Chapter 6: Basic Features of Clinical Interventions Flashcards
Psychotherapy
Treatment offered by a trained mental health professional and administered within the confines of a professional relationship to help clients overcome psychological problems
Psychotherapy Approaches
Psychoanalytic Humanistic Existentialist Integrative Behavioral Cognitive Behavioral
Participants in Psychotherapy
The Client
The Therapist
Some reasons why clients seek therapy
Unhappy marriage Lack of Self Confidence Nagging Fear An Identity crisis Depression Sexual Problems Coping with Injury or Trauma Insomnia
Client Variables & Treatment Outcomes
Client's Sex Client's Age Client's Ethnicity Socioeconomic Status Intelligence Religious Attitudes, etc.
Client variables that show up as important in psychotherapy outcome research
Cooperation Vs. Resistance Openness Vs. Defensiveness Internal Representations of Therapists Client Motivation Level of Distress Expectations for treatment success Coping style
The Effective Therapist
Can recognize differences andintensities in clients’ emotional experiences and who have a verbal repertoire capable of putting these shadings into words
Has relationship-building skills
Skills in Self-Awareness or Self-Management
Self-monitoring skills
Macroskills
Broad skills such as communicaiton, relationship building, and self-monitoring
Difficulties that therapists face in their work
Competency Related Difficulties
Personality Based Difficulties
Situational Difficulties
Competency-Related Difficulties
Transient difficulties resulting from situations in which therapists questioned whether they had the knowledge or skills to be effective in a given situation
Personality-Based Difficulties
Involved therapists questioning the degree to which their own enduring personal characteristics compromised their effectiveness
Situational Difficulties
REsulted from characteristics of the therapists’ client base or work situation
Important Dimensions of the Therapeutic Relationship and is called Therapeutic Alliance
Emotional bonds that develop between the therapist and the client
Shared understanding of what is to be done and what is to be achieved
Settings for Psychotherapy
Outpatient Settings
Inpatient Settings
Outpatient Settings
Therapists’ Offices
Larger spaces in office buildings, hospitals, community centers, senior centers, church basements
Inpatient Settings
Public, private, and VA Hospitals
Residential Rehabilitation and Treatment centers
Prisons, jails, and many other settings
Goals of Clinical Interventions
Reducing Emotional Discomfort Fostering Insight Encouraging Catharsis or self-expression Providing new information (education) Assigning Extratherapy tasks (homework) Developing faith,hope, and expectations for change
Catharsis
Expressing emotions freely in the protective presence of the therapist;
Emotion Focused Intervention
Synthesize or getting in touch with emotions so that they can be understood and expressed in acceptable, constructive ways
Intensifying certain emotions, often through nonverbal, expressive methods, so they can instigate useful behavior
Restructuring emotions by giving new information that allows emotions to be modified in dersired directions
Evoking emotions so that thoughts and behaviors strongly and specifically bound up with these emotions can be reexamined
Directly modifying those emotions that have become so maladaptive that the client’s functioning is impaired
Bibliotherapy
The process of suggesting reading material about a topic
Extratherapy Tasks
Homework; tasks which the therapists often ask clients to perform outside of therapy for the purpose of encouraging the transfer of positive changes to the real world; completion of homework assignments appear to fare beter in therapy than those who do not
Crucial Contributors to Therapeutic Improvement
Developing Faith, Hope, and Expectations for Change
General Principle of PAP Ethics Code
Respect for the Dignity of Peoples and Persons
Competent Caring for The Well Being of Persons & Peoples
Professional and Scientific Responsibilities to Society
Confidentiality
The therapist protects the client’s privacy, and, except in specific circumstances, does not reveal information that the client shares in therapy
Competency
Clinicians will be professionally responsibile and practice only within their areas of expertise, to maintain high standards of scientific and only within their areas of expertise
Informed Consent
Obligates therapists to tell clients about the limits of confidentiality, about potential outcomes oftreatment, and about anything else that might affect the clients’ willingness to enter treatment
Conflict of Interest
Refers to the therapist’s obligation to maintain therapeutic boundaries or a therapeutic framework; occurs when the therapist’s personal interests compete with the best interests of the client
Treatment Duration
From one session to several years, depending on the type and severity of the disorder, the motivation and other characteristics of the client, the skill and orientation of the therapist, and the availability of funding for treatment
Psychotherapy Sessions
Weekly basis for sessions that average 45-55 minutes, group sessions typically last 90 to 120 minutes
Treatment Fees
Depend on location, clinicians’ level of training, and funding sources
Record Keeping
Guidelines outline basic contents of records, control and retention of records, and disclosure of records; designed to benefit clients, the clinicians, and their institutions; also valuable if clinicians are involved in legal proceedings, and reviewing records, especially records of effectiveness, can motivate clinicians to find ways to improve their services
What Psychologists Should Keep Records of
Their clients' identifying information Dates and types of service Fees Assessment Results Treatment Plans Consultations with others about clients
Treatment Planning
Depends on case formulation, which in turn depends on assessment
Approaches to Treatment Planning
Therapist-based treatment
Diagnosis-based treatment
Outcome-based treatment
Therapist-Based Treatment
Orientation-based/Theory based treatment; therapist learns a basic theoretical orientation to psychotherapy and uses it for every client
Diagnosis-Based Treatment
The client’s diagnosis, not the therapist’s orientation, determines the mode of treatment
Outcome-Based Treatment
Attempt to base treatment planning on all the factors that can affect treatment outcome; factors related to client (diagnosis, personality traits, therapist (orientation, techniques, personality traits) and situational or emergent qualities (treatment setting, therapeutic alliance)
Therapist Self-Disclosure
The sharing of personal information such as their emotional reactions, incidents from their own lives, etc.
Termination of Psychotherapy
Attrition or Premature Termination
Termination
Likely to bring mixed feelings to both client and clinicians; can reflect their shared efforts and accomplishment; clients typically experience this as evidence of their independence and growth; after successful treatment, it is a positive experience for both
