Chapter_12

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Introduction to
Clinical Psychology:
Science, Practice and Ethics
Chapter 12
Humanistic, Experiential and
Family Therapies
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Gestalt Therapy
• Conceptualizes person as an organized
whole
• People engage in self-defeating behaviors
which deflect them from expressing their
true selves
• The Now – anxiety, depression, etc. result
from being diverted from the now
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Gestalt Therapy
• Focus upon increasing awareness of the
now (“being mindful of current reality”)
• Focus upon non-verbal behavior
• Focus upon accepting responsibility
• Focus upon confrontation
• Insight – awareness of one’s experience
such that things appear in a meaningful
pattern
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Gestalt Therapy Techniques
• Empty chair
• Topdog – Underdog
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Gestalt Therapy: Evaluation
• Gestaltists tend to oppose research
• Very little research
• Research is methodologically poor
• Absence of contemporary research
• Technique-centered (although Gestalists
say this is not so)
• Treatment goals are vague
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Carl Rogers’ Client-Centered
Therapy: Theory
• Phenomenology
– Phenomenal field
– Phenomenal self
• Key Assumptions
– Self-actualization
– Need for positive regard
– Conditions of worth
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Client-Centered Therapy
• Unconditional Positive Regard
– Care about the client
– Accept the client
– Trust the client’s capacity to change
• Empathy
• Genuineness (congruence)
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Client-Centered Therapy:
Evaluation
• + Positive alternative to psychodynamic therapy
•
(Empathy, nonjudgemental stance are standard
for therapists now)
+ Emphasis upon research
– 1960s and 1970s positive correlation between
empathy and outcome
– But relationships are modest
– Client’s perception most important
• + Some support for efficacy particularly with
adjustment problems
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Client-Centered Therapy:
Evaluation
• - monolithic – every client treated in the same
•
•
•
way (consequently not much research since the
1980s)
- not effective with more serious
psychopathology
- evidence of improvement weak on external
validity
- esoteric terminology (e.g., congruency,
organismic experience, genuine)
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Eclectic Treatment Combinations
• Three-Stage Model of Helping
• Process-Experiential Therapy
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Three-Stage Model of Helping
• Hill and O’Brien (1999)
• Exploration
• Insight
• Action
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Process-Experiential Therapy
(Emotion Focused Therapy)
• Leslie Greenberg & Robert Elliott
• Focus on helping clients understand their
inner experience
• Focus on clients making choices
• Elements of client-centered, existential
and Gestalt therapies
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Emotion-Focused Therapy:
Assumptions
• Psychological distress results from inability to
•
•
find words or images to understand/express
one’s experience
And when interpretation of experiences is
dysfunctional
Emotional Schemes – “implicit, idiosyncratic
organizational structures that serve as the basis
for human experience and self-organization”
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Emotion Focused Therapy: 6
principles
• Relationship principles
– Empathic attunement
– Therapeutic bond
– Task collaboration
• Task facilitation principles
– Experiential processing
– Growth and choice
– Task completion
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Emotion Focused Therapy:
Therapeutic Tasks (examples)
• Empathic exploration
• Two chair work
– Experiencing chair
– Other chair
• Empty chair dialogue
• Meaning work
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Process-Experiential (or Emotion
Focused) Therapy: Evaluation
• Research-based (strategies and
assumptions based upon process
psychotherapy studies)
• Treatment clearly described (compared to
other humanistic therapies)
• Model for training
• Most helpful for relatively mild distress and
minor psychopathology
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Process-Experiential (or Emotion Focused)
Therapy: Research on Outcome
• Clients show therapeutic change (in
uncontrolled studies)
• These changes appear to be stable over
time
• Treated clients improve more than
untreated clients (in controlled studies)
• Compared to other therapies (in controlled
trials) clients show comparable gains
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Process-Experiential (or Emotion Focused)
Therapy: Research on Outcome
• Large “researcher allegiance” effects
• Questionable outcome measures (biased
toward treatment type)
• Results from uncontrolled studies of
questionable validity
• Most studies no treatment manuals
• Clients with unspecified (or unclearly
specified e.g., “neuroses” ) problems
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Family Therapy
• Systems Perspective
• Interdependent
• Triangles
• Feedback
– Negative
– Positive
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Schools of Family Therapy
• Communication Approaches
– Gregory Bateson
– Don Jackson
– Jay Haley
– Mara Selvini Palazzoli
• Psychoanalytic Multigenerational Systems
– Family Systems Model
– Murray Bowen
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Schools of Family Therapy
• Experiential Systems
– Carl Whitaker
– Virginia Satir
• Structural Family Therapy
– Salvadore Minuchin
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Family Therapy: Criticisms
• Assumption that if one member is
mentally ill, the family system is sick.
• Difficult to research
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Group Therapy
• Group Analytic Psychotherapy
• Behavior Therapy in Groups
• Humanistic Group Therapy
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