Psychological Interventions.The basic forms
Zoltan Kovary PhD
ELTE PPKDepartment of Clinical Psychology and Addictology
2015/16 Autumn Semester
Classifications of psychotherapies
ProfoundityFrom supportive to dynamicBasic formsIndividual, group & system approachesBased on trendsFrom PA to cognitive, etc..Different aimsSymptoms, personality or relationshipTimeShort term or long termVerbalityFrom verbal to expressive
Individual Psychotherapies
Psychoanalysis & dynamic psychotherapies
Historical antecedents
Freuds personal and professional developmentHysteriaCharcot & hypnosisBreuers Anna O-case Cathartic technique
Understanding the Unconscious
Analysing symptomsStudies on Hysteria (1895)Analysing dreamsInterpretation of Dreams (1900)Analyisng parapraxesPsychopatology of Everyday Life (1901)Repetition Compulsion
The mind in conflict: the psychoanalytic model of pathologies
Symptoms Intrapsychic conflictsAnxietyDefenceConstructions (Compromise)Primary gain of illnessPathologic balance Suffering pressureMotivation for therapy
Methods and rules of psychoanalytic therapy
NeutralityAbstinenceFundamental rule - Free associationsSymptomsDreamsParapraxesInterpretationInsights or Resistance (defence)Gains from illness
The process of psychoanalysis
The infantile origins of neurosesFixation and regressionTransferenceThe repetition of infantile conflictWorking throughEmotional insightsReleasing libido to achieve the goals of the egoContertransferenceTraining therapy
The goals of psychoanalytic therapy
Where id was, ego shall bePleasure and reality principlesRestart stalled developmentLove and work
Famous case studies of Freud
Dora 1905 - hysteriaLittle Hans1909 - phobiaRatman1909 - obsessional neurosisThe Schreber-case 1911 - paranoiaThe Wolfman1918
Further developments of psychoanalytic (dynamic) therapies
Sndor Ferenczi and the Budapest SchoolThe antecedent of relational psychoanalysisTrauma therapiesEgo-analysisTime limited dynamic therapiesObject relational therapiesPsychoanalytic Selfpsychology
Jungian therapy
Four basis of time limited dynamic therapies
Good first interview (Argelander) with test interpretationRight psychodinamic focusActive treatment of reistenceActive treatment of detachmentt
The central relational conflict in time limited dynamic psychotherapy according to LuborskyActual therapeutical relationshipActual external relationshipsFormer relationshipsCentral relational conflict
The focus the triangle of conflictHidden feelingAnxietyDefence
The focus the triangle of personsTherapistParentsThe triangle of conflict has to be assigned to every peak of the triangleOthersO/PO/TT/P
Behavior therapies
BehaviorismThe phases of BTAnalysis of promlematic behavior S=f(S,O,C,C)Precise targetsTherapeutic planBT methodsSystematic desenzitizationOperant conditioningFloodingSelf-controlNegative practiseBlended into cognitive therapy = CBT
Cognitive TherapiesCognitive approach to pathologiesCognitive distortionsThe cognitive triad in depressionConceptualizationCharacteristicsTime limitedStructured with exact aimsNeeds active cooperation (home works)
The evolution of psychological disorders according to cognitive paradigmEarly life events
Dysfunctional basic assumptions
Significant life event
Basic assumptions Spontanous negative thoughts Cognitive distortions
Symptoms(Cognitive, affective, motivational, somatic, behavioral)Circulus vitiosusactivation
The most inportant methods in CBT
Cognitive techniques
Distratction
Counting the thoughts Reframing
Behavioral techniques
Notation of activities
Planning activties
Cognitive-behavioral techniques
Recognizing spontaneous negative thoughts
Questioning spontanous negative thoughts
Behavioral experiments
The five coloumns techique
Person Centered TherapyCarl Rogers, humanistic psychologyNon specific factorsEmpathyCongruencyUnconditioned positive regardNondirectivitySpecific factorsEncounterMirroring & VerbalizationConcentrating on the here and nowAvoiding authorityNo contraindications
Hypnotherapy
Historical backgroundTheories about hypnotic stateSusceptibilityTechniquesDirectIndirectIndications and fields of application
Relaxation and imagination therapyHistoryJung - ImaginationSchultz ATDesoilles Directed waking dreamLeuner Kathatym imaginated psychotherapyBackgroundPhysiological changes detectedArchaic consciousness-techniquesTransformation and integration of experiencesFormsAutogenic training, progressive relaxationApplicationBroad indications; contraindicationsIndipendent and combined forms individually and in groups; short & long versions
Group Therapies
Features of group therapies
Interpersonal processes are in focusGroup leaderHandling individual, interpersonal and group processes at the same timeThe client has to go beyond medical models of functioningSocialization is lowerFear of the group
The types of groups
SizeSmall (6-15 p.)Medium large (15-40)Large (over 40)CompositionHomogenous vs heterogenousOpen or closed
The nonspecific effects of groups according to I.D. YalomHope UniversalityInformationAltruismSocializationModelingInterpersonal learningCatharsisExistential factorsPrimary groupGroup cohesion
The proportion of individual and group processes in the cases of different techniquesGroup focusIndividual focusAnalytic, Interpersonal, Gestalt, Psychodrama, Person Centered, Cognitive
Therapeutic and group leading consequences
Individual, interpersonal and group processes system approach requiredRelational conflicts are dramatizedGroup as a psychological training groundThe destructive effects of absenteeism, failure and aftergroupsModeling co-therapy
Group analysis
The 1920s: Burrow - neurotic groupsThe 1930s: Slavson childrens groupsLewin Group dynamics1940s Group analysisW. Bion Working group and basic assumption groupUnconsciuos group fabtasiesFoulkes The group s primacyThe matrix-modelThe process of therapyAdvantages and disadvantages
The foundations of psychodrama
Jacob Levi Moreno (1889-1974)Focusing on personality, not symptomsThe group as a micro social mediumFramework and spontaneityReorganizing psychological universeExploring and resocializing aspectsIndication and contraidnicationComposition of groups
The structure of a psychodrama session
System Approaches in Psychotherapy:Couple & Family therapies
System approach in psychotherapy
Open and closed systemsThe principle of nonsummativityHomeostasisCircular reasoningSet of rulesLevels of communicationCoevolution
Couples and marriage therapies
The pair as a system and its disorders: Jrg Willis collusion-theoryPair: a new systemChoice of partner: intrapsychic needsWe bring it from our childhood experiencesThe aim of choice is establishing balance CollusionMutual and covert satisfaction of unconsciously determined needs Forming a joint neurosis constructed from wishes, anxiety and defenceForms of collusion: narcissistic, oral, anal, phallic
Couples and marriage therapies
Joint participationIndicationsCouple & marriage: explicit and implicit set of rulesBrought from childhood familyConflictsResistence - loyalityIntervention a third person out of the system
Family therapies
The family life cycle
Family dynamics
SystemHierarchiesBordersRolesStability and changeCoevolutionNormative and paranormative crisesThe index patients
Family therapy trendsPsychodynamic approachContextual approachIvn Bszrmnyi nagyTheory of familial systemsBowenExperimental schoolCarl Whitaker, Virginia SatyrBehavior therapeutic approach Liebermann, Stuart, PattersonStructual approachSalvador MinnuchinStrategic approachPalo Alto, Millano School (Selvini-Palazzoli), McMaster modell
Thank you for your attention!
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