NSG527 / NSG 527 Midterm Exam (Latest 2024 / 2025): Psychopathology, Theories, & Advanced Clinical Modalities | Rated A Questions and Verified Answers
Deep Brain Stimulation Infection? ANSWER Complications such as infection can result in the removal of the DBS hardware. Deep Brain Stimulation Side effects ANSWER Dizziness, problems concentrating, possible infection, allergic reaction, pain, tingling, ect. Deep Brain Stimulation What is it used for? ANSWER -Treatment in Parkinson's disease for movement symptoms such as tremors, rigidity, stiffness, slow movement, and walking problems. - it can also be used to treat Tourette's, epilepsy, OCD, dystonia, and treatment resistant depression. Deep Brain Stimulation What is it? ANSWER Surgical treatment in which a device called neurostimulator delivers tiny electrical signals to a area of the brain. (Electrode is in the brain pulse generator is in the chest area, usually under the collarbone. They are connected through a wire under the skin of the head, neck, and shoulder). Dyadic Developmental Psychotherapy Erikson's stage of development ANSWER Stage 1: trust vs mistrust Dyadic Developmental Psychotherapy Founder ANSWER Daniel Hughes Dyadic Developmental Psychotherapy Maslow's hierarchy of needs ANSWER Focuses on safety and security Dyadic Developmental Psychotherapy PACE ANSWER 1. Playfulness: creating a fun, light, and playful atmosphere, when communicating with a child. 2. Acceptance: this is about accepting that whatever the child is feeling right now is OK (ex. "I hate you", "I'm sorry you feel that way)
3. Curiosity: seek to understand what is that drives them. (ex. "why did you do that?" "what do you think that was about?") 4. Empathy: putting yourself in someone else's shoes, provide comfort and support. - PACE shows a caregiver can respond to a child that helps them feel safe and loved (helps with self regulation). Dyadic Developmental Psychotherapy Principals ANSWER 1. therapy must be experiential (PACE) 2. Therapy must be family focused. 3. Trauma must be directly addressed. 4. A comprehensive milieu of safety and security must be created. 5. Therapy is consensual and not coercive Dyadic Developmental Psychotherapy Therapist ANSWER - therapist must maintain emotional attunement with a child (PACE). - the attitude of the therapist to set a healing pace to therapy Dyadic Developmental Psychotherapy What is it for? ANSWER - helping trauma attachment disordered children heal, that is, developing health, trust, and secure relationships with caregivers. - it is a family-focused treatment, attachment-based - teaching parents about attachment facilitation, parenting methods, and the importance of attunement and responsiveness (sensitive parenting is essential) Existential therapy Applications ANSWER Can be used for substance abuse, depression, anxiety, PTSD. Existential therapy Focus? ANSWER - Universal features of the human condition and the acceptance of pain as an important part of the search for inner peace and happiness. - Anxiety is viewed as part of the human condition - Anxiety arises from our personal need to survive, to preserve our being, and to assert our being can be neurotic or normal. Existential therapy Founder? ANSWER Rollo May & Irvin Yalom Existential therapy Function of the therapist? ANSWER Understand client's subjective world
Existential therapy Goal? ANSWER -embracing the true nature of human existence to overcome anxiety and find the meaning in life -Believing you are capable of making choices about who you want to be. - patient to express an increase in his or her private world by making choices in order to confront and overcome feelings of meaningless and isolation. Existential therapy Individuals world view ANSWER 1. Eigenwelt: own world (self identity, thoughts) 2. Mitwelt: with public world (interaction with society) 3. Unwelt: natural world around (how we relate to environment) 4. Uberwelt: ideal world (based on beliefs and values) Existential therapy Philosophy ANSWER You can make changes to be the person that you want to be. - Based on the philosophical concern with what it means to be fully human. - Based on a personal relationship between client and therapist - Stresses personal freedom in deciding one's fate -Places value on self-awareness Existential therapy Techniques ANSWER - focusing on freedom and responsibility - confronting negative thoughts and fears - encouraging the embrace of life with hope, despite anxiety - it does not focus on past, but past are used as tools to promote self-awareness and assertiveness - the use empathetic approach to foster personal responsibility for choices Existential therapy Yalom's four givens of existence ANSWER 1. Death: Death anxiety influences human behavior subconsciously. 2. freedom: responsible for one's life or destiny. 3. existential isolation: conformity to society's norms in order to not be isolated from the masses. 4. Meaning of life: finding one's purpose (self-actualization) Gestalt therapy Attributes to dialogue ANSWER 1. Inclusion: immersion into the experience of the person without judgment, analysis, or interpretation, while maintaining a sense of one's detachment 2. Presence: The therapist opens herself to the patient remarks, fondness, feelings, private experiences, and opinions expressed on a regular basis, sensibly, and without discrimination of situation.
3. Commitment to dialogue: contact is something that happens between people. The Gestalt therapist surrenders to this intrapersonal process., allowing contact to happen authentically without manipulation of the outcome. 4. Dialogue is lived: The mode of dialogue can be dancing words or any modality that expresses and moves the energy between and among the participants. Gestalt therapy Dealing with impasse ANSWER - a challenge when trying to connect feelings - no external support - experience, a sense of being paralyzed - to get into contact with their frustration and accept whatever it is - important to work through an impasse and have patients experience their feelings. Gestalt therapy five layers of neurosis ANSWER 1. Phony- authentic, reactions are unauthentic. 2. Phobic- avoiding pain. 3. Impasse- afraid of change. 4. Implosive- awareness increase, not ready for action 5. Explosive- they are authentic. Gestalt therapy Focus ANSWER - Focus is on "what" and "how" of behavior (what does the client encounter and how do they respond?) - Focus is on the here and now- "now" is the current awareness of the client, "now" is applied to the present moment, not past happenings (previous happenings may be the items of current awareness, but the process of awareness (ex. remembering) is right now) - Focus on unfinished business of the past (people who resent the past, and are not focusing on the hearing now due to lack of closure) - experience feelings intensely - pay attention to their own nonverbal messages. Gestalt therapy Founder ANSWER Fredrick Perls and Laura Perls Gestalt therapy Goal ANSWER - move from environmental support to self support through awareness and selfdetermination. - the goal is to have the patient gain more awareness and eventually be able to support themselves for regulation instead of relying on the environment. Gestalt therapy
Key concepts ANSWER 1. Acceptance of personal responsibility. 2. Awareness of present moment. 3 dealing with impasse Gestalt therapy Perls Belief ANSWER Perls believed that one of the reasons patients develop mental health symptoms was because they weren't aware of their sense or emotion. They didn't have recognition of bodily sensations, and poor awareness of their environment. He also believed mental health symptoms could be caused by unfinished business (feelings are not expressed) and not taking responsibility. Gestalt therapy Premise ANSWER - Change occurs through the increase the awareness of the here and now - it focuses on what's happening in the moment, both within the client and therapist. Gestalt therapy Techniques ANSWER 1. Topdog vs Underdog: it is done when there are two opposing opinions/attitude within the client. Tyrannical "topdog" demand things be a particular way. "Underdog" play the role of a disobedient child. Client becomes split between the two sides, struggling for control. 2. Empty chair: two chairs are facing each other. One represents the patient or one aspect of the patient's personality. The other chair represents another person, or the opposing part of the personality. As the patient alternates the role, he, or she sits in the first or second chair. In the process, emotion and conflict are evoke, empath may be brought about and resolved, and awareness and integration of polarities may develop. 3. Fantasy: client's self-awareness of their thoughts and emotions and bring about closure to unfinished business. Therapist use guided imagery techniques (fantasy) to encourage clients to imagine situations such as what they would do in a certain situation, or by projecting themselves into different roles. Motivational Interviewing Founder ANSWER William Miller and Stephen Rollnick Motivational Interviewing Principals ANSWER 1. Express Empathy 2. Develop Discrepancy: this is to listen for or employee strategies that facilitate the clients identification of discrepant elements of a particular behavior or situation. Example: values vs behavior. 3. Roll with Resistance: avoid argument. This refers to the providers ability to side step or diminish resistance, and proceeded to connect with the client and move in the same direction. 4. Use collaboration
5. Support self-efficacy: this is the providers ability to support the clients hopefulness that change or improvement is possible. Motivational Interviewing Strategies: Change Talk (DARN) ANSWER Change Talk: patient's own arguments for change D- statements of Desire A- Ability R- Reason for change N- Need for change Motivational Interviewing Strategies: OARS ANSWER O- open-ended questions: this provides the opportunity for clients to express their point of view and for counselors to discover and follow the client's perspective. A- affirmation: two. Actively listen for the client strength, values, aspirations, and positive qualities, and to reflect those to the client in an affirmation manner. Ex. Client: "I feel like a failure". Therapist: "what I am hearing is that it is very important to you to change this behavior". R- Reflective listening: a skillful manner of responding to what a client says. In MI, one responds to clients with more reflective statements than questions. S- Summarizing: sessions are ended with a strategic, collaborative summary. Motivational Interviewing Therapist interaction style of MI ANSWER Direct and client centered, spirit of MI Motivational Interviewing What is it? ANSWER Collaborative, person-centered form of guiding to elicit and strengthen motivation for change. Compared with nondirective counseling, it is more focused and goal-directed Motivational Interviewing What is spirit of MI? ANSWER Autonomy, evocation, collaboration. The spirit of MI encompasses collaboration in all areas of MI practice; soliciting, and respecting the clients ideas, perceptions and opinions; soliciting and reinforcing the clients autonomy and choices; and acceptance of the clients decisions. Rational- Cultural Theory Aligned with feminist and multicultural movements in psychology ANSWER Feminist movement: a form of psychology centered on social structure and gender. Multicultural movement: considers the influence of contextual varieties (ex. race, ethnicity, language, orientation, education, class status) on human functioning and diverse societies. Rational- Cultural Theory
Basis ANSWER Relationships are both the indicator for, and the healing mechanisms in psychotherapy towards mental health and wellness. Rational- Cultural Theory Central Relational Paradox ANSWER Assumption that we all have a natural drive towards relationships, and in these relationships we belong for acceptance. However, we come to believe that there are things about us that are unacceptable or unlovable. Thus, we choose to hide these things (we keep them out of our relationships). In the end, the connections we make, with others, are not as fulfilling and validating as otherwise might have been. Rational- Cultural Theory Five Good Things ANSWER 1. Greater sense of zest, vitality, and energy. 2. Increase knowledge of oneself and the other person in the relationship. 3. A desire to take action in the relationship and outside of it (feeling more able to act and do act) 4. Overall increased sense of worth. 5. Feels more connected to the other person and has a greater motivation for connection with other people beyond those in this specific relationship. Rational- Cultural Theory founder ANSWER Jean Baker Miller Rational- Cultural Theory Goal ANSWER Create and maintain mutually- growth- fostering relationships. relationships in which both parties feel that they matter. repetitive transcranial magnetic stimulation (rTMS) Advantages over ECT ANSWER - General anesthesia is not required - it is an outpatient procedure - it requires less energy - the stimulation is specific and targeted - convulsion is not required repetitive transcranial magnetic stimulation (rTMS) Pros ANSWER - FDA- APPROVED - cost-effective - non-invasive - administered under the supervision of a doctor - administrated in an outpatient setting
repetitive transcranial magnetic stimulation (rTMS) S/E ANSWER Rare side effects include memory loss and seizure repetitive transcranial magnetic stimulation (rTMS) What can it treat? ANSWER Auditory hallucinations, major depressive disorder, as an add-on to drug therapy and, in particular, as an alternative to electroconvulsive therapy for patients with treatment resistant depression. repetitive transcranial magnetic stimulation (rTMS) What is it? ANSWER - noninvasive way to stimulate nerve self in the area of the brain. - During rTMS, an electric current passes through a wire coil placed over the scalp. the current induces of magnetic field that produces an electrical field in the brain that causes nerve cells to depolarize, resulting in the stimulation or disruption of the brain activity. Transtheoretical Model of Behavior Change Core? ANSWER - Basic understanding is that an individual moves through a series of stages and makes any personal changes. - people will only change when they are ready, willing, and able. Transtheoretical Model of Behavior Change Founder ANSWER Prochaska and Velicer Transtheoretical Model of Behavior Change Stages of Change Behavior ANSWER 1. Pre-contemplation: not aware that action are problematic. 2. Contemplation: gains awareness of problematic behavior (weighs pros and cons) 3. Preparation: Intends to take action, taking small steps 4. Action: takes explicit action, resulting in positive change. 5. Maintenance: works to prevent relapse. 6. Termination: has no desire to return to old unhealthy behavior. Transtheoretical Model of Behavior Change What is it? ANSWER An integrative model of behavioral change that develops from many different psychological theories, such as Social Cognitive Theory and Learning Theory. Why people do not change? ANSWER 1. The timing is not right 2. They are not motivated. 3. They are afraid to change. 4. They have failed in the past and are afraid to fail again.
5. They don't want to change. 6. Addiction.