Introduction to Clinical and Counselling Psychology 08 - Interventions - The Foundations

7/24/2019 Introduction to Clinical and Counselling Psychology 08 - Interventions - The Foundations

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Psychological Interventions.

The foundations

Zoltan Kovary PhD

ELTE PPK

Department of Clinical Psychology and Addictology

!"#$"% Autumn &emester


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'istory ( institutionalframe)or*


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'istorical introduction I.

Pre+historical phase ,agical practises Ancient gree*s (

romans ,edeival age

The -eginnings ofscientific approach Ara-ian ( e)ish

medicine /eneissance

Paracelsus


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'istorical introduction II. "0th century

The triumphal of hypnosis 1rench schools

Charcot

2ernheim (Lie-ault

2eginnings ofPsychoanalysis

!th century

Psychoanalyis

2ehaviorism

3ther trends Individual 4roup &ystem approaches

Institualization


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Psychotherapy in Hungary

1rom "0"56 The 2udapest&chool of Psychoanalysis The contri-ution of &andor

1erenc7i 8prising and decline in the "0!9s

and 5!9s

After :: The decades of stagnation

The school of 1erenc ,;rei Appearance of ne) methods 1rom the "0

:or*shops ,odern trends


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The question ofcompetences

Professional protocol Psychiatrist

Psychologist

Clinical psychologist Psychotherapist

Training systems 4radual training

2achelor9s and masterdegree

Postgradual degree

Psychotherapist9s training


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Psychologists9 competence Psychologist

Primary =psychoterapy>care Crisis intervention

&upportive therapy Patient management

Clinical psychologist

Clinical cases

Psychotherapist Psychotherapy )ith

special methods


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Training systems for clinical psychologists andpsychotherapists in 'ungary

Psychologist

?,aster@

Clinicalpsychologist

(4 years)

&pecific methodtraining

Psychotherapisttraining

Psychotherapisteam

Physician

&pecialist ?notonly psychiatrist@

Introductoryphase fornon+psychiatrists

"#! hours oftrainingtherapy

B"!! ?#!@ hours of training

therapy


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Institutional framework

'ealth Care 'ospitals ?inpatients@

Departments of Psychiatry 3ther departments

Institutes for psychoterapy Am-ulances ?outpatients@

Psychiatric am-ulances Drug am-ulances

Private practise

Centers Team+)or*

&upervison


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The foundations of

psychotherapies

Wh t i h th ?


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What is psychotherapy?The common characteristics of

denitions

,ethods Psychological disorders

Communication

Professional ualifications ,eans and su-ect are the

same /epeated and targeted

encounters /elationship Process


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Criteria for psychological interventionsI.

1irt intervie) is compulsory Personal contact and

relationship

1rame)or* and contracts Trial phase Attitudes of the helper Professional competence

,ethodological preparedness

Practise &elf care Professional community


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Criteria for psychological interventionsII.

4eneral aim6 help thepsychological )or* of theclinet

,ethod6 focusedinterventions

Attitudes to)ards themethods

'appenings ,utual facilitation 8nderstanding the relationship

3pening up


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Classications ofpsychotherapies

Profoundity 1rom supportive to dynamic

2ased on trends

1rom PA to cognitive etc..

Basic forms Individual group ( system

approaches

Different aims &ymptoms personality or

relationship

Time &hort term or long term

Verbality 1rom ver-al to epressive


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'elping ( everyday relationshipsCommon means

/eassurance diversiondimming

&upporting ventilation Defence Empathy Confrontation

/einforcement 4uidance


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&pecificities of the helpingrelationships

Professional AFD intimaterelationship

1rame)or*s 'as eplicit aims Patient and helper have to

match Cannot -e forced 'as to -e terminated Complications

'elper syndrome 2urn out

Training therapy and continuoussupervison!


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The process of therapy


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Phases of psychotherapyprocess

Antecedents of firstencounter

Preparatory phase Introductory phase ,iddle$ main$ )or*ing

phase

Termination + Closure After closure G 1ollo) up

Preliminaryphase


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Structure of apsychotherapy session

Attunement

Transition :arm+up ,ain phase Closure Transition Decay


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Preliminary phase ofpsychotherapy

3verlaps )ith psychiatry 3verlaps )ith pedagogy Diagnosis indication and

re*lationship -uilding isorganically interconnectedH Psychotherapy diagnosis is

F3T psychiatric diagnosis

Lasts until the contract is

signed ?"+# sessions@ Contains

psychotherapeutic effects


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Steps of diagnosis inpsychoterapy

Psychiatric diagnosis ,otivational diagnosis

/elational diagnosis Diagnosis of fitting together Environmental relational

diagnosis Diagnosis of suita-ility Diagnosis of specific method


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Indication =Is the particular therapist

and therapy is suitia-le forthe treatment of theparticular patient>

2ased on psychotherapydiagnosis Contraindications

1orm of pathology

Eternal pressurre

&ecret

/elatives friends

/evulsions

&eual attraction

h h


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Psychotherapy contract what is it a!out?

Aims Actions

Therapist Patient

1ormal characteristics Conditions

&pace Time

1reuency Payment

A-sence

H i i li i


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Happenings in preliminaryphase

1irst session /elief hopes

&ha*edo)n sociali7ation trust?"+# sessions@

Emergence of the main theme Emotional involvement G the

uestion of acceleration Pro-lems

Escape into health

Early failure 'aste :orsening


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Working phase

=Therapeutic honeymoon>6 #+! sessions

1irst results

If caring is important6fiation ( stagnation

It turns out ifJ diagnosis

And indications )ere 3K

Fegative reactions of thesocial environment

Emergence of negative sides


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Therapeutic e"ects

During the session

After the session In everyday life 2e carefulH

,ay-e the symptoms appearonly )ithin therapy

,ay-e the symptomsdisappear only )ithin therapy


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How does psychotherapy

cure? Changes the functioning

that forms in sociocultralcontet Processing eperiences /egulating tension emotions 2ahavioral control ,otivations Communication Interpersonal functioning

:hat a-out detecta-leneural changes


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=Common factors>+researches

Duncan ""


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Specic factors

Individual therapies Psychoanalysis 2ehaviorism 'umanistic psychology Cognitive therapies /elaation

4roup therapies &ystem approaches

Couple therapies 1amily therapies


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#on$specic factors

Personality of the client The nature of the pro-lem Intelligence ,otivation Personality traits

Personality of the therapist Empathy 8nconditional positive regard Congruency 2eing personal

The relationship ,utuality 2alance Partnerships


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Termination $ closure If it )or*s out fine has to -e

finsihed 'ave )e reached the goals

Termination is fied in the

contract Dynamic press 1rom the -eginning of the third

part 'ard to udge ?together@

4ladness Panic

:orsening

Continuation 1ollo) up


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Psychological features ofclosure

Intensification ofsymptoms relapses

&eparation Gindividuation theme

,ourning The effects of formal

losses &ummary 4ratitude


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%fter closure

1ollo) up Can -e udged 5

months after closure Control sessions

The insecurity of thetherapist

Therapist )ill remainthe patient9s therapistlifelong


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&ack to therapy

Appro. #! + its notfinal

1ractional therapy Improves self+

*no)ledge

5+% months -rea*s To avoid dependence

'ave to avoid any other*ind of relationshipH 2usiness seual friendship

Colleagues


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Handing o'er patients

:ithout overlapsH

Fe) therapist ne)themes ne)diagnosis ne) aimsJ

Therapist do not

discuss their casesafter handoverH

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Introduction to Clinical and Counselling Psychology 08 - Interventions - The Foundations

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