Tuesday, November 17, 2015

Statutes, case law and regulations

Professional disclosure statement tells clients about:o the education and qualifications of the therapist
o the nature of the therapeutic process
o Informed Consent
o Document that the client reads about the specifics of therapy treatment
o Client consents to treatment by signing the form
o Procedures and goals of therapy
o Potential harms or risks to client
o Reasonable benefits of therapy
o Qualifications and policies of therapist
o Theoretical orientation of therapist
o Ability to terminate treatment at any time
o Reassurance of referral sources for treatment (3 is standard)
o Fee disclosure

o Ethical obligation of therapist to keep communications between themselves and client private.
o May be charged in contempt of court if therapist refuses to testify about a client.

Exceptions:o Child abuse reporting laws: mandated to report the suspicion of child abuse or neglect. (in some states this is required of all citizens not just counselors)
o Duty to warn: if therapist establishes there is a likelihood that client will cause harm to him/herself or to someone else and the therapist knows who that victim may be.

Privilege- Legal right, owned by the client, which is an exception to the general rule that the public has a right to relevant knowledge in court proceedings. This means information revealed in session is not permitted in court.

Appropriate standard of care- how most therapists would treat a case under similar circumstances. Those who do not follow this are at risk for malpractice.

Dual relationship- occur when therapist does not keep appropriate boundaries and thereby blends personal or business relationships with the therapeutic relationship.

Secret policies- written statements about how information shared privately will be handled by the therapist. Must be signed by both parties.

Tuesday, November 10, 2015

Risk factors for and patterns of abuse

Recognizing sings of abuse
In the child: o Sudden changes in behavior or school performance
o Not medical attention for problems brought to parents attention.
o Learning problems, difficulty concentrating, that cannot be attributed to specific disabilities.
o Tends to be watchful, expecting something to happen.
o Lacks adult supervision.
o Overly compliant, passive, or withdrawn.
o Comes to school or other activities early, stays late, does not want to go home.

The Parent: o Shows little concern.
o Denise existence of, or blames the child, for problems at school or home.
o Asks teachers to use physical discipline.
o Describes child as bad or burdensome.
o Demanding high levels of academic and physical performance.
o Relies on child for care, attention, emotional needs.

Parent and Child: o Do not look or touch each other.
o View of relationship is only negative.
o State they do not like each other.

Pattern of Abuse
Tension building o Anger builds.
o Poor communication.
o Victim feels the need to keep the abuser calm.
o Tension mounts.
o Victim constantly feels weary of abuser.
o Abuse (physical, emotional, or sexual) takes place.
Making up:
o Apology may be made.
o Promise of the last time.
o Victim blaming.
o Denial of abuse.
o Calm
o Abuser acts as if nothing has happened.
o Some promises may be met, during this time.
o Victim may believe the abuse is truly over.
o Abuser may give gifts to victim.

Monday, November 2, 2015

Gottman's Theory of Couples Therapy

Four Horseman
1. Criticismo Criticism= Why do you always put your work ahead of me? I am always on the bottom of the totem pole. What happened to having dinner just the two of us tonight?
o Complaint= You should check with me before inviting coworkers over for dinner to our home. I was hoping to spend time with just you tonight.
o Statement= Im upset. I was under the impression we were supposed to have dinner alone tonight.

2. Contempto Sarcasm and Cynicism
o Name Calling
o Eye-rolling
o Sneering
o Mockery
o Hostile Humor
o Contempt is poisonous to a relationship because it conveys disgust.

3. Defensivenesso Defensiveness is just a way of blaming.
o Defensiveness escalates the conflict.

4. Stonewallingo At a certain point, criticism, contempt and defensiveness give way to stonewalling.
o One partner shuts down, closes up, an emotionally leaves.
o Men are more likely to stone wall (85%)

Flooding= when one partners negativity- whether in the guise of criticism or contempt, or even defensiveness- is so overwhelming and so sudden that it leaves the other partner shell-shocked and defenseless.

Monday, October 26, 2015

Gottman's Theory of Couples Therapy

7 Principles for Making Marriage Work

1. Enhance Love Mapso Develop a deep knowing about each other
o Demonstrate interest in each others lives and priorities

2. Nurture Fondness and Admirationo Develop awareness of the things about your partner that you admire
o Fondness and admiration are antidotes for contempt
o Re-write the history and update the philosophy of your marriage

3. Turn toward each other in stead of away
o Make deposits into emotional bank accounts
o Engage in stress-reducing conversations
o Be on your partners side

4. Let your partner influence youo Learn to accept influence
o Power sharing
o Emotional intelligence

5. Solve your solvable problemso Soften your start up
o Learn to make and receive repair statements
o Sooth yourself and each other
o Compromise
o Be tolerant of each others faults

6. Overcome Gridlocko Moving from gridlock to dialogue
o Give voice and share your dreams
o Steps to resolutions
o Become a dream detective
o Make peace

7. Create shared meaningo Family rituals
o Align roles and expectations
o Share personal goals
o Symbols: create, define and share

Monday, October 19, 2015

Bowenian Family Systems Therapy

Key Terms
o Detriangulation: the process by which an individual removes himself from the emotional field of two others.

o Differentiation of self: psychological separation of intellect and emotions, and independence of self from others. Opposite of fusion.

o Emotional cutoff: Bowens term for flight from an unresolved emotional attachment.

o Family life cycles: stages of family life from separation from ones parents, to marriage, having children, growing older, retirement, and finally death.

o Family of origin: a persons parents and siblings.

o Fusion: a blurring of psychological boundaries between self and others.

o Genogram: Schematic diagram of the family system.

o I-Position: statements that acknowledge ones personal opinions rather than blaming others.

o Multigenerational transmission process: concept of passing on chronic anxiety from one generation to the next.

o Process questions: questions designed to help family members think about their own reactions to what they are doing.

o Triangle: a three person system

o Triangulation: caused by anxiety bringing in a release person into conflict between two people, but only freezes that conflict.

o Undifferentiated family ego mass: emotional stuck-togetherness or fusion of the family. Prominent in schizophrenic families.