Psychotherapy Samenvatting
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, Lecture 1 Psychotherapeutic change
A few concerns and a few praises
- Gap: academic psychology and clinical practice: small impact of research findings
- Little theoretical integration across psychotherapy schools
- Strong effect for disorder-specific treatments
- Sound disorder-specific psychopathological theories, but these account for psychotherapy
only partially
Mental disorders
Experience of:
- Feelings, thoughts, behavior tendencies, bodily sensations
- As a problem: unwanted, intolerable, abnormal, uncontrollable, absurd
- ‘Who is in charge?’ fragmented sense of ‘self’ (feeling you can cannot change yourself, also
searching for external factors that are the cause)
What is the goal of psychotherapy?
- Correct: change unwanted of subjective experiences
- Or – viewed from medical model – reduce agreed upon symptoms, disorders, etc.
- Wrong: make patients happy (again)
- Wrong: help patients understand reality
1. Means: Changing propositional representations?
- Language-based, symbolic, deductive, reasoning (using language to help patients does not
help, because it is too propositional)
- Change is easy: provide information; reason, persuade; psycho-education, cognitive therapy
- Problems: (1) therapist is authoritarian; (2) patient is likely to be passive; (3) persuasion often
ineffective or transient
2. Means: Discover who you are?
- Self-knowledge; classical philosophical proposition
- Core of psychoanalysis and client-centered therapy
- Problem 1: Classical psychoanalysis (interpretations, ‘archaelogy’) inefficient; client-centered
therapy assumptions untenable
- Problem 2: Unsupported by academic psychology; mental processes hardly accessible,
fragmented sense of self; instead ‘English butlers’
- Possibility 1: Change schematic representations by simultaneously activating multiple neural
networks
e.g., induce emotions: connect past present future, images, and previous experiences
- Experiential techniques: Chair technique, imagery rescripting
- Problem: Typically within sessions
- Possibility 2: Changing narrative (propositional representations) but may be helpful
1
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, 3. Means: Systematic exercise?
- Change associative representations
- Core business in cognitive therapy, behaviour therapy, systems therapy
- In and between (homework assignments) sessions
- E.g., exposure, systematically challenging negative automatic thoughts, behavioural
rehearsal, assertiveness training, role playing, communication skills
- A lot of evidence for effectiveness
- Problem: Patients have to participate
4. Means: Patient activation and involvement?
- Without involvement no change in the way we experience things
- Preferably in and between sessions
- E.g., disclosure (patient), emotional experiences (optimal), training, etc.
5. Means: High quality therapeutic alliance?
- Core ingredient in client-centered therapy and psychoanalysis
- Used for motivation and involvement in behaviour therapy and cognitive therapy
- Consistently (but moderately strong) related to psychotherapy results
- Problem: Fuzzy and untested theories in clinical psychology
- But: Sound theories from social psychology and communication science about (resistance to)
social influence
6. Means: Reorganizing environment & social interactions
- E.g., spouse and family support; enhance/ increase social or daily activities; reduce stress
(e.g., moving); job-related interventions
- Also, (family) care plan (multiple professionals), alert plan, relapse prevention plan
- Strong (and last resort) treatment packages for severe psychiatric disorders
Conclusions
Psychotherapy: undertaking aimed at changing unwanted patterns of experience: ‘That things are
otherwise’ had to be made available
Means
1. Patients’ involvement
2. High quality therapeutic relationship
3. Providing information (propositional)
4. Systematic exercise (associative)
5. Simultaneous activation of meanings (schema)
For severe psychiatric disorders
6. Rearranging environment
Brain sub-programmes (English butlers)
a lot of different parallel processes are active in the brain and your body reacts, but later on your
consciousness knows the information (implicit processes). Your conscious is the last to know
Adaptation of English butlers
2
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, Synaptogenesis
- Emotions
- Experience-based
- Repeated encounters: ‘cells that fire together wire together’
Associative representations
Lecture 2 Behaviour therapy and cognitive therapy
BT: correct characteristics
- Psychopathology (psychological problems) based on S-R associations, that is, an interaction
between person and environment
- Rather symptom- than person-oriented
- Observation and self-monitoring are part of treatment and treatment planning/ evaluations
BT: incorrect characteristics
- BT involves behaviour only it focusses a lot on emotions
- BT is cold and mechanical they work with you together and confront you
- BT is fully evidence-based
BT process
1. Problem inventory
- What is the problem? How often? How severe?
- How did it start? Course? Why treatment now?
- What elicits or exacerbates the problem?
- What prevents or reduces the problem?
- Positive consequences? Short-term? Long-term?
- Negative consequences? Short-term? Long-term?
- What means or solutions have already tried?
- What is the treatment goal?
2. Position in holistic theory
Therapist is going to think about the things he has gathered in the intake and think about
whether it all makes sense. And if the problem chosen is a good idea?
3. Problem selection, measurement and functional analysis
Select the problem and create a hulpvraag. Monitoring homework assignments as
measurement.
4. Treatment plan and treatment execution
5. Treatment evaluation
3
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Dit document is auteursrechtelijk beschermd, het verspreiden van dit document is strafbaar. extra verdienen?
Hoorcolleges
Gedownload door: ikarumba316 | € 912 per jaar
Dit document is auteursrechtelijk beschermd, het verspreiden van dit document is strafbaar. extra verdienen?
, Lecture 1 Psychotherapeutic change
A few concerns and a few praises
- Gap: academic psychology and clinical practice: small impact of research findings
- Little theoretical integration across psychotherapy schools
- Strong effect for disorder-specific treatments
- Sound disorder-specific psychopathological theories, but these account for psychotherapy
only partially
Mental disorders
Experience of:
- Feelings, thoughts, behavior tendencies, bodily sensations
- As a problem: unwanted, intolerable, abnormal, uncontrollable, absurd
- ‘Who is in charge?’ fragmented sense of ‘self’ (feeling you can cannot change yourself, also
searching for external factors that are the cause)
What is the goal of psychotherapy?
- Correct: change unwanted of subjective experiences
- Or – viewed from medical model – reduce agreed upon symptoms, disorders, etc.
- Wrong: make patients happy (again)
- Wrong: help patients understand reality
1. Means: Changing propositional representations?
- Language-based, symbolic, deductive, reasoning (using language to help patients does not
help, because it is too propositional)
- Change is easy: provide information; reason, persuade; psycho-education, cognitive therapy
- Problems: (1) therapist is authoritarian; (2) patient is likely to be passive; (3) persuasion often
ineffective or transient
2. Means: Discover who you are?
- Self-knowledge; classical philosophical proposition
- Core of psychoanalysis and client-centered therapy
- Problem 1: Classical psychoanalysis (interpretations, ‘archaelogy’) inefficient; client-centered
therapy assumptions untenable
- Problem 2: Unsupported by academic psychology; mental processes hardly accessible,
fragmented sense of self; instead ‘English butlers’
- Possibility 1: Change schematic representations by simultaneously activating multiple neural
networks
e.g., induce emotions: connect past present future, images, and previous experiences
- Experiential techniques: Chair technique, imagery rescripting
- Problem: Typically within sessions
- Possibility 2: Changing narrative (propositional representations) but may be helpful
1
Gedownload door: ikarumba316 | € 912 per jaar
Dit document is auteursrechtelijk beschermd, het verspreiden van dit document is strafbaar. extra verdienen?
, 3. Means: Systematic exercise?
- Change associative representations
- Core business in cognitive therapy, behaviour therapy, systems therapy
- In and between (homework assignments) sessions
- E.g., exposure, systematically challenging negative automatic thoughts, behavioural
rehearsal, assertiveness training, role playing, communication skills
- A lot of evidence for effectiveness
- Problem: Patients have to participate
4. Means: Patient activation and involvement?
- Without involvement no change in the way we experience things
- Preferably in and between sessions
- E.g., disclosure (patient), emotional experiences (optimal), training, etc.
5. Means: High quality therapeutic alliance?
- Core ingredient in client-centered therapy and psychoanalysis
- Used for motivation and involvement in behaviour therapy and cognitive therapy
- Consistently (but moderately strong) related to psychotherapy results
- Problem: Fuzzy and untested theories in clinical psychology
- But: Sound theories from social psychology and communication science about (resistance to)
social influence
6. Means: Reorganizing environment & social interactions
- E.g., spouse and family support; enhance/ increase social or daily activities; reduce stress
(e.g., moving); job-related interventions
- Also, (family) care plan (multiple professionals), alert plan, relapse prevention plan
- Strong (and last resort) treatment packages for severe psychiatric disorders
Conclusions
Psychotherapy: undertaking aimed at changing unwanted patterns of experience: ‘That things are
otherwise’ had to be made available
Means
1. Patients’ involvement
2. High quality therapeutic relationship
3. Providing information (propositional)
4. Systematic exercise (associative)
5. Simultaneous activation of meanings (schema)
For severe psychiatric disorders
6. Rearranging environment
Brain sub-programmes (English butlers)
a lot of different parallel processes are active in the brain and your body reacts, but later on your
consciousness knows the information (implicit processes). Your conscious is the last to know
Adaptation of English butlers
2
Gedownload door: ikarumba316 | € 912 per jaar
Dit document is auteursrechtelijk beschermd, het verspreiden van dit document is strafbaar. extra verdienen?
, Synaptogenesis
- Emotions
- Experience-based
- Repeated encounters: ‘cells that fire together wire together’
Associative representations
Lecture 2 Behaviour therapy and cognitive therapy
BT: correct characteristics
- Psychopathology (psychological problems) based on S-R associations, that is, an interaction
between person and environment
- Rather symptom- than person-oriented
- Observation and self-monitoring are part of treatment and treatment planning/ evaluations
BT: incorrect characteristics
- BT involves behaviour only it focusses a lot on emotions
- BT is cold and mechanical they work with you together and confront you
- BT is fully evidence-based
BT process
1. Problem inventory
- What is the problem? How often? How severe?
- How did it start? Course? Why treatment now?
- What elicits or exacerbates the problem?
- What prevents or reduces the problem?
- Positive consequences? Short-term? Long-term?
- Negative consequences? Short-term? Long-term?
- What means or solutions have already tried?
- What is the treatment goal?
2. Position in holistic theory
Therapist is going to think about the things he has gathered in the intake and think about
whether it all makes sense. And if the problem chosen is a good idea?
3. Problem selection, measurement and functional analysis
Select the problem and create a hulpvraag. Monitoring homework assignments as
measurement.
4. Treatment plan and treatment execution
5. Treatment evaluation
3
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Dit document is auteursrechtelijk beschermd, het verspreiden van dit document is strafbaar. extra verdienen?
