Our Definition of Psychotherapy Psychotherapy is the informed and
intentional application of clinical methods and interpersonal stances derived from established psychological principles for the purpose of assisting people to modify their behaviors, cognitions, emotions, and/or other personal characteristics in directions that the participants deem desirable.
Informed & Intentional
Informed by what? Theory & Experience
Intentional There is a purpose/goal Systematic
Clinical Methods and Interpersonal Stances Clinical Methods
Specific techniques developed from practice and research
Interpersonal Stances Ways of being
Established Psychological Principles Again, psychotherapy is theory
driven Personality theories Theories of psychopathology Social psychological theory Cognitive/information processing
theories
Modify Behaviors, Cognitions, Emotions and/or Characteristics Psychological suffering manifests as
dysfunctional behavior, thoughts and/or feelings
The “stuff” of therapy includes all psychological processes
In many ways directly modifying one of these processes can change any or all the others
Different systems often focus on modifying different processes
Participants Deem Desirable Participants = Patient & Therapist There is no set psychological process
to address Participants examine the patient’s
current perspective/functioning to develop goals
Therapy is COLLABORATIVE Never should it be one-sided
The Importance of Theory
A theory is a set of assumptions that organize the data of natural phenomena for the purposes of explanation and hypothesis generation
What makes a good theory? Is it comprehensive? Is it logical? Is it parsimonious (simple, not too simple)? Does it agrees with empirical research? Does it generate ideas/research? Is it disconfirmable? Is it practically useful?
Without a theoretical orientation therapy suffers No consistency Lack of organization Lack of prioritization
Positive Expectations
The belief that therapy will be effective
Significant degree of outcome predicted by client/therapist belief in the effectiveness of the therapy
Critical precondition for therapy to play out
It is more than a placebo
Therapeutic Relationship
Composed of a number of factors Mutual respect Agreement on goals Agreement on tasks Therapist skills of
– Acceptance– Warmth– Empathy– Encouragement of risk taking
The most robust and most important common factor Some studies show that it accounts for 60% of
outcome Patient’s view more important than therapist’s
Hawthorne Effect
Improvement secondary to attention being given Therapeutic attention is “special”
specific and non-reciprocal What makes therapy different than
friendship is that the attention paid is one-sided.
Specific Factors: Techniques• Factors unique to specific therapies
Biofeedback Systematic desensitization Dream interpretation Cognitive restructuring
• Some specific techniques are especiallyhelpful with certain symptoms anddisorders
Exposure with anxiety disorders Cognitive interventions with depression
Consciousness Raising
Finding facts & ideas that support the behavior change
Self-Reevaluation: behavior change is important in personal identity
Environmental Reevaluation: realizing positive or negative impact of healthy behavior on one’s social & physical environment
Catharsis
Emotional release can lead to change Corrective emotional experience
Stimuli come from within Dramatic Relief
Experiencing emotion in others
“Psychological laxative”
Choosing
Results from an increase in consciousness, awareness of alternatives, and results in increased responsibility
Self-liberation Individual becomes of aware of
alternatives Social liberation
Changes in the environment open up alternatives
Conditional Stimuli
Change occurs through the modification of the conditional stimuli that control our responses Counterconditioning – associating a
response incompatible to the problem response to controlling stimuli
Stimulus control – Change the probability of occurrence of a stimuli
Contingency Control
Behavior change through altering the relationship between a behavior and its consequences (reinforcement, punishment) Contingency management
Direct modification of the environmental contingency Reinforcement something never reinforced or was
punished Remove reinforcement from a problem behavior to
decrease the behavior
Reevaluation Modify the behavior without changing the
contingencies
Psychotherapeutic Content Process = How ----- Content = What Content is often specific to the
system Psychoanalytic = Unconscious Existential = Meaning finding Behavioral = Overt behavior Cognitive = Thought patterns
One factor that relates to most types of content is CONFLICT
Types of Conflict Intrapersonal Conflict – Conflict taking place
within the individual Anxieties and defenses, self-esteem identity
Interpersonal Conflict – Conflict taking place between individuals Intimacy, c0mmunication, problem resolution
Individuo-social Conflict – Conflict taking place between and individual and some institution Adjustment to social role, discrimination
BEYOND CONFLICT – Meaning and Fulfillment
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