Theory and Practice of Counseling and Psychotherapy
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Transcript Theory and Practice of Counseling and Psychotherapy
Interpersonal Psychotherapy
Introduction and Overview
A need for
conceptual framework
Conceptual frameworks help recognize
relational patterns and cognitive schemas
Treatment plans will be developed from the
conceptual frameworks
Historical context
Interpersonal Domain (Sullivan)
Sullivan keep away from Freud’s drive theory
(sexual and aggressive instincts)
Personality develops through repetitive
interactions with parents and others
personality as the collection of interpersonal
strategies to avoid anxiety and disapproval, and
maintain self-esteem.
Historical context
Cognitive Domain
Internal working model (Object Relations and
Attachment theory)
View of self and others
Emotional responsiveness and availability
Good parents vs. bad parents
Schemas (Cognitive Behavioral therapy)
Can be called maladaptive cognitive schemas, core beliefs,
or faulty expectations
Schemas: A cognitive structure for screening, coding, and
evaluating the stimuli.
Historical context
The familial/contextual domain
Family system theory
Internalize family roles (i.e., rescuer) as selfschemas
Re-create family roles/patterns with others
Faulty communication patterns
Family rules
Family myths
Core Concepts
1. The Process Dimension
The relationship b/w therapist and client is the
foundation of therapy
Understanding and intervening with what is going
on b/w therapist and client in their interaction.
Content vs. Process comments
A powerful tool for genuine understanding and
honest communication.
Core Concepts
2. Corrective Emotional experience
Identify maladaptive cognitive & interpersonal
patterns
Use “process comments” to clarify interpersonal
styles
Engage the client in work together to find a way to
change
Transfer the learning in therapy to others in clients’
lives.
Core Concepts
3. Client Response Specificity
Definition: therapists need to tailor their
response to fit the specific needs of each
client.
Flexible to modify interventions and
respond in new ways
Match the needs for diverse clients
Interpersonal process approach
Establishing a Working Alliance (WA)
Honoring the client’s resistance
A internal focus for change
Responding to painful feelings
Familial and developmental factors
Inflexible interpersonal coping strategies
Interpersonal patterns and themes
An interpersonal solution
Resolution and change
Establishing a Working Alliance (WA)
The WA is a collaborative relationship
Empathic understanding is the foundation for WA
WA: agree on goals, collaborate on tasks, and establish a
bond relationship based on trust and acceptance
Genuine concern, respect, and non-judgmental attitude
Demonstrate understanding and identify patterns
Immediacy—working in moment
Using process comments to build WA
Honoring the client’s resistance
Identify resistance
Help client identity when resistance is occurring
with a non-judgmental manner
Address reluctance to resistance
Validate the protection aspects
Do not repeat maladaptive patterns in session
Formulate working hypotheses
What is the threat?
Respond to resistance
Educate
Explore the danger/identify the threat
A internal focus for change
Shifting to an internal focus
A prerequisite for change
Focusing clients inward
Reluctance to adopt an internal focus
Placing the locus of change with clients
Fostering clients’ initiative
Avoiding a hierarchical relationship
Supporting clients’ own autonomy and initiative
Shared control in the therapist-client relationship
A internal focus for change
Helping clients in solving their own problems
Providing a corrective emotional experience
Tracking clients’ anxiety
Identifying signs of clients’ anxiety
Approach clients’ anxiety directly
Focus clients inward to explore their anxiety
Responding to painful feelings
Approach the clients’ feelings
Expand and elaborate clients’ affect
Identify the predominant affect
Hold client’s pain
Therapists’ factors for not responding to
clients’ feelings
Familial and developmental factors
Understand structural family relations-patterns
The family’s ability to respond to the child’s need for
both relatedness & separateness
Three styles of parenting: control and affection
Authoritative - high control/high affection
Authoritarian - high control/low affection
Disengaged – low control/low affection
Permissive – low control/high affection
Love withdrawal
Insecure attachment
Inflexible interpersonal coping strategies
Horney’s interpersonal model
Unmet development needs
Core Conflict or Anxiety
Inflexible interpersonal
coping style
Move
Toward
Others
please
Move
Away from
Others
avoid
Turning against self to block
core conflict
Move
Reject
Against
self
Others
intimidate
Reject
others
Elicit
Rejection
From
others
Interpersonal patterns and themes
How clients bring their problems into the
therapeutic relationship
moving toward, moving against, or moving
away
Testing Behavior
Transference Reactions
Interpersonal balance
An interpersonal solution
Resolving problems through the interpersonal
process
Bring client’s conflicts into the therapeutic
relationship
Using the process dimension to facilitate
change
Providing a corrective emotional experience
Therapists’ initial reluctance to work with the
process dimension
Resolution and change
The working –through process
Change relationship patterns with therapist
acquaintancessupportive othershistorical
figuresprimary others
Therapist actively help clients
Realistically anticipate others responses
Provide corrective emotional experience
Resolution and change
Work through family-of origin work
Internal focus for change
Grief work
Plan for future:
Orienting clients to listen to themselves
what they want to do, what they want to be,
and what they want to become
Resolution and change
Clients are ready to terminate when
Clients report they consistently feel better &
can respond in more adaptive ways
Client expand their old coping styles and don’t
reenact maladaptive relational patterns
Others gives them feedback that they are
different
Accepting that the relationship must end
Resolution and change
Effective terminations: review-predict-practice
Review what has changed
Predict and make realistic plans for coping with
the problems which could come up
practice to respond differently
Ending the relationship
Say good-bye