psychotherapy - psychodynamic and humanistic therapies

what do psychodynamic therapies originate from?

psychoanalysis

what do psychodynamic therapies focus on?

unconscious processes that impact client’s present behavior

what are some psychodynamic therapies?

short-term psychodynamic therapy, mentalization-based therapy, transference-focused therapy

where do humanistic/experiential therapies originate from?

Rogers and client-centered therapy

what are humanistic/experiential therapies based on?

premise that individuals are “self-actualizing”

what are some examples of humanistic/experiential therapies?

Gestalt therapy, existential therapy, emotion-focused therapy

what therapy was originally designed as a therapy placebo?

interpersonal psychotherapy

what is the thesis of the paper by Blagys and Hilsenroth (2000)?

the features that distinguish psychodynamic and humanistic therapies from others

what distinction do Blagys & Hilsenroth (2000) draw between P and H therapies and others in terms of affect?

P and H therapies have a focus on affect and the expression of patient emotions

why do P and H therapies have a focus on affect?

believe intellectual insight is not sufficient, need emotional insight

how do P and H therapies focus on expression of emotions?

encourage expression rather than management or control and draw attention to uncomfortable feelings

what distinction do Blagys & Hilsenroth (2000) draw between P and H therapies and others in terms of patient’s attempts to hinder progress?

P and H therapies include an exploration of the patient’s attempts to avoid topics or engage in activities that hinder therapy progress

what actions would P and H therapies consider to be patient’s attempts to hinder progress?

redirect conversations, not complete homework, miss session, not pay bill

why do P and H therapies explore patient’s attempts to hinder progress?

to uncover unconscious meaning behind them

what distinction do Blagys & Hilsenroth (2000) draw between P and H therapies and others in terms of identification of patterns?

P and H therapies identify patterns in actions, thoughts, feelings, experiences, and relationships, not just thoughts

what specifically are P and H therapies interested in when it comes to patterns?

how patterns in interpersonal functioning repeat over time, settings, and people

how are patterns identified in P and H therapies?

through interpretations

what distinction do Blagys and Hilsenroth (2000) draw between P and H therapies and others in terms of past experiences?

P and H therapies emphasize past experiences, both pre-adult and adult

why do P and H therapies have an emphasis on past experiences?

to identify origin of patient difficulties and understand how they have manifested in lifetime

what distinction did Blagys and Hilsenroth (2000) draw between P and H therapies and others in terms of interpersonal experiences?

P and H therapies have a strong focus on interpersonal experiences

why do P and H therapies focus on interpersonal experiences?

problematic relationships interfere with ability to fulfill needs and wishes

how do P and H therapies focus on interpersonal experiences?

compare and contrast patient functioning with that of others and the impact patient has on others

what distinction did Blagys and Hilsenroth (2000) draw between P and H therapies and others in terms of the therapeutic relationship?

P and H therapies view therapeutic relationship as a vehicle of change

what is transference?

patient’s projections onto therapist

what distinction do Blagys and Hilsenroth (2000) draw between P and H therapies and others in terms of patients’ wishes, dreams, and fantasies?

they are explored in P and H therapies to uncover clues to unconscious functioning

what is the goal of short-term psychodynamic therapy?

symptom relief and limited, but significant, character change working on one contained area of focus

what is the structure of short-term psychodynamic therapy?

once per week for less than one year

who is considered to be a prime candidate for short-term psychodynamic therapy?

patients who are psychologically minded, insightful, and motivated and who have the capacity to engage readily and disengage easily

what kinds of techniques are used in short-term psychodynamic therapy?

supportive, expressive, and monitoring countertransference

what are the supportive techniques used in short-term psychodynamic therapy?

defining the therapeutic “frame”, demonstrating genuine interest and respect, noting gains, maintaining here-and-now perspective

what are the expressive techniques used in short-term psychodynamic therapy?

offering empathic comments, pushing back, interpretation

what kind of study was Steinert et al (2017)?

meta-analysis of 23 RCTs comparing psychodynamic therapy to an established treatment, both using manuals

what was the primary outcome of Steinert et al (2017)?

target symptoms, ie depression

what was the secondary outcome of Steinert et al (2017)?

general symptoms and functioning

what did Steinert et al (2017) test for?

equivalence of the two treatments

what did Steinert et al (2017) find no difference between the treatments on?

overall outcomes at post-treatment and follow-up

what did Steinert et al (2017) find psychodynamic therapy was superior for?

functioning at follow-up

who developed emotion-focused therapy?

Leslie Greenberg at York University

what was emotion-focused therapy originally called?

process-experiential therapy

how long is emotion-focused therapy?

16-20 sessions

why does emotion-focused therapy focus on emotions?

emotion is a key determinant of self-organization

why do people have maladaptive views of emotions?

how we make sense of our emotional experiences is influenced by culture, which can undervalue emotional expression

what are primary emotions?

direct initial reaction, ie sadness from loss

what are secondary emotions?

reaction to primary emotions, ie guilt over sadness

what are adaptive emotions?

primary emotions that communicate information

what are maladaptive emotions?

“old familiar feelings” that do not change with situation

what are the three principles targeted in emotion-focused therapy?

emotion awareness, emotion regulation, emotion transformation

what is emotion awareness?

becoming aware of primary adaptive emotions, accepting them, actually feeling them instead of thinking about them, and expressing them

how is emotion regulation targeted in EFT?

work to determine which emotions need to be regulated then teach skills like tolerance and self-soothing

what is emotion transformation in EFT?

process of changing emotion with emotion, undoing a maladaptive emotional response with a more adaptive emotion

what techniques are used in emotion transformation?

shifting attention, positive imagery, remembering another emotion

what technique is used in EFT for self-critical conflicts?

two-chair dialogue

what technique is used in EFT for unfinished business?

empty-chair work

what did Watson et al (2004) find about EFT for major depression?

outcomes similar in EFT and CBT, greater decrease in interpersonal problems in EFT

what did Goldberg et al (2006) find about EFT for major depression?

symptom remission greater in EFT compared to client-centered therapy

who developed interpersonal psychotherapy?

Klerman and Weissman in 1970s

what is interpersonal psychotherapy concerned with?

interpersonal context, the relational factors that predispose, precipitate, and perpetuate distress

what is the interpersonal triad?

acute interpersonal crisis, inadequate social support, and attachment and biopsychosocial vulnerability

how long is interpersonal psychotherapy?

12-16 sessions

what factors make someone a good candidate for interpersonal psychotherapy?

secure attachment, specific interpersonal focus of distress, and good support system

what are IPT problem areas?

role transitions, role disputes, grief, and interpersonal sensitivity

how is the problem area chosen in IPT?

interpersonal inventory is administered

what is done during session in IPT?

work collaboratively to develop solutions to problem area

what is done between sessions in IPT?

patient implements developed solution

what techniques are used in IPT?

interpersonal incidents, communication analysis, problem solving and role-playing, encouragement of affect

what did Cuijpers et al (2016) find in their meta-analysis of IPT for depression?

IPT significantly superior to control treatments, slightly superior to other psychotherapies

what did Agras et al (2000) find about IPT for bulimia nervosa?

CBT more rapidly improves symptoms, but those treated with IPT continue to improve post-treatment

what did Wilfley et al (2000) find about IPT and binge eating disorder?

group IPT is comparable to group CBT

what is the interpersonal incidents technique in IPT?

reviewing recent conflicts to help clients understand their role in them, process the emotions involved

what is the communication analysis technique in IPT?

examining recent interaction to help client identify ineffective communication, understand their impact, and develop more adaptive communication

what is the encouragement of affect technique in IPT?

helping clients express/explore emotions related to IP issues to gain insight and promote emotional processing and resolution