PERSONALITY EXAM 3 STUDY GUIDE
GENERAL OUTLINE:
I)
A)
B)
C)
II)
A)
B)
III)
A)
B)
IV)
A)
B)
V)
A)
B)
C)
VI)
Gender-Sensitive Therapies
Feminist Theory
Gilligan & Chodorow
Male-Sensitive Therapy
Multi-cultural Therapies
Comas-Diaz, Sue, Greene
LGBT clients
Constructivist Therapies
Solution-focused:
1) Insoo Kim Berg
Narrative
Integration / Eclecticism
Theoretical Integration
1) Wachtel’s Cyclical Psychodynamics
Technical Eclecticism
1) Lazarus’s Multi-modal Therapy
Transtheoretical Therapy
Processes of change
Stages of change
Levels of change
Future Directions
DETAILED OUTLINE
I)
GENDER-SENSITIVE THERAPIES
General Notes:
1) Creation: during the 60’s and 70’s as a result of the woman’s movement
2) Philosophical Summary: ALL psychological problems occur in and are reflective of the
SOCIOCULTURAL CONTEXT. Problems are, largely, CULTURALLY DETERMINED.
3) Major Theorists:
(a) Carol Gilligan: wrote in a different voice; challenges Kohlberg’s stages of moral development as
androcentric
(b) Chodorow: boys and girls have different kinds of relationships w/ mothers. Boys do not identify with
mothers, therefore do not become nurturant.
B)
Psychopathology / Personality
1) Most theories of psychotherapy: were created by white, European men. Hence, most of them are biased
against women and the experience of women. These theories often make the fundamental attribution error
and erroneously blame the vicitm for problems that actually exist in the culture and society and “pathology” is
actually the NORMAL response to environmental pressures, stresses, and realities.
2) Power inequalities: exist between men and women (i.e., men have more power)
3) Gender role expectations: the roles perscribed by society related to expected behaviors due to apparent
gender of the person (e.g., women should be quiet, submissive; men should be bold and tough)
4) Sexual harassment and trauma: major contributor to pathology in women. Is far too prevalent and
underreported.
5) Role strain / role conflict: Role strain is the pressure from conflicting demands from different roles. For
example: being a mother, a wife, a student, and a worker. Role conflict is when roles clash with one another—
for example, when being a good father conflicts with being a good student or good worker, etc.
6) Internalized oppression: when the messages from society that devalue a person become internalized and
unconsciously accepted by that person.
C)
Therapy:
A)
1
D)
E)
II)
A)
B)
1) Goal: increasing awareness of feminist philosophy (CONSCIOUSNESS RAISING), empowerment of
women, and socio-political chge. They advocate for equal rights for men and women.
2) Empowerment: Instilling in clients the power to make choices. Educating the client that they indeed have the
power to choose the life circumstances that they want—not solely those set out for them by gender roles.
3) Processes:
(a) Consciousness Raising: increasing awareness of societal injustices and the disctimination of women;
teaching client that the “pathology” she experiences is really a normal reaction to the roles and restrictions
present in society.
(i)
Power-analysis, sex-role analysis, BIBLIOTHERAPY
(b) Choosing: once enlightened, women need to choose careful the degree to which they challenge the status
quo.
(i)
Social liberation: increasing alternatives for social behaviors. That is, advocating for social
change to create more alternatives for women. Women are encouraged to step outside of their
personal lives and make a difference in society in order to have better lives.
4) Content:
(a) Anxiety: is a natural reaction to the forces of sexism, discrimination, and violence. The conflict between
acting out desires for autonomy and the need to maintain social ties creates the anxieties and defenses.
(b) Self-esteem: women have negative views of self (internalized oppression) and try to please men
(c) Responsibility: usually felt for everyone except self; responsible to make time for self and break cycle of
oppression.
5) Relationship:
(a) Egalitarian: equal power between therapist and client. decisions are made by consensus, knowledge is
shared.
Research / Effectiveness:
1) NO RANDOMIZED, CONTROLLED OUTCOME RESEARCH
2) female therapist and same-sex therapists contribute to therapeutic process
3) Symptom reduction vs. Social change: both are goals of therapy; but what makes an intervention truly
successful? Changing the individual or changing the society?
Male-Sensitive Therapies:
1) Results of male socialization:
(a) Achievement / success
(b) Constriction of emotional expression
(c) Alexithymia: difficulty in identifying and expressing emotions. Men are often genuinely unaware of
emotions. Tend to rely on cognition to determine how they feel.
2) Men overvalue autonomy and undervalue connections
3) Uses same processes as feminist therapy
MULTI-CULTURAL THEORIES
General Notes:
1) Philosophy: Psychotherapy is inescapbly bound to its particular cultural framework. ONE SIZE DOES NOT
FIT ALL.
2) Major Names:
(a) Comas-Diaz: developmental stages of psychotherapy w/ ethnic minorities
(b) Sue: why do asian-americans under-utilized mental health services?
(c) Greene: pathology with culturally marginazlized clients.
3) Definitions:
(a) Cultural Relativism: advocates different kinds of therapies to be used with different cultural populations.
(b) Cultural Universality: refers to developing transcultural therapeutic skills that are applicable across a wide
variety of minority groups.
(c) Culture: practices that are transmitted to succeeding generations—major determinant of personality
(d) Race: people realted by common ancestry or heredity; perceived in terms of features or traits
(e) Ethnicity: shared culture; clients can be same race but different ethnicity
Personality / Pathology:
1) *Personality is determined largely by cultural contexts. Pathology results as a product of the cultural context;
especially the discrimination and racism experienced by minority cultures (poverty, health issues, etc.)
2
C)
D)
E)
III)
A)
B)
C)
D)
Therapy:
1) Processes:
(a) Consciousness raising: much like feminists therapist, educate the client about the injustices in their
society and that their reactions to them is normal.
(b) Catharsis: give arena for expression of anger, hostility b/c of discrimination.
(c) Choosing: must choose how to channel new found pride constructively. How integrated do you want to
become?
2) Content:
(a) Intimacy: due to loss of connections not only with dominant culture, but also sometimes from “home”
culture, connections can be lost
(b) Commnication: fails when differences b/w the groups and individuals the focus rather than similarities.
(c) Hostility: natural reaction to oppression
(d) Control:fight being controlled by messages / discrimination
3) Therapeutic Relationship:
(a) listen, support, and validate.
(b) The goal is to join the client whereever he/she is: depending on client's cultural values, the relationship
will take a congruent form.
(c) Advocacy: empowering the clients for social change-the therapist, while working with the individual is
also working to change society
Research:
1) Minorities are largely underserved in mental health
2) Ethnically SIMILAR therapists are preferred by minority clients.
3) FEW CONTROLLED STUDIES
(a) no RCTs “The gap between research and practice is acute.”
LGBT Therapy
1) Reparative Therapy: not demonstrated as effective, probably detrimental
2) Therapy:
(a) Processes: consciousness raising, catharsis, choosing
(b) Therapeutic Relationship: EMPATHY and ACCEPTANCE is central.
CONSTRUCTIVIST THERAPIES
General: very brief and very new (4-5 sessions)
Philosophy: based on post-modernism; reality is SUBJECTIVE and socially constructed. No EXTERNAL
REALITY that is the TRUTH. Looks down on empiricism as the “priviledged” truth.
Solution-Focused Therapy:
1) Psychopathology / Personality: NONE
2) Good Goals:
(a) positive, process-oriented, and client-directed.
(b) Asking the miricle question
(c) Overall: focus on strengths and positives; what are the exceptions to the problem and build on them.
3) Therapy:
(a) Processes:
(i)
Consciousness raising: help client to see the positive and know how to build on strengths
(ii)
Choosing: CHOICE is central; must choose to experiment with solutions, choose to set goals, etc.
(b) Practical use: used in coaching, teaching, etc. Similar to Motivational Interviewing
Narrative Therapy:
1) Focuses on how we tell the stories of our past—these are what define our future.
2) Psychopathology / Personality: Useless—these theories are the therapist’s stories, not the client’s
3) Therapy:
(a) Deconstruction: break down the client’s story; see recurring themes, how they lable others and self.
Become aware of the dominant discourse that takes place in families.
(b) The Problem: become aware of how much this has controlled us (the old story). The old story or way we
told our life story is the way we define our current reality. But the way we usually tell our story is not the
only way. We can construct a new story and a new understanding of ourself.
(c) Processes:
3
(i)
E)
IV)
A)
B)
V)
A)
B)
Choosing: Once we are able to deconstruct our old story, we can CHOOSE how to think of
ourselves and tell our own stories.
(ii)
Counter-conditioning: actively create a new story via writing, speaking, telling and retelling.
Research:
1) NO RANDOMIZED CLINICAL TRIALS
2) Conflict of philosophy b/w constructivist and need for effectiveness research.
3) Therapist testimonials are bulk of “effectiveness” research.
INTEGRATIVE / ECLECTIC APPROACHES
Theoretical Integration: two or more systems are integrated in the hope that the result will be better than the
constituent therapies alone.
1) emphasis on integrating the techniques as well as the underlying theories.
2) seeks a theory that is more than the sum of its parts. Beyond the technical blend of methods to a theoretical
framwork that synthesizes the best elements of different approaches.
3) Wachtel’s Cyclical Psychdynamics:
(a) combines interpersonal psychodynamic and behaviorism
(b) Pathology / Personality
(i)
Conflicts follow from and cause how one lives. Wachtel sees conflicts as affecting behavior and
the resulting behaviors affecting our conflicts. It is a 'vicious cycle.' "A patient's current way of living
both stems from and simultaneously perpetuates his or her problems."
(c) Therapy:
(i)
Processes:
 insight and action: CONSCIOUSNESS RAISING and COUNTERCONDITIONING
(ii)
Relationship:
 important, passive like psychoanlytic w/ humanistic stance plus directive and teaching like
behavioral
(d) Reasearch
(i)
NONE to date
Technical Eclecticism: selecting from pool of available techniques the ones that will work best for THIS
client; regardless of originating theory.
1) Lazarus’s Multi-Modal Therapy:
(a) BASIC I.D.
(i)
Behaviors
(ii)
Affect
(iii)
Sensation
(iv)
Imagery
(v)
Cognition
(vi)
Interpersonal Relationships
(vii)
Drugs/Biology
(b) Therapy:
(i)
Assess client on all 7 dimensionsselect treatment of choice to achieve client-directed
(ii)
Pickthe best treatment for that particular client and his or her goals.
(iii)
Relationship:
 authentic chameleon
 precondition but not sufficient for change
TRANSTHEORETICAL THERAPY – TTT
General:
1) Goal: to create a therapy that relies on common change strategies or processes
2) Perry’s Model of Intellectual Development:
(a) Dualists  Multiplists  Relativists  Commitment
3) Perry’s Model:
(a) Blob w/ no distinctions  Focusing on distinctions  integration
Processes of change:
1) strategies, common factors: including change strategies incorporated by people to change their lives outside of
tx
4
C)
D)
E)
F)
VI)
2) Consciousness raising is the most common process
3) Expectancy: another key factor
Stages of change:
1) precontemplation – sees no change needed Denial. REALLY resistant
2) contemplation – “I might change”
3) preparation – Intention “I will change ________”
4) action – I am changing
5) maintenance – I’m maintaining the change.
6) termination – I have changed
7) Spiral:
(a) clients cycle through the stages, often regression back to the earlier stages, but not a same level as began
8) Stage of change is powerful predictor of therapy success.
9) Failures of therapy: occur when therapist uses a process that is inappropriate with the stage of the client.
Levels of Change:
1) clients present with changes needed at different levels THE WHAT OF TX
2) symptoms / situational problems
3) maladaptive cognitions
4) current interpersonal conflicts
5) family / systems conflicts
6) intrapersonal conflicts
7) **As you go down the list, the problems and their causes are LESS conscious to the client and MORE
historical (aka, the longer it will take)
8) Start at the first level, then move down the list as needed.
Summary: TTT people work by deciding WHAT (level of treatment) to treat HOW (which process) based on
WHEN (stage of client) by:
1) shifting levels
2) key levels
3) maximum impact: ALL at the same time
Research:
1) Supportive so far
2) based on addictions treatment and health behaviors: smoking, stress, multiple bxs, bullying/violence
Future: look at study guide
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