Samenvatting
assessment interpersoonlijke
processen
MARGAUX D’HUYVETTER
2024-2025
1
,Inhoudsopgave
1. historiek en definitie...........................................................................................................................................................6
1.1 definitie........................................................................................................................................................................6
1.1.1 modellen................................................................................................................................................................6
1.1.2 therapeutische setting...........................................................................................................................................6
1.1.3 interpersoonlijk perspectief/systeemtherapie.....................................................................................................7
1.2 historiek en theoretische grondslagen........................................................................................................................7
1.2.3 movements (p. 55 – 56)........................................................................................................................................7
1.2.4 onderzoek en theorievorming.............................................................................................................................11
1.3 hedendaagse theoretische uitgangspunten..............................................................................................................22
1.3.1 eerste uitgangspunt: sociale complexiteit als vertrekpunt.................................................................................22
1.3.2 tweede uitgangspunt: individu/cliënt in zijn context.........................................................................................29
1.4 van model naar praktijk.............................................................................................................................................36
1.4.1 indicatiestelling...................................................................................................................................................36
1.4.2 disciplines en sociale kaart..................................................................................................................................37
2. aanmelding en assessment (proces en gesprektechnisch)..............................................................................................39
2.1 fasering therapie........................................................................................................................................................39
2.2 aanmelding/planning.................................................................................................................................................40
2.2.1 settingkeuze: wie uitnodigen..............................................................................................................................40
2.2.2 agenda opstellen – wat vragen?.........................................................................................................................44
2.2.3 contextuele reflectie...........................................................................................................................................44
2.3 assessment – doel......................................................................................................................................................44
2.3.1 eerste doel: probleemtaxatie..............................................................................................................................45
2.3.2 tweede doel: asessmentcontract opstellen........................................................................................................46
2.3.3 derde doel: opbouw therapeutische alliantie.....................................................................................................46
2.4 assessment – procesmatige reflecties.......................................................................................................................49
2.4.1 doel één = probleemtaxatie................................................................................................................................49
2.4.2 assesment als interventie....................................................................................................................................53
2.4.3 settingwissels.......................................................................................................................................................54
2.5 assessment gesprekstechnieken................................................................................................................................55
2.5.1 gesprekstechnieken binnen assessment.............................................................................................................55
2.5.2 overzicht gesprekstechnieken.............................................................................................................................55
2.5.3 structureren.........................................................................................................................................................55
2
, 2.5.4 concretiseren.......................................................................................................................................................56
2.5.5 differentiëren......................................................................................................................................................56
2.5.6 samenvatten........................................................................................................................................................58
2.5.7 invoegen..............................................................................................................................................................60
2.5.8 automatische piloot............................................................................................................................................60
2.5.9 waarnemen versus interpreteren.......................................................................................................................61
2.5.10 meervoudige inleving/partijdigheid..................................................................................................................61
2.5.11 normaliseren.....................................................................................................................................................62
2.5.12 herkadreren.......................................................................................................................................................62
2.5.13 gemeenschappelijke interpunctie.....................................................................................................................66
2.5.14 metacommunicatie...........................................................................................................................................66
2.5.15 meerpersoonsrelaties.......................................................................................................................................67
2.5.16 parafraseren......................................................................................................................................................69
2.5.17 reflecteren.........................................................................................................................................................70
2.5.18 vragen stellen....................................................................................................................................................71
3. hypothesevorming............................................................................................................................................................74
3.1 assessment hypothesevorming..................................................................................................................................74
3.1.1 hypothesevorming..............................................................................................................................................74
3.2 assessment – hypothesevorming gedragspatronen..................................................................................................75
3.2.1 hoe zicht krijgen op probleeminstandhoudende gedragspatronen?.................................................................76
3.2.2 hoe zicht krijgen op uitzonderingen op probleeminstandhoudende gedragspatronen?...................................76
3.2.3 hoe bevragen van probleeminstandhoudende gedragspatronen......................................................................77
3.2.4 hoe bevragen van uitzonderingen hierop?.........................................................................................................77
3.2.5 gedragspatronen die we kunnen herkennen......................................................................................................78
3.2.6 ineffectieve communicatie/probleemoplossing.................................................................................................84
3.2.7 gemeenschappelijke activiteiten – koppels........................................................................................................89
3.2.8 capitalization – koppels.......................................................................................................................................89
3.2.9 vergeving – koppels.............................................................................................................................................89
3.3 assessment – hypothesevorming beliefs...................................................................................................................90
3.3.1 hypothesevorming – beliefs................................................................................................................................90
3.3.2 beliefs uit onderzoek...........................................................................................................................................93
3.4 assessment – hypothesevorming context...............................................................................................................101
3.4.1 hoe zicht krijgen op de probleeminstandhoudende contextuele factoren?....................................................102
3.4.2 hoe bevragen van probleeminstandhoudende contextuele factoren..............................................................102
3
, 3.4.3 hoe zicht krijgen op de uitzonderingen op probleeminstandhoudende contextuele factoren.......................103
3.4.4 historische factoren – gezin van herkomst.......................................................................................................103
3.4.5 constitutionele factoren....................................................................................................................................108
3.4.6 Actuele contextuele factoren............................................................................................................................110
Hechting.........................................................................................................................................................................119
hechtingservaringen hechtingsstijl............................................................................................................................120
4. caseformulation en feedback.........................................................................................................................................122
4.1 doel één = probleemtaxatie.....................................................................................................................................122
4.2 caseformulation.......................................................................................................................................................122
4.2.1 casus voorbeeld.................................................................................................................................................122
4.2.2 integratieve assessment (3 kolommen)............................................................................................................125
4.3 feedback...................................................................................................................................................................126
enkele tips..................................................................................................................................................................126
gedetailleerd verslag/feedbackbrief..........................................................................................................................127
4.3.3 mandaatbespreking...........................................................................................................................................128
4.3.4 bespreking slaagkansen behandeling...............................................................................................................128
4.4 behandeling (is voor het vak systeemtherapie).......................................................................................................129
4.4.1 selectie interventie............................................................................................................................................129
5. assessmentmethodieken................................................................................................................................................130
5.1 overzicht methodieken:...........................................................................................................................................130
5.2 klinisch interview......................................................................................................................................................130
5.3 vragenlijsten.............................................................................................................................................................130
5.3.1 vragenlijsten gezinnen.......................................................................................................................................132
5.3.2 overzicht gezinsvragenlijsten............................................................................................................................145
5.3.2 vragenlijsten partnerrelaties.............................................................................................................................146
5.4 genogram.................................................................................................................................................................156
5.4.1 symbolen van een genogram............................................................................................................................157
5.4.2 voorbeeld (carr p.236).......................................................................................................................................157
5.4.3 opgelet...............................................................................................................................................................158
5.4.4 andere grafische voorstellingen context: ECOGRAM........................................................................................158
5.5 non-verbale technieken...........................................................................................................................................159
5.5.1 observatie spontaan gedrag (in spreekruimte) – gedragspatronen.................................................................159
5.5.2 dramatechnieken..............................................................................................................................................159
5.5.3 gebruik van poppetjes en objecten...................................................................................................................161
4
assessment interpersoonlijke
processen
MARGAUX D’HUYVETTER
2024-2025
1
,Inhoudsopgave
1. historiek en definitie...........................................................................................................................................................6
1.1 definitie........................................................................................................................................................................6
1.1.1 modellen................................................................................................................................................................6
1.1.2 therapeutische setting...........................................................................................................................................6
1.1.3 interpersoonlijk perspectief/systeemtherapie.....................................................................................................7
1.2 historiek en theoretische grondslagen........................................................................................................................7
1.2.3 movements (p. 55 – 56)........................................................................................................................................7
1.2.4 onderzoek en theorievorming.............................................................................................................................11
1.3 hedendaagse theoretische uitgangspunten..............................................................................................................22
1.3.1 eerste uitgangspunt: sociale complexiteit als vertrekpunt.................................................................................22
1.3.2 tweede uitgangspunt: individu/cliënt in zijn context.........................................................................................29
1.4 van model naar praktijk.............................................................................................................................................36
1.4.1 indicatiestelling...................................................................................................................................................36
1.4.2 disciplines en sociale kaart..................................................................................................................................37
2. aanmelding en assessment (proces en gesprektechnisch)..............................................................................................39
2.1 fasering therapie........................................................................................................................................................39
2.2 aanmelding/planning.................................................................................................................................................40
2.2.1 settingkeuze: wie uitnodigen..............................................................................................................................40
2.2.2 agenda opstellen – wat vragen?.........................................................................................................................44
2.2.3 contextuele reflectie...........................................................................................................................................44
2.3 assessment – doel......................................................................................................................................................44
2.3.1 eerste doel: probleemtaxatie..............................................................................................................................45
2.3.2 tweede doel: asessmentcontract opstellen........................................................................................................46
2.3.3 derde doel: opbouw therapeutische alliantie.....................................................................................................46
2.4 assessment – procesmatige reflecties.......................................................................................................................49
2.4.1 doel één = probleemtaxatie................................................................................................................................49
2.4.2 assesment als interventie....................................................................................................................................53
2.4.3 settingwissels.......................................................................................................................................................54
2.5 assessment gesprekstechnieken................................................................................................................................55
2.5.1 gesprekstechnieken binnen assessment.............................................................................................................55
2.5.2 overzicht gesprekstechnieken.............................................................................................................................55
2.5.3 structureren.........................................................................................................................................................55
2
, 2.5.4 concretiseren.......................................................................................................................................................56
2.5.5 differentiëren......................................................................................................................................................56
2.5.6 samenvatten........................................................................................................................................................58
2.5.7 invoegen..............................................................................................................................................................60
2.5.8 automatische piloot............................................................................................................................................60
2.5.9 waarnemen versus interpreteren.......................................................................................................................61
2.5.10 meervoudige inleving/partijdigheid..................................................................................................................61
2.5.11 normaliseren.....................................................................................................................................................62
2.5.12 herkadreren.......................................................................................................................................................62
2.5.13 gemeenschappelijke interpunctie.....................................................................................................................66
2.5.14 metacommunicatie...........................................................................................................................................66
2.5.15 meerpersoonsrelaties.......................................................................................................................................67
2.5.16 parafraseren......................................................................................................................................................69
2.5.17 reflecteren.........................................................................................................................................................70
2.5.18 vragen stellen....................................................................................................................................................71
3. hypothesevorming............................................................................................................................................................74
3.1 assessment hypothesevorming..................................................................................................................................74
3.1.1 hypothesevorming..............................................................................................................................................74
3.2 assessment – hypothesevorming gedragspatronen..................................................................................................75
3.2.1 hoe zicht krijgen op probleeminstandhoudende gedragspatronen?.................................................................76
3.2.2 hoe zicht krijgen op uitzonderingen op probleeminstandhoudende gedragspatronen?...................................76
3.2.3 hoe bevragen van probleeminstandhoudende gedragspatronen......................................................................77
3.2.4 hoe bevragen van uitzonderingen hierop?.........................................................................................................77
3.2.5 gedragspatronen die we kunnen herkennen......................................................................................................78
3.2.6 ineffectieve communicatie/probleemoplossing.................................................................................................84
3.2.7 gemeenschappelijke activiteiten – koppels........................................................................................................89
3.2.8 capitalization – koppels.......................................................................................................................................89
3.2.9 vergeving – koppels.............................................................................................................................................89
3.3 assessment – hypothesevorming beliefs...................................................................................................................90
3.3.1 hypothesevorming – beliefs................................................................................................................................90
3.3.2 beliefs uit onderzoek...........................................................................................................................................93
3.4 assessment – hypothesevorming context...............................................................................................................101
3.4.1 hoe zicht krijgen op de probleeminstandhoudende contextuele factoren?....................................................102
3.4.2 hoe bevragen van probleeminstandhoudende contextuele factoren..............................................................102
3
, 3.4.3 hoe zicht krijgen op de uitzonderingen op probleeminstandhoudende contextuele factoren.......................103
3.4.4 historische factoren – gezin van herkomst.......................................................................................................103
3.4.5 constitutionele factoren....................................................................................................................................108
3.4.6 Actuele contextuele factoren............................................................................................................................110
Hechting.........................................................................................................................................................................119
hechtingservaringen hechtingsstijl............................................................................................................................120
4. caseformulation en feedback.........................................................................................................................................122
4.1 doel één = probleemtaxatie.....................................................................................................................................122
4.2 caseformulation.......................................................................................................................................................122
4.2.1 casus voorbeeld.................................................................................................................................................122
4.2.2 integratieve assessment (3 kolommen)............................................................................................................125
4.3 feedback...................................................................................................................................................................126
enkele tips..................................................................................................................................................................126
gedetailleerd verslag/feedbackbrief..........................................................................................................................127
4.3.3 mandaatbespreking...........................................................................................................................................128
4.3.4 bespreking slaagkansen behandeling...............................................................................................................128
4.4 behandeling (is voor het vak systeemtherapie).......................................................................................................129
4.4.1 selectie interventie............................................................................................................................................129
5. assessmentmethodieken................................................................................................................................................130
5.1 overzicht methodieken:...........................................................................................................................................130
5.2 klinisch interview......................................................................................................................................................130
5.3 vragenlijsten.............................................................................................................................................................130
5.3.1 vragenlijsten gezinnen.......................................................................................................................................132
5.3.2 overzicht gezinsvragenlijsten............................................................................................................................145
5.3.2 vragenlijsten partnerrelaties.............................................................................................................................146
5.4 genogram.................................................................................................................................................................156
5.4.1 symbolen van een genogram............................................................................................................................157
5.4.2 voorbeeld (carr p.236).......................................................................................................................................157
5.4.3 opgelet...............................................................................................................................................................158
5.4.4 andere grafische voorstellingen context: ECOGRAM........................................................................................158
5.5 non-verbale technieken...........................................................................................................................................159
5.5.1 observatie spontaan gedrag (in spreekruimte) – gedragspatronen.................................................................159
5.5.2 dramatechnieken..............................................................................................................................................159
5.5.3 gebruik van poppetjes en objecten...................................................................................................................161
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