Chapter 11: Constructivist Theory And Therapy Flashcards
Constructive Theories and Therapies
Place a strong emphasis on helping clients reconstruct or restory their lives in more adaptive satisfying ways; requires that therapy interactions focus primarily on the present and future; Diving more deeply into the abyss of “as if” as introduced to philosphers; has its roots in traditional therapy
Immanuel Kant
Reality is Unknowable
Hans Vaihinger
Conception of many individual fictional realities both are at the root of contemporary constructive theory
Constructivism
Holds that individuals perceive and construct reality based on their own experiences
Objectivism
Holds that individuals know reality by passively receiving sensory information directly from the environment
George Kelly
Developed first unarguably constructive approach to therapy; his preposterous interpretations which were deliberately offered worked very well in moving clients toward more positive future behavior and emotions
Foundational Constructivist Psychological Concepts
Criteria for interpretative statements
- integrate his clients’ current perspective
- have ramifications for approaching the future in a different way
Milton Erickson
considered the origin of solution-focused constructivist thinking; considered the innovative inspiration for the strategic therapy approach with individuals and families; made no effort to correct causative underlying maladjustments lurking in his clients’ unconscious, self, past, or environment; his focus was how to deconstruct and reconstruct the skills and strengths his clients brought with them to therapy
Utilization
Both an intervention and a theoretic concept; crucial for clients to utilize whatever strengths they brought with them to therapy; these strengths included their humor, work experiences, language style, personal sources, and nonverbal behavior
Characteristics of Erickson’s Personal Attributes that led to his Legacy
Optimistic (and confident)
Clever (and intelligent)
Indirect (and collaborative)
Gregory Bateson
Began Double-Bind Communications Projects (DBCP); Project focused on communication patterns in schizophrenic families
Positive Connotation
Negative symptoms or behaviors are recast in a positive light
Mental Research Institute
Established by Donald Jackson, Virginia Satir, and Paul Watzlawick;
Solution-Focused Brief Therapy
Brief Family Therapy Center;founded by Steve de Shazer & Insoo Kim Berg; emphasizes that clients don’t need to know anything about why or how their problem originated; focuses on helping clients geneate solutions
Formula Tasks/Skeleton Keys
Standard Therapy Interventions
Theoretical-Practical Precursors to Solution-Oriented Approach
Milton Erickson’s Work
Strategic Intervention and Problem-Solving Techniques developed at MRI
de Shazer and Berg’s solution-focused brief therapy
Personal Narrative Metaphor
Story that defines and organizes each individual’s life and relationship with the world; gives our lives meaning and continuity; includes an organized plot, characters, points of tension and climax, and a beginning, middle, and end
Michel Foucault
The application of his therapy process allows individuals who have opressed themselves through personal narratives to deconstruct and reconstruct their life stories into more complete, more adaptive, and personally meaningful storylines
Narrative Therapy
As formulated by White and Epston also helps individuals break free from internalized social, cultural, and political oppression and rewrite their life stories from a perspective of personal freedom
Postmodernism
Firmly believe in the fact that there is no thing as an objective fact; Position is illogical, subjective, nonlinear, and essentially unprovable, but from the postmodernist’s perspectives, such is the inherent nature of all things; derives from art and literature; originally referred to a movement or perspective that was in opposition to or in reaction against modern art or literature
Steve de Shazer
Antirealist nature of client symptoms: There are no wet beds, no voices without people, no depressions. There is only talk about wet beds, talk about voices without people, and talk about depression
Modernism
Associated with the scientific, objective, and deterministic paradigm of an external reality;
Confusion Techniques
Speaking to clients in ways that were circular, nonlinear, and confusing
Constructive Therapists
Focus on how language builds, maintains, and changes each individual’s worldview; language determines reality
Adaptation
Requirement for change; humans assimilate and accommodate from their environment to learn what they need to know about surviving and thriving in the world
Assimilation
Process of fitting reality and personal experience into one’s current cognitive organization;
Accommodation
Modification or adjustment of one’s cognitive organization that comes as a result of the demands of reality and personal experience
Narrative Therapists
Help clients focus on their lived experiences and integrate them into their personal narratives; similar to Piaget’s accommodation; change is always happening, and small changes are all that is needed to begin a ripple effect toward larger changes
Constructive Therapy using Narrative Therapy Format
Therapists helps clients cough up their old life stories and chew them a in a new and different way before trying to swallow and digest them again
Constructivist Theoretica Positions
Egalitarian therapy relationships; therapists are considered accountable when clients resist therapy;
Consulting Your Consultants
When people are established as consultants to themselves, to others, and to the therapist, they experience themselves as more of an authority on their own lives, their problems, and the solutions to these problems
Constructive Therapists Direct Clients Toward
Solutions
Exceptions to their problem-centered viewpoint
Optimism and self-efficacy
New versions of personal stories that promote greater psychological health
Psychopathology of Constructive Theorists
Diagnosis of clients viewed as an unhelpful procedure; anxiety and depression are not really objective entities but part of an individual’s personal emotional experience cast within an overall personal life narrative; meeting clients where they are, emphasizing unique strengths that each client brings to therapy;
Determinants of Client Problems
The client has gotten stuck using ineffective solutions
The client believes in an unhealthy, pathology-based self-, couple, or family narrative
Lived Experience
Personal repetitive tendencies
Reasons for a lack of client preparation for constructive therapy
Constructive therapies are relatively new
Historical roots characterized by indirectness
Constructivist approaches emphasize meeting clients where they are
Solution-based approaches capitalize on the fact that their strength-based, accepting, and respecting style is a pleasant but unexpected surprise for clients
Application of Strategic-Constructive Techniques to Yourself
Observe your tendency to repeat reactions and attitudes that you’ve applied to problems in the past.
Notice our redundant applications of habitual problem-solving strategiesl being aware of our usual attempted solutions
Examine one of our problems and try to fiend at least five possible strategies for solving it, apart from the solution that spontaneously comes to mind
When no further alternatives come to mind, how another person that we know might look at the situation and react to it
Start applying the first one and observe its effects
Spending a few days repeatedly asking what you can do to make a situation worse. If I really wanted to increase the problem, how could I acieve that? What should I think or not think in order to make things even worse?
Collaboration Between Constructive Therapist and Client
Continuous process with clients to identify goals, strategies, and the overall therapy directions
Primary Focus of Constructive Therapy
Either on identifying and implementing solutions or on deconstructing problem narratives and constructing more satisfying narratives
Emphasizes that clients are the best expert on their own lives and should be treated as such
Opening the section of Constructivist Therapy
What brings you here? Allows the clients to discuss their conceptualization of the problem and take the lead in the ensuing therapeutic conversation
Scaling Questions
Ask clients to rate problems, progress, or vitually any therapy-related issue on a scale of 1 to 10 with 1 as the lowest
Purpose of Using Scaling Questions
To obtain an initial rating of the size of the client’s problem from the client’s perspective
Monitor client’s progress
Identify intermediate therapy goals
Make specific plans for improvement
Percentage Questions
Give therapists a simple method for measuring exactly what change would like.
Assessing Client Motivation
Therapy is just a matter of helping clients notice changes that are already happening; producing specific change and movement directly related to the client’s stated problem is critical
Clients’ Roles
Customers for change
Complainants
Visitors to Treatment
Customers for Change
Clients not equally interested in personal change
Complainants
Clients who appear in therapy only because significant others have insisted on their participation
Visitors to Treatment
Court mandated clients who are not interested in change
Specific Constructivist Therapy Techniques
Pretreatment Change Question Unique Account and Redescription Questions Externalizing Conversations Relabeling Presuppositional Questions Formula Tasks Letter Writing Reflecting Teams or Therapeutic Breaks
Pretreatment Change Question
What improvements in your situation have you noticed between the time when you called the clinic for your appointment and right now?
How did you manage that?
Unique Outcome/Sparkling Moment
What the clients construe as progress
Externalizing Conversations
Designed to help clients, couples, and families stop blaming themselves and one other; helps clients dissociate from the problem, look at it from a greater distance, and develop strategies for eliminating it
Relabeling/Reframing
Relabeling and reframing each of these aspects of therapy to make the process more user-friendly and egalitarian;
Language
Used as a foundation for reframing or positive relabeling;
Positive Incentives
Positive reinforcement approaches
Presuppositional Questions
Used to cocreate therapeutic and life goals with clients; Questions presuppose that a positive change have already been made and ask for specific descriptions of these changes
Formula Tasks
First Session: Designed to help clients shift from a focus on the past and negative expectations to a present-future focus and positive expectations
Second Session: Clients return with two or three specific descriptions of positive interactions they would like to have continue
Miracle Question
Suppose you were to go home tonight, and while you were asleep, a miracle happened and this problem was solved. How will you know the miracle happened? What will be different?
Do Something Different Task
Direct but nonspecific intervention that is especially well suited to repeating, dissatisfying behavior sequences
Summary Letter
Typically written from the therapist’s perpective but highlight sparkling moments and use the client’s words to produce a more strength- and hope-based storytime
Letters of Invitation
Written to family members who are reluctant to attend therapy sessions; these letters generally highlight the individual’s important status in the family, focusing on the positive reasons for attending a session, rather than on the negative consequences or implications associated with nonattendance
Redundancy Letters
Articulate observations and client reports of overlapping or enmeshed family roles; outlines the client’s impulse, using her own words, to move forward and establish a more unique identity of her own; often accompanied by a discharge letter
Discharge Letter
One family member formally discharges another family member from performing a redundant duty;
Letters of Prediction
Written to help clients continue strength-based storylines into the future; purpose is that these letters serve as a 6-month follow-up or review that is both interesting and potentially helpful; 2nd purpose the therapist suspects that the client will not wait six months to open the letter and that is serves as a possible positive prophesy
Tom Andersen
Norwegian psychiatrist who had his own approach to family therapy; Integrated reflecting teams or therapeutic breaks into individual, couple, and family therapy
Reflective Team
Feedback procedure that is different from the traditional one-way mirror in family therapy training;
One-Way Mirror Paradigm
A supervisor and fellow students sit behind a one-way mirror and observe family therapy sessions
Reflecting Procedure
During an impasse when the therapist is unsure how to proceed, or at a preplanned time, a reflective team meeting is intiated.
The therapy session stops as the therapist and family turn to the mirror and the lights and sound system are reversed.
The therapist and family watch and listen as the reflecting team spontaneously provide tentative hypotheses about the family’s problem issues.
During the relecting team meeting, care is taken to talk about the family in a respectful, nonpathologizing manner.
When the reflecting team meeting ends, the lights and sound system are again reversed and family members and therapist have a conversation about the reflecting team conversation.
Reflecting Teams
Seek to honor the family, while at the same time providing fresh new perspectives; Breaks down heirarchical boundaries of traditional one-way mirror supervision introducing a two-way mirror reflecting team
Why Constructive Therapies are Multicultural
Respect for the individual Respect for personal language Languaging Narrative Respect for each individual's construction of reality
Possibility Therapy (Previously Solution-Oriented Therapy)
Values and honors human diversity;
Approaches are more formulaic and could be practiced in ways reflecting a less-than-ideal multicultural orientation
