Recognizing our personal assumptions about helping In class Therapist Do s and Don ts Psychotherapy Intro and Ethics CLP 4374 Psychotherapy Psychotherapy 1 Theories vs Techniques i What are they ii What s the difference a You use techniques based on theory iii Why are they necessary a Structure b Rules help us figure out what to do when we don t know what to do Psychotherapy 1 What is it a Talking treatment b Dealing with issues stress c Empowerment d Promote well being e new conceptualizations positive development positive psychology Clients 1 client vs patients a Client is on the street just go for an hour b Patient is in a hospital 2 Who goes to therapy a Self referred b Court mandated c Kids adolescents adults i symptom reduction vs transformational change 1 symptom reduction but people aren t broken Not good enough because people are still depressed Therapeutic Process 1 Therapist Client Relationship a Solid trusting i About empowerment self efficacy ii About independence 2 Overt vs covert process 3 What you see like a Overt visible measurable signs b Incongruities laugh at a funeral can help take a step forward 4 What s internal and you don t see like a b such a cute dress 0 o If you tell a client to tell his mom to go f herself the client agrees in your face but never comes back 5 How is each important 6 How is each necessary a Necessary if they become more congruent b Otherwise you need to keep an open mind about other options 7 How is each a positive and potential negative treat depression treat emotion expression Lesson for the day get life a little messy Therapy Process Map 5 steps a Act depressed but really it s about an inability to express anger towards abusive parents Don t 1 Establish rapport breaking the ice a Identify a problem or focal issue 2 3 Working phase 4 Practicing 5 Termination a Think about overall process how do you know when therapy is over Can t prolong it Establishing Rapport 1 What brought you to therapy 2 Access client expectations a What are some things you re afraid of in therapy b Magic Techniques or Miracle Q i If you could make a wish to change anything what would it be c Explain how therapy works there s no magic it s a process 3 Collaboration vs therapist as healer Problem Identification 1 Try to focus the attention on 1 2 issues 2 Why 3 Who decides what to focus on 4 What if therapist and client disagree 1 Getting into the presenting problems and what may be feeding maintaining or causing them 2 Not all clients get here easily or at all a What are some of the hindrances Working Phase Practicing Termination 1 Begin to apply new understanding in the world 1 Don t just end therapy suddenly why Therapist techniques 1 Directive a few examples a Empty chair you pretend your problem person is in the chair perfectionist b Free association c Homework assignments Indirect non directive a Reflecting show same emotions as client helps them develop a relationship 2 i Content and feelings difference b Silence c Body language d Empathy empathic listening i What is a therapist s best tool 1 Themselves 1 How do therapists know what to do a Dueling positions scientific vs humanistic 2 Scientific a Evidence based b Empirically supported practiced c Therapy is science 3 Humanistic Role of Research in Therapy a Therapy is art Psychotherapy theories 1 For therapists theories a Help describe people and their behaviors i Why do they do what they do b Explain how people get to be the way they are c Describes how people should be i Maladaptive vs normative d Describes how they can change 2 For researchers theories a Organize info and give meaning to facts b Guides future research and theory development Theoretical Assumptions 1 Origin of personality in born Shaped by experience 2 Development trajectory is smooth Stage like Freud 3 Significance of early experience early life or later life is more important 4 Consciousness conscious or unconscious mind more influential 5 Human nature are we basically good or basically bad or rationalis capex Inherently bad Hobbes a b Rationalis capex capability of being rational Research Evidence 1 400 theories out there to explain human behavior psychology 2 1960s 70s Carl Rogers and colleagues what makes people get better a It seems to be the therapist client relationship that really helps people improve 3 1970s 80s Population studies effect sizes a Crude estimate of which methods work better why crude i Results all methods good if used properly only looks at averages not special outlyers b Population study test a small sample of a population really that simple 4 1990s present what works for whom and when 1 4th edition TR text revision 2 Classification of all legitimized mental health related problems 3 Necessary but not uncontroversial part of mental health work DSM Manual IV TR Using the DSM 1 Multi axial or multi dimensional approach 2 5 dimensions symptoms checklists clinical categories Axis 1 Axis 2 Axis 3 Axis 4 Axis 5 Clinical disorders Personality disorders General medical disorders Psychosocial environmental disorders GAF global assessment functioning Depression anxiety OCD Borderline histrionic OCD Problems causing mental symptoms Problems may cause contribute to mental symptoms 1 100 General people GAF is about 90s About to die teens Ethics 1 the client comes first a Can be more difficult than you expect b Mandatory vs aspirational ethics 1 Licensing a Must abide by uniform ethical codes 2 Responsibility on therapist to know nuances of laws within their state 3 Ethics help keep this a professional field help us reflect on and improve our practice of counseling a Working with others during their vulnerable times requires a responsible approach Basic Ethical Principles 1 Beneficence a Focus on doing good b Bad indifference ill will vengefulness or spite 2 Non malfeasance a Doing no harm b Bad using known harmful treatment false vagina lmao 3 Autonomy 4 a Self determination independence b Bad need to be needed you yourself are co dependent Justice a Considerations for fair treatment involvement b Keep patients for the right reasons 5 Fidelity a Faithfulness loyalty support to client and one s profession b Client ALWAYS COMES FIRST Client s Rights Informed consent assent 1 2 Competent treatment how do you know if you re competent How does the client know 3 Competent referrals if you re not competent 4 Cultural competence i If a client wants you to testify for them you draft a contract of topics you can cover a Sensitivity