part 2: Psychotherapeutic Interventions

Emotional-Focused Individual Therapy (EFit)

It emphasises on processing and expressing emotions to achiever resolution.

Solution-Focused Brief Therapy (SFBT)

It focusses on identifying solutions and building strengths rather than dwelling on problems/issues.

What are the 4 stages of EFit?

1. Engagement and Assessment —> building therapeutic alliance and understanding the clients emotional landscape

2. Emotional Awareness and Expression —> client is helped to process difficult emotions in a safe and validating way e.g. calming/grounding exercises.

3. Regulation and Transformation —> helping the client regulate intense emotions and transform maladaptive emotional patterns.

4. Consolidation and Integration —> solidifying the changes made in therapy and integrating new emotional insights into daily life

What are the strengths of EFit?

1. Focus on the exploration and processing of emotions can lead to deeper understanding and resolution of underlying issues.

2. Flexibility - can be adopted to many mental health issues

3. Prioritises client’s experiences = tailored approach that aligns with individual needs and goals.

4. A comprehensive, holistic treatment approach

5. Can lead to lasting change and improved emotional wellbeing as it addresses underlying issues.

What are the limitations of EFit?

1. Requires extensive training and expertise to effectively implement; limited accessibility to both practitioners and clients

2. Process is very time-consuming, therefore can also be expensive

3. Higher potential for clients to resist exploring and experiencing emotions as it may be uncomfortable therefore making it more challenging for practitioners and thus they need to be more skilled to navigate these issues

4. The evidence based research for EFit is still developing and therefore is a bit ambiguous

5. The success of this heavily relies on the therapist’s ability to create a safe therapeutic environment.

Characteristics of SBFT?

1. The role of autonomy (vs authority) is central to- client is empowered by the idea that change occurs from them and in multiple ways

2. The problem has little to do with the solution - more than the mere absence of the problem

3. Focuses on solutions not problems

4. Focuses on present time

5. Often around 6 sessions involving goal setting etc

6. Highlights elements of the solution already present in the clients life

7. Desired life vs development of problems

4 SFBT CORE PRINCIPLES

1. building rapport through empathy

2. Rolling with ‘Resistance’ i.e. avoid eliciting ‘resistance’ by not confronting clients ambivalence about change —> help examiner new points of view in a gentle manner.

3. Developing discrepancy: helping client identify such discrepancies b/w current circumstances/ values and future goals (process is gradual) —> using visual cards can be less confrontational to the client.

4. Supporting self-efficacy; increasing an individual’s belief in their capacity to execute behaviours necessary to produce specific performance attainments

Solution-Focused Process Model (Grant,2022)

Supporting Self Efficacy

OARS - what does it stand for?

O - open-ended questions

A - affirmations

R - reflection

S - summaries

“change talk”

Includes statements by the client that reveal consideration of, motivation for, or commitment to change

What are the different types of change talk?

1. DARN-CAT

1. Predatory change talk

   • D - Desire

   • A - Ability

   • R - Reason

   • N - Need

2. Implementing Change Talk

   • C - Commitment

   • A - Activation

   • T - Taking Steps

What is Scaling?

What is Solution Talk

The miracle question - De Shazer ext al., 2021

Future orientated, identify existing solutions, clarify goals, give clues to strategies

Strategy talk

Strengths of SFBT

Limitations of SFBT

Emotions

• instinctive and intuitive psychological and physiological reactions to a variety of stimuli i.e. social interactions, events, perceptions, etc.

• = behavioural, experiential, autonomic, neuroendocrine changes that allow us to address relevant challenges

  • e.g. fear as a car comes speeding towards you = behavioural response of moving out of harms way.

3 purposes of emotions

1. Survival

2. Social Cohesion

3. Integrating thinking and feeling; decision making skills

Basic emotions (Ekman, 1999) - innate and biologically adaptive

1. happiness

2. Sadness

3. Anger

4. Fear

5. Surprise

6. Disgust

7. Contempt

Problematic Emotions

1. Not adaptive or helpful

2. Interferes with normal life functioning

3. Person lacks the skills necessary to regulate emotions effectively

4. Maladaptive avoidance

5. Associated with undesirable behaviours

6. Hinder personal growth and wellbeing