Brief Therapies

Question 1

Brief Therapies

Answer 1

1. time limited (6-30 sessions)
2. current concerns rather than past
3. therapist is active and encourages client to become actively engaged in change process.
4. Types:
   
   1. interpersonal
   2. solution-focused
   3. transtheorectical model
   4. motivational interviewing.

Question 2

1.0

Interpersonal Therapy

Answer 2

Interpersonal Therapy (IPT): Klerman/Weissman developed a manual-based therapy to treat depression, now applied to bipolar, bulimia, substance abuse/dependence.

influenced by Meyer, Sullivan, Bowlby to combine psychodynamic psychotherapy and cognitive-behavior therapy.

Maladaptive BX: problems in social roles and interpersonal relationships that are traceable to lack of strong attachments early in life.

GOALS/TECH:

• focus on current social relationships to reduce symptoms and improve interpersonal functioning.
  
  • psychoeduction, instillation of hope, meds, and interventioins to target 4 primary problem areas:
  • unresolved grief, interpersonal role disputes, role transitions, and interpersonal deficits.
• Three Stage
  
  • 1: assessment to diagnose and id problem areas
  • 2: strategies to address the problem areas
  • 3: review progress, termination and relapse prevention.

Question 3

2.0

Solution-Focused Therapy

Answer 3

de Shazar’s Solution-Focused Therapy:

• you get more of what you talk about
• focus on solutions to clients problems rather than the problems themselves.
• etiology of problem is irrelevant: focus on solution
• client as expert: therapist is consultant/collaborator that poses different QUESTIONS to help client recognize and use his strengths and resources to achieve goals
• QUESTIONS:
  
  • Miracle Question:
  • Exception Question: id when problem wasn’t there
  • Scaling Question: rate intensity, motivation
• Structured and repeated:
  
  • id goals, answer questions, compliment successes, task to complete.

Question 4

3.0

Transtheoretical MODEL

Answer 4

Transtheoretical Model: change entails progress via a series of predictable stages and id’ed 10 empirically supported change processes:

• consciousness raising, self-liberation, social liberation, dramatic releif, self-reevaluation, counterconditioning, environmental reevaluation, reinforcement management, stimulus control, helping rx.
• first for intervene with addictive behaviors like smoking but now a range of ideas.
• Focus on Factors that Facilitate Behavior

​6 Stages of Change

1. Precontemplation Stage: little insight or motivation to change. Denial
2. Contemplation Stage: aware of need to change, may act in 6 months but not committed. Ambivalent.
3. Preparation Stage: plans to take action in immediate future (next month), realistic plan of action
4. Action Stage: concrete steps to change bx. Public commitment to change
5. Maintenance Stage: changed for 6 months and preventing relapse
6. Termination Stage: resists temptation and confident no risk of relapse.

Stages are not necessarily linear, may be repeated.

best intervention that match the person’s stage of change

Decisional Balance: pros/cons of problem bx weighed and is important during all stages but especially contemplation.

Self-Efficacy: client’s confidence to cope with high-risk situations w/o relapsing, helps move to more active stages

Temptation: intensity of urges to engage in problem bx and is inversely related to self-efficacy. highest in early stages.

Question 5

4.0

Motivational Interviewing

Answer 5

**Motivational Interviewing: **

1. used with people who were ambivalent about changing bx.
2. alcohol abuse/dependence but now applied to range of issues.
3. Rogers’ client-centered tehrapy and Bandura’s self-efficacy models.
4. No focus on etiology of issue but on factors that impede ability to change bx.
5. GOAL: to enhance intrinsic motivation to alter bx and help client examine and resolve ambivalence about changing.

Four Basic Principles to guide intervention:

• express empathy
• develop discrepancies between current bx and personal goals/values
• roll with resistence (do not oppose it)
• support self-efficacy
• OARS:
  
  • open-ended questions
  • Affirmations for empathy
  • Reflective listening
  • Summaries