Traps, dilemmas, and snags are techniques typically used in:
A. Cognitive analytical therapy was first developed by Ryle as a brief form of therapy. The therapy is based on the principle that purposeful behaviour activity always follows a sequence. These sequences can be faulty in three ways. Traps are repetitive cycles of behaviour in which the consequence of the behaviour perpetuates it. For example a depressed student is hopeless and stops studying for his exam. He fails the exam, and feels more hopeless and depressed. Dilemmas are false choices or unduly narrowed options. For example, people who fear angry feelings may think they have to choose between placation and aggression. They choose to placate others who then take advantage of them, thus making them even angrier. Snags are the anticipation of highly negative consequences of action such that the action is never carried out and therefore never subject to a reality check.
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Which of the following statements accurately describes collaborative empiricism in Cognitive Behavioural Therapy (CBT)?
D. Collaborative empiricism is a term used in cognitive therapy to describe the therapeutic relationship with a high degree of collaboration and an experimental but pragmatic tone to the therapy. This allows the therapist to formulate hypotheses and helps the client to test the validity of the hypotheses, thus actively contributing to the client’s therapy. It does not necessarily mean that the client and the therapist must agree with each other on every aspect of the therapy. In addition, the therapist need not collude with dysfunctional assumptions the client holds in order to achieve the collaboration.
A method of group psychotherapy where members of the group take on the roles of ‘the protagonist’ and ‘auxillary ego’ while the therapist takes on the role of ‘the director’ is:
C. Psychodrama is a method of group psychotherapy originated by Jacob Moreno, a Viennese-born psychiatrist. In this type of psychotherapy, the personality make-up, interpersonal relationships, conflicts, and emotional problems are explored by means of special ‘dramatic’ methods. Therapeutic dramatization of emotional problems includes the ‘protagonist’ or patient, the person who acts out his/her problems. The enactment is carried out with the help of ‘auxiliary egos’, people who enact varying aspects of the patient. The therapist takes up the role of the ‘director’ and guides those in the drama towards the acquisition of insight. Situations are chosen by the protagonist – this usually focuses on any special area of functioning or symptoms. The auxiliary ego takes on the role of other significant people in the protagonist’s life. The therapist directs the situations, and the group can comment on various ways in which the protagonist deals with the situation he/she is in. Techniques to advance the therapeutic process and to increase productivity and creativity include the soliloquy (a recital of overt and hidden thoughts and feelings), role reversal (the exchange of the patient’s role for the role of a significant person), the double (an auxiliary ego acting as the patient), the multiple double (several egos acting as the patient did on varying occasions), and the mirror technique (an ego imitating the patient and speaking for him or her). Other techniques include the use of hypnosis and psychoactive drugs to modify the acting behaviour in various ways.
Justin is a medical student who faints every time he encounters medical situations involving blood or injury. His therapist trains him to tense the muscles of the arms, legs, and torso at the earliest signs of faintness.
This type of therapy is called:
B. This is called applied tension. Unlike those with other specific phobias who show an increase in sympathetic output on exposure to phobic stimuli, patients with blood–injury– injection phobia show a unique, biphasic response. The first phase is associated with increased heart rate and blood pressure. In the second phase, however, the blood pressure suddenly falls and the patient faints. To treat the problem, patients are shown a series of slides that are provocative (e.g. mutilated bodies). They are trained to identify early-warning signs of fainting, such as queasiness, cold sweats, or dizziness. They also learn how to apply the learned muscle tension response quickly, contingent on these warning signs. Patients can also perform applied tension while donating blood or watching a surgical operation. The technique of isometric tension raises blood pressure, which prevents fainting.
The acronym ‘FRAMES’ in brief intervention for alcohol dependence stands for all except:
B. The acronym FRAMES captures the essence of a number of interventions commonly used under the terms ‘brief intervention’. These are interventions that cover a range from one 5-minute interaction to several 45-minute sessions. The major positive studies discussed in this section typically consist of one interaction lasting between 5 and 20 minutes, sometimes with one brief follow-up contact. The acronym FRAMES stands for: feedback: about personal risk or impairment; responsibility: emphasis on personal responsibility for change; advice: to cut down or abstain if indicated because of severe dependence or harm; menu: of alternative options for changing drinking pattern and, jointly with the patient, setting a target; intermediate goals of reduction can be a start; empathic interviewing: listening reflectively without cajoling or confronting; exploring with patients the reasons for change as they see their situation; self-efficacy: an interviewing style that enhances people’s belief in their ability to change. ‘Rolling with resistance’ is a part of Miller and Rollnick’s motivational interviewing.
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