Psychotherapy & Clinical Practice: Intervention Theories and Models

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Psychotherapy & Clinical Practice: Intervention Theories and Models
2011-01-27 13:56:30
Psychotherapy Clinical Practice

Intervention Theories and Models
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  1. Alderian Psychotherapy
    • Appropriate for issues of goals and direction
    • Techniques:
    • Examination of life script
    • Guided and Eidetic Imagery
    • Empowerment and encouragement
    • Analysis of birth order and family
    • Early recollections
    • Role-playing
    • Natural and logical consequences
    • Development of social interest
  2. Behavioral Therapy
    • Targeting dysfunctional behaviors
    • Altering actions
    • Describe symptoms in terms of behavior
    • For clients with low to moderate functioning
    • ie. eating disorders, conduct disorders, substance use disorders, impluse control disorders, conflict disorders, phobias and sexual
    • combo with cognitive therapy for depression and anxiety, early stage personality
  3. Cognitive Therapy
    • Symptoms described in terms of cognitive dysfunction
    • Low to moderate functioning clients benefit most
    • generally combined with behavi
  4. Existential Psychotherapy
    • Goal of changing meaning
    • Indicated for high functioning individuals (& V Code diagnoses)
    • For mild to moderate depression or anxiety, help coping with a life-threatening illness , those seeking a sense of meaning and direction in their lives
    • Techniques:
    • Encouraging client responsibility and self-confidence
    • Clarification of options, facilitation of choices
    • Life review to discover meaning and accomplishments
    • Development of spirituality, discussion of belief system
    • Paradoxical interventions
  5. Gestalt Counseling
    • Used in combination with other cognitive and behavioral approaches
    • Moderate to high functioning
    • Ongoing concerns into somatic complaints
    • Goal of unblocking/unlocking feelings
    • Targets anger, grief, anxiety and depression
    • Techniques:
    • Unfinished business
    • Giving voice to physical sensation, nonverbal cues
    • Dream exploration
    • Empty chair
    • Top Dog/underdog
    • Exaggerating feelings and actions
    • Confrontation
    • Encouragement of awareness and responsibility
  6. Person-Centered Techniques
    • For high functioning individuals with minor concerns, desiring personal growth
    • Helps with disorders invol. self-esteem and self-confidence
    • Clients seeking direction in goal setting and find it helpful
    • Focusing on the stressor and the symptom
    • Techniques:
    • Acceptance, unconditional positive regard
    • Empathy, reflection of feeling
    • Support, encouragement
    • Clarification, open questions, goal setting
    • Genuineness, modeling, rapport building
  7. Prolonged Psychoanalysis
    • For individuals diagnosed with hysteric or phobic disorders
    • Ineffective for: paranoia, borderline personality & obesity
  8. Psychodynamic Psychotherapy
    • For high functioning individuals with V Code disorders
    • Short-term is beneficial for depression, anxiety and situational disorders with repeated patterns
    • Long-term useful for personality disorders, multiple personality disorders
    • Target the unconscious to affect the conscious
    • Techniques:
    • Analysis of transference
    • Exploration of dsyfunctional patterns
    • Relationship of history to present concerns
    • Discussion of dreams
    • Processing of early childhood memories
    • Hypnotherapy
    • Interpersonal psychotherapy(analysis of focal relationship concerns)
    • Making the unconscious conscious
    • Interpretation
  9. Family System
    • Murray Bowen: Family as the emotional system> balance btw individuality and togetherness
    • Differentiation of self
    • Mechanisms of reactivity in the nuclear family
    • Triangles
    • Multigenerational transmission processes
    • Sibling position
    • anxiety
    • Emotional cutoff
    • Techniques:
    • Neutrality
    • Questions
    • A triangle is formed - avoid taking sides
    • Couples need to be forced to deal with each other
    • The therapist takes an "I" position
    • Makes non-reactive observations and statements of opinion
    • Goal to develop the person-to-person relationships
    • See family members as people rather than emotionally charged images
    • Learn to recognize triangles
    • Detriangle oneself
    • Speaking and listening skills
    • Use genograms
  10. Behavioral Family
    • Environment either positive or negative
    • Learning occurs with positive or negative reinforcement
    • Techniques:
    • Parent effectiveness training
    • Treating of sexual dysfunction
    • Martial technique
  11. Experiential Family
    • Carl Whitaker
    • Virginia Satir
    • Promote communication and interaction
    • Emotion organizes attachment responses and serves a communicative function in a relationship
    • Encourage clients to relax defensive fears so genuine emotions can emerge and illicit a more compassionate and nurturing response from partners and family
  12. Whitaker: Techniques:
    • Co-therapists
    • Therapy with "crowd" in the room
    • Whitaker- psychotherapy as Absurd
    • Therapist active and directive
    • Therapist takes a theoretical stance
    • Facilitation of individual autonomy and a sense of belonging in the family
    • Encourage spontaneity, creativity, the ability to play and the willingness to let go and be "crazy"
    • The therapist's role is more of a facilitator, through the use of reflection
  13. Satir
    • Techniques:
    • This approach stresses the involvement of the therapist with the family
    • Family mapping and chronologies
    • Create new meaning and liberate family members
    • Open communication
    • Intergenerational Model of Family reconstruction: A psycho-dramatic reenactment of a significant event used to help unlock the point from which the dysfunctional patterns stem
    • Co-therapy to balance out transference
    • Family sculpting
    • Family puppet interviews
    • Family art therapy
    • Draw a picture of how you see yourself as a family
    • Gestault therapy techniques: Empty chair
    • Role playing
  14. Narrative Family
    • Michael White
    • How people construct meaning in their lives rather than just ways they behaved
    • to maintain new narratives, clients need supportive communities.
    • Advocates writing letters to clients.
    • Techniques:
    • Externalize the problem: the person is not the problem
    • tell their problem-saturated story
    • Ask the question: “Who’s in charge, the person or the problem?”
    • Read between the lines
    • Re-author the whole story
    • Reinforce the new story
    • Deconstruct destructive cultural assumptions
    • Strategies fall into three stages:• Problem narrative stage• Find exceptions stage• Recruit support stage
    • These strategies involve a series of questions• Deconstruction questions: Externalize the problem• Open Space questions: Uncover unique outcomes• Preference questions: Make sure unique outcomes represent preferred experiences• Story Development questions: Develop new story from seeds of preferred uniqueoutcomes• Meaning questions: Designed to challenge negative self images and emphasizepositive agency• Questions to extend the story into the future
    • The concept is that problems in the family are unconscious conflicts that are projected on thechildren.
    • Techniques:
    • The therapist works with the most motivated and responsible individuals in the family andstrives through them to produce change and growth in the family system
    • Bateson’s model,brief therapy.
    • Milton Erickson and Jay Haley
    • Erickson stressed a strategic approach of the therapy
    • pragmatic and problem solving in conjunction with hypnotherapy.
    • Haley developed his own brief therapy model focusing on context and possible function of symptoms. He instructed clients to act in a manner contradictory to their maladaptive pattern. Rules are the problem, not the behavior.
    • Techniques:
    • Reframing
    • Paradoxical intervention
    • Positive feedback loops
    • Changing rules that govern behavior
    • Salvador Minuchin, structural family therapy divides family problems into thoserelationships within a family unit or those in what he termed the ‘subsystems’ of the family.
    • Techniques:
    • Creating healthy boundaries
    • Techniques are active, directive and carefully thought out
    • Family mapping
    • Enactment
    • Joining
    • Reframing