Effective Psychotherapy (Miller & Moyer, 2021)

Question 1

An invitation

Answer 1

One assertion is that more effective therapist( those whose clients tend to get better) share more certain interpersonal characteristics, regardless of their particular theoretical orientation or treatment approach (Anderson et al., 2009)

Question 2

Mind and heart: therapeutic attitudes

Answer 2

Consider that therapeutic skills involved both an internal experiential component and an external expressive component

Question 3

Mind and heart: therapeutic attitudes

Answer 3

Perhaps most fundamental in helping relationships is a commitment to compassion… this is not just feeling for (sympathy) but a desire and intention to alleviate suffering and facilitate others wellness and growth (Armstrong, 2010)

Question 4

Mind and heart: therapeutic attitudes

Answer 4

A second therapeutic attitude, underlying therapeutic skills is a sense of counseling and psychotherapy as a partnership… in order to help people change their behavior or lifestyle, you need their expertise and partnership

Question 5

Therapist effects

Answer 5

Therapist effects have been a subject of psychological research since the 1940s, and the results have been reassuringly consistent overtime

Question 6

Therapist effects

Answer 6

In treatment outcome research, such other factors include attributes of the client being treated (age, gender, problems, severity, personality) of the treatment itself (length, structure, manual, guided, supervision, and quality assurance)

Question 7

Therapist effects

Answer 7

Studies of this kind, typically fine little or no outcome difference based on the specific treatments being compared, but a significant difference attributable to the therapist who provide the treatments

Question 8

Differences between therapists

Answer 8

Differences and therapist effectiveness can be detected as early as the first session predicting clients treatment out (Erekson et al., 2029)

Question 9

Differences between therapists

Answer 9

Rather than simply being an effective, some therapist may actually be harming their clients.. in fact, therapist and therapies can cause harm

Question 10

Differences within therapists

Answer 10

Therapist do differ in overall effectiveness (i.e. can be rank ordered in their helpfulness when compared with each other) and also very in their skills and effectiveness, depending on the client, they are treating

Question 11

Differences within therapists

Answer 11

Even the best therapist are not effective with every client, and even the worst may be helpful with a few

Question 12

Client – therapist match

Answer 12

There will be other biases that therapist Harbor, and working with various clients, and demographic client variables, such as age, ethnicity, and gender, do not tell the whole story

Question 13

Client-therapist match

Answer 13

Some therapist know it is easier to form a collaboration with some clients, and with others, for reasons that are not always clear

Question 14

Therapeutic skills

Answer 14

Eight therapeutic skills of more effective therapist:

Accurate empathy
Acceptance
Positive regard
Genuineness
Focus
Hope and expectation
Evoking
Offering information and advice 

Question 15

Accurate empathy 

Answer 15

Empathy is a skill more than just a trait or inexperience.. the skill of accurate empathy does not require feeling the same thing. Another person is feeling at the same time she or he is experiencing it.

Question 16

The how of communicating accurate empathy

Answer 16

A helping relationship involves understanding and appreciating another’s experience, being able to perceive reality from his or her perspective, as if you were that person

Question 17

The communication aspect of accurate empathy

Answer 17

Consider silence, and how that can benefit the process, misunderstanding, mishearing and people don’t always say exactly what they mean 

Question 18

Empathetic, listening

Answer 18

It is a way of listening that helps you avoid roadblocks and step inside another person’s world (please see page 25 for the 12 roadblocks to listening, Gordon, 1970

Question 19

What to reflect

Answer 19

The active reflection focuses on particular facets of what someone says, selectively, emphasizing, or strengthening them.. no one reflects; to do so would be bizarre

Question 20

What to reflect?

Answer 20

Some authors have suggested that what is reflected, and indeed, how much empathy is expressed, should be align with the needs of the client

Question 21

Do clients cause therapist empathy?

Answer 21

One rival explanation is that better – prognosis clients (e.g. those who are more ‘motivated’) inspire counselors to be more empathetic and that’s why therapist empathy predicts better outcomes

Question 22

Acceptance 

Answer 22

Nonjudgmental acceptance has long been regarded as an important, therapeutic skill and counseling

Question 23

Acceptance

Answer 23

The counselors manner is unconditional… acceptance is “the ability to listen without preconception, prejudgment, or condemnation” (Strupp, 1960)

Question 24

The attitude of acceptance

Answer 24

Non-judgmental acceptance is a key element in the practice of mindfulness

Question 25

The attitude of acceptance

Answer 25

Implicit in this therapeutic attitude is a belief that human beings have inherent worth in deserve respect without needing to earn it

Question 26

The how of communicating acceptance

Answer 26

Clients can be particularly sensitive to perceived, blame or disapproval

Question 27

Positive regard

Answer 27

Clients do not need to prove or earn a counselor respect. PR is a precondition extended to all without regard for apparent merit, rooted in an intentional view of humankind as inherently.. “ positive, forward moving, constructive, realistic, and trustworthy”-Rogers, 1962)

Question 28

Positive regard

Answer 28

There appears to be a number of different terms used to refer to the same or similar concepts with relation to positive regard- such as warmth, acceptance, respect and support

Question 29

Affirmation

Answer 29

Affirmation is a way to convey positive regard. It involves both noticing and commenting on a persons strengths, positive actions, and attributes

Question 30

Positive regard

Answer 30

Positive regard is also communicated in many ways besides direct verbal affirmations.. clients may value what you do even more than what you say about them (Suzuki & Farber, 2016).. for example the client may value a therapist being a good listener

Question 31

Genuineness

Answer 31

Therapist genuineness is greater when they spend less effort, concealing themselves, and instead, responding ways that are uniquely and authentically their own

Question 32

Genuineness

Answer 32

Genuineness means the therapist as a person shines through, rather than being hidden behind a façade (Lietaer, 2001a).

Question 33

Negative emotions towards clients

Answer 33

A common reason for clinicians to choose interpersonal distance over genuineness, is the avoidance of intense negative emotion that can arise with some clients from time to time

Question 34

Focus

Answer 34

With each new client and initial step for focusing is to clarify the goals of your work together

Having a clear focus is by no means universal and practice .. one element of focus in the therapeutic relationships is a felt responsibility to have clear direction for your services

Question 35

The how of focusing

Answer 35

The focusing process, then, is one of finding direction for treatment among these various, and sometimes conflicting potential goals

Question 36

Hope

Answer 36

A hopeful attitude is optimism: anticipating and expecting positive change. Optimism is a choice, a benefit of the doubt… you decide to see a glass is half full, rather than half empty

Question 37

Evocation

Answer 37

Evocation calls forth and supports what clients already have, their own strength, and wisdom

The ability to evoke, a clients own resources is a particular skill of therapist that stands in contrast to the technical skills of teaching and advising

Question 38

The attitude of evocation

Answer 38

A starting point in the attitude of evocation is recognizing that there is something important to evoke from clients

Question 39

The attitude of evocation

Answer 39

Some forms of psychotherapy have heavily emphasize, giving client something that they lack, be insight, knowledge, skills, motivation, or rational, thinking.

Evocation:” you have what you need, and together, we are going to find it“

Question 40

Offering information and advice

Answer 40

 client relationships range from directing to following

Question 41

Offering information and advice

Answer 41

At one extreme is a directing style that involves telling people what they should do by dispensing, information, solutions, instructions, or advice. .. there are times when this is an appropriate and even expected role

Question 42

Offering information and advice

Answer 42

At the opposite extreme is a compassionate companion, who listens empathically, conveys acceptance, and affirmation, and assiduously avoids, providing answers or advice.. sometimes this is what clients prefer

Question 43

Asking permission

Answer 43

One useful step is the ask permission before offering information or advice

Question 44

Asking permission

Answer 44

Asking permission honors self -direction

Question 45

Training

Answer 45

We defined training as the conveying of skills that are needed to improve treatment in someway

Question 46

Supervising

Answer 46

 supervision is a formal relationship between two providers, one of whom has authority over the other

Question 47

Coaching

Answer 47

Coaching on the other hand is a collaborative relationship. It typically requires directly observing a learners performance and providing feedback and suggestions for skill improvement.

Question 48

Experiential learning

Answer 48

Engaging trainees in experiential practices is particularly important for developing interpersonal therapeutic skills