Phases of psychotherapy
Phase 1: Remoralization
Phase 2: Remediation
Phase 3: Rehabilitation
Phases of psychotherapy:
Phase 1: remoralization
- Increase the individual’s subjective feelings of hope that psychotherapy will be of assistance in overcoming present difficulties
- Foundation upon which the therapeutic work will be done
Phases of psychotherapy
Phase 2: remediation
- Abatement and lessening of symptoms or direct manifestations of the client’s current distress and life problems.
- Varyingly conceptualized depending on the approach
- Treatment consists of redirecting/ refocusing the patient’s coping skills in a way that brings systematic relief (16 sessions)
Phases of psychotherapy
Phase 3: rehabilitation
- Focused on unlearning troublesome, maladaptive, habitual behaviours and establishing new ways of dealing with life
- the number of sessions depends on the severity of the disability.
Processes involved in psychotherapy
Generic model of psychotherapy
Therapeutic contract
Formal aspect
- normative definition of reciprocal roles of therapist and patient with respect to goals, methods and terms of treatment, that is maintained over the course of treatment
Processes involved in psychotherapy
Generic model of psychotherapy
Therapeutic operations
Technical aspect: cycle of enactment of role-specific behaviours by participants
1) Patients presentation of relevant complaints and characteristic cognitive, affective and behavioural patters.
2) Therapist’s construal and diagnostic evaluation of the patient’s presentation
3) Therapist’s intervention strategy and techniques
4) Patient’s cooperation or response to the therapist’s intervention.
Processes involved in psychotherapy
Generic model of psychotherapy
Therapeutic bond
Interpersonal aspect:
quality of personal relatedness between individuals who occupy the roles of patient and therapist vis-à-vis each other, reflecting the emergent combination of their interpersonal behaviour with respect to issues of teamwork (personal investment and task coordination) and rapport (empathetic resonance and emotional climate
Processes involved in psychotherapy
Generic model of psychotherapy
Self-relatedness
Intrapersonal aspect:
the patient’s and the therapist’s psychological openness or defensiveness as manifested in therapy. It refers to the cognitive and emotional controls that govern self-awareness, self-direction, self-discipline and self-esteem
Processes involved in psychotherapy
Generic model of psychotherapy
In-session impacts
Clinical aspect:
Immediate positive or negative impacts during sessions.
Transtheoretical model of change
Temporal patterns
Precontemplation: unaware of problem
Contemplation: becomes aware, no commitment to change
Preparation: intent on taking action. Believe change can be made.
Action: active modification of behaviour
Maintenance: change occurs and new behaviour substitutes old on
Relapse: falls back into old patterns of behaviour
They all coexist at each moment. Configuration changes over time as microevents (within therapy sessions) or macroevents (over the course of treatment)
Contingencies:
the possibility that something happens or it doesn’t
What to we want to change with psychotherapy?
Awareness or insight therapies
- Consciousness raising: with feedback confrontations…
- Catharsis/ Dramatic relief: psychodrama, role-playing…
- Self-evaluation
- Environmental reevaluation: empathy training and documentary reflection
- Choosing: self-liberation (becoming aware of new alternatives), social liberation ( changes in environment)
What do we want to change with psychotherapy?
Actions or behavioural therapies
- Conditional stimuli: counterconditioning (healthier alternatives), stimulus control (managing the presence)
- Contingency control: contingency management (modifying in the environment), cognitive reevaluation (modifying internal responses to external consequences)
What do we want to change in psychotherapy?
Helping relationship
Caring, trust, openness and acceptance are necessary for behaviour change.
