empathy rather than blame.
334
What is unified detachment?
A CBT-informed strategy that helps couples step back and view their conflict objectively as a pattern, rather than as personal attacks.
335
What is tolerance building in IBCT?
Helping partners respond more effectively to remaining differences through increased resilience and perspective-taking.
336
What are the four common themes that IBCT uses to conceptualize couples' conflicts?
(1) Closeness/Distance
(2) Control/Power
(3) Acceptance/Recognition
(4) Integrity/Autonomy
337
What is a central assumption of IBCT?
Many couples’ problems stem from natural differences and behavioral patterns that escalate, rather than malicious intent.
338
What is the structure of the IBCT assessment phase?
1 joint session, two individual sessions, then a feedback/formulation session.
339
What is the DEEP formulation in IBCT?
A framework for case formulation including:
D = Differences
E = Emotional sensitivities
E = External stressors
P = Patterns of interaction
340
What is a behavior exchange intervention?
Encouraging partners to engage in positive, enjoyable behaviors together to increase warmth and reinforcement.
341
What communication skills are commonly taught in IBCT?
Softened start-ups, validation, active listening, and expressing primary emotions rather than secondary/blaming emotions.
342
What does the term polarization process mean in IBCT?
A cycle in which partners’ attempts to change each other cause them to become more extreme in their positions.
343
What is a "softened" emotional expression in IBCT?
Sharing hurt or vulnerability instead of anger or criticism, to reduce defensiveness and increase connection.
344
What is the goal of acceptance work in IBCT?
To help couples reduce futile conflict and respond with compassion and flexibility to ongoing differences.
345
What role does functional analysis play in IBCT?
It identifies triggers, behaviors, and consequences that maintain negative interaction cycles.
346
What are examples of acceptance techniques in IBCT?
Empathic joining, unified detachment, and tolerance building strategies.
347
What types of problems is IBCT useful for?
Chronic interpersonal patterns, emotional disconnection, communication problems, betrayal recovery, parenting conflict, and blended family stress.
348
What are the two types of change emphasized in IBCT?
Acceptance-based change and behavioral/skill-based change.
349
What is existential therapy?
A therapy approach focused on helping clients confront fundamental issues of existence—such as meaning, freedom, isolation, and mortality—to live more authentically.
350
Existential therapy: What are the four “givens” of human existence according to existential therapy?
Death, freedom, isolation, and meaninglessness (Yalom’s existential givens).
351
What is the goal of existential therapy?
To help clients discover meaning, take responsibility, and live with greater authenticity and purpose.
352
What does existential therapy believe about anxiety?
Anxiety is a natural part of existence that signals freedom, responsibility, and the need to make choices.
353
What is existential guilt?
The guilt that arises when a person avoids their potential, fails to choose, or lives inauthentically.
354
What is “authenticity” in existential therapy?
Living in alignment with one’s values, choosing freely, and taking responsibility for one’s existence.
355
How does existential therapy view freedom?
As the ability—and burden—to make choices that shape one’s life.
356
What is the therapeutic stance in existential therapy?
A collaborative, present-focused, empathic exploration of the client’s experience, not technique-driven.
357
What is phenomenology in existential therapy?
Exploring the client’s subjective experience without imposing interpretation or judgment.
358
What does existential therapy believe about the search for meaning?
Meaning is something each person creates through choices, relationships, and values.
359
What is Viktor Frankl’s major contribution to existential therapy?
Logotherapy: the idea that meaning-making is central to human survival and well-being.
360
What is the role of the therapist in existential therapy?
A genuine partner who helps clients examine choices, values, and existential concerns.
361
What is existential isolation in existential therapy?
The reality that each person is fundamentally alone in experiencing the world and making choices.
362
What is the existential perspective on death?
Awareness of death sharpens appreciation of life and clarifies what truly matters.
363
Does existential therapy focus more on the past or present?
Primarily on the present—what the client is experiencing right now.
364
How does existential therapy view symptoms?
As signals of deeper existential conflict or avoidance, not simply as disorders to eliminate.
365
What is “existential choice” in existential therapy?
The idea that humans constantly create their lives through conscious and unconscious decisions.
366
What techniques are used in existential therapy?
Dialogue, reflection, meaning exploration, phenomenological inquiry—not structured or manualized techniques.
367
What is phenomenological exploration in existential therapy?
Carefully exploring the client’s lived experience without imposing interpretation or judgment.
368
Does existential therapy use manualized techniques?
No. It is not technique-driven; interventions are tailored to the client's lived experience and meaning-making.
369
What is meaning-making work in existential therapy?
Helping clients explore sources of purpose, values, and significance in their lives.
370
What is a values exploration intervention in existential therapy?
Guided reflection to help clients identify core values that can direct choices and actions.
371
What is responsibility re-engagement in existential therapy?
Encouraging clients to acknowledge their capacity to choose and contribute to their life circumstances.
372
What is death awareness / mortality exploration in existential therapy?
A therapeutic discussion that increases awareness of life’s finiteness to clarify priorities and deepen meaning.
373
What is dereflexion (Logotherapy technique) in existential therapy?
Redirecting attention away from obsessive self-focus toward engagement with meaningful activity or relationships.
374
What is paradoxical intention (Logotherapy technique) in existential therapy?
Encouraging clients to intentionally engage in or exaggerate a feared thought or behavior to break anxiety cycles.
375
What is narrative meaning reconstruction in existential therapy?
Helping clients rewrite life stories in ways that emphasize agency, meaning, and resilience.
376
What is a here-and-now relational focus in existential therapy?
Using the therapeutic relationship as a living example of authenticity, choice, responsibility, and interpersonal meaning.
377
What is Adlerian therapy?
A holistic, goal-oriented therapy emphasizing social interest, purposeful behavior, and the client’s ability to shape their life.
378
What is Adler’s view of human behavior?
Behavior is purposeful and goal-directed, reflecting an individual’s attempts to overcome feelings of inferiority and strive for significance.
379
What is the primary motivating force in Adlerian theory?
The striving for superiority or striving for significance.
380
What is inferiority in Adlerian psychology?
A universal human experience that motivates growth and mastery when handled constructively.
381
What is an inferiority complex in Adlerian?
When feelings of inferiority become overwhelming and lead to avoidance, insecurity, or dysfunctional behavior.
382
What is social interest (Gemeinschaftsgefühl) in Adlerian?
A sense of community belonging, contribution, empathy, and concern for the welfare of others.
383
What is the lifestyle in Adlerian theory?
The unique, patterned way a person approaches life, developed in early childhood based on private logic and family experience.
384
What is private logic in Adlerian?
An individual’s internal beliefs and assumptions that may differ from common sense or socially useful perspectives.
385
What is the Adlerian position on birth order?
Birth order influences development, personality tendencies, and coping strategies, though not deterministically.
386
What is the Adlerian view of symptoms?
Symptoms serve a purpose and reflect the person’s lifestyle and goals, not random pathology.
387
What are the four phases of Adlerian therapy?
1) Relationship building
2) Lifestyle assessment
3) Insight/Interpretation
4) Reorientation/Reeducation
388
What is the main assessment tool in Adlerian therapy?
The lifestyle assessment, including family constellation and early recollections.
389
What is a family constellation interview in Adlerian?
An exploration of birth order, sibling relationships, family values, and early dynamics influencing lifestyle.
390
What are early recollections (ERs) in Adlerian?
First memories that reveal themes, beliefs, and patterns that shape a client’s lifestyle and private logic.
391
What is the purpose of interpretation in Adlerian therapy?
To help clients gain insight into lifestyle patterns, mistaken beliefs, and self-defeating strategies.
392
What is encouragement in Adlerian therapy?
The central therapeutic intervention: affirming capability, effort, and progress to foster courage and social interest.
393
What is a reorientation intervention in Adlerian?
Guiding clients to adopt new behaviors aligned with social interest and more adaptive goals.
394
What is acting “as if” in Adlerian?
An intervention where clients behave as if they already possessed the desired qualities or solutions.
395
What is the push-button technique in Adlerian?
Teaching clients that they can influence emotions by choosing thoughts/images associated with desired feelings.
396
What is spitting in the client’s soup in Adlerian?
A technique that spoils the usefulness of a self-defeating behavior by revealing its hidden purpose.
397
What is catching oneself in Adlerian?
Helping clients become aware of maladaptive patterns as they occur, so they can choose alternate responses.
398
What is natural/logical consequences in Adlerian work (especially with parenting)?
Letting clients or children learn responsibility through realistic outcomes of their actions.
399
What are task assessments / task setting in Adlerian?
Reframing life challenges as tasks and clarifying who owns the task, promoting boundaries and responsibility.
400
What is the goal of Adlerian dream work?
To understand dreams as reflections of current lifestyle and problem-solving attempts, not symbols of the unconscious.
401
What types of concerns is Adlerian therapy well-suited for?
Identity and self-esteem issues, relationship and parenting work, school and behavior concerns, career and life transitions.
402
What is Dialectical Behavior Therapy (DBT)?
An evidence-based cognitive-behavioral therapy integrating acceptance and change strategies, designed initially for chronic suicidality and borderline personality disorder.
403
What does the term dialectical mean in DBT?
The synthesis of opposites—holding two seemingly opposing truths at once (e.g., acceptance and change).
404
What is the DBT biosocial theory?
Emotion dysregulation develops from the interaction of biological emotional sensitivity and an invalidating environment.
405
What are the primary treatment targets in DBT (in order)?
1) Life-threatening behaviors
2) Therapy-interfering behaviors
3) Quality-of-life interfering behaviors
4) Skills acquisition
406
What are the four DBT skills modules?
1. Mindfulness
2. Distress Tolerance
3. Emotion Regulation
4. Interpersonal Effectiveness
407
What is wise mind in DBT?
The synthesis of emotion mind and reasonable mind, representing inner wisdom and balanced decision-making.
408
What is validation in DBT?
Communicating that a person’s thoughts or feelings make sense within their context, even if the behavior must change.
409
What is the role of behavior chain analysis in DBT?
To assess triggers, vulnerabilities, thoughts, emotions, and consequences leading to a target behavior.
410
What is the role of phone coaching in DBT?
To help clients apply DBT skills in real-life, high-risk moments.
411
What are the core mindfulness skills in DBT?
What Skills: Observe, Describe, Participate
How Skills: Nonjudgmentally, One-mindfully, Effectively
412
What is the purpose of distress tolerance skills in DBT?
To help clients survive emotional crises without making things worse.
413
Name the four major distress tolerance skills categories in DBT.
TIPP
ACCEPTS
Self-soothe
Pros/Cons.
414
What does TIPP stand for in DBT?
T = Tip the temperature
I = Intense exercise
P = Paced breathing
P = Paired muscle relaxation.
415
What does ACCEPTS stand for in DBT?
A = Activities
C = Contributing
C = Comparisons
E = Emotions
P = Pushing away
T = Thoughts, Sensations.
416
What is the purpose of emotion regulation skills in DBT?
To reduce vulnerability to intense emotions and increase emotional resilience.
417
What are the three major emotion regulation skill sets in DBT?
Check the Facts
Opposite Action
PLEASE (reduce vulnerability).
418
What does PLEASE stand for in DBT?
--Treat Physical illness
--Balanced Levels of eating
--Avoid Excessive mood-altering substances
--Balanced Sleep, Exercise.
419
What is the purpose of interpersonal effectiveness skills in DBT?
To build and maintain relationships, assert needs, and maintain self-respect.
420
What are the DEAR MAN interpersonal effectiveness components in DBT?
Describe
Express
Assert
Reinforce
Mindful,
Appear confident
Negotiate.
421
What are the GIVE skills used for in DBT?
To maintain relationships: Gentle
Interested
Validate
Easy manner
422
What are the FAST skills used for in DBT?
To maintain self-respect: Fair
Apologies (few)
Stick to values
Truthful
423
What is radical acceptance in DBT?
Fully accepting reality as it is, without approval, to reduce suffering caused by resistance.
424
What is opposite action in DBT?
Acting opposite to an unjustified emotion to change the emotional experience.
425
What is self-soothing in DBT?
Using the five senses to comfort and ground oneself in distress.
426
What types of problems is DBT most effective for?
Borderline personality disorder, chronic suicidality, self-harm, PTSD, emotion dysregulation, eating disorders, and substance use disorders.
427
Founder of Rational Emotive Behavior Therapy
Albert Ellis (1950s)
428
Central premise of REBT
People are not disturbed by events themselves but by their beliefs about those events.
429
What does the ABC model stand for in REBT?
A = Activating Event
B = Beliefs
C = Consequences (emotional/behavioral)
430
What does the D and E stand for in the extended ABC model in REBT?
D = Disputing irrational beliefs
E = Effective new philosophy/beliefs
431
Types of beliefs targeted in REBT
Irrational beliefs including demands, awfulizing, low frustration tolerance, and global evaluations of self/others.
432
Three core irrational beliefs Ellis identified in REBT
I must do well and win approval or I'm worthless.
Others must treat me kindly and fairly.
Life must give me what I want and be easy.
433
REBT view of emotions
Emotions are influenced by beliefs. Changing beliefs changes emotional reactions.
434
Main goal of REBT
To replace irrational, self-defeating beliefs with rational, self-helping beliefs.
435
Additional goals of REBT
Reduce unhealthy negative emotions (e.g., anxiety, shame)
Improve problem-solving and coping skills
Accept self, others, and life unconditionally
436
What is Unconditional Self-Acceptance in REBT?
Viewing oneself as inherently worthwhile, regardless of mistakes or imperfections.
437
What is Unconditional Other-Acceptance in REBT?
Accepting that others are fallible and not globally rating them as "good" or "bad."
438
What is Unconditional Life-Acceptance in REBT?
Accepting that life is not always fair or comfortable, and you can still pursue value and meaning.
439
What is cognitive disputation in REBT?
Directly questioning and challenging irrational beliefs (e.g., evidence, logic, usefulness).
440
Behavioral techniques in REBT
Exposure exercises
Homework assignments
Behavioral activation
Skill building and practice
441
Emotive techniques in REBT
Rational-emotive imagery
Shame-attacking exercises
Role-playing
Humor to reduce self-seriousness
442
What are Shame-Attacking Exercises in REBT?
Practicing potentially embarrassing behaviors to challenge fear of disapproval and promote self-acceptance.
443
What is Rational–Emotive Imagery?
Visualizing a distressing event while practicing rational, healthy emotional responses.
444
Common disputation questions used in REBT
Where is the evidence?
Is this belief logical?
Is this belief helping me or hurting me?
445
Summary of REBT focus
Identify irrational beliefs → Dispute them → Replace with rational beliefs → Increase healthy emotions and behaviors.
446
CA LMFT Clinical Exam
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