Monday, September 14, 2015

Diagnostic interviewing techniques

o Client asked direct questions in areas determined by interviewer
o Questioning may be open or closed.
Open= unlimited answer options
Closed= Yes, No, or one word questions

o Restate the clients cognitive or emotional material
o Demonstrate empathic understanding
o Rogerian Client-Centered Therapists rely heavily on reflection
o Overuse is counterproductive - important areas are left unaddressed

Restatement (Paraphrasing): 
o Rephrase what client says.
o Demonstrates active listening.
o Reflection is type of intervention, clarifies and joins themes.

o Accompanied by utilizing other techniques such as questioning, paraphrasing, restating
o Shows understanding of client in the interview
o If done from a not knowing stance, should not invoke defensive response.

o May be used to call client out on discrepancies
o Is often used with substance abusers in order to break denial and/or rigid defenses
o This may increase anxiety and avoidance but is necessary and can be constructive.

o The sharing of personal experiences by the therapist to the client relative to the session with the purpose of helping.
o Intended to facilitate client disclosure.
o Should be used minimally
o Must be careful not to cross boundaries.

o While this may occur unintentionally there are many benefits if used correctly.
o Provides both client and therapist time to process what is being understood.
o Timing is essential
o Promotes introspection

o Therapist test the limits of what client is willing to process.
o May be used to determine clients level of insight.

Reframing (Cognitive reframing): 
o This allows for a different perspective
o Used to challenge negative self concepts and harmful thinking patterns.
o The purpose is to lead to behavioral change. offers online prep for NASW. Unlimited access to practice exams, case studies, simulations, video, audio, and flash cards 24/7.

Monday, September 7, 2015

Reference materials regarding medication side effects and classification

AllPsych Online

⋄ One of the largest psychology websites on the Internet.
⋄ Holds over 920 individual, cross referenced, web pages and an estimated 3000 pages of printed material.
⋄ It is referenced by over 100 colleges and universities in ten countries.
⋄ It provides:
        o Drug name
        o How they work
        o What they treat
        o Possible side effects


⋄ This is a full text database that critically analyzes the published drug side effect literature on drugs currently in use.
⋄ Drug class chapters are prepared by recognized authorities who critically assess published literature each year.
⋄ The goal of the database is to document every drug known to have a side effect reported in the literature.
⋄ It is organized by drug class chapters and does not contain any speculative or unsubstantiated statements.
⋄ Some of the specific areas covered include:
        o adverse drug reactions
        o drug interactions
        o drug toxicity
        o special risk situations
        o pharmacological or patient-dependent factors associated with the occurrence of side effects. offers online prep for NASW. Unlimited access to practice exams, case studies, simulations, video, audio, and flash cards 24/7.

Monday, August 31, 2015

Managing Transference and Countertransference


⋄ Feelings client projects onto the counselor.
⋄ Have to do with relationship client has experienced in the past.
⋄ Intensity of feelings has to do with unfinished elements of client’s life.
⋄ Client may identify in the therapist characteristics that are reminiscent of the person they are transferring their emotions from.
⋄ Feelings can be productively explored so client becomes aware of how they are keeping an old pattern functional in other present time relationships.
⋄ Therapy becomes an ideal place to become enlightened to patterns in relationship of psychological vulnerability.
⋄ Clients gain insight into how their unresolved issues lead to dysfunctional behavior.
⋄ Group therapy may provide a microcosm of how people function in general social settings.
⋄ Ask client to tell more about how the therapist has affected them to elicit additional information about how the client developed the transference.
⋄ Do not become defensive.
⋄ “I wonder if I remind you of anyone you have had similar feelings with?”
⋄ There is potential for rich therapeutic progress!
⋄ Carefully take on a symbolic role and allow the client to work through their unresolved conflict.


⋄ Feelings aroused in the counselor by the client.
⋄ Feelings have to do with unresolved conflict from other past or present relationships rather than the therapeutic relationship with this particular client.
⋄ Discuss how you are affected by certain clients in supervision on with a colleague.
⋄ Get other’s perspectives on whether you are maintaining unconditional positive regard.
⋄ Self-knowledge is the basic tool in dealing with Counter-transference.
⋄ Unacknowledged, this can lead to an unproductive group. If leaders are not willing to deal with their own issues, how can they expect clients to do so?
⋄ Counter-transference in groups can be indicated by exaggerated and persistent feelings that tend to recur with various clients of different groups. offers online prep for NASW. Unlimited access to practice exams, case studies, simulations, video, audio, and flash cards 24/7.

Monday, August 24, 2015

Individually based theory and therapy models

Psychoanalysis- Freud/Erikson/Mahler
Role of Therapist

■ Invisible- Blank Screen (detachment)
■ Fosters transference
■ Focus on Resistance

Therapeutic Goals

■ Bringing the unconscious to the conscious
■ Strengthen the ego

Key Ideas

Deterministic- problems are rooted in the first six years of life and trapped in unconscious motivations
Reality Principle- maximize gratification minimize punishment
Biological Drives- sex and instincts
Parts of Personality- Id/Ego/Superego
Id- Pleasure principle, “Demanding Child,” deterministic, unconscious, satisfy basic survival
Ego- Reality principle, “Traffic Cop,” mediator between Id and Superego
Superego- Moral Principle, “The Judge,” strive for perfection

Psychosexual Stages of Development

Oral Phase- 0-1 years, greedy, mistrust, unable to form intimate relationships
Anal Phase- 1-3 years, anal retentive, aggressive
Phallic Phase- 3-6 years, identity disturbance (Oedipal/ Electra complex)
Latency- 6-12 years, Socialization stage
Genital- 12+, Interpersonal relations freedom to love/work


■ Brief psychodynamic therapy (BPT)- treating selective disorders within an established time.
■ Hypnosis
■ Dream Interpretation
■ Free Association
■ Projective Techniques
■ Freudian Slips offers online prep for NASW. Unlimited access to practice exams, case studies, simulations, video, audio, and flash cards 24/7.

Monday, August 17, 2015

Risk factors, stages and patterns of grief response

•        DSM Diagnosis under Other Conditions That May be Focus of Clinical Attention, V62.82, Bereavement- used for death of a loved one.
•        Depression in this case is considered “normal” but individual my be seeking treatment to relieve symptoms such as insomnia or anorexia.
•        Expression of “normal” bereavement time is relative to different cultures.
•        Major Depressive disorder is not diagnosed unless symptoms last longer than two months after loss.

Stages of Grief:
•        Denial
•        Anger
•        Bargaining
•        Depression
•        Acceptance

Reactions commonly seen in children:
        o        Disbelief- children may act as if it did not happen.
        o        Complain of headaches, stomachaches, or fear of their own death.
        o        Anger- concern over own needs and about being alone, or with God.
        o        Guilt- feelings of causing death, or not having been “better”
        o        Anxiety/Fear: may become clingy and need validation of love.
        o        Regression: revert to bed wetting or thumb sucking
        o        Sadness: lethargy and isolation

Short Term Treatment Goals
•        Express fear and anger, grieve in a healthy way.
•        Loss and Grief Counseling Group
•        Recall fond memories
•        Create a phone list of supportive people to call
•        New coping techniques
•        Find a “safe place” to spend limited time thinking about deceased
•        Exercise regiment
•        Relaxation techniques- progressive muscle relaxation, guided imagery

Long Term Treatment Goals
•        Reach a point of coping without being overcome with grief.
•        Regain normal activity.
•        Reduce feelings of guilt and anger towards self, others, and God.
•        Re-mature over regressed behaviors
•        Understanding of death and life.

Therapeutic Interventions
•        Writing Activities
        o        Letter to deceased for closure
        o        Journal of thoughts (may be shared in counseling, in group, or with family members)
•        Art therapy:
        o        Finger paints are useful in expressing feelings
        o        Draw pictures of activities enjoyed with deceased (useful with children).
        o        Collage on a theme
        o        Splatter room: area where (particularly children) are free to throw violent splotches of paint to get anger out.
•        Play Therapy:
        o        Model clay or dough to vent anger or create ritual objects
        o        Puppetry- to express feelings
        o        Sand tray to play out themes, “burry” deceased for closure, or rake sand for relaxation or meditation.
•        Bibliotherapy:
        o        Appropriate self help books
        o        Books related to symptoms client is displaying
•        Loss Graph or Timeline:
        o        Used to discuss types of loss
        o        Used to recall fond memories and celebrate life
•        Storytelling:
        o        Fantasy monologues
        o        Mutual storytelling
•        Therapeutic Metaphors
        o        Helpful in understanding concept of death
•        Empty Chair
        o        Gestalt technique
        o        Imagine deceased in chair and speak to them for closure offers online prep for NASW. Unlimited access to practice exams, case studies, simulations, video, audio, and flash cards 24/7.