Group Therapy: A Comprehensive Guide to Psychological Healing and Personal Development, Exams of Nursing

Download Group Therapy: A Comprehensive Guide to Psychological Healing and Personal Development and more Exams Nursing in PDF only on Docsity! 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 FINAL EXAM QUESTIONS AND ANSWERS 2024 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). 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 Beck assumption - Distorted thinking contributes to and maintains bheavior (symptoms) Ellis - RET (Rational Emotive Therapy) a form of cbt 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 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. Behavioral therapy - Behavioral therapy is base on the assumption that changes in maladaptive behavior can occur without insight into the underlying cause. This approach works best when it is directed at specific problems and the goals are well defined. Behavioral therapy is effective in treating people with phobias, alcoholism, schizophrenia, and many other conditions. desired goals are achieved or behaviors are performed, clients might be rewarded with tokens. These tokens can be exchanged for food, small luxuries, or privileges. This reward system is known as a token economy. been useful in improving the verbal behaviors of mute, autistic, and developmentally disabled children. In clients with severe and persistent mental illness, behavior modification has helped increase levels of self-care, social behavior, group participation 4 types behavioral therapy - Modeling, operant conditioning, systematic desensitization, aversion Systematic Desensitization - Systematic desensitization is another form of behavior modification therapy that involves the development of behavioral tasks customized to the client's specific fears; these tasks are presented to the client while using learned relaxation techniques. The process involves four steps: The client's fear is broken down into its components by exploring the particular stimulus cues to which the client reacts. The client is incrementally exposed to the fear. The client is instructed in how to design a hierarchy of fears. The client practices these techniques every day. Approach to patient wanting to use CAM to treat his health conditions - studies in the field are minimal when compared to those of conventional medicine. no standards or regulations that guarantee the safety or efficacy of herbal products. Consumers may waste a great deal of money and risk their health on unproven, fraudulently marketed, useless, or harmful products and treatments. Another concern regarding CAM therapies is that diagnosis and treatment may be delayed while clients try alternative interventions, which is common with mental health symptoms such as major depression and anxiety. Research on herbs such as St. John's wort, valerian, and ginkgo biloba and mind-body interventions such as yoga and meditation is extensive, and results are available on the NCCAM website. Cognitive distortions - schemas can be conceptualized as stored bodies of knowledge that interact with incoming information to influence selective attention and memory search schema is an abstract cognitive plan that serves as a guide for interpreting information and solving problems schema as "the basis for molding data into cognitions, defined as nay verbal or pictoral content schema is dormant until activated by a relevant stimulus DBT - tx designed specifically for individuals with self harm behaviors, self cutting, suicide, etc. 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 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. Possible outcomes for patients with Schizophrenia when conducting a symptom management group - found that skills training programs produce moderate but significant improvement in social functioning (ES = 0.52) and negative symptoms (ES = 0.40) and reduce hospitalization rates over a 1- to 2-year follow-up period Reinforcement while conducting group therapy - Positive behavior is rewarded and motivated. Rules are established by the therapist that specifies behaviors to be rewarded. This technique is based largely on behaviorism. Tokens for example are used to note a reward; accumulated tokens are then rewarded with an established reward Silent Sam - With such clients the goal is to find a way to get all members, especially those who are less verbal, to participate in all group sessions. "Mary, we haven't heard from you tonight." "Mary, I noticed that you haven't said much tonight. How has your week gone?" "Bill has just shared his frustrations with the group. Mary, I know you've said you felt frustrated insimilar situations. What advice can you give Bill?" [This example directly targets a silent client by asking him or her to offer advice or suggestions to another client.] Late laura - Although most clients who come late to groups are aware of their behavior, some fail to understand the effect their behavior has on the group. Having the group respond to such clients is more likely to result in changes (e.g., coming to subsequent groups on time) than is being told they are late by group leaders. The following responses would be used only with clients who are repeatedly late or who miss several group meetings. "This is the third time Mary has been late. What suggestions can the group provide to help her get here on time?" "I'm wondering how others feel about Mary being late for group several times." [Although this response is more direct than the first example, open discussion of some issues can increase members' sensitivity to their own behavior, as well as help them understand how their behavior affects the entire group.] Tommie THerapist - Such clients may have been attending a group for several sessions, or they may have considerable prior therapy experience. At times, such clients' interactions in groups will parallel those of a therapist. Although such advice can sometimes be helpful to group members, on other occasions the advice can be disruptive or too direct. "Bill, your comments have been helpful. Let's see how others view Mary's concerns." "Bill, that is one way of looking at how Mary can handle the situation. What additional options canothers offer Mary?" Chatty Cathy and Monopolizing Mike - Such clients dominate group discussions. Group leaders need to find effective ways to interrupt such clients, as they are often unaware of the impact that their behavior has on the group. A strategy that group leaders can use when a Chatty Cathy client is talking is to direct questions to the group as a whole. For example: