Lecture 4 psychotherapy

Systematic evocative unfolding for..

problematic reactions

Two -chair dialogues at..

Conflict splits

Empty chair dialogues for..

Unfinished business

The central hypothesis of client-centered therapy

The individual has within himself or herself vast resources for self-understanding, for altering his or her self-concept, attitudes, and self-directed behaviour - and that these resources can be tapped if only a definable climate of facilitative psychological attitudes can be provided

What kind of climate does client-centered psychotherapy need?

A growth-promoting climate for personal and social transformation

What is emphasized in non-directive therapy?

Fundamental emphasis on the therapist’s nondirectiveness

What are the core conditions for therapeutic change according to Carl Rogers client-centered therapy?

1. Empathy

2. Unconditional positive regard

3. Congruence

Congruence

The authenticity and genuiness of the therapist. Willingness of the therapist to be real and transparent with the client

Actualizing tendency

Capacity for growth present in all living beings. Tendency to move toward greater complexity, integration, and autonomy

Psychopathology according to Rogers

Rigid

Incongruence between self-concepts and experience

Being closed to feedback

Conditional acceptance in childhood

Psychological health according to rogers

Openness, flexible, evolving

Goal of therapy according to Rogers

Not just symptom relief, but restoring growth and congruence

What is Rogers view on feeling and when do changes occur?

Feeling isnt emotion, but a gut level sense of what’s going on. Felt meaning is more poowerful than intellectual insight and changes happen when clients are in touch with their inner experiences.

What is Rogers definition of fully functioning?

When one can listen to their feeling and adjust in a personal and creative way

What is the main mechanism of change in Client-centered therapy?

The therapeutic relationship

What is process-outcome research?

It studies how therapy works, not just if it works

Common therapeutic factors (Jerome Frank and Bruce Wampold)

Elements present across different types of therapy that contribute to client improvement and drive therapeutic change (=/ specific factors)

Common factors

• goal consensus/collaboration

• empathy

• alliance

• positive regard/affirmatiion

• therapists (naturalistic)

• congruence/genuiness

• Therapistis (RCTs)

• Cultural adaptation of EBT

• Expectations

Specific factors

• treatment differences

• rated competence

• adherence to protocol

• specific ingredients

Therapist Responsiveness (TR)

therapists adapt their behaviours, interventions and relational appraoch in the moment, based on the client’s needs, signals and unfolding process (doing the right thing at the right time). The timely display of Facilitative interpersonal skills

Facilitative interpersonal skills (FIS) examples

• verbal fluency

• warmth and acceptance

• hope and expectations

• empathy

The FIS task definition and steps

A performance test of therapist’s use of FIS

1. standardised set of video-recodrings portraying “difficult clients”

2. The therapist responds to the “client” immediately as if in a session. The therapist’'s answer is video-recording

3. A team of raters rates the FIS displayed by the therapist, following a manual

FIS scores predict:

• treatment outcomes

• Therapeutic alliance

• Therapist effects

Does a therapist display more or less FIS in helpful moments compared to random and unhelpful moments?

More

Field theory

Behaviour arises from people’s perceptions and itneractions with the field of realtions or environment within which they are embedded

Self-actualization

Tendency to enhance your own self-development

Intuitive knowing

knowing self and world by experiencing

Neuroception

Inner, bodily felt sense that provides information to the organism about what is happening in the environment to assess safety and threat

Emotion according to PE-EFT (process-experiential) theorists

Emotion is fundamentally adaptive and provides information quicly and efficiently to individuals about the impact of their environments so that they can respond to meet their needs and goals

Emotion schemes consist of these 4 elements:

1. perceptual-situational: person’s awareness of external situation

2. Bodily-expressive aspect: bodily reaction and felt sense

3. Sybolic-conceptual: verbal and visual representation of experience or the labels we apply to different states

4. Motivational-behavioural: needs, actions and behaviours that accompany different emotional states

Dialectical constructivism

The self is a constantly evolving but organized multiplicty of selves. People consits of different voices, or aspects of the self. OR they are experiencing potentials. No single way of construing the world is dominant, but there are an infinite number of ways a person can construe and itneract with the world given the multiple ways of perceiving experience.

Psychopathology in person-centered view

abnormal behaviour is an attempt to cope that goes wrong, likely to arise if a person is unable to utilize their potential to operate in an evolving growing way

Dysfunctionaly occurs when? according to person-centered

when we are unable to be open to information so that we can learn from feedback

Primary adaptive emotion

Direct emotional response that is consistent with the situation and enable the person to take appropriate action in response to it. Essential for survival.

Secondary emotions

Occur in response to adaptive emotions so as to transform them

Instrumental emotions

Deliberate attempt to use emotional reactions as a way of manipulating or controlling others

Process diagnosis

An assessment of how clients are realting to their emotional experience at any given moment in the session

Markers

Are specific verbal, behavioural, or emotional signs that a client is struggling with a particular kind of emotional processing problem

Transference

The tendency of the client to read things into the therapist behaviour based on the clients past experience

Countertransference

The tendency of the therapist to read things into the client’s behaviour based on the therapist’s past experience and unresolved problems

Technique of person-centered psychotherapy

The therapeutic relationship

What does change arise from according to Focusing-oriented psychotherapy (Gendlin)?

Tuning into and working with a bodily felt sense

Three way sof experiencing processes by focusing-oriented psychotherapy (Gendlin)

1. empathic responding (experiential responding)

2. Sharing of their own immediate experience in therapy in the relationship with clients. For clarifying nature of what is going on between them.

3. Focusing. Clients are asked to focus inwardly and clear a space by imagining that they have set all problems aside for the moment. THe client reaches the problem that seems most salient.

What do client’s problems result from according to process-experiental/emotion-focused psychotherapy

Inadequately processing certain aspects of their experiencing including cognitive affective information

What is the goal of process-experiental/emotion-focused psychotherapy

Facilitate different types of cognitive-affective operations in the client as diffferent times to enhance deeper exploration

What should the therapist do in process-experiental/emotion-focused psychotherapy

Listen for statements that indicate that client struggles with a specific issue and suggest ways of working and offer suggestions and guide the client systematically through steps

2 techniques used by process-experiental/emotion-focused psychotherapy

1. two chair dialogues (conflict split)

2. Empty chair dialogues (unfinished business)