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Attachment - Attempts to explain the dynamics of interpersonal relationships between humans. A child needs to form a relationship between at least one primary caregiver.
WILKES NSG 526 EXAM 2: QUESTIONS
AND ANSWERS 2025
Group Therapy primary purpose - The primary purpose of group therapy is to facilitate changes by the patient to address identified problems. A technique for dealing with an over talkative client and silence from other participants in a group during therapy - make an observation about the group's silence and invite the others to comment the technique of "Information Giver". - During group members sharing methods they personally use for dealing with problems CBT - consists of active questioning, homework assignments, and dream survey. The therapist helps the patient consider personal ideas and beliefs in order to increase the patient's realization about how thoughts influence behaviors. Mileu - Milieu therapy requires consideration of the client's social, economic, and cultural status. Complementary Alternative Medicine vs Western major difference - Western medicine focuses on what is done to the patient whereas CAM focuses on mind-body interactions. Beck - Beck developed the cognitive model of depression and the concept that cognitive processing distortions underlie psychological disorders ACTIVE, TIME-LIMITED APPROACH depression can be understood via schemas: - Beck; cognitive errors, and the cognitive triad (i.e., negative views of self, tendency toward interpreting experiences in a negative manner, and holding negative views of the future). Beck assumption - Distorted thinking contributes to and maintains bheavior (symptoms) Ellis - RET (Rational Emotive Therapy) a form of cbt
RET assumption - People make themselves sick anytime they escalate a desire or preference into a demand or absolute must. (People become who they become based on their beliefs). Imparting information - Yaslom: While this is not strictly speaking a psychotherapeutic process, members often report that it has been very helpful to learn factual information from other members in the group, for example, about their treatment or about access to services. Corrective recapitulation of primary family experience - Yaslom: Members often unconsciously identify the group therapist and other group members with their own parents and siblings in a process that is a form of transference specific to group psychotherapy. The therapist's interpretations can help group members gain understanding of the impact of childhood ret - unrealistic and irrational beliefs cause many emotional problems. The purpose of RET is to identify an irrational belief and dispute it through active, philosophical, confrontational therapy. Skinner - operant conditioning Operant conditioning - voluntary behaviors are learned through consequences, and behavioral responses are elicited through reinforcement, which causes a behavior to occur more frequently. Positive reinforcement- getting a gift, or negative reinforcement- removal of objectionable' or aversive stimulus Skinner - Absence of reinforcement, or extinction, also decreases behavior by withholding a reward that has become habitual. Teachers employ this strategy in the classroom when they ignore acting-out behavior that had previously been rewarded by more attention. Skinner's behavior model provides a concrete method for modifying or replacing behaviors. Behavior management and modification programs based on his principles have shown to be children, adolescents, and individuals with many forms of chronic mental illness. Universality - Yaslom: The recognition of shared experiences and feelings among group members and that these may be widespread or universal human concerns, serves to remove a group member's sense of isolation, validate their experiences, and raise self-esteem. Altruism - Yaslom: The group is a place where members can help each other, and the experience of being able to give something to another person can lift the member's self esteem and help develop more adaptive coping styles and interpersonal skills. Instillation of hope - Yaslom: In a mixed group that has members at various stages of development or recovery, a member can be inspired and encouraged by another member who has overcome the problems with which they are still struggling. successful in altering targeted behaviors. Programmed learning and token economies represent extensions of Skinner's thoughts on learning. Behavioral methods are particularly effective with
Primary purpose of group therapy - (1) human beings are social animals, and (2) that we heal in community. This is why group therapy is so efficacious. This correlated to Maslow's third level in his hierarchy of needs; the need for love and belonging. People benefit by both giving and receiving feedback Role of Information giver in a group session - Shares facts or own experience as an authority figure Characteristics of an effective leader - In any group, the leader must be thoughtful about communication techniques, since these have a tremendous impact on group content and process. Mileu therapy benefit - It is an all-inclusive term that recognizes the people, setting, structure, and emotional climate as all important to healing Milieu therapy takes naturally occurring events in the environment and uses them as rich learning opportunities for clients. therapuetic community A well-managed milieu offers clients a sense of security and comfort. Milieu benefit to sexual disorders - Individuals with paraphilias tend to isolate themselves. Group therapy can offer no more isolation Milieu benefit eating disorder - including normalization of eating. The highly structures milieu includes precise meal times, adherence to the selected menus, observation during and after meals, and regularly scheduled weighing Milieu benefit schitzophrenic - (1) protection from stressful or disruptive environments and (2) structure Milieu benefit bipolar - Seclusion room- comfort and relief for those that are out of control. Reduces overwhelming environmental stimuli Protects a client form injuring self, others, or staff Prevents destruction of personal property or property of others Milieu benefit depression - The client with depression needs protection from suicidal acts and a supervised environment for regulating treatments. Often, being removed from a stressful interpersonal situation increases therapeutic value. Milieu benefit anxiety - Structuring the daily routine to offer physical safety and predictability, thus reducing anxiety over the unknown Providing daily activities to promote sharing and cooperation Providing therapeutic interactions, including one-on-one nursing care and behavior contracts Including the client in decisions about his or her own care
Therapeutic touch - useful in relieving premenstrual syndrome, depression, complications in premature babies, and secondary infections associated with human immunodeficiency virus (HN) infection; lowering blood pressure; decreasing edema; easing abdominal cramps and nausea; resolving fevers; and accelerating the healing of fractures, wounds, and infections. Organization to help learn more about complementary and alternative medicines - National Institutes of Health (NIH) established the National Center for Complementary and Alternative Medicine (NCCAM) in 1998. Acupuncture. - The term "acupuncture" describes a family of procedures involving the stimulation of anatomical points on the body using a variety of techniques. The acupuncture technique that has been most often studied scientifically involves penetrating the skin with thin, solid, metallic needles that are manipulated by the hands or by electrical stimulation. health is achieved by maintaining the body in a "balanced state"; disease is due to an internal imbalance of yin and yang. This imbalance leads to blockage in the flow of qi Qi can be unblocked, according to TCM, by using acupuncture at certain points on the body that connect with these meridians. Herbal therapies advantages - echinacea (immune stimulant and anti-infection agent); garlic (antihypertensive and antibiotic); ginger (anti-nauseant and antispasmodic); ginseng root (increased stamina and decreased fatigue); kava kava (calming effect); and St. John's wort (anxiolytics and antidepressant). Concurrent use of SSRI and St. John's Wort - No, risk of serotonin syndrome Yoga as a treatment approach - People use yoga for a variety of conditions and to achieve fitness and relaxation. Dolores Krieger and use of therapeutic touch - Dolores Krieger, a nursing professor at New York University healing is promoted by balancing the body's energies. practitioners focus completely on the person receiving the treatment, without any other distraction. Practitioners then assess the energy field, clear and balance it through hand movements, and/or direct energy in a specific region of the body. The therapist does not physically touch the client. After undergoing a session of therapeutic touch, clients report a sense of deep relaxation. Beck's Cognitive Triad in depressed patients. - negative views of self tendency toward interpreting experiences in a negative manner holding negative views of the future Operant conditioning - Operant conditioning is the basis for behavior modification and uses positive reinforcement to increase desired behaviors.
three modes of dbt - individual, skills group (mindfullness, interpersonal effectiveness (ie), emotional regulation (er), distress tolerance (dt), telephone crises management, contract to call therapist for suicide or self harm behaviors piaget - theory of cognitive development children move through 4 difference stages of mental development. sensorimotor- birth to 2 yearspreoperational- 2-7 yearsconcrete operational- 7-11 yearsformal operational- 12 plus piaget assumption - Assumption: children construct their own knowledge in response to their experiences. Learn many things on own without intervention, children are intrinsically motivated to learn Ainsworth - theorist that studied types of attachment by use of the strange situation test strange situation test - Gradually subjecting a child to a stressful situation and observing his or her behavior toward the parent or caregiver. This test is used to classify children according to type of attachment—secure, resistant, avoidant, or disorganized/disoriented. Yalom - existential psychotherapy is an attitude toward human suffering and has no manual. Asks deep questions about the nature of the human being and nature of anxiety/despair/grief/loneliness/isolation. Questions meaning of love, creativity. Primary purpose of group therapy. - group therapy helps promotes and enhances understanding of one's self, overcome fears, undesirable thoughts, and feelings and adopt new behaviors. Open groups - permits termination of members at different points and their substitution by new members. learning from each other, lots of participation, ideal for most settings, groups also can vary in purpose a group in which new members are added as others leave closed groups - members begin and end the group at the same time. ex. outpatient smoking cessation a group in which membership is restricted; no new members are added when other leave Agenda group - size 6-12, inpatient/outpatient, each individual states an agenda for that day's session. Higher functioning clients Focus group - size 4-7, inpatient, higher pathologies, lower functioning, goal is to make this successful, non anxiety producing so clients comfortable in group, simple tasks Heterogeneous group - a group in which a range of differences exists among members
Homogeneous group - a group in which all members share central traits (e.g., men's group, group of clients with bipolar disorder) reasons a therapist to share personal information with patients - using self-disclosure: demonstrate how you had changed similar automatic thoughts. altruism in therapy - the group is a place where members can help each other, and the experience of being able to give something to another person can lift the member's self esteem and help develop more adaptive coping styles an interpersonal skills Interpersonal learning. - it occurs when group members learn from one another. it involves exchange of feedback on relational styles through the rational experiences that occur in the here and now of the group. Overgeneralization - affects people with depression or anxiety disorders. way of thinking where you apply one experience to all experiences, including those in the future. Ex. i once gave a poor speech, therefore I always screw up speeches. secure attachment- ainsworth - a relationship in which an infant obtains both comfort and confidence from the presence of his or her caregiver caregiver: reacts quickly and positively to the childs needs. Child- distressed when caregiver leaves, happy when return, seek comfort when scared or sad. insecure-avoidant attachment - a pattern of attachment in which an infant avoids connection with the caregiver, as when the infant seems not to care, no distress, no acknowledgement about the caregiver's presence, departure, or return. Child- dismissive, doesn't seek or make contact with caregiver insecure-ambivalent- anxious attachment - responds to child inconsistently. distress when caregiver leaves, not comforted by return of caregiver. a smaller portion of infants experienced greater levels of distress and upon reuniting with the parents, seemed both to seek comfort and to attempt to "punish" the parents for leaving insecure-disorganized attachment - a pattern of attachment in which an infant seems confused or apprehensive and shows contradictory behavior, such as moving toward the mother while looking away from her. Abusive, neglectful, responds in frighening ways. No attaching behaviors, often appear dazed, confused or apprehensive in presence of caregiver. Children- no particular pattern of attachment. Effective group leader - Leaders must have skills in communicating effectively, listening actively, working with people, and helping others work together in groups. Leaders must have integrity and honesty.....True leaders focus on helping their group achieve its goals rather than on their own personal recognition.
Can form attachments to more than one person, develops gradually It results in the infant wanting to be with the person who is perceived as stronger, wiser, able to reduce stress and anxiety. Gives the infant a feeling of security The amount of time spent together is less important than the amount of activity between the two. Harry Harlow - was able to show with monkeys: Isolating monkeys from birth led to behaviors that were withdrawn, unable to relate to peers, unable to mate, and incapable of caring for their offspring Pre-attachment stage - (birth to 8-12 wks)- babies orient to their mothers, follow them with their eyes over a 180 degree range, and turn towards mothers voice. Attachment in the making - 8-12 wks - 6 months. Infants become more attached to one or more persons in the environment. Clear-cut attachment - 6-24 months. Infants show signs of distress when separated from caretaker or mother. Can occur as early as 3 months. Insecure-avoidant - Tends to avoid close contact with people andlingers near caregivers rather than approaching them directly. Insecure-ambivalent- - child finds exploratory play difficult, even in the absence of danger, clings to his or her inconsistent parents. Insecure-disorganized - - Children in this case have parents who are emotionally absent with a parental history of abuse in their childhood, Albert Ellis' Rational Emotive Therapy - People control their own destinies and interpret events according to their own values and beliefs. A-B-C theory - Activating event, belief, consequences (emotional and/or behavioral) Ellis- RET Forms of irrational beliefs - Something should be different/Something is awful or terrible/One cannot tolerate something/Something or someone is damned or cursed. Ellis-RET "Masturbatory" ideologies have 3 forms: - I must do well and win approval or I am a rotten person/You must act kindly toward me or you are a rotten person/My life must remain comfortable or life hardly seems worth living. Ellis-RET
Assumption of RET - People make themselves sick anytime they escalate a desire or preference into a demand or absolute must. (People become who they become based on their beliefs). Ecosocial theory - is a broad and complex theory with the purpose of describing and explaining causal relationships in disease distribution. While it incorporates biological and psychosocial influences on disease occurrence, the theory is also suited to analyse the relationships between social factors and disease development in public health research. Embodiment - describes the literal physical incorporation of the social and biological world into an individual's body. Ecosocial theory Pathways to embodiment- - describes the various ways that social, biological, and environmental forces may interact with an individual's body in context. Ecosocial theory The cumulative interplay of exposure, susceptibility, and resistance - describes how patterns of disease occur within a social, ecological, and biological context. It emphasizes how individuals in different socio-economic positions have different exposures, susceptibilities, and resistance (both biological and political) to disease, based on their unique histories and experiences over the lifecourse, based on spatio-temporal factors and the interaction with groups, power structures, discrimination, and inequality. Ecosocial theory Agency and accountability - claims that the State is a responsible agent in the patterns of disease distribution in a given society Ecosocial theory Jean Piaget's theory of cognitive development suggests that - children move through four different stages of mental development. Sensorimotor stage - birth to 2 years Preoperational stage: - ages 2- 7 Concrete operational stage: - ages 7 to 11 Formal operational stage: - ages 12 and up Therapy consists of... for RET - Therapy consists of detecting and eradication irrational beliefs, Disputing: Detecting irrationalities, debating them, discriminating between logical and illogical thinking, and defining what helps create new beliefs. Debating: Questioning and disputing the irrational beliefs. Discriminating: Distinguishing between wants and needs, desires and demands, and rational and irrational ideas. Defining: Defining words and redefining beliefs.
Group Dynamics - Group dynamics deals with the attitudes and behavioral patterns of a group. It can be used as a means for problem-solving, teamwork, and to become more innovative and Intermittent Explosive Disorder and Piaget's model. - An inability to resist aggressive urges towards others with bouts of explosive anger and assault towards others and their property "Bill, it sounds like a lot has happened with you this week. I am wondering what has happened with other group members." (The group leader then calls on another member.) "Mary, how did your week go?" "Mary, you seem to have had a lot going on this past week. Let's take a look at what's been happening with you for a few more minutes, and then let's see how others have been doing this past week."Interrupting IvanThe behavior of such clients in groups is disruptive, as they frequently interrupt ongoing group discussions. "We seem to be having an active discussion about [insert topic] today, but several members are talking at the same time. I'm wondering how this is affecting the group and what the group thinks we should do." "I know we all have important things to say, but we need to respect each other and let others finish what they are saying before the next person speaks." Resistent Roberta - Clients who feel they are forced or coerced to attend groups (e.g., by a spouse, probation officer, employer) are often not happy and, consequently, participate minimally, if at all. "Bill, as with many people, it appears that you are upset about your probation officer telling you that you have to come to treatment. What suggestions does the group have for Bill?" "Mary, it sounds like you feel you had no choice in coming to group and you are angry. Who else with similar experiences can share with Mary how they've handled such situations?" productive as an organization. The concept of group dynamics will also provide you with the strengths, success factors, and measures along with other professional tools Goal of the cognitive-behavioral model according to Beck and Ellis. - Therapist goals are to provide symptom relief, facilitate a remission of the disorder, help the patients resolved their most pressing problems, and teach them skills to avoid relapse. Cognitive reconstruction - is a group of therapeutic techniques that help people notice and change their negative thinking patterns. When thought patterns become destructive and self- defeating. It's a good idea to explore ways to interrupt and redirect him. That is what cognitive reconstruction can do
. All-or-Nothing Thinking - You see things in black-or-white categories. If a situation falls short of perfect, you see it as a total failure. When a young woman on a diet ate a spoonful of ice cream, she told herself, "I've blown my diet completely." This thought upset her so much that she gobbled down an entire quart of ice cream
Magnification - You exaggerate the importance of your problems and shortcomings, or you minimize the importance of your desirable qualities. This is also called the "binocular trick." "Should statements" - Dr. Albert Ellis has called this "musterbation." "Should statements" that are directed against yourself lead to guilt and frustration. Should statements that are directed Mental Filter - You pick out a single negative detail and dwell on it exclusively so that your vision of all reality becomes darkened, like the drop of ink that discolors the entire beaker of water. Discounting the positive - reject positive experiences by insisting they don't count. If you do a good job, you may tell yourself that it wasn't good enough or that anyone could have done as well. Discounting the positive takes the joy out of life and makes you feel inadequate and unrewarded. Jumping to Conclusions: - You interpret things negatively when there are no facts to support your conclusion Mind Reading - Without checking it out, you arbitrarily conclude that someone is reacting negatively to you Fortune-telling - You predict that things will turn out badly. Before a test you may tell yourself, "I'm really going to blow it. What if I flunk?" If you're depressed you may tell yourself, "I'll never get better." Emotional Reasoning - You assume that your negative emotions necessarily reflect the way things really are: "I feel it, therefore it must be true." You assume that your negative emotions necessarily reflect the way things really are: "I feel terrified about going on airplanes. It must be very dangerous to fly." Or "I feel guilty. I must be a rotten person." Or "I feel angry. This proves I'm being treated unfairly." Or "I feel so inferior. This means I'm a second-rate person." Or "I feel hopeless. I must really be hopeless against other people or the world in general lead to anger and frustration: "He shouldn't be so stubborn and argumentative." Labeling: - : Labeling is an extreme form of all-or-nothing thinking. Instead of saying "I made a mistake," you attach a negative label to yourself: "I'm a loser." .Personalization and blame - Personalization occurs when you hold yourself personally responsible for an event that isn't entirely under your control. When a woman received a note that her child was having difficulties at school, she told herself, "This shows what a bad mother I am," They blame other people or their circumstances for their problems, and they overlook ways that they might be contributing to the problem: "The reason my marriage is so lousy is because my spouse is totally unreasonable."
