General Systems Theory
The movement of a system from a current state to a more complex state, usually triggered by a stressor that cannot be handled by the system in its current state.
What is anamorphosis?
[What is homeostasis? How is it that both are considered "healthy?"]
In Structural Family Therapy, the joining of the therapist into the family structure by adopting the family's ways of verbally and non-verbally communicating, as well as taking on its emotional responses.
What is mimesis?
[What are the other 2 stages of Structural Family Therapy? What happens during those stages?]
Name 1 therapist-related factor that contributes to burnout.
Poor self-care, personal life stressors (e.g., family, finances, illnesses), blind spots (e.g., belief that we "should" be able to handle things, that we don't need help).
Which MI Principle calls for the therapist to help the patient see ways in which the current behavior is inconsistent with who they want to be (to elicit change talk)? What technique from a family therapy approach is this similar to?
What are Developing Discrepancy and Paradoxical Directives?
[Can you explain how these are similar or different?]
Maintains the status quo by reducing the discrepancy between how a subsystem is functioning in that "moment" and how it has generally been functioning.
What are negative feedback loops?
[What are positive feedback loops? How do feedback loops relate to the 2 states that a family can be in?]
When an alliance agrees that a problem within the alliance is the fault of someone outside the alliance.
What is a detouring coalition?
[What is a stable coalition? What is triangulation?]
How is the Opposite Action skill similar to Exposure?
Exposure is essentially Opposite Action for anxiety -- that is, anxiety makes a person want to avoid the thing that making them anxious. Opposite Action would be to stay with that thing. Exposure is also staying with the thing that makes us anxious.
What was the first therapeutic approach in which we discussed the importance of Values?
What was the Person-Centered/Humanistic approach?
[Which other approaches include a focus on values?]
A system that does not allow information to come and go between itself and its broader contexts.
What is a Closed System?
[What are examples of those "broader contexts?" What's an open system? Which type of system is healthy?]Whereas THIS type of family therapist tries to stay neutral and provide objective observations only, THIS type of family therapist will form and voice opinions and will request (but not demand) that the family make particular changes.
What are the Systemic therapist and the Structural therapist?
[What is the stance of the Strategic therapist?]
How are distress & burnout different?
Distress is an acute response to a stressor. Burnout is an accumulation of distress due to poor self-care following a number of stressors over time (though not always a long time).
"I know that I'm just worthless." Contrast (and explain) how CBT would address this thought and how ACT would address this thought.
CBT will use cognitive restructuring -- identify the distortion here, and then reappraise the thought so that it is an accurate reflection of the situation. ACT will use cognitive defusion -- disconnect the self from the concept of worthless, probably by using metaphors and activities that help the person see that "they" are not inherently imbued with the quality of "worthlessness."
[What kinds of techniques do these approaches use to address behaviors?]
Describe how diffuse boundaries contribute to pathology.
Diffuse boundaries result in enmeshment. Subsystems become overly involved with one another and share/communicate information that is not appropriate (should not cross that boundary).
[How else can boundaries be pathological? What makes a boundary healthy?]
Explain Restraining.
Restraining is a paradoxical directive in which the therapist explains why it would be dangerous for the subsystem to change a problematic behavior. And so the subsystem is told to continue doing the behavior. Ultimately, however, because human nature is to push back when told what to do, the subsystem often decreases the behavior instead of maintaining it.
[Can you explain Positioning? Prescribing the Symptom?]
How is validation different from a reflection?
Reflections restate (sometimes extending or twisting) what a patient has said, but do not suggest any form of "agreement" with the patient's experience. Validation is not a restatement; it acknowledges the truth in a patients experience, agreeing that their experience is real and important.
Compare/contrast the purposes of Progressive Muscle Relaxation, Mindfulness exercises, and the Self-Soothing technique.
PMR helps the patient experience the difference between tense and relaxed states and can help the patient reduce anxiety in the moment. Mindfulness does not seek to have any influence on emotional state; it is about awareness, but attentional/experiential awareness broadly, whereas PMR is about awareness of tension in particular. Self-Soothing is similar to PMR in addressing emotional state, but is not specific to anxiety. Self-Soothing should be done from a state of mindful awareness in order to fully benefit from the skill.
What is optimal functioning, according to General Systems Theory? (Need at least 4 to get it "right")
A system is functioning optimally when: the system is open to the context, has healthy (appropriately permeable) boundaries, can self-regulate in effective ways to maintain homeostasis or experience growth (as needed), has flexible/adaptive rules, and is founded on cohesive structures that are committed to one another.
Explain who is involved and what is happening during the Pre-Session and during the Rejoining the Family portions of a Systemic Family Therapy session.
Pre-Session: Family and primary therapists in room, with the family sharing what has been going on since last time; rest of therapy team in observation room; all therapists observing the transactions among family members. Rejoining: Primary therapists come back into therapy room to share observations with the family and provide chosen interventions; all members of therapy team now observing how the interventions are received and how the family interacts during them.
[Can you explain who is involved and what is happening in the other phases of a session?]
Why is self-care an ethical imperative?
Our ethics code requires that we ensure that our personal experiences do not have a detrimental impact on the patient. However, burnout reduces empathic abilities, can fracture the therapeutic alliance, and make us less competent at providing therapy.
Contrast (and explain) what would likely be on an MI-based homework monitor with what would likely be on a DBT-based homework monitor.
Given that MI is about building motivation, that has to be on the monitor somehow. In contrast, given that DBT will focus on reducing life-threatening and therapy-interfering behaviors, while increasing skillful behaviors, the monitor would need to reflect at least some of these.
[What would be on monitors for other approaches (that would ever bother using a monitor)?]