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SWK6511.Teyber: Chapters 1-3
Transcript of SWK6511.Teyber: Chapters 1-3
Strategies The Interpersonal Process Approach
To Therapy What were your general reactions
to this chapter? Describe the thesis of Chapter 1 in 2-3 sentences. After reading the chapters, what personal and external factors increase your performance anxiety? Experiential
Relearning Core Concepts of Therapy Empathy
Warmth Interpersonal Process
Domain Interpersonal Domain Cognitive Domain Three
Domains Harry Stack Sullivan: Interpersonal School
Self system, developed through repetitive interactions with caregivers and others Cognitive Behavioral Therapy:
Automatic thoughts and schemas
Attachment theory: Internal working models Draws from family systems and structural theories
Clarifies familial rules, roles, myths, communication patterns, and boundary issues that defined their clients’ development Client
Experience Identify the faulty beliefs and expectations, maladaptive relational patterns, and ineffective coping styles that keep occurring and causing problems in the client’s life
Anticipate how these patterns or themes that are disrupting relationships with others may be expressed or come into play in the current interaction with the therapist—especially along the process dimension or way they are interacting together (i.e. arguing, distancing, controlling)
Provide new and corrective responses that help to resolve rather than repeat this familiar but problematic pattern in the relationship with the therapist
Help clients generalize this new way of interacting to others in their everyday lives Chapter II The Working Alliance Why do clients stop
coming to treatment? Approaches Directive Nondirective Active •Provide feedback about the relational or cognitive patterns they observe
•Help clients consider alternative frames of reference and consider situations from new perspectives that expand their schemas
•Offer empathic understanding of the clients’ feelings and validate their experiences
•Provide interpersonal feedback
•Use process comments to make the current interaction overt and utilize the therapeutic relationship as a social learning laboratory
•Check out the client’s reactions toward the therapist The First Interview Empathy Ways the Client
May Not Feel
Understood Identify Recurrent
Themes 1)Repetitive relational themes or interpersonal patterns
2)Pathogenic beliefs, automatic thoughts, or faulty expectations
3)Recurrent affective themes or central feelings. Repetitive Relational Themes
Beliefs and Schemas
Behavioral dysregulation Immediacy
Interventions Process Comments Self-Involving Statements Interpersonal Feedback Metacommunication Ruptures in
Therapy •The covert or overt hostility describe above (referred to as “client negativity”)
•Reenactments or interpersonal scenarios that clients keep recreating with others that ensnare or embroil the therapist
•The simple human misunderstandings that occur in every meaningful relationship Chapter Three:
Working with Resistance Or is it....
Ambivalence? Themes Around Ambivalence If I let myself trust or depend on the therapist, he might criticize or judge me, try to control me, start to depend on me or need me, or in some unwanted way take advantage of me—just as others have done when I needed them. I cannot ask for help because I must be independent and in control all the time I don’t deserve to be helped by anyone, I don’t really matter that much I cannot need anything from others—if I’m not perfect, I’ll bring shame to my family Asking for help is admitting that there really is a problem, and that proves there really is something wrong with me I am afraid of what I will see or what a perceptive therapist will learn about me if I stop and look inside myself If I cannot handle this by myself, it mean I really am weak, just as they always said I’ll start crying and won’t be able to stop. 1. The therapist is trying to help clients identify their outdated coping strategy with others (such as being perfect, withdrawing, intimidating, complying, etc.)
2. The therapist validates the protection this interpersonal coping strategy once provided
3. The therapist holds a steady intention to track the process dimension and ensure that the therapeutic relationship does not repeat this problematic pattern that has transpired so often with others.
4. The therapist ultimate goal is to help clients transfer this new experience or re-learning with the therapist and apply it with others. Formulating Working
Hypotheses 1) What does this client elicit from others? 2) What is the threat? How can therapy be aversive for client? 3) How will the client express resistance? Exploring & Addressing
Resistance Explore during the initial phone contact Explore at the end of the first session
Responding nondefensively 1. Permission giving and educative response 2. Explore the potential threat these feelings hold; this focuses on the defense 3. Interpretation Shame V. Guilt After reading the chapters, what personal and external factors decrease your performance anxiety? How are the interpersonal domain, cognitive domain, and familial domain related to your case conceptualization? How are client conflicts reenacted versus resolved in the therapeutic relationship? What does it mean for the therapist to provide a corrective emotional experience? Which method comes most naturally when you are
just starting out?
What is the hardest part about understanding the client? THE EXAMPLE OF JOHN Why do therapists tend to avoid the unspoken messages in their clients’ narratives, and “embedded messages” about the therapeutic relationship, rather than approach and address them? What is meant by “finding an integrating focus” for treatment? How does the counselor begin to identify the treatment focus? How might the counselor address this with the client so that the treatment focus becomes mutually owned—ensuring that treatment proceeds in a collaborative manner?