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Therapeutic Alliance
- Quality of personal relationship between therapist and client that allows them to function as a team with goals
- Positive affective aspect of the relationship that allows the client to feel valued and liked
- Considered the main predictor of outcome
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Choosing to follow ESTs vs common factors is influenced by
- Insurance companies insist on use of ESTs for reimbursement
- Clients can sue if ESTs were called for but not used
- Common factors are enhanced by ESTs
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Theory
- Set of related principles that explains a group of phenomena
- Allows predictions about future
- Can be tested for accuracy
- Helps comprehension and guides action in relevant situations
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Case Conceptualization
- Theory of the person
- Organizes information
- Different from diagnosis because:
- integrates healthy, adaptive elements of client
- individualized
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Informed Consent
- Letting client know about goals, techniques, theory, fees, expectations etc. of therapy
- Young clients may need parent to sign for informed consent
- Should obtain child's assent
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Multi-Cultural Issues
- Stereotypes intended to help you become more competent in understanding clients from these groups
- Even if positive they are still stereotypes and people within the groups range far afield
- Not not knowing anything about client's cultural background is a problem but group specific cultural values and behavior may increase stereotyping
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Male Violence
- Not considered a problem inherent in male psychology
- If man hits a stranger: we ask "Why is he so aggressive and hostile?"
- If he goes home and hits his wife: we ask "Why does she stay with him?"
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Why do Group Differences matter?
- Each person exists in a web of demands
- Some are common human demands
- Some are dictated by the mainstream culture where they live
- Some are determined by the subcultures they belong to
- Some may spring from unique personal attributes
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Unconscious
Area of mental life that is outside of awareness and perception, yet still affects the way we think, feel, and behave
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Psychoanalytic Theory
- Assumes all human behavior is determined by psychic energy and early childhood experiences
- In order to make sense of a person's current behavior patterns, it is necessary to understand the behavior's roots in largely unconscious conflicts and motives
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Psychodynamic Theory
- Contends that all behavior is ultimately dependent on the interaction of two fundamental human drives: Libidinal drives-Eros
- Death drives-Thantos
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How have theories evolved?
Psychodynamic schools have prevailed and have demonstrated a general move toward humanism
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Freud's Stages of Life
- Oral (0-18mo): Exploration focused on mouth Fixation-too much talk, eating, dependency
- Anal (18-36 mo): Pleasure focused on defication in conflict with social demands Fixation-stinginess and orderliness, or impulsivity and sloppiness
- Phallic (3-6 yrs): Pleasure focused on genital area, resolved by id with same-sex parent Fixation-rebelliousness, sexual id problems
- Latency (6yrs-puberty): Pleasure focused away from sexual toward play, school, & friendship
- Genital (puberty onward): Pleasure again focused on genitals for the rest of life Mature sexual relationships and desire to reproduce, if other stages are successfully resolved
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Erikson's Stages of Life
- First year: Trust vs Mistrust
- Second year: Autonomy vs Shame and Doubt
- 3-5 years: Initiative vs Guilt
- 6 yrs-puberty: Industry vs Inferiority
- Adolescence: Identity vs Role Confusion
- Early Adulthood: Intimacy vs Isolation
- Middle Age: Generativity vs Stagnation
- Old Age: Integrity vs Despair
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Deterministic
All events including human actions and choices are fully determined by preceding events - no free will
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Drives
- sex & aggression/love & death
- (are biological and inborn)
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Oedipal/Electra Complex
Between the ages 3-6, children want the opposite-sex parent all to themselves and hate the same-sex parent for monopolizing their love object. Causes anxiety because children fear same-sex parent will find out about their wishes and punish them severely. In adjustment they id with same-sex parent so they can vicariously possess opposite-sex parent and experience less fear
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Id
- Present at birth
- Largely unconscious
- Original system of personality and primary source of psychic energy and the seat of the instincts
- Has no sense of time
- Never matures
- Is chaotic
- Ruled by pleasure principal-relentlessly driving toward personal gratification
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Ego
- Develops as the ind interacts with external world
- Largely conscious
- Acts as mediator between id and superego
- Functions under reality principle-can't act out id urges but can't live up to superego. Logically and realistically plans appropriate ways to fulfill needs. Manages by setting up defense systems and adaptations
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Superego
- Often seen as "the conscience"
- Internalized civilization message from parents
- Strives for perfection
- Rewards through feelings of pride and self-love
- Punishes through feelings of guilt and inferiority
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Anxiety
- Realistic: occurs in face of actual threat
- Neurotic: fear you won't be successful in taming id
- Moral: fear that you are offending the standards of superego
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Defense Mechanisms
Since the ego is in touch with reality it can unconsciously redefine reality to make it less threatening
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Rationalization
Create a logical reason to explain a painful experience (failed a test because it was unfair, rather than facing the fact that you didn't study enough and you are disappointed
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Reaction Formation
You act and speak in opposition to impulses you wish you didn't have (homophobia-reaction formation against own same-sex attraction)
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Repression
You forget painful experiences and situations (unconsciously)
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Regression
You behave as though you are at an earlier stage of development
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Collective Unconscious
- Holds the experience of our species throughout history
- Motivates us in certain directions
- Explains cross-cultural and ancient phenomena such as universal appeal to certain types of stories
Jung: Father of Analytical Psychology
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Archetypes
Universal characters that make up part of our personalities
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Persona
Mask we wear for the world to see
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Shadow
Unacceptable urges and desires/darker self that is usually hidden from others
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Anima
Represents feminine side of men
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Animus
Represents male side of a woman
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Self
Unifies all the others in a whole, healthy psyche - most important archetype
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Self-actualization
Living up to our full potential as individuals and members of society
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Birth Order
- The psychological make-up of the family as a whole affects the style of life established by each child
- Personality characteristics assigned according to chronological place in family
- Importance of psychological birth order
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Phenomenology
- The world is the way you see it and interpret it
- Any experience may have many interpretations
- There are no two people who will draw the same conclusions from a similar experience
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Encouragement/Discouragement
- Psychopathology equals discouragement - a feeling that oneself and the world aren't going to change, so why try?
- Major goal of therapy is to encourage the client - they must feel that change is possible and worth the effort
- Making the effort is what takes courage
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Basic Mistakes
- As children we make up reasons and principles behind what we see and they are purely or partly fictional
- These errors continue into adulthood as firm convictions about ourselves, others, and the world
- They lie behind how we interpret experience and how we choose to behave
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Insight
Superficial if it doesn't lead to a change in motivation and from there, a change in behavior
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Compensation
Inventory strong points and skills and investigate what can be done with those
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Adler's beliefs about children's behavior
(Like adults) is purposeful and can be understood by its function in the family/classroom constellation
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Dreikurs' belief about children's behavior
- Children's misbehavior can be understood in terms of its motivation - attention seeking, need for power, desire for revenge, and inadequacy
- Parents and teachers can identify children's motives by looking inside themselves for how they reacted emotionally to the child's bad behavior
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Humanistic Approach
- Centers on humans and their values, capacities, and worth
- Concerned with the interests, needs, and welfare of humans
- Emphasis on positive and constructive side
- Sees human nature as good, with inborn actualizing tendency that drives toward our highest potential &
- An organismic valuing process that leads us to prize choices that are good for us and for the peace and harmony of humanity
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Innate Striving for Self-Actualization
- We naturally move toward self-actualization
- Our distinctive potentials struggle for expression
- Capacities clamor to be used, and stop their clamor only when they are used sufficiently
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Core Conditions
- 1. Two persons in psychological contact
- 2. 1st (client) in state of incongruence being vulnerable or anxious
- 3. 2nd (therapist) is congruent or integrated in the relationship
- 4. Therapist experiences unconditional positive regard for client
- 5. Therapist experiences an empathetic understanding of client
- 6. The communication to the client of the therapist's empathic understanding and unconditional positive regard is achieved to a minimal degree
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Therapist Congruence
- Therapist must present themselves as a person
- The counselor's feelings, thoughts, and actions are not at odds, though not all thoughts and feelings are expressed
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Unconditional Positive Regard
- Warm acceptance of each aspect of the client's experience as being part of that client
- No conditions of acceptance
- Shown by respect for client and
- sympathetic rewording of what client has said and background verbalizations of "uh-huh" & "mmm-hmm"
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Locus of Evaluation
- The place you value in terms of judging your actions and motivations, successes and failures
- External: dominated by public opinion, family appraisal, and custom
- Internal: you consider the values and beliefs of others respectfully without making them your own automatically
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Fully Functioning Person
- Someone who possesses
- An openness to experience
- A trust in one's own experience
- An internal locus of evaluation
- A willingness to be in process
- Has a sense of meaning or purpose in life, and not one merely accepted from outside authority
- They accept and trust others rather than regarding them suspiciously
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The Self and Ideal Self
- A large discrepancy between what we are and what we aspire to be is a signal of low self-acceptance
- Q-sort: person sorts cards with self-descriptors into piles ranging from "Like Me" to "Not Like Me." Then client sorts cards as though they were ideal self
- Found that clients' real selves became closer to their ideal selves during client-centered therapy
- And their ideal selves moved slightly closer to their real selves
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Play Therapy
- Children may not have words to discuss their inner lives or the abstract thinking to categorize their range of feelings
- Provide psychologically safe place for open self-expression through toys
- Through observing and interacting with child, the counselor can determine the child's worries, wishes, fears, desires, and developmental struggles
- After child is comfortable, the counselor often reflects or summarizes the feelings they are nonverbally expressing
- Ultimately counselor helps the child integrate therapy experiences into real life outside of sessions
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Turning Points in Life
- We are confused and unsure about the best course of action
- Humanistic counselor can help uncover client's true desires and inner sense of direction
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Social Activism
- Carl Roger's belief in the goodness of human nature extended to world arenas in ways few other psychological theories ever have
- Was an activist for social justice and world peace, giving workshops and lectures aimed at solving interracial and international tensions
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What do Existential Psychologists believe?
That between specific problems and personality defects are always problems inherent to all human existence
Kierkegaard and Nietzshe founded Existential Psychology
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Meaninglessness
- Finding our purpose in life related to our values
- Desire to see meaning in hardships life hands us
- Must make our own life story
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Freedom
- Can have some extent of freedom even in the most restrictive circumstances (Viktor Frankl)
- Freedom of choice means taking personal responsibility for choices
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Isolation
- We are ultimately alone
- Loving relationships relieve our isolation
- See loved one as whole being not object to relieve isolation - through I/Thou relationship
- Some people unable to tolerate being alone and use others to avoid pain - through fusion
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Death
- Cannot be escaped
- Defend against the threat by belief in specialness and belief in the ultimate rescuer
- Lessen anxiety by leading a meaningful life
- Some find comfort in belief of afterlife
- Death forces us to live life with zest and creativity
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20th century existential psychologists' thought were influenced by 19th century existential philosophers
- Common themes were emphasis on:
- human emotions
- importance of subjective experience
- deep respect for individuality
- belief in free will
- importance of attempting to make sense out of life
- freely acting upon interpretation of life's meaning
- Aim for mobilizing choice, freedom, and responsibility toward a meaningful life
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Phenomenological Stance
- See people's problems as characteristics of their whole response to existence as they see it
- The same occurrence is different when perceived by different people
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Guilt as a Message
- Sins of omission
- Failure to live up to our potentialities
- Dreadful feeling of creating a self-restricted life due to fear of unknown
- Sign all is not well
- Acts as guide to action, frequently being the feeling that brings people to therapy
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Existential Therapeutic Process
- Does not progress in clear stages with identifiable transitions between them
- Beginning Stage: understand client's four worlds of self, others, nature, and spirit
- Middle Stage: identify meanings, purposes, and values; change attitudes accordingly; dissolve affect blocks
- Closing Stage: acceptance of existential dilemmas and construction of ways to have an authentic life within existential limitations; insights transferred from therapy to outside life are evaluated
- Goals: clients deal more effectively with fears and anxieties, make better use of their potentials
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Persistent Disorders
- Problems that have lasted a long time and have taken over sufferer's life come from a conviction that the self is an object without will
- Responses to meaninglessness, freedom (and accompanying responsibility), isolation, and death
- Represent choices of security over growth, no matter how uncomfortable security is to maintain
- Choices of external control - blaming things outside of self, instead of taking responsibility
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