Group Therapy Overview
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Questions and Answers

What is the primary focus of most group therapy approaches?

  • Interpersonal interaction (correct)
  • Psychodynamic exploration
  • Cognitive restructuring
  • Behavioral modification

    • Which of these is NOT a therapeutic factor in group therapy?

  • Instillation of hope
  • Universality
  • Development of socializing techniques
  • Cognitive reframing (correct)

    • How does the therapeutic factor of universality work in group therapy?

  • Clients realize they are not alone in their struggles. (correct)
  • Clients learn new information about their condition.
  • Clients practice new communication skills in a safe environment.
  • Clients develop stronger connections with the therapist.

    • What is the ideal group size for group therapy?

    <p>5-10 members (C)</p> Signup and view all the answers

    What is the main goal of practicing relationship skills within a group therapy context?

    <p>To generalize these skills to improve relationships outside the group. (C)</p> Signup and view all the answers

    What does the text mean when it refers to the group as a "social microcosm" for each client?

    <p>The group is a representation of the client's real-life relationships. (A)</p> Signup and view all the answers

    Which of these is NOT a characteristic of the "here-and-now" focus in group therapy?

    <p>Encouraging discussion of past experiences and relationships. (D)</p> Signup and view all the answers

    Who is a prominent figure in the interpersonal approach to group therapy?

    <p>Irvin Yalom (D)</p> Signup and view all the answers

    What is the complete state model of mental health and illness, according to Keyes and Lopez (2007)?

    <p>A model that describes the four states of mental health: flourishing, struggling, languishing, and floundering. The model is characterized by two dimensions: subjective well-being and psychopathology. (A)</p> Signup and view all the answers

    What is the main difference between a clinical diagnosis and a clinical psychological assessment?

    <p>A clinical diagnosis focuses on identifying the specific disorder, while a clinical psychological assessment focuses on understanding the individual and the factors contributing to their problems. (B)</p> Signup and view all the answers

    What does a psychologist need to understand beyond a clinical diagnosis in order to effectively address a client's problem?

    <p>The underlying causes and contributing factors to the problem. (A)</p> Signup and view all the answers

    What is a major criticism of the DSM diagnostic system, according to the text?

    <p>The DSM-5-TR provides a label but does not offer insights into the underlying causes of a mental health problem. (D)</p> Signup and view all the answers

    Which of the following is NOT mentioned as a major classification system used for clinical diagnosis?

    <p>APA-6 (American Psychiatric Association) (A)</p> Signup and view all the answers

    What is the primary goal of a clinical psychological assessment?

    <p>To understand the individual's problems and the factors contributing to them. (D)</p> Signup and view all the answers

    What is the purpose of using intelligence and personality assessments in clinical psychology?

    <p>To provide a more comprehensive understanding of the individual's mental health. (A)</p> Signup and view all the answers

    What does the author suggest is the primary difference in the way a psychiatrist and a psychologist might approach a client's depression?

    <p>A psychiatrist focuses on medication, while a psychologist explores the underlying causes. (B)</p> Signup and view all the answers

    What does resilience primarily refer to in a psychological context?

    <p>Psychic resistance to stressors and adversity (A)</p> Signup and view all the answers

    Which of the following is a characteristic that contributes to resilience?

    <p>Stable relationships with primary individuals (D)</p> Signup and view all the answers

    Which of the following statements about stress is accurate?

    <p>Stress involves a perception of threat that impacts well-being (B)</p> Signup and view all the answers

    Which concept is NOT directly related to resilience?

    <p>Chronic procrastination (B)</p> Signup and view all the answers

    What is considered a dynamic protective factor in resilience?

    <p>Social support outside the family (D)</p> Signup and view all the answers

    According to the complete state model of mental health and illness, what term describes individuals who experience high psychopathology but low subjective well-being?

    <p>Struggling (A)</p> Signup and view all the answers

    Which of the following best describes 'self-efficacy' in the context of resilience?

    <p>Believing that one can achieve difficult tasks (D)</p> Signup and view all the answers

    What characteristic is NOT a part of the complete state model of mental health?

    <p>Increased social isolation (A)</p> Signup and view all the answers

    What is a key difference between circular causality and linear causality in family therapy?

    <p>Circular causality suggests that events influence each other reciprocally. (A)</p> Signup and view all the answers

    Which statement best describes the functionalism of symptoms in family systems?

    <p>Symptoms may serve an adaptive purpose for the family. (D)</p> Signup and view all the answers

    What is the primary aim of group therapy?

    <p>To enable clients to meet and resolve interpersonal problems together. (D)</p> Signup and view all the answers

    What distinguishes the family life cycle in family therapy?

    <p>It encompasses seven distinct stages of family development. (B)</p> Signup and view all the answers

    Which of the following is NOT a recognized stage in the family life cycle?

    <p>Families with elderly parents. (B)</p> Signup and view all the answers

    Which of the following is NOT considered a part of the helping relationship?

    <p>Yoga instructor (D)</p> Signup and view all the answers

    What is a key ethical essential in psychological helping relationships?

    <p>Client harm prevention (C)</p> Signup and view all the answers

    Which factor is crucial for the effective assessment of psychological issues?

    <p>Empathy and understanding (B)</p> Signup and view all the answers

    What is meant by 'post-traumatic growth' in the context of psychological help?

    <p>A beneficial life change resulting from overcoming trauma (A)</p> Signup and view all the answers

    Which of the following statements best describes the subjective experience of a problem in therapy?

    <p>Clients must express concern about their behavior or feelings. (C)</p> Signup and view all the answers

    What does it mean to treat difficulties as a problem to be solved in therapy?

    <p>Viewing them as opportunities for personal growth and change (C)</p> Signup and view all the answers

    Which criteria indicates that a client is ready to receive psychological help?

    <p>Demonstrating right motivation towards change (D)</p> Signup and view all the answers

    Which of the following is a common psychological disturbance leading to the need for specialized help?

    <p>Sudden, inappropriate behaviors (A)</p> Signup and view all the answers

    What are stressors?

    <p>Internal or external stimuli for which there is no ready adaptive response (A)</p> Signup and view all the answers

    Which of the following best describes eustress?

    <p>Positive experiences that promote well-being (C)</p> Signup and view all the answers

    What is the role of primary appraisal in stress experiences?

    <p>It is an initial evaluation of threat level and relevance of an event (D)</p> Signup and view all the answers

    Which statement best reflects the concept of resources in the context of stress?

    <p>Resources are objects and personal characteristics essential for survival (D)</p> Signup and view all the answers

    How does culture influence stress experiences?

    <p>Cultural factors shape the appraisal of events and stressors (A)</p> Signup and view all the answers

    Which type of stress is referred to as ambient stress?

    <p>Chronic negative conditions embedded in the environment (D)</p> Signup and view all the answers

    What is secondary appraisal focused on?

    <p>Evaluating one's coping resources and options against the stressor (A)</p> Signup and view all the answers

    What is the main relationship between control and stress?

    <p>The perception of control creates stress but can also alleviate it (A)</p> Signup and view all the answers

    Study Notes

    Lecture 1-2: Foundations of Clinical Psychology

    • Lecture 1-2 covered the foundations of clinical psychology, delivered by Anna Gabińska, Ph.D.
    • The course organization includes syllabus, Google Classroom, and consultations. A Clinical Psychology Club Facebook group is available.

    Lecture Overview

    • The lecture overview covered foundations of clinical psychology, including:
      • Historical overview of clinical psychology.
      • Defining clinical psychology, areas of interest, and tasks.
      • Relationships between clinical psychology and other disciplines.
      • Empirical basis of psychological practice.
      • The scientist-practitioner model.

    What is Clinical Psychology?

    • Clinical psychology integrates science, theory, and practice to understand, predict, and alleviate maladjustment, disability, and discomfort.
    • The field promotes human adaptation, adjustment, and personal development.
    • Lightner Witmer (1907) defined clinical psychology as the study of individuals through observation and experimentation to promote change.
    • Clinicians combine research knowledge of human responses and mental processes with assessment to treat individuals.
    • Focus is on examining human behavior, personality characteristics, and psychopathology.
    • Clinical psychology focuses on cognitive, emotional, social, behavioral, and biological contributors to human functioning across the life span, in varying cultures, and at all socioeconomic levels.
    • Clinicians differ from other psychologists in their approach to human beings.

    Intro to Clinical Psychology

    • Different theoretical orientations are used in clinical psychology.
    • Different approaches have varying ideas on the causes of psychological disorders.
    • Most psychological disorders are caused by multiple factors (biopsychosocial model).
    • Treatment is shaped by the understanding of the causes of the problem.
    • Eclectic approaches combine ideas from various psychological approaches.

    Clinical Psychology vs. Psychiatry

    • Clinical Psychologists learn to think as researchers, evaluate findings, defend views using data, and view clients' problems in a multivariate way.
    • Psychiatrists, are physicians who learn facts to understand and treat patients, focusing on biological aspects.
    • Both diagnose and use therapy, but psychotherapy training is more emphasized for clinical psychologists.
    • Counseling Psychology: Most similar to clinical psychology, with similar training, focusing on adjustment in healthy individuals; historically in university counseling centers; now expanded to private practice.
    • Psychotherapy/Coaching: Unregulated, anyone can offer services; requires licensing, but not necessarily formal training. Clinical psychologists can conduct psychological assessments.
    • Social Work: Focused on working with disadvantaged populations in diverse settings (e.g., social security, housing, foster care); emphasizes therapy but lacks diagnostic training or research emphasis; Master of Social Work (MSW) is the typical degree.

    Clinical Psychology Specializations

    • The lecture lists various specializations in clinical psychology, including adult disorders (diagnosis, psychotherapy, rehabilitation, substance abuse); child and adolescent health, neuropsychology, geropsychology, community psychology, forensic psychology, and psychoanalysis.

    What do Clinical Psychologists Do?

    • Conduct research on human behavior and mental processes.
    • Make psychological assessments.
    • Use therapy to treat mental problems and disorders.
    • Teach as faculty.
    • Provide consultation.
    • Work in administration.
    • Develop/engage in/direct health promotion programs.
    • Develop/engage in/direct prevention programs.

    Significance of Research

    • Psychology hasn't always been viewed as a purely scientific discipline, particularly its clinical branch, which has been frequently referred to as an art form.
    • Recent association with cognitive sciences and more prevalent scientific methods are not always appreciated or adopted by all psychologists, who often hold a more humanistic approach.
    • There is conflict between research psychologists and practicing clinicians.
    • The notion of pseudoscience in psychology is important to consider because of its misuse in different contexts (by various occupations and fields, amongst professionals, etc.).

    Significance of Research (continued)

    • Psychological disorders are real problems affecting real people.
    • Research into the causes and treatment of psychological disorders is crucial.
    • Differentiating science from pseudoscience is essential.
    • Popular books and websites might falsely claim specific traits are present or common in certain populations. (e.g., adult children of alcoholics don't have unique traits, based on research).
    • Handwriting analysis is not a valid method for psychological assessment.

    Significance of Research (continued)

    • Psychiatric medication use has increased relative to psychological interventions.
    • Building evidence for insurance and policy makers of effective psychological interventions.
    • Cathartic technique (releasing emotions/venting anger) is used in therapy but may paradoxically intensify negative emotions with prolonged use
    • Limitations of the cathartic technique exist, including personality tendencies, anger expression, bereavement, and immediate debriefing after traumatic events.

    Interested?

    • Relevant research on emotional coping in psychotherapy by Trzebińska & Gabińska (2015).

    The Scientist-Practitioner Model

    • The call for clinical psychologists to be scientists goes back to early days of the field of psychology.
    • Witmer (1907) argued that pure and applied sciences advance as one; progress in one (e.g., pure science) fostering progress in the other.
    • The Boulder Conference (1949) formulated the Scientist-Practitioner Model.

    Main reasons for "joint" training as scientists and practitioners

    • To help students develop interests in both research and practice despite most concentrating on one or the other in their careers.
    • Addressing assumed narrowness of thinking and rigidity of action if specializing only in research or practice.
    • Enhanced knowledge of clinical issues by direct involvement in clinical work by researchers—leading to increased study of these issues.

    Why are clinical psychologists required to engage in research?

    • To effectively and critically evaluate published research on assessment methods and treatments.
    • To objectively evaluate their own treatment methods.
    • To expertly assess the effectiveness of the agency's programs—especially within community mental health centers.
    • To supervise and mentor students in research programs.

    What are Evidence-Based Practices?

    • Interventions that show scientific evidence of beneficial client outcomes.
    • A scientific alternative to authority-based practice (appealing to famous people, popularity, tradition, or consensus).

    The Pyramids of Evidence

    • Illustration of the hierarchy of evidence sources (from rigorous scientific methods at the top to less rigorous and pseudoscientific methods at the bottom)

    EBP = Evidence Based Practice, EBM = Evidence Based Medicine, EBPP = Evidence-Based Practice in Psychology, EBA = Evidence Based Assessment

    • Definitions and their applications in psychology.

    APA Policy Statement (2005)

    • Evidence-based practice is the combination of best available research and clinical expertise in the context of patient characteristics, culture, and preferences.
    • To rationally guide treatments based on funding decisions (like prescribing medications).

    The EBP Model

    • It advocates a scientific view of clinical psychology.
    • Understanding research design and methods of clinical psychology is needed
    • Accessing the best available research and skills in evaluating relevant evidence is needed.

    Multiple Types of Research Evidence

    • Various types of research evidence used in psychology.
    • The lecture identifies multiple types of research evidence.

    Lecture 3: The concept of health and disease in clinical psychology

    • The lecture covered the concept of health and disease in clinical psychology, covering topics like psychological health, criteria for assessing mental health & disorders, diagnosis, and classification of psychological problems.

    Specificity of Psychological Norm

    • Norm is conceptualized as an ideal or real pattern of characteristics, behavior, personality, or development.
    • Psychological norm and health are used synonymously.
    • This section emphasizes that norm as a lack of pathology.

    Statistical Model

    • Normal or healthy health or normal behavior is defined as mediocre, average behavior patterns prevalent in most people. Pathological behavior is deviations from an accepted standard of normalcy, based on prevalence.

    Socio-Cultural Model

    • Normal behavior is defined with reference to cultural norms and conventions considered typical of a group or culture.
    • An abnormal individual deviates from these norms.
    • This is the most relativized psychological model of health.
    • Normal behavior is defined as meeting the typical social-cultural, ethical, and legal behavior expectations and norms of a specific society's culture.

    Theoretical model

    • Normality & appropriate standards are defined via theoretical models, typically from specific psychological paradigms (e.g., psychoanalytic, cognitive-behavioral, humanistic, and systemic).
    • Models define standards to which individual behavior is compared for determining if the behavior is normal.

    How to define abnormality?

    • Defining abnormality includes qualitative criteria (functionality significantly different from healthy).
    • Quantitative criteria (significantly deviate from typical average); criteria of coexisting symptoms (how frequently certain symptoms co-occur).
    • The four Ds of abnormality (Distress, Deviance, Dysfunction, Danger) or sometimes referred to as three Ds (Distress, Deviance, Dysfunction). A person exhibiting only one of these criteria is often symptomatic of the presence of a mental disorder.

    Psychopathological symptom, Psychopathological syndrome, Mental Disorder

    • Psychopathological symptom is a disruption or disturbance in basic mental functions (e.g., thinking, mood, behavior).
    • A set of symptoms which indicates a psychological dysfunction & specific pattern is called a psychopathological syndrome.
    • A particular set of symptoms with a recognizable beginning, course, and end is called a mental disorder.

    Models of classifications

    • Categorical (separate classes of mental disorders, often differing from other classes).
    • Dimensional (classifying along certain dimensions of severity or intensity, defining health only in terms of severity or intensity of the condition when classifying).
    • Prototypical (classifying by defining a representative or prototypical case)

    Classifications of mental disorders

    • The ICD-11 (International Classification of Diseases and Related Health Problems)
    • The DSM-5-TR (Diagnostic and Statistical Manual of Mental Disorders)
    • The CCMD-3 (Chinese Classification of Mental Disorders)

    The DSM-5-TR definition of mental disorder

    • A mental disorder is a syndrome characterized by clinically significant disturbance in an individual’s cognition, emotion regulation, or behavior.
    • The syndrome reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning and is associated with significant distress or disability in social, occupational, or other important activities.
    • An expectable or culturally approved response to a common stressor or loss is not a mental disorder.

    The complete state model of mental health and illness

    • Diagram illustrating mental health and illness using categories such as struggling, flourishing, floundering, and languishing.

    Lecture 4: Between clinical assessment and clinical diagnosis

    • The lecture's overview covered the intersection and relationship between clinical assessment tools and the process of diagnosis.
    • The lecture focused on the role of intelligence, personality, and behavioral assessment in clinical psychology. Specific assessment tools (e.g., structured interviews like SCID-5-CV and SCID-5-PD ) and the idea of clinical judgment.

    What is clinical psychological assessment?

    • A broad psychological assessment using multiple sources (psychological tests, interviews, observations, reports).
    • The aim is to form an accurate understanding of a client’s psychological condition.

    Why to assess?

    • Working with psychiatrists to correctly diagnose a case.
    • Understanding the psychological issues, likely causes, and best approaches for dealing with problems.
    • Identifying client strengths and weaknesses to create appropriate treatment approaches and plans.

    Psychological assessment process

    • Integration of information from multiple sources (e.g. psychological tests, observations, interviews).
    • Evaluation, interpretation of assessment instruments, and the integration of results into a coherent report.

    How do I know which psychological tools to use?

    • The type of tools depends on the purpose of the diagnosis which is often clarified by a clinical interview from the beginning (e.g when referral already has direction).
    • An interview is necessary to determine if there are any contraindications to using a particular tool (e.g., vision/hearing/mobility/language/cultural barriers).

    Different assessment tools used by clinical psychologists

    • Nomothetic & Idiographic methods; standardized vs. qualitative; objective vs. projective tests; psychometric tests/inventories
    • Specific tests for intelligence, personality, interviews, projective tests, and behavioral assessments.

    Different assessment tools used by clinical psychologists (continued)

    • Various interview types: structured interviews for DSM disorders, intake/admission interviews, case history interviews, and mental status examinations.
    • Questionnaires: broad screening measures (SCL-90-R), symptom checklists (BDI), personality inventories (MMPI, NEO-PI-R).
    • Projective tests: Thematic Apperception Test (TAT) and Rorschach Inkblot Test (RISB).
    • Sample Task Performance (e.g., WAIS-IV or Stanford-Binet-5th Edition).
    • Behavioral assessment (functional analysis).

    Clinical Judgement → Diagnostic inference

    • Creating an accurate description of a client/patient.
    • Developing rapport (increase likelihood of optimum functioning / performance).
    • Consideration of the impact of situational variables (e.g., transient conditions, assessment context).

    Clinical Judgement → Diagnostic inference (continued)

    • Clinician's objectivity is subject to biases (e.g., primacy/first impression; self-fulfilling prophecies; confirmatory/hypothesis-testing biases; personal experience).
    • Accurate person perception is correlated with intelligence, emotional adjustment, and cultural background similarity.
    • Accuracy in clinical judgments depends heavily on the clinician's knowledge, the sources used to create client descriptions, and acknowledgment that predictions are not 100 percent accurate (considering the role of chance).
    • Clinical judgment vs mechanical / actuarial diagnosis (Meehl 1954).

    Problems with diagnosis of mental disorders in children & adolescents

    • Significant differences between clinical and epidemiological data on mental disorders—often overdiagnosis, particularly in ADHD cases.
    • Research by Bruchmüller and colleagues (2012) suggest that diagnosticians are more prone to false-positive rather than false-negative diagnoses.
    • Diagnostic criteria not always fulfilled (with ADHD e.g., 16.7% of psychotherapists diagnosted ADHD although diagnostic criteria were not fulfilled.

    Lecture 5: Main models of human functioning and approaches used in clinical psychology. Part 1

    • Overview and discussion of main models of human functioning in clinical psychology, focusing on one-dimensional/multipath models; diathesis-stress model; psychodynamic approach; and humanistic approach.

    Pathogenic approach, Multipath models

    • One-dimensional models view mental disorders as caused by a single factor, predominantly linearly.
    • Multipath models emphasize a holistic, complex interaction of biological, psychological, social and sociocultural factors as causes of mental disorders (e.g., biopsychosocial model such as understanding the interactions between biology, psychology, and social context to create a wholistic picture of someone's mental or physical condition).

    The Interaction of Genes and Environment

    • Genetic factors contribute to all disorders (but less than 50%), always needing an environmental trigger.
    • Diathesis-stress model: individuals inherit a predisposition (diathesis) for certain behaviors/traits which may be activated by stress.
    • Vulnerability is genetically determined and makes a person susceptible / prone to developing disorders.
    • High vulnerability = need for less stress / lower level of stress to generate a condition.

    Psychodynamic Model

    • Sigmund Freud challenged the view that mental disorders are caused by solely physical illness.
    • Proposed psychological factors as the cause of mental disorders.
    • Explores the forces (dynamics) that drive a person's behavior:
      1. Personality structure.
      2. Level of awareness (conscious, preconscious, unconscious).
      3. Psychosexual stages.
      4. Defense mechanisms.

    Personality structure (id, ego, superego) , Levels of awareness, Psychosexual stages

    •  Personality
      • Id: impulsive, unconscious, present at birth, driven by pleasure principle.
      • Ego: conscious and rational, develops around age two, balances Id demands, gratification delay.
      • Superego: develops around age four—learned aspect of self; ego ideal & conscience.
    • Levels of awareness
    • Conscious: logical mind.
    • Unconscious: pleasure principle.
    • Preconscious: material accessible just beneath conscious level.
    • Psychosexual:
      • Oral: 0–1 years (mouth).
      • Anal: 1–3 years (anus).
      • Phallic: 3–6 years (genitals).
      • Latent: 6–12 years (no erogenous zone).
      • Genital: 12–20 years (genitals).

    Defense Mechanisms

    • Ego's attempt to keep conflicts and their discomfort from reaching consciousness by employing unconscious defense mechanisms.
    • Help the individual cope; may or may not be adaptive. Types of defense mechanisms: Displacement, projection, denial, sublimation, suppression. Overusing defense mechanisms causes problems (i.e. disguised expression of repressed emotions/impulses).

    Humanistic Model

    • Emphasis on people as friendly, cooperative, fundamentally good, constructively oriented, trustworthy.
    • Self-actualization, the drive to better oneself (abilities to become who we wish to be—fulfilling one's potential).
    • External motivation and recognition can promote actualization and health but are not the only motivations.

    Rogers’ Humanistic Theory

    • Abnormal behaviour arises from incongruence between self-concept and actualizing tendency.
    • Conditions of worth hinder actualization; it is essential that people experience unconditional positive regard. This does not depend on their actions but on respecting the individual.

    Abraham Maslow

    • Proposed that people are motivated by a hierarchy of needs, progressing upward from fundamental psychological needs that lead to reaching self-actualization (the realization of one's potential).

    Lecture 6: Main models of human functioning and approaches used in clinical psychology. Part 2

    • Cognitive Approach: focused on explaining how people's thoughts and ideas relate to their actions, behavior, and feelings.
    • Behavioral Approach.

    Behavioral Model

    • All human behavior is learned (as opposed to being inborn).
    • Behavior is the focus of understanding a person's problems instead of searching for mind or feelings.
    • People are born as a neutral, "blank slate", and develop through learned responses to stimulus from their life experiences—not necessarily predispositions.
    • The behavioral model focuses on symptoms & not the causes; it equatates normality to have an adequately large repertoire of learned responses & a major cause for abnormal behavior is learned maladaptive responses.
    • Classical (Pavlov: stimulus-response-learning) and Operant (Skinner: reward-punishment-learning) Conditioning principles (conditioning can lead to various disorders).
    • Observation learning (Bandura)

    Classical Conditioning

    • Learning through temporal association / occurring successively: Pairings of stimuli—both unconditioned, and conditioned—create classical associations and conditions.

    Operant Conditioning

    • Learning through consequences (reward/punishment).
    • Increasing/decreasing a certain behavior by influencing consequences (providing reinforcement for a positive behavior, removing a negative reinforcer for a positive behavior, punishment by providing a negative consequence).
    • Extinction (the opposite of reinforcement).

    Observational Learning (Social Learning Theory)

    • Learning by observing and imitating others.
    • Individuals observe role models and learn about the consequences of behavior through indirect reinforcement.
    • Consequence as expectations of future outcomes is stored as internal mental representations.

    Cognitive Model

    • Based on information processing, cognition involves mental functions (perception, recognition, judgement, reasoning).
    • Schemas are sets of assumptions rooted in experiences (beliefs, values, perceived capabilities, and expectancies).
    • Irrational and maladaptive assumptions/thoughts.
    • Cognitive distortions (e.g. interpretations in terms of extremes, all-or-nothing thinking, overgeneralization)

    Cognitive Model - Ellis

    • Ellis believed that human thoughts can vary between rational and irrational.
    • Rational thoughts correlate with happiness, competence, and efficiency.
    • Irrational thoughts might lead to various psychological issues (depression/anxiety).
    • The cognitive approach in a nutshell: Distorted thinking creates various negative emotions.

    What are Automatic Thoughts?

    • Thoughts that happen spontaneously in response to situations.
    • Verbal or visual; not necessarily based on logical reasoning.
    • Hard to turn off and may be hard to articulate.
    • Core Beliefs: Automatic Thoughts are often influenced by underlying core beliefs.

    Examples of Core Beliefs

    • Helpless core beliefs (inadequate, powerless, vulnerable, failure).
    • Unlovable core beliefs (rejected, abandoned, ugly, different).
    • Worthless core beliefs (worthless, hurtful, undeserving of life).

    Cognitive Conceptualization

    • Current situation activates automatic thoughts.
    • Automatic thoughts, in turn, affect bodily functions (physiology).
    • Underlying core beliefs influence these thoughts.
    • Compensatory strategies, such as trying to avoid an issue or to deal with emotional distress, derive directly from our core beliefs, also affecting our physiological and emotional responses to present life events.

    Cognitive Distortions

    • Errors in thinking (or biases, e.g., selective abstraction, overgeneralization, jumping to conclusions).
    • A negative bias in how people process information in the case of mental illness.
    • Extreme/dichotomous thinking, emotional reasoning, magnification/minimization.

    Lecture 7: Characteristic features of psychological help and psychological interventions used in clinical psychology

    • Focus on the helping relationship, components of change determinants in the contexts of ethics.
    • Emphasizes the common factors in psychotherapy (factors in achieving good outcomes in psychotherapy, in general; such as relationship / alliance, hope, attention).
    • The role of clinical assessment in the provision of effective psychological help

    .### Who is helping?

    • Variety of people, including friends, family, role models, religious figures, fortune tellers.
    • Also, professionals such as psychiatrists and therapists (psychologists).

    Psychological helping relationship

    • Considering social and cultural factors in assessment & diagnosis.
    • Recognition of psychological disorders to determine if specialized help is needed.
    • Understanding human behavior instead of judging it morally.
    • Elements of the helping relationship include empathy, unconditional acceptance, and a focus on the client's side, psychopathological symptoms, function, and psychological mechanisms.

    Psychological helping relationship (continued)

    • Treating difficulties as problems to be solved and pathways to beneficial life change (e.g., posttraumatic growth, social resources, mental strength, and social support).
    • Restraint towards atypical behaviours that deviate from normal functioning (individual autonomy, client's rights, and therapeutic contract).
    • Following the rules/code of ethics of mental hygiene.

    Ethical Essentials

    • Confidentiality, informed consent, multiple roles.
    • Client harm (e.g., sexual abuse).
    • Competence (required knowledge and additional ethical issues involved).

    Criteria for receiving psychological help

    • Subjective experience of the problem.
    • Psychological nature of the problem.
    • Right motivation for seeking help.
    • No contraindications for seeking help (e.g., suicidal thoughts, neuro/psychological disorders).

    Subjective experience of the problem (criteria)

    • Client expresses concerns about their behavior, feelings, or thoughts.
    • The client’s problems are described as disturbed, inappropriate, or unsafe.
    • Evidence of intentional efforts to change, but without success.
    • Seeking professional help after unsuccessful attempts.

    Psychological nature of the problem

    • Problems directly related to the client or those closely connected.
    • Client has some level of influence on the problem.
    • The problem is addressed within the scope of the psychologist.

    The right motivation

    • Motivation may derive either from the patient (internal), or from others (external).
    • The magnitude of the problem should also be considered—e.g., how annoying or worrisome or troublesome it is.
    • Those affected by the issue, besides the patient themselves, should be considered.

    Contraindications for receiving psychological help

    • Suicidal thoughts/tendencies.
    • Neurological functioning.
    • Consciousness disturbances.
    • Strong psychopathological symptoms.
    • Physical/emotional exhaustion.
    • Low levels of intellectual functioning.

    Stages of Change

    • Precontemplation (denials—or acknowledging a problem is present but unsure one can do anything about it, or no problem).
    • Contemplation (ambivalence—acknowledging a possible problem and weighing the pros and cons of solving it, or still not sure what to do about a problem).
    • Preparation/determination (admission).
    • Action.
    • Maintenance (ongoing efforts to maintain successful behavioural changes).
    • Relapse (or attempting to return to more effective procedures).

    What works in therapy?

    • Common/general factors (i.e., general effects) underling all psychotherapies (70 percent in one review and/or study; with other factors/components, such as theoretical model(s), also influencing outcomes up to 22 percent, for example).
    • Specific effects linked to specific models.
    • Client differences.

    So what works in psychotherapy?

    • The therapeutic relationship and alliance are pivotal in achieving positive outcomes in psychotherapy—not techniques.

    Common factors of psychotherapy

    • Shared fundamentals in psychotherapy (e.g., therapeutic relationship/alliance, instillation of hope, attention, corrective experience).
    • These are "active ingredients" in achieving positive outcomes in therapy, generally speaking.

    Common factors of psychotherapy associated with positive outcome (Three-stage sequential model)

    • Support factors, learning factors, and action factors in a sequential order that contributes to successful outcomes in therapy.
      • Support factors: strong therapist-client relationship, rapport, warmth and trust.
      • Learning factors: changing expectations of self; changing thinking patterns; insights; and experiencing positive emotional changes.
      • Actions factors: risks taken, fears faced, practice and mastering new behaviors and working through problems that face the client.

    Therapeutic Factors in Group Therapy

    • Features of effective group therapy (e.g., instillation of hope, universality, imparting information, altruism, corrective recapitulation, socializing techniques.
    • Imitative behavior, interpersonal learning, group cohesiveness, catharsis, & existential factors.

    Client's pathway

    • Steps a patient takes/follows towards various available types of treatment (e.g. assessment, treatment, group therapy, or individual therapy).
    • A patient who opts into a service is invited for an initial consultation to assess if that service fits the patient’s needs.
    • Steps can involve an information session, assessment, treatment, and/or referral (e.g., group, individual, or other relevant services).

    Lecture 8-9: Types of psychological help available in solving various psychological and health problems

    • Variety of actions a psychologist might take (e.g., psychoeducation, prevention; promotion; counseling), crisis intervention, or psychotherapy methods based on various types of psychological/theoretical approaches.

    Types of psychological help

    • Prevention, promotion, psychoeducation, counseling, psychotherapy, crisis intervention.

    Different types of psychological help in health care systems

    • Promotion, prevention, treatment, and aftertreatment procedures.

    Promotion

    • Aim: improve overall well-being by encouraging and increasing protective factors (e.g., healthy behaviors, mental wellbeing).
    • Target various groups.
    • Focused on populations at risk as well as general populations to enhance developmentally appropriate tasks; positive self-esteem; well-being; and ability to cope with adversity.)

    Prevention

    • Aim: prevent problems before they occur.
    • Address specific population segments (national, local, community, neighborhood or age at-risk, etc.)
    • Focused on prevention effort(s) depending on intensity levels and in conjunction with development.

    Mental health literacy

    • Understanding how to obtain/maintain mental health.
    • Understanding mental disorders and treatments.
    • Enhancing help-seeking efficacy (knowing when/where to seek help and building capabilities).
    • Decreasing stigma related to mental disorders (stereotypes, prejudice, discrimination—involving the public & sufferers / potential sufferers from mental health).

    Healthy People 2020 Framework

    • National efforts to improve health in diverse populations & increase public understanding about determinants of health (priorities; opportunities/strategies towards these goals; activities at the national, state, and local levels), with policy and practice.

    Prevention (Primary, Secondary, Tertiary) tiers

    • Primary: countering stressful circumstances before they have chance to create problems.
    • Secondary: identifying & treating early in order to prevent disorders from developing.
    • Tertiary: mitigating negative impact once a problem/illness has arisen and reducing negative effects (e.g., complications or disability).

    Primary Intervention

    • Goal: prevent/eliminate causative risk factors that often lead to problems (e.g., disease).
    • Uses approaches intended to reduce the impact or risk of a problem. (e.g., immunization, or educating people to increase healthy behaviors).

    Secondary Intervention

    • Goal: early detection and treatment to reduce the severity and duration of problems/diseases (e.g., illness detection through screening or testing).

    Tertiary Intervention

    • Goal: improve quality of life & reduce the impact of the disease or disorder (e.g., after a condition has arisen).

    Universal Preventive Interventions

    • Interventions aimed at the entire population (national, local, community level).
    • Everyone in the identified population should benefit from the intervention (e.g., health-promotion/educational campaigns, or knowledge-based or social-skill-focused programs to prevent smoking initiation among teenagers).

    Selective Preventive Interventions

    • Targeting population subgroups having higher-than-average risk for acquiring a particular problem.

    Indicated Preventive Interventions

    • High-risk individuals with early symptoms who don't meet diagnostic criteria.
    • Interventions are often used at the onset of the first symptoms, based on pre-emptive actions, or taken before an obvious problem is present.
    • Interventions aimed at educating people on how to identify and manage high-risk scenarios/symptoms.

    Sick Individual and Sick Populations

    • Populations may be susceptible to particular diseases.
    • Not all individuals belonging to a susceptible population will get that disease/disorder.
    • Determinants of illness/health that vary by level (individual vs population).

    Prevention Paradox

    • Large # people exposed to a small risk may cause more cases than small # exposed to high risk.

    Levels of Intervention

    • Interventions targeted to systems (governmental, organizational).
    • Community interventions (directed to people within communities, like specific segments at risk, and to change norms, practices, and behaviours; e.g., social marketing campaign).
    • Individual/family interventions (directed towards an at-risk individual or family or to specific families.) These interventions are intended to protect the community from adverse health effects, or to educate, teach skills, or modify behaviours in individuals or families at-risk.

    Ethical and Philosophical Principles

    • Choice of health promotion model is influenced by individual and societal values.
    • Health promotion/preventative activities are underpinned by political ideologies.

    Prevention - negative strategy

    • Aim: reduce or remove existing risk factors.
    • Minimizing threats (e.g., policy changes).
    • Social influence: improving awareness of consequences and increasing risk avoidance, and adopting protective measures.

    Prevention - positive strategy

    • Aim: enhance resources—of individuals and their environments.
    • Includes education of parents & creating social support systems (e.g., youth clubs.)
    • Designed primarily to improve resources and competencies in addressing threats.

    Lecture 14: Health promotion and disease prevention. Part 2

    • Review of health promotion and prevention, its approaches, and strategies for interventions.

    The Paradox of Progress

    • Modern technology has brought time-saving but also "choice overload" and economic abundance leading to "possession overload" which can lead to less contentment.
    • It is important to find meaning and direction, sometimes through self-help books.

    The search for direction

    • The challenge of modern life is the search for meaning or a sense of direction.
    • People may turn to unhelpful methods as a result of desperation.
    • Self-help books, in general, are not all useful.

    The value of self-help books

    • There are effective self-help books but most may be ineffective due to vague messages that focus too heavily on "psychaobabble" rather than sound, scientific, basis or research.
    • Books should be detailed and specific when offering solutions.

    The Roots of Happiness

    • Many studies of subjective well-being and life satisfaction are often undertaken in order to discover the determinants of happiness.

    The Roots of Happiness—What Isn't Very Important?

    • Money (weak correlation).
    • Age (unrelated).
    • Gender (little influence).
    • Parenthood (good/bad parent balance each other out).
    • Intelligence (no significant correlation).
    • Physical attractiveness (weak correlation).

    The Roots of Happiness—What Is Somewhat Important?

    • Health (positive correlation of .32).
    • Social relationships (meaningful connections and interactions).
    • Religious beliefs/convictions (are often beneficial).
    • Leisure activities (activities unrelated to work).
    • Culture (in certain contexts different cultures have different averages on related scales of happiness).

    The Roots of Happiness—Conclusions

    • Happiness is contextual and relative.
    • People's perceptions of happiness depend on their immediate surroundings and their individual expectations.
    • Hedonic adaptation (shifting of the neutral point, the baseline, over time; the mental scale for evaluating unpleasantness/pleasantness of events changes over time).

    Stress, Personality, and Illness

    • Link between Type A personality (competitive, impatient, hostile) and coronary risk (strongest link between hostility and coronary disease).
    • Research suggests that individuals with more anger/hostility are twice as likely to suffer from atherosclerosis than those with below-average hostility scores.
    • Physiological reactivity often plays a significant role in the negative consequences of chronic stress (e.g., increased occurrence of coronary heart disease).

    Emotional reactions and heart disease

    • Transient stress/extreme emotions can often damage the heart.
    • Brief stress episodes/strong emotions (e.g., triggered anger after experiencing a heart-attack).
    • Rumination = mulling over concerns/distressing thoughts; significant factor associated with poor health outcomes.
    • Depression is often a major risk factor for suffering from heart disease, and may cause the condition.

    Stress and Cancer/Other Diseases

    • Stress is linked to cancer, but may not be the absolute cause.
    • Stress is implicated in the process of certain diseases, like cancer.
    • Stress is linked to a broader group of diseases (e.g., headaches, hypertension; inflammatory bowel diseases; gastrointestinal disorders; and infections.)

    Health Problems Linked to Stress (list)

    • A list of common health problems (e.g. common cold; ulcers; asthma; migraine; premenstrual/vaginal distress) & their potential linking to stress.

    Summary

    • Coping with stress is essential; chapters 12-13 provide detailed explanations linked to stress, coping, and associated negative/positive factors, health outcomes.

    Lecture 15: Fields of application of Clinical Psychology

    • Overview of adult clinical psychology, neuropsychology, forensic psychology, child and adolescent clinical psychology, geropsychology; community psychology; health psychology as distinct areas/specialisations of clinical psychology.

    Adult Clinical Psychology

    • Addresses various mental health and adjustment challenges in the post-adolescent life-span, including a wide range of conditions/problems (e.g., schizophrenia, anxiety, social phobia, or impulse disorder ; marital problems, dementia, suicidality, addictions, and chronic depression).
    • Clinical psychologists have rigorous educational and training requirements that set them apart from some mental health practitioners. The major aspects of the field are assessment; treatment; and teaching.

    Neuropsychology

    • Focuses on brain-behavior relationships, assessing how brain function affects behavior and psychological/neurological problems.
    • Covers issues including dementia, head injuries, tumors, autism, stroke, AIDS, epilepsy and Alzheimer's disease.
    • Psychologists are well-trained to assess cognitive abilities, executive function, sensory functioning, memory skills, and abstract reasoning.
    • Practiced in various contexts (e.g., hospitals, rehabilitation clinics, or private clinics).

    Forensic Psychology

    • Applying principles of human behavior to legal/judicial/legal systems issues (e.g., individual rights and liberties, custody).
    • Demands expertise beyond clinical experience.
    • Practitioners take on specific roles and responsibility ("expert to the court," or as "expert representing the profession").
    • Psychological evaluations are conducted—and presented in court—for cases involving forensic matters.

    Child and Adolescent Clinical Psychology

    • Specialists work with children and families; provide consultation regarding behavioral problems, and family dynamics (especially in hospital contexts when a child faces illnesses, e.g., cancer, epilepsy, diabetes).
    • Training in developmental theories and associated treatments are required; family therapy & play therapy are often used.
    • Distinguishing between internalizing (e.g., depression, anxiety) & externalizing disorders (e.g., ADHD, conduct disorders).

    Health Psychology

    • Explores the link and influence between lifestyle factors and physical/mental health, maximizing prevention, and increasing healthy behaviours to improve wellness in all populations, for example, assisting people who want to improve health or who want to cope with chronic physical illness, such as pain.
    • Provides knowledge to improve self-management of illnesses; improve coping with physical illness; and to promote information and advice toward appropriate health organizational agencies. Works to encourage healthy behaviours and practices with specific populations.

    Geropsychology

    • Studying the elderly (aging process); focused on healthy aging.
    • Covers biological, social, and psychological aspects of aging; the major psychological paradigm relevant to the field is psychodynamic developmental theory.

    Community Psychology

    • A psychological approach/movement that emphasizes environmental factors—the interplay between person and environment—to understand mental health issues.
    • It addresses issues from a broader scope, often tackling problems at a societal level (versus individual level).
    • The aim is often preventive rather than remedial.
    • Interventions should consider the needs and risks within a community when designing any intervention or prevention strategy.

    Community Psychiatry / Community Mental Health Teams

    • Support for individuals with disabilities and chronic mental illness.
    • Collaborative and multitasking efforts directed to diverse individuals with various mental illness needs and/or developmental issues.

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    Description

    This quiz examines key concepts and approaches in group therapy, focusing on therapeutic factors, ideal conditions, and notable figures in the field. Test your understanding of the principles that guide group therapy and the significance of group dynamics. Ideal for those studying psychology or counseling.

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