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Interpersonal Psychotherapy. Introduction and Overview. A need for conceptual framework. Conceptual frameworks help recognize relational patterns and cognitive schemas Treatment plans will be developed from the conceptual frameworks. Historical context. Interpersonal Domain (Sullivan) - PowerPoint PPT Presentation
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Interpersonal Psychotherapy
Introduction and Overview
A need for conceptual framework Conceptual frameworks help recognize
relational patterns and cognitive schemas
Treatment plans will be developed from the conceptual frameworks
Historical context Interpersonal Domain (Sullivan)
Sullivan keep away from Freud’s drive theory (sexual and aggressive instincts)
Personality develops through repetitive interactions with parents and others
personality as the collection of interpersonal strategies to avoid anxiety and disapproval, and maintain self-esteem.
Historical context Cognitive Domain Internal working model (Object Relations and
Attachment theory) View of self and others Emotional responsiveness and availability Good parents vs. bad parents
Schemas (Cognitive Behavioral therapy) Can be called maladaptive cognitive schemas, core
beliefs, or faulty expectations Schemas: A cognitive structure for screening, coding, and
evaluating the stimuli.
Historical context The familial/contextual domain
Family system theory Internalize family roles (i.e., rescuer) as self-
schemas Re-create family roles/patterns with others Faulty communication patterns Family rules Family myths
Core Concepts 1. The Process Dimension
The relationship b/w therapist and client is the foundation of therapy
Understanding and intervening with what is going on b/w therapist and client in their interaction.
Content vs. Process comments
A powerful tool for genuine understanding and honest communication.
Core Concepts 2. Corrective Emotional experience
Identify maladaptive cognitive & interpersonal patterns
Use “process comments” to clarify interpersonal styles
Engage the client in work together to find a way to change
Transfer the learning in therapy to others in clients’ lives.
Core Concepts 3. Client Response Specificity
Definition: therapists need to tailor their response to fit the specific needs of each client.
Flexible to modify interventions and respond in new ways
Match the needs for diverse clients
Interpersonal process approach Establishing a Working Alliance (WA) Honoring the client’s resistance A internal focus for change Responding to painful feelings Familial and developmental factors Inflexible interpersonal coping strategies Interpersonal patterns and themes An interpersonal solution Resolution and change
Establishing a Working Alliance (WA)
The WA is a collaborative relationship WA: agree on goals, collaborate on tasks, and establish a
bond relationship based on trust and acceptance
Empathic understanding is the foundation for WA Genuine concern, respect, and non-judgmental attitude Demonstrate understanding and identify patterns
Immediacy—working in moment Using process comments to build WA
Honoring the client’s resistance Identify resistance
Help client identity when resistance is occurring with a non-judgmental manner
Address reluctance to resistance Validate the protection aspects Do not repeat maladaptive patterns in session
Formulate working hypotheses What is the threat?
Respond to resistance Educate Explore the danger/identify the threat
A internal focus for change Shifting to an internal focus
A prerequisite for change Focusing clients inward Reluctance to adopt an internal focus
Placing the locus of change with clients Fostering clients’ initiative Avoiding a hierarchical relationship Supporting clients’ own autonomy and initiative Shared control in the therapist-client relationship
A internal focus for change
Helping clients in solving their own problems Providing a corrective emotional experience
Tracking clients’ anxiety Identifying signs of clients’ anxiety Approach clients’ anxiety directly Focus clients inward to explore their anxiety
Responding to painful feelings Approach the clients’ feelings
Expand and elaborate clients’ affect
Identify the predominant affect
Hold client’s pain
Therapists’ factors for not responding to clients’ feelings
Familial and developmental factors Understand structural family relations-patterns The family’s ability to respond to the child’s need for
both relatedness & separateness Three styles of parenting: control and affection
Authoritative - high control/high affection Authoritarian - high control/low affection Disengaged – low control/low affection Permissive – low control/high affection
Love withdrawal Insecure attachment
Inflexible interpersonal coping strategies Horney’s interpersonal model
Unmet development needs
Turning against self to block core conflict
Core Conflict or Anxiety
Inflexible interpersonal coping style
Move Away from
Othersavoid
Move Toward Othersplease
MoveAgainstOthers
intimidate
Reject self
Rejectothers
Elicit Rejection
Fromothers
Interpersonal patterns and themes How clients bring their problems into the
therapeutic relationship moving toward, moving against, or moving
away Testing Behavior Transference Reactions
Interpersonal balance
An interpersonal solution Resolving problems through the interpersonal
process Bring client’s conflicts into the therapeutic
relationship Using the process dimension to facilitate
change Providing a corrective emotional experience Therapists’ initial reluctance to work with the
process dimension
Resolution and change The working –through process
Change relationship patterns with therapist acquaintancessupportive othershistorical figuresprimary others
Therapist actively help clients Realistically anticipate others responses Provide corrective emotional experience
Resolution and change Work through family-of origin work
Internal focus for change Grief work
Plan for future: Orienting clients to listen to themselves
what they want to do, what they want to be, and what they want to become
Resolution and change Clients are ready to terminate when
Clients report they consistently feel better & can respond in more adaptive ways
Client expand their old coping styles and don’t reenact maladaptive relational patterns
Others gives them feedback that they are different
Accepting that the relationship must end
Resolution and change Effective terminations: review-predict-practice
Review what has changed Predict and make realistic plans for coping with
the problems which could come up practice to respond differently
Ending the relationship Say good-bye