can easily become the target of their clients' affections and, if they are not careful, may respond inappropriately (and in a way, that reinforces rather than acts to resolve their clients' problems). Preconscious Includes those things of which we are aware, but where we are not paying attention. We can choose to pay attention to these and deliberately bring them into the conscious mind. Phobias Psychoanalysts propose that when repression does not work, individuals with phobias displace their anxiety upon a situation or object that is less relevant. For Freud, the compulsive behavior of the neurotic is a behavioral manifestation of an instinctual drive repressed in childhood. A psychoanalyst offers interpretations of psychodynamic causes of problems. It is through these interpretations, the patient gains 'insight' (i.e., an understanding of the unconscious source of problems). However, the process of psychoanalysis can difficult and often is faced with challenges of: patient resistance, patient transference, and repetition compulsion. Person-centered Therapy- Carl Rogers Founder: Carl Rogers. Key figure: Natalie Rogers. Person-centered expressive arts therapy, in the expressive arts are used in healing, and growth. A branch of humanistic psychology that stresses a phenomenological approach, person-centered therapy was originally developed in the as a reaction against psychoanalytic therapy. Emphasizes the client’s resources for becoming self-aware and for resolving blocks to personal growth. Philosophy and Assumptions grounded on a positive view of humanity that sees the person as innately striving toward becoming fully functioning Basic assumption is that it is the therapist’s attitudes and belief in the inner resources of the client that create the therapeutic climate for growth. By participating in the therapeutic relationship, clients’ self-healing capacities are activated, and they become empowered. Key Concepts Clients have the resourcefulness for positive movement. Capacity for resolving life’s problems effectively without interpretation and direction from an expert therapist. clients value most is being understood and accepted, which results in the creation of a safe place to explore feelings, thoughts, behaviors, and experiences mental health as a congruence between what one wants to become and what one is. Therapeutic
This technique involves a series of actions involving the entire family in a sequence of steps, forming a play that is to be enacted under specific circumstances. An example of a ritual is a family sitting together daily, each getting equal time to speak well of the family, with no negative opinions allowed. Family Systems Therapy De-triangulating The triangle is the smallest, stable relationship systems, but paradoxically is the most difficult for an individual to tolerate because there is always one person who is "on the outside." Bowen talked about "putting the other with the other," meaning linking individuals directly with one another rather than having the 3rd present to absorb the tension. It is imperative the therapist do the same with the therapist's presence, specifically not taking sides. Genogram This involves drawing a complete genogram (sometimes called the Family Map), looks like a family tree, but is comprised of additional information, such as emotional dynamics (marriages, divorces, significant events, over involved relationships, distance, conflict, and cutoffs). It is a snapshot representation of the family for the client, enabling hypotheses and insights, and the purpose and principles of the model are not withheld from the client. I-Positions The therapist continuously uses "I" messages to differentiate himself or herself from the individual, couple, or family. The purpose is to demonstrate the responsible vs. irresponsible use of "I," the first of which differentiates by defining one's own beliefs and values, and the second of which makes demands (i.e. "I deserve" or "My right"). General Systems Theory Advocacy The therapist will engage necessary supports or assist the client when points cannot be overcome and present as a hindrance to the central work, including advocacy regarding unfair or outdated policies. Ecomap The therapist will draw an Ecomap with the client to discover the social environment (conditions, circumstances, and interactions) surrounding the client, which will enable the therapist to see the interactions with multiple systems (friends, politics, religious, educational, vocational) that the client engages inputs and outputs. Draw the family household membership in the center circle. Then, engage the connecting systems with appropriate lines, which will indicate strength and direction of the relationship (i.e. strong, tenuous, conflicted, one way). Reframing The or problem is removed from the identified client and assigned as a family issue and becomes the focal point of the intervention. Tapping into all Systems
Experience attacks of worsening neurologic function (relapses) followed by partial or complete recovery periods (remissions). Secondary-progressive MS Disease worsens more steadily. Exacerbation, relapses, &/or plateaus may not occur. Primary-progressive MS Slowly worsening neurological functioning w/ no periods of remission. Progressive-relapsing MS Steadily worsening disease along w/ periods of exacerbations which may or may not be followed by periods of remission. Typical symptoms: Fatigue, numbness, walking/balance/coordination problems, bladder dysfunction, bowel dysfunction, vision problems, dizziness and vertigo, sexual dysfunction, pain, cognitive dysfunction, emotional changes, depression, & spasticity. Treatment: Immunomodulatory alter course by slowing progression & reducing relapse rate. Steroidal meds reduce severity & duration of exacerbations. Accommodations: Weakness/fatigue (e.g., modified work schedule). Motor dysfunction (e.g., automatic door openers). Cognitive problems (e.g., written memos). Sensory problems (e.g., use of large print). Heat insensitivity (e.g., air-conditioned work environment). Diabetes Type 1 AKA juvenile or insulin dependent. Typically, 1st diagnosed in children, teens, or young adults. Beta in pancreas stop producing insulin because body’s immune system has destroyed them. Acute onset Symptoms: Frequent urination, drinking, eating, and weight loss. Severe attack can cause coma/death. Type 2 AKA adult-onset Most prevalent form of diabetes. Insulin resistance: fat, muscle, and liver cells fail to use insulin properly & over time the pancreas loses the ability to secrete sufficient insulin in response to increased blood sugar levels. Overweight & inactive Type 2. Slower & insidious onset. Symptoms: Fatigue, nighttime urination (nocturia), and vision difficulties.
Delusions Erroneous beliefs involving misinterpretation of perceptions or experiences. Hallucinations Perceptual distortions that can occur in any sensory modality such as gustatory (taste), visual, olfactory (smell), and touch (tactile). Auditory are most common. Disorganized speech Loose associations and use of neologisms (use of newly coined terms/words). Grossly disorganized or catatonic behavior Unpredictable agitation and difficulties performing ADLs. Negative symptoms: Flat affect (lacking emotional expression). Poverty of speech (Alogia). Lack of motivation (Avolition). May experience impairments in: Verbal and nonverbal memory Working memory Attention Executive functioning Processing speed Schizoaffective disorder: When person experiences symptoms of schizophrenia and a co-occurring affective disorder such as depression and/or mania. Schizophreniform Experiences sufficient symptoms of schizophrenia but the symptoms have not been present for at least 6 months. Pharmacological Treatments: Antipsychotic meds have significant side effects: Tardive dyskinesia (involuntary stereotyped movements of the mouth and face). Hypotension. Tremors of the arms. Rigidity in extremities. Internal listlessness (akathisia): agitation, distress, restlessness. Dry mouth Blurred vision Sexual dysfunction Weight gain Depression 10-25% and 5-12% of men. Dysthymic disorder has many features like depression but less vegetative symptoms (e.g., sleep problems, appetite problems, weight changes, and psychomotor symptoms). Symptoms: Negative and pessimistic beliefs.