final Flashcards
Interpersonal Therapy (IPT) Basics
Manualized
Short-term (12-16 sessions)
Focused on interpersonal relationship as source of emotional distress
Combo psychodynamic and cog-beh approaches
IPT–Interpersonal Disputes
Incongruence in expectations b/w client & other person
INTERVENTIONS
-Draw connection b/w symptom onset & symptom
-Understand role expectations
-Identify patterns of relationship attachment
-Problem-solving to change expectations/roles
IPT–Role Transitions
Normal transitions–>role adjustment, experienced as loss
INTERVENTIONS
-Identify new role challenges
-Grieve loss of old, view new +, sense of mastery of new
IPT–Grief
Death–>impact client relational capacity
INTERVENTIONS
-Facilitate mourning
-Reconstruct relationship with lost person
-Become willing/able to invest in other relationship
IPT–Interpersonal Deficits
Impoverished relationships in quality & quantity
INTERVENTIONS
-Focus on reducing social isolation/formulating new relationships
-Use psychodyn idea of transference to understand patterns of attachment
IPT: Non-directive exploration
Encouraging client to initiate and inteify problem areas and solutions
IPT: Encouragement of affect
Allows & encourages expression of emotions
IPT: Clarification of beliefs & perceptions
Therapist draws attention to inconsistencies in order to correct cognitive distortions
IPT: Communication analysis
Assist client in improving communication skills and verbalizing needs and desires
IPT: Therapeutic relationship
Used as a model for healthy interpersonal relationships
IPT: Behavioral change strategies
Focuses on assisting client in seeing range of behavioral options and actively choosing and developing new skills
IPT: Stages
Assessment
Intermediate sessions focused on problem area
Termination
IPT: Criticisms
Medical model of mental illness (not person in environment)
Requires specialized training
Lacks own theoretical underpinnings
Motivational Interviewing (MI) Basic Concepts
- Some reason for maladaptive behavior
- Focuses on motivation for change
- Desire for change must be internal
- Reflect back pros & cons
- Ambivalence normal–help progress through stages of change
MI: Therapeutic Relationship
Empathy
Non-judgmental
Active listening
Client is capable of change when ready
MI: Interventions
- Rolling w/ resistance–understand that client has reasons for behavior and lack of motivation to change
- Highlight discrepancies between client’s values & behaviors
- Elicit change talk
MI: Skills
OARS Open-ended questions Affirming statements Reflective listening Summarizing throughout the therapeutic process
Phases of MI
FIRST Resolve ambivalence Increase intrinsic motivation THEN Develop and implement plan for change
MI: Criticism
Focuses only on motivation
Lacks broad theoretic basis
Worker selectively choosing what elements of change talk to bring out
Evidence-Based Practice: Benefits
- proven results
- easier to bill for
- provides measure of success
- clear quantitative objectives
- shared language/lingo of profession
EBP: Drawbacks
- some research biased
- can put us in a box-insurance dictates treatment
- need to base on individual client, not just want research says will work
Psychological Assessment: Functions
- Assist in problem solving and prioritizing interventions to target symptoms
- Provide communication between and within care team
- Make recommendations re: tx setting, intensity, goals, mode, strategies and techniques, methodological framework
Psychological Assessment: Components
- Specifics of the problem
- Client resources
- Client’s personal characteristics
- Environmental circumstances
- Treatment recommendation
Specifics of the Problem
Severity
Duration (length, remission/relapse)
Onset (when, what brought it on)
Specific symptoms (times when worse)
Client Resources
Social supports
History of treatment & experience of it
Psychological/emotional/spiritual strenths
Client’s Personal Characteristics
Level of motivation–why here?
Willingness to engage in treatment
Stage of change
Treatment Recommendations
Based on: Level of functioning Social supports Problem complexity/chronicity Coping styles Resistance Subjective distress Problem-solving (related to stage of change)
Level of Functioning
- Level of restrictiveness needed (inpatient, outpatient, partial hospitalization)
- Intensity needed (frequency, duration)
- Biological/medical concerns (inc. medication)
- Prognosis
- Urgency of achieving goals
Problem complexity/chronicity
Underlying patterns or themes present in multiple domains of client’s life
Subjective distress
Client’s perception of symptomatic distress
Can be stimulant for change
Psychological assessment report
- Demographics
- Reason for referral
- How evaluated
- Behavioral observation
- Background info (onset, symptom, hx of tx, meds)
- Test results
- Impressions and interpretations
- Summary and recommendations
Spiritual assessment–why?
- Understand client perspective
- Obtain knowledge a/b how healthy perspective is & influence on counseling
- Determine possible resource of beliefs & support groups
- Determine possible interventions that can be used in counseling
- To clarify the level of need to address spiritual or religious views in counseling
Psychodynamic Basics
Deterministic
All behavior has meaning
Behavior is determined by unconscious drives, motivation, and instincts
Psychodynamics: 5 Major Constructs
Topographic hypothesis Dynamic hypothesis Economic hypothesis Structural hypothesis Adaptive hypothesis