Diversity of models and common factors in psychotherapy

Question 1

Psychotherapy exists in many different forms/models, and clinicians have been battling for decades about the “best” way to bring the client to change. Each specialized model has?

Answer 1

o basic philosophy/view of human nature,
o key concepts
o specific goals

Question 2

Each different model and theory influences?

Answer 2

o The therapeutic relationship

o The techniques of therapy

Question 3

What are the Basic philosophies of each model?

• Psychoanalytic therapy
• Person-centered therapy
• Behavior Therapy
• Cognitive behavioral therapy
• Solution Focused therapy
• Family systems therapy

Answer 3

• Psychoanalytic therapy
  Human beings are determined by psychic energy and by early experiences. Unconscious motives and conflicts are central in understanding present behavior.
• Person-centered therapy
  Positive view of people; we have an inclination towards becoming fully functioning and congruent.
• Behavior Therapy
  Behavior is the product of learning. We are both a result of our environment as well as the creators of our environment.
• Cognitive behavioral therapy
  Individuals can develop faulty thinking, which can lead to emotional and behavioral problems. Thoughts are the major determinants of how we feel and act.
• Solution Focused therapy
  People have a tendency to do things in the same way, over and over again. Patterns get established. The client is taught to recognize patterns and change them, by identifying the solutions that they are already equipped with.
• Family systems therapy
  People cannot be considered alone, they are always connected to other people. An individual’s dysfunctional behavior can only be understood in the context of the interactions of the individual with his/her social system.

Question 4

What are the Goals of therapy of each model?

• Psychoanalytic therapy
• Person-centered therapy
• Behavior Therapy
• Cognitive behavioral therapy
• Solution Focused therapy
• Family systems therapy

Answer 4

• Psychoanalytic therapy
  To make the unconscious conscious. To assist clients in reliving earlier experiences and working through repressed conflicts. To achieve intellectual and emotional awareness.
• Person-centered therapy
  To provide a safe climate that allow client to move toward openness, greater trust in self, and increased spontaneity and aliveness. To find meaning in life and to experience live fully.
• Behavior Therapy
  To eliminate maladaptive behaviors and learn more effective behaviors. To identify factors that influence behavior.
• Cognitive behavioral therapy
  To teach clients to confront faulty beliefs with contradictory evidence that they gather and evaluate. To help clients become aware of automatic thoughts and change them.
• Solution Focused therapy
  To help clients recognize adaptive and maladaptive patterns in relationships. To help clients identify solutions to stop maladaptive patterns and increase adaptive patterns.
• Family systems therapy
  To help family members become aware of patterns in relationships that are not working well and to create new ways of interacting.

Question 5

What are the Therapeutic relationship of each model?

• Psychoanalytic therapy
• Person-centered therapy
• Behavior Therapy
• Cognitive behavioral therapy
• Solution Focused therapy
• Family systems therapy

Answer 5

• Psychoanalytic therapy
  The classical analyst remains anonymous and clients develop projections towards him or her. Focus is on reducing the resistances, working with transference, and helping the client uncover conflicts and gain insight by talking.
• Person-centered therapy
  The relationship is of primary importance. The qualities of the therapist include genuineness, warmth, accurate empathy, and acceptance. Clients use this genuine relationship to help them transfer what they learn to other relationships.
  “In my early professional years, I was asking the question: How can I treat, or cure, or change this person? Now I would phrase the question in this way: How can I provide a relationship which this person may use for his own personal growth?” Carl Rogers
• Behavior Therapy
  The therapist is active and directive and functions as a teacher or mentor to help clients learn more effective behaviors. Clients must be active in the process and experiment with new behaviors.
• Cognitive behavioral therapy
  The focus is on a collaborative relationship. Using a Socratic dialogue, the therapist helps the client identify dysfunctional beliefs and discover alternative rules for living. Clients must actively practice changing self-defeating thinking and behaving.
• Solution Focused therapy
  Therapy is a collaborative partnership. Clients are viewed as the experts on their own life. Therapists use questioning dialogue to help clients free themselves from their problem-saturated stories and create new life-affirming stories.
• Family systems therapy
  The family therapist functions as a teacher, coach, model and consultant. The therapist may start with the presenting problem, but will seek to understand who else is connected to it, and reflect back the process of family interaction to help the family change dysfunctional patterns.

Question 6

What are the Techniques of therapy of each model?

• Psychoanalytic therapy
• Person-centered therapy
• Behavior Therapy
• Cognitive behavioral therapy
• Solution Focused therapy
• Family systems therapy

Answer 6

• Psychoanalytic therapy
  The key techniques are interpretation, dream analysis, free association, analysis of resistance, analysis of transference and countertransference. Techniques are designed to help clients gain access to their unconscious conflicts, which leads to insight and a strengthening of the ego.
• Person-centered therapy
  This approach uses few techniques but stresses the attitudes of the therapist and a “way of being”. Therapists strive for active listening, reflection of feelings, “being there” for the client, and focusing on the moment to moment experiences of the client.
• Behavior Therapy
  The main techniques are reinforcement, shaping, modeling, systematic desensitization, relaxation methods, flooding, assertion and social skills training. Contracts and homework assignments are typically used.
• Cognitive behavioral therapy
  Therapists use a variety of cognitive, emotive, and behavioral techniques, such as engaging in Socratic dialogue, debating irrational beliefs, keeping a record of activities, role playing, imagery, etc. Homework is typically used.
• Solution Focused therapy
  “Change-talk” is the main technique, with emphasis on a client’s life when the problem was not a problem. The therapist mirrors back strengths and skills clients already have. Other techniques include the Miracle Question, Scaling, and Exceptions.
• Family systems therapy
  A variety of techniques can be used, depending on the theoretical orientation of the therapist. Techniques can include genograms, teaching, asking questions, joining the family, tracking sequences, issuing directives, reframing, enactments, and setting boundaries.

Question 7

Repeat again now

Answer 7

…

Question 8

Psychoanalytic therapy

Answer 8

• Basic philosophies:
  Human beings are determined by psychic energy and by early experiences. Unconscious motives and conflicts are central in understanding present behavior.
• Goals of therapy:
  To make the unconscious conscious. To assist clients in reliving earlier experiences and working through repressed conflicts. To achieve intellectual and emotional awareness.
• Therapeutic relationship:
  The classical analyst remains anonymous and clients develop projections towards him or her. Focus is on reducing the resistances, working with transference, and helping the client uncover conflicts and gain insight by talking.
• Techniques of therapy:
  The key techniques are interpretation, dream analysis, free association, analysis of resistance, analysis of transference and countertransference. Techniques are designed to help clients gain access to their unconscious conflicts, which leads to insight and a strengthening of the ego.

Question 9

Person-centered therapy

Answer 9

• Basic philosophies:
  Positive view of people; we have an inclination towards becoming fully functioning and congruent.
• Goals of therapy:
  To provide a safe climate that allow client to move toward openness, greater trust in self, and increased spontaneity and aliveness. To find meaning in life and to experience live fully.
• Therapeutic relationship:
  The relationship is of primary importance. The qualities of the therapist include genuineness, warmth, accurate empathy, and acceptance. Clients use this genuine relationship to help them transfer what they learn to other relationships.
  “In my early professional years, I was asking the question: How can I treat, or cure, or change this person? Now I would phrase the question in this way: How can I provide a relationship which this person may use for his own personal growth?” Carl Rogers
• Techniques of therapy:
  This approach uses few techniques but stresses the attitudes of the therapist and a “way of being”. Therapists strive for active listening, reflection of feelings, “being there” for the client, and focusing on the moment to moment experiences of the client.

Question 10

• Behavior Therapy

Answer 10

• Basic philosophies:
  Behavior is the product of learning. We are both a result of our environment as well as the creators of our environment.
• Goals of therapy:
  To eliminate maladaptive behaviors and learn more effective behaviors. To identify factors that influence behavior.
• Therapeutic relationship:
  The therapist is active and directive and functions as a teacher or mentor to help clients learn more effective behaviors. Clients must be active in the process and experiment with new behaviors.
• Techniques of therapy:
  The main techniques are reinforcement, shaping, modeling, systematic desensitization, relaxation methods, flooding, assertion and social skills training. Contracts and homework assignments are typically used.

Question 11

• Cognitive behavioral therapy

Answer 11

• Basic philosophies:
  Individuals can develop faulty thinking, which can lead to emotional and behavioral problems. Thoughts are the major determinants of how we feel and act.
• Goals of therapy:
  To teach clients to confront faulty beliefs with contradictory evidence that they gather and evaluate. To help clients become aware of automatic thoughts and change them.
• Therapeutic relationship:
  The focus is on a collaborative relationship. Using a Socratic dialogue, the therapist helps the client identify dysfunctional beliefs and discover alternative rules for living. Clients must actively practice changing self-defeating thinking and behaving.
• Techniques of therapy:
  Therapists use a variety of cognitive, emotive, and behavioral techniques, such as engaging in Socratic dialogue, debating irrational beliefs, keeping a record of activities, role playing, imagery, etc. Homework is typically used.

Question 12

• Solution Focused therapy

Answer 12

• Basic philosophies:
  People have a tendency to do things in the same way, over and over again. Patterns get established. The client is taught to recognize patterns and change them, by identifying the solutions that they are already equipped with.
• Goals of therapy:
  To help clients recognize adaptive and maladaptive patterns in relationships. To help clients identify solutions to stop maladaptive patterns and increase adaptive patterns.
• Therapeutic relationship:
  Therapy is a collaborative partnership. Clients are viewed as the experts on their own life. Therapists use questioning dialogue to help clients free themselves from their problem-saturated stories and create new life-affirming stories.
• Techniques of therapy:
  “Change-talk” is the main technique, with emphasis on a client’s life when the problem was not a problem. The therapist mirrors back strengths and skills clients already have. Other techniques include the Miracle Question, Scaling, and Exceptions.

Question 13

• Family systems therapy

Answer 13

• Basic philosophies:
  People cannot be considered alone, they are always connected to other people. An individual’s dysfunctional behavior can only be understood in the context of the interactions of the individual with his/her social system.
• Goals of therapy:
  To help family members become aware of patterns in relationships that are not working well and to create new ways of interacting.
• Therapeutic relationship:
  The family therapist functions as a teacher, coach, model and consultant. The therapist may start with the presenting problem, but will seek to understand who else is connected to it, and reflect back the process of family interaction to help the family change dysfunctional patterns.
• Techniques of therapy:
  A variety of techniques can be used, depending on the theoretical orientation of the therapist. Techniques can include genograms, teaching, asking questions, joining the family, tracking sequences, issuing directives, reframing, enactments, and setting boundaries.