Telehealth & Psychotherapy: Glossary

Intersubjectivity & Mutuality, Victor Bloomberg 10/3/2021

The first set of articles is derived from my book, Transformative Psychotherapy and Telehealth. The posts often use words precisely and there is jargon that I avoid when I write for the general public. This glossary covers most of the special concepts. Please don’t hesitate to suggest updates. Thank you.

Andragogy is an educational process through which the student engages in self-directed learning supported by a teacher. (Blaschke, 2012)

Big Change is intended from transformative psychotherapy; it is new resilience from relating with others such that emotion response cycles routinely militate against the Fight-Flight-Freeze response intensified by past events.

Bigger Picture is a term used in a special way by the Western Institute for Social Research to indicate that understanding human phenomena, problems, and solutions requires synthesis of societal dynamics and individual experience. (WISR, 2015)

Blended care is a combination of online and face-to-face therapy (Wentzel et al., 2016..

Blended psychotherapy (bPT) is a treatment that integrates internet- and mobile-based interventions into out-/inpatient psychotherapy. (Titzler et al., 2019)

Cerebral cortex is the part of the brain where memory, awareness, and conscious ‘thinking’ take place. (Ruud, 2019)

Cisgender refers to a person whose "sense of personal identity and gender corresponds with the sex put on their birth certificate." (The LGBTQ Experiment. 2018, para. 1)

Code-switching is reflected when a person speaks differently based upon the culture of the persons in the interaction. (Zainuddin, 2016)

Cognitive Behavioral Therapy (CBT) is one of the most common and best studied forms of psychotherapy. It is a combination of two therapeutic approaches, known as cognitive therapy and behavioral therapy... What we think, how we feel and how we behave are all closely connected – and all of these factors have a decisive influence on our well-being. (National Center for Biotechnology Information, 2016)

Confidentiality is the question of how personal data collected for approved social purposes shall be held and used by the organization that originally collected it, what other secondary or further uses may be made of it, and when consent by the individual will be required for such uses. It is to further the patient's willing disclosure of confidential information to doctors that the law of privileged communications developed. (Office of Assistant Secretary for Planning and Evaluation, 2016)

Constructivist grounded theory explains the co-construction of knowledge by a scholar and research participants, and it was developed by Kathy Charmaz. (Singh & Estefan, 2018)

Countertransference is transference manifested by the psychotherapist and it can usefully guide inquiry.

Dialectical thinking involves seeking out contradictions and being constantly open to an assumption being revised, repudiated, or overturned. (Roberts, 2000)

Emotion response cycle is a concept based on a model of the sexual response cycle. (Bloomberg, 2015)

Emotions are signals from the amygdala which is part of the limbic system of the brain. (Ruud, 2019)

Evidence-Based Practice (EBP): Evidence based medicine is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients. (Dotson, n.d.)

Expert-level proficiency uses feel and familiarity, does not require calculation, and can improvise in an unfamiliar moment to achieve success. (Dreyfus & Dreyfus, 1989, p. 50.)

Family systems theory “is concerned with family dynamics, involving structures, roles, communication patterns, boundaries, and power relations.” (Rothbaum, et al., 2002, p. 329)

Field theory is a method of exploring that describes the whole field of which the event is currently a part. (Yontef, 1993)

Fight-Flight-Freeze is a response to danger rooted responses associated with the amygdala. (University of Toledo, n.d.)

First-order change refers to solutions that do not change the problem but that create stability. (Fraser & Solovey, 2007)

Generalization is a form of inductive reasoning that draws conclusions based on recurring patterns or repeated observations. (LibreTexts, 2021)

Gestalt psychology provides a “[field theory] perception [that posits] neural… processes with which the perceptual facts are associated are located in a continuous medium [and] events in one part… influence events in other regions in a way that depends directly on the properties of both in relation to the other.” (Köhler, 1973, p. 55)

Gestalt psychotherapy “directs attention” to the “contact itself, the place where self and environment state their meetings and become involved with each other.” (Perls et al., 1994, p. 28)

Grounded theory is the result of a research methodology which goes back-and-forth between data collection and analysis, and in the process builds a conceptual model. (Glaser & Strauss, 1967)

Good Enough Parent: “In order to be consistent, and so be predictable for our children, we must be ourselves. If we are ourselves our children can get to know us. Certainly if we are acting a part we shall be found out.” (Winnicott, 1993, p. 123) [Italics in the original].

Health coaching is a client-centric process to increase motivation and self-efficacy that supports sustainable lifestyle behavior changes and active management of health conditions. (Lawson et al., 2013)

Health information technology (HIT) involves the processing, storage, and exchange of health information in an electronic environment. (U.S. Department of Health & Human Services, n.d.-a)

Heutagogy is an educational process of self-directed learning independent of a teacher. (Blaschke, 2012)

HIPAA (Health Insurance Portability and Accountability Act) of 1996 was enacted in 1996, and it requires the Secretary of HHS to publicize standards for the electronic exchange, privacy and security of health information. (U.S. Department of Health & Human Services, 2013)

Humanist Psychotherapy focuses on a person’s individual nature, rather than categorizing groups of people with similar characteristics as having the same problems.  The emphasis is on a person’s ability to use strengths to find wisdom, growth, healing, and fulfillment. (“Humanistic therapy”, n.d.)

Inductive reasoning draws conclusions based on recurring patterns or repeated observations. (“Inductive Reasoning”, 2021)

I-It/I-Thou (I-You) is a philosophical construct about the perception by one person of another as either an object or a human being. (Buber, 1970)

Information and Communication Technology (ICT) provides asynchronous messages and streaming connection. (National Assessment Governing Board, 2014)

Informed consent is a process that involves three key features: (1) disclosing to a potential research subject information needed to make an informed decision; (2) facilitating the understanding of what has been disclosed; and (3) promoting the voluntariness of the decision about whether or not to participate in the research. (U.S. Department of Health & Human Services, n.d.-b)

Intersectionality - "Kimberlé Crenshaw uses the term to describe this phenomenon; as she says, if you're standing in the path of multiple forms of exclusion, you're likely to get hit by both." (UC Santa Barbara, n.d., para. 1)

Intersubjectivity is a shared meaning that emerges from and is enacted within the social fabric of interaction. (Garte, 2016, para. 1)

Introception is conscious and unconscious tracking of internal bodily functioning. (Porges, 2011)

Intuition is sensing something without being able to explain it with certainty.

Me/Not-me consciousness is deduced from the observations of newborns and their subsequent development. (Winnicott, 1993)

Mensch can be [characterized as]"responsibility fused with compassion, a sense that one's own personal needs and desires are limited by the needs and desires of other people. A mensch acts with self-restraint and humility, always sensitive to the feelings and thoughts of others". (Rabbi Neil Kurshan, quoted by Rocker, 2015)

Narrative therapy seeks to be a respectful, non-blaming approach to counselling and community work, which [centers] people as the experts in their own lives. It views problems as separate from people and assumes people have many skills, competencies, beliefs, values, commitments and abilities that will assist them to reduce the influence of problems in their lives. (Dulwich Centre, n.d.)

Neural node is another term for synapse.

Neuroception is the subconscious totality of neural processes that facilitate adaptive defense behaviors such as fight, flight, or freeze. (Porges, 2011)

Neuropeptides activate and modulate signals in the brain. (Russo, 2017)

Neuroscience refers to the study of brain physiology and activity.

Nominal variables are characteristics, qualitative factors used to sort research findings and explain something or form, refine questions for study.

Object relations theory developed from psychoanalysis and it emphasizes the importance of infantile and early childhood interactions with the primary caregivers in formation of the Unconscious. (Winnicott, 1989)

Optimal failure is the idea that when a parent fails to satisfy a child’s developmental need in a given situation, it presents the child with the challenge to progress, as long as the failure is not catastrophic. The concept was developed by D.W. Winnicott. (1989, p. 445)

Paradigm is a philosophical and theoretical framework of a scientific school or discipline within which theories, laws, and generalizations and the experiments performed in support of them are formulated. (“Paradigm”, n.d.)

Participatory action research (PAR) differs from most other approaches to public health research because it is based on reflection, data collection, and action that aims to improve health and reduce health inequities through involving the people who, in turn, take actions to improve their own health. (Baum, et al., 2006)

Pedagogy is an educational process that transfers knowledge from a teacher to students. (Blaschke, 2012)

Piaget’s theory is that all cognitive development (including both intellectual and affective development) progresses towards increasingly complex and stable levels of organization. (UC Berkeley, n.d.).

Polyvagal theory proposes that a state of safety is mediated by neuroception, a neural process that may occur without awareness, which constantly evaluates risk and triggers adaptive physiological responses that respond to features of safety, danger, or life threat. (Geller & Porges, 2014)

Presence, as used in the context of Telehealth, encapsulates 2 elements: (1) the degree to which the web-based experience of another person is analogous to a real-world meeting and (2) the degree to which the user experiences agency and control that impacts the real world. (Riva, 2009 cited by Cataldo, et al., 2021)

Privacy Rule protects all "individually identifiable health information" held or transmitted by a covered entity or its business associate, in any form or media, whether electronic, paper, or oral. There are no restrictions on the use or disclosure of de-identified health information. De-identified health information neither identifies nor provides a reasonable basis to identify an individual. (U. S. Department of Health & Human Services, 2013)

Psychodynamic (psychoanalytic) psychotherapy refers to a range of treatments based on psychoanalytic concepts and methods that involve less frequent meetings and may be considerably briefer than psychoanalysis proper. (Shedler, 2011)

Psychodynamic theory attempts to explain human behavior in terms of intrapsychic processes and the repetition of interpersonal patterns that are often outside of an individual’s conscious awareness and have their origins in childhood experiences. (Deal, 2007)

Psychology refers to theories about the nature of the human mind and its connection to a person’s body, thoughts, emotions, behavior, relationships, etc.

Psychotherapy refers to theories about and methods used by trained professionals for interventions to improve a person’s functioning, using talking and reflecting in the process.

Qualitative research is used to understand people's beliefs, experiences, attitudes, behavior, and interactions. (Pathak et al., 2013)

Randomized-controlled studies are a subset of scholarship that structures knowledge, categorizes, quantifies and evaluates. (Yale University, 2020)

Rational-Emotive Behavior Therapy (REBT) “served as a sort of precursor to the widely known and applied Cognitive-behavioral therapy (CBT), and the [REBT] ABC Model is still commonly used as a treatment in CBT interventions.” (“Albert Ellis' ABC model...”, 2021, para. 2)

Recessive trait is an "inherited trait that is outwardly obvious only when two copies of the gene for that trait are present… The recessive condition is said to be masked by the presence of the dominant gene when both are present." (Gale Encyclopedia of Medicine, 2008)

Relational Embodiment Gestalt is a somatic and relational practice that has the view that our bodies are inextricably embedded and co-creating with the environment, and that we know our body and the world through our embodiment. (Clemmens, 2019)

Relational schema is a cognitive structure representing regularities in patterns of interpersonal relatedness. (Baldwin, 1992)

Schema (core beliefs) “[are different from] underlying assumptions (conditional beliefs) and automatic thoughts [that are temporary.]” (Padesky, 1994, p. 267)

Second-order change transforms the first-order solutions, resulting in a resolution of the problem. (Fraser & Solovey, 2007)

Self-Thou echoes the concept I-Thou, and emphasizes self-awareness through which a person perceives and experiences their own humanity.

Sensitizing concepts merely suggest directions along which to look, whereas definitive concepts provide prescriptions of what to see. (Blumer, 1954)

Sexual response cycle is a physiological wave pattern consisting of excitement, plateau, orgasm, and resolution. (Cleveland Clinic, 2017)

Snowball sampling is a recruitment technique in which research participants are asked to assist researchers in identifying other potential subjects. (Oregon State University, 2010)

Stress response involves the amygdala signaling to the hypothalamus leads to an endocrine cascade through the hypothalamic pituitary adrenocortical (HPA) axis, producing increased levels of circulating cortisol. (Kaiser et al., 2017)

Surfing flows from safety, trust and respect. It is synonymous with the emotion response cycle.

Synapse is sometimes called a neural node, and it releases signals in the brain. (Russo, 2017)

Tacit knowledge begins as personal intuition before it becomes easily communicated. (Polanyi, 2015)

Telebehavioral health (TBH) is another term for telemental health which uses videoconferencing technology to provide counseling and psychotherapy. (U.S. Department of Health & Human Services, 2021)

Telehealth is the use of electronic information and telecommunication technologies to provide care when the client and the provider aren’t in the same place at the same time. (U.S. Department of Health & Human Services, 2021)

Telemedicine is synonymous with telehealth.

Telemental health is synonymous with “telebehavioral health.”

Telepresence “is a phenomenon whereby technology creates an experience that allows the user to ‘feel as if they were present, to give the appearance of being present, or to have an effect at a place other than their true location’” (Hilty, et al., 2019).

Telepsychotherapy refers to mental health treatment provided via telehealth. (Rosen et al., 2020)

Therapeutic alliance and working alliance refer to the strength of the collaborative dimensions of the therapist–client relationship. The concept is rooted in psychodynamic theory, more recently it has evolved into a pan-theoretical concept. (Horvath, 2015)

Thing-Person Swing is the oscillation between I-It/I-Thou (I-You).

Transformative learning is a fundamental change in perspective that transforms the way that an adult understands and interacts with his or her world. (Wang et al., 2016)

Transference is a psychoanalytic concept that explains out-of-place emotional reactions to the psychoanalyst flow from the Unconscious. (Horney, 1939)

Triple Bottom Line is a framework to evaluate business activities in terms of the impact on people, the planet, and profitability. (University of Wisconsin Sustainable Management, n.d.)

Unconscious is a concept from psychodynamic theory and enhanced by field theory, it can be visualized as nodes that contain hot-spots from past injuries which generate emotional signals, and the signals are emitted while a person is not cognizant of their origins.

Venn Diagram is a visual aid that uses overlapping circles to represent relationships. Some things are separate, but there's a space that is shared.

Web 2.0 is used to refer to a new generation of websites that are supposed to let people collaborate and share information online in ways that were not possible before. (University of South Florida, n.d.)

White matter is a “vast, intertwining system of neural connections that join all four lobes of the brain (frontal, temporal, parietal, and occipital), and the brain’s emotion center in the limbic system, into the complex brain maps being worked out by neuroscientists” (Filley, 2005, para 5).

Wormhole is a metaphor, based on the Einstein-Rosen bridges, to represent an unconscious connection between past and present. (Bloomberg, 2015)

Zone of Proximal Development (ZPD) is a social interaction model whereby advances in learning occur through work and play among persons who are apart, but not too much, in understanding and skill. (Vygotsky, 1986).