LSW 3

• 1: relationship building, exploration, engagement, assessment, and planning
• 2: implementation and goal attainment
• 3:termination, planning matienence strategies, and evaluation

• situational (a stressful event)
• maturnational (developmentally based)
• due to cultural values/norms (homosexuality)
• a crisis is not pathology, but it may cause unresolved conflict from the past to stir up and results in inappropriate over or under reaction

• reduce impact in the immediate moment
• mobilize internal/external resources of the person to more effectively deal with the impact of the event
• restore to at least pre-crisis functioning

• 1-crisis/precipitating event
• 2-increased tension and shock, possible denial, failure of customary coping skills
• 3-sharply escalating tension, varying levels of depression, feelings of being overwhelmed, hopeless, confused, or hopeless
• 4-attempts at coping, either adaptive or maladaptive with the appropriate consequences

• 1-formulation of problem/crisis identification (first interveiw)
• 2-Implementation (first to fourth interview)
• 3-treatment/termination (last inerview or two)

• 1-conduct a biopsychosocil and imminent danger assessment
• 2-rapidly est rapport
• 3-ID major problems/crisis precipitants
• 4-deals with clients feelings/emotions
• 5-generate and explore alternatives and new coping skills
• 6-restore functioning through implementation of an action plan
• 7-follow-up

• Jeffery Mitchell
• developed for use with first responders
• on scene management (debriefing)
• a specific 7phase small group process that is conducted 24-72 hours after the incident
• normalizes and teaches new stress response strategies
• further research is needed on efficacy (some studies say it makes people worse)

• used to unlearn maladaptive responses to environmental stimuli
• conditioning an individul to associate pleasant feelings with a stimulus that has been anxiety producing
• based on counterconditioning by Wolpe focuses on the technique of reciprocal inhibition

• a counter-conditioning interventions typically used to treat phobias
• uses relaxation training, consturction of an anxiety heirarchy, and desnsitization in imagination

the pairing of relaxation and real life experience with an anxiey producing stimulus until the person no longer responds to the experience with anxiety

• communicating directly and honestly
• behavorial rehearsal is important

having couples focus on pleasuing each other without using breasts/genitals at all, the focus is on pleasure not orgasm; used to build the sexual repitiore

focuses on behaviors that operate or act on the envionment with the goal of botaining some response (ex reinforcing behavior so that it will be repreated)

the repetition of a behavior because the behavior is followed by a pleasant stimuli

the repetition of a behavior because of the behavior's power to run off negative stimuli

using a high probability behavior to reinforce a low probability behavior in order to increase the frequency of the low probability behavior (allowing a child to watch tv for 30 mins if they do their homework)

reinforcing successive approximations toward a desired behavior

reinforcing every occurrence of the target behavior (useful early in the learning process)

reinforcement of only some occurrences of the target bevhavior (useful in maintaining behavior)

providing reinforcement after a specific time period has elapsed followeing the occurrence of the desired behavior

reinforcement occuring at varying times after occurrences of the desired behavior

reinforcement that is give on a non-varying basis

reinforcement that is given on a varying basis (after 5 occurences)

• following a behavior with an aversive stimuli
• often does not teach appropriate behavior, causes the person to hate the punisher

failing to reinforce a behavior which results in disappearance of the behavior

withdrawing a specific positive reinforcer each time and undesirable behavior is performed

• Behavior modificaiton technique
• a treatment contact that makes a specified consequence, pleasant or unpleasant, contingent on a specific behavior

• behavior modification technique
• used to reinforce desireable behaviors that involves rewarding those behaviors with tokens that can be redeemed for reinforcers

• william glasser
• individuals have a number of innate needs (including 4 psychological needs: belonging, power, freedom, fun)
• psychological disorders represent failure to act upon the world in a manner that brings about the responsible (moral) satisfaction of needs
• focuses on current behavior
• stresses conscious rather than unconscious processes
• seeks to teach clients to evaluate their behavior in terms of whater the behavior is enabling them to satisfy their needs without interfering with the satisfaction of the needs of others

• focus is primarily on the present and has a large educational component
• pt is taught how to identify, evaluate, and change dysfunctional thoughts and beliefs

• also dichotomous thinking
• all things are one way or another, no grey area

refers to an individual believing that something is true because the individual feels strongly about it and ignores evidence to the contrary

individual arrives at broad principles derived from minimal information

magnifying the negative and minimizing the positive

when person A erroneously believes that the negative behaviors of person B is the result of something person A has done

when an individual assumes that he or she knows another person's thoughts on an issue

the client and social worker work in tandem to test the validiy of the clients beliefs

the use of questions to lead the individual to discover a reality

interventions are structured, including the use of a progression of questions, to enable clients to discover inaccuracies in their thinking

used to help clients see that the vents are really not the end of the world, even if they are very difficult

the identification of cognitive errors and distortions in thining followed by the consideration of alternative beliefs

helping the client break their pattern of seeing self as the reference for all life events

• explanation of personality
• A-activitating events
• B-Belief system of Individual
• C-consequent emotion of A and B
• D-disputing irrational thought and beliefs
• E-Emotional and cognitive effecs of revised beliefs
• the activitating event doesnt make a person feel anything, their belief about the event does

• therapist educates the client about the principles of EBT
• therapist challenges the rationality of the client's beliefs and assists the client in learning how to challenge their own beliefs
• client and therapist work together to dispute the irrational beliefs that results in negative consequences

• focus is on the client's self-statements
• training, modeling, practicing in therapy
• 1-social worker and client make an assessment of the client's self-statements and a conceptualization of the problem
• 2-client practices using self-statements in imaginary situations
• 3- client and social worker work togethe to develop self-statements that result in greater enjoyment in life

• individual and group components
• mindfullness:observing, describing, participating
• interpersonal effectiveness: assertiveness and problem solving training to help the person maintain relationships
• distress tolerance:accpeting reality that cannot be changed, finding meaning, and tolerating distress; distraction coping skills
• emotion regulation:identifying and labeling emotions, increasing experience of positive emotions, becoming mindfull of current emotions, untilizing coping skills

• 1-social goals model: raising consciousness, social responsibility, informed citizenry, and to encourge political and social action (group leader is model and enabler)
• 2-remedial model: clinical and oupt settings: restore or rehabilitate individuals exhibiting dysfunctional behavior.
• 3- reciprocal model: clinical, outpt, community settings: provide mutual aid to group members in achieving optimum adaptation and socialization

• task groups involve agendas and rules; the goal is to accomplish a specific task; the roles are assigned; standard for success is achievement of goal; must have specific knowledge to be in the group
• treatment groups are formal or informal; goal is to help members meet their needs;role develop naturally over time; standard for success is individual achievement of goals

• support groups: member have a common problem or set of circumstances who support each other
• educational groups:help members learn info and skills that will benefit each individually
• growth groups:provide members with growth opportunities as opposed to remediation
• therapy groups: provide remedial and or rehabilitation
• socialization groups: assist members in negotiating developmental stages and adapting to changes in roles or environment

members should be matched by age, chronological as well as developmental, single gender reccomended for children, co-ed okay for adolscents, mixed is best for adults

• best to have heterogeneity for conflict areas and homogeneity for ego strength
• believes that concurrent group and individual therapy is NOT necessary or beneficial

a group that is too homogeneous in terms of undesirable characteristics will lead to reinforcement of these characteristics

• closed more effective for short term, task oriented therapy
• open offers fresh imput, but impedes development of trust, acceptance, and cohesiveness
• assimlation of new members has a lot to do with size/age of the group
• 7-10 members is ideal (though 3-6 can work if the number remains mostly consistant)

• forming (anxiety, tentative sharing, look for leadership from facilitator)
• storming (competition and conflict, anxiety about safety, confrontations of the leader can be essential for cohesiveness)
• norming (a consensus on the group tasks and a working process emerge)
• performing (mature and productive group process)
• adjourning (termination, talk about experience with members and group, discuss maintenence)

can result when group members help each other, the experience of being able to give something to another person can lift a member's self esteem

the experience of relief from emotional distress through the free and uninhibited expression of emotion

the process of learning that one has to take responsibility for one's own life and the consequences of one's decisions

refers to group member developming social skills through the modeling process, observation, and imitating the therapist and other group members

when group members are inspired and encouraged by another member who has overcome the problems with which they are still stuggling

group members achieving a greater level of self-awareness through interaction and receiving feedback from others (insight, self-understanding)

the situation of members unconsiously identifying the group therapist and other group members with their own parents and siblings, a form of transferrence; the therapist points this out when it happens to make the client conscious of their self doing it in other people

recognizing of shared experiences and feelings among group members and the acknowledgin that the "problems" may be widespread or be universal human concerns; reduces feelings of isolation, a validation of experiences, and increased self-esteem

a graphic model of interperonsal behavior that can be applied to many different theories of group interaction and is useful in evaluating interpersonal interaction and group effectiveness; better used with groups with high cohesiveness

• Bowen
• goal is to achieve higher level of differentiation of self on the part of each family member.
• often involves working with one family member to change the rest of the family, each member is assisted in taking responsibility for their own role in their problems

family members' ability to discriminate between their identities and experiences and that of other family members (rather than having fused identities)

• formerly called undifferentiated family ego mass
• a family in which members' identifies are fused

• denotes that relationships have periods of closeness and periods of distance.
• occurs during periods of distance-an "outsider" of the relationshiptakes sides with one person in the relationship

the emotional system governs behavior on a societal level, promoting both progressive and regressive periods in society

an unhealthy way of dealing with intergeneration undifferentiation (if a teen severs ties with parents)

the development of specific personality characteristics

the process through which parents transmit their lack of differentiation onto the offspring

the transmission, through the generations, of the family's emotional process

refers to therapist "joining" or engageing in work with couple, avoiding triangulation, and helping the couple address their problems

a process in which the therapist avoids taking sides with partners and encourages each of them to take responsibility for their part in family problems.

a graphic representation of family relationships that includes a minimum of three generations

the primary goal is to alter the interactional patterns that maintain the dysfunctional communication patterns which function to maintain homeostasis in the family

• communications/experiential family therapy
• all communcation takes place on a report level (what is actually said) and a command level (the covert message relative to how the communication is to be taken)

• communications/experiential familly therapy
• symm:egalitarian relationships in which rules are mirror images
• complementary: a fit between different roles

the same results can be obtained via different means

behaviors of different subsystems that reciprocally impact each other

• blaming/criticizing
• mind reading
• making incomplete statements
• making statements that imply that events are unalterable when they are not
• over generalizing
• double bind communication/contradictory demands
• disqualification of the communication of another member of the family

• 5 styles of communcation:
• the placator (agreement, apologizing, pleasing)
• the blamer (accuses, criticizes, dominates)
• the super reasonable (outward appearance of calm but is emotionally detached)
• the irrelevant (seeks to distract others and seemingly has difficulty relating to what is going on in the moment)
• the congruent communicator (send clear, straight forward messages an is genuine)

• salvador minuchin
• identifies the maladaptive structural elements that underlie maladaptive family interactions, as well as relationships between the family and nonfamily entities, and then makes changes in these structural elements

the therapists entrance into the family's interactional system. It inclues forming a strong bond with family members, acknowledging the various perspectives of members, and accomodating the family's organization and patterns

• the maping of underlying structures of the family
• restructuring involved changing the family sructure via enactment, spontaneous behavior sequences and reframing

the therapist has the family act out, in session, how they typically deal with a specific problem, the therapist either pushes family to contiue their strategy or comment on the problem and provide new skills

occur when the therapist highlights an interaction that is naturally occurring in the moment and assists the family in modifying problem sequences

redefining the family's perspective on problems as problems with the sturcture of the family

• Jay Haley
• emphasizes change technqiues over theory
• the therapist is very directive and relieves symptoms by helping patients find alternative ways of defining relationships
• especially useful with change-resistant families

the therapist takes a very direct, active role, therapist is responsible for changing maladaptive family organization and for solving the problems, therapist must maintain control

• d: tasks given by the therapist
• pd: "prescribing the symptom", tasks assigned by the thearpist that he wants the family members to resist

making the clien's symptoms too much trouble for the client to continue to have

meeting the family's resistance to change with warnings of the dangers implicit in change and the need to change slowly

a form of paradox that involves having a family member act in an exaggerated way, consistent with another person's apparent perception of them

• Mara Selvini Palazzoli
• focuses on two aspects of family interaction: the struggle for powerand the protective role of symptoms
• each session consists of a
• presession (intial hypothesis formulation)
• session (info gathering)
• intersession (ID intervention to be used)
• intervention (treatment team provides agreed upon strategy)
• post-session (team members discuss the family's response and plan the next session)

treatment team formulates a hypothesis before the session begins which is modified based on data obtained in session

equal acceptance of all family members by the therapist, therapist avoids allying with any family member

engaging family members in repetitious behavior designed to counter dysfunctional family rules and to reinforce the postive connotation of behaviors

interrupting destructive paradoxes in disturbed family that involves prescribing the problem behavior and all of the interactions that surround it

a technique tha involves promoting family solidarity and decreasing resistance to therapy via interpreting symptoms as family preserving efforts

an interviewing technique whereby family members are asked questions that help them to think in relational terms, the client is asked to think what another person thinks, increases awareness of the other person and empathy

• M:the same beginning point may lead to different results
• E: different beginning points may lead to the same result