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Common Factors in Therapy - Counseling and Therapy - Lecture Slides, Slides of Psychotherapy

Common Factors in Therapy, Characteristics, Readiness, Positive Outcomes, Common Curative Factors, Working Alliance, Powerful Dynamic Construct, Outcomes of Therapy, Expectations, Pre Contemplation are some key points of this lecture slides.

Typology: Slides

2011/2012

Uploaded on 12/31/2012

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Working Alliance &
Common Factors in Therapy:
Old and New Challenges.
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Working Alliance &

Common Factors in Therapy:

Old and New Challenges.

AIMS for this presentation:

  • Review stages of client readiness for change.
  • Examine client and therapist characteristics that facilitate positive outcomes.
  • Explore common curative factors responsible for quality outcomes in therapy.
  • Provide an overview of the working alliance as a powerful dynamic construct.

Motivational Readiness

& Stages of Change:

Pre-contemplation (no intentions)

Contemplation (considering)

Preparation (some commitment)

Action (new behaviours)

Maintenance (working consistently over time)

Termination (self-efficacy, 100% confidence)

(Prochaska, DiClementi, Norcross, 1992 )

Readiness &

Stage of Change: “CUSTOMER”

GREEN LIGHT

  • Able to identify goal (agree)
  • Views self as part of solution (explore)
  • Willing to take steps (encourage)
  • A “doer”

Homework : Assign doing tasks.

(BTC, 1993; deShazer; Prochaska & DiClemente)

Client Characteristics related to

Positive Outcomes: (Weiner, 1998)

  • Client motivated , and hopes to change, and expects that intervention will help accomplish the change.
  • Client is a likable person with good capacity for expressing and reflecting on their experiences.
  • Reasonably intact personality.

Therapist Characteristics &

Bond development: (Pope, 1998)

10 most significant attributes

Empathy, Acceptance,

Genuineness, Sensitivity,

Flexibility, Open-mindedness,

Emotional Stability, Confidence,

Interest in people, Fairness.

What Theory Works Best?

Outcome Research: Efficacy!

  • Comprehensively proven that therapeutic interventions do have a positive impact
  • 25-50 years of research: Failure to establish any one school/theory/model is superior to any other (Smith, Glass, & Miller, 1980)
  • “Everyone has won and all must have prizes!”
  • Shared core/common features that are curative
  • Not IF it works or WHAT works, but HOW it works…

(Lambert, 1992)

Four Common Curative Factors:

  • Client Factors (remission, inner strengths, goal directedness, motivation, personal agency, fortuitous events, social support, faith) 40%
  • Expectancy/Placebo/Hope (credibility) 15%
  • Techniques/Models (questions, feedback, reframing, interpretation, modelling, info) 15%
  • Therapeutic Relationship Factors (empathy, warmth, respect, genuineness, acceptance, encouragement of risk-taking) 30%

Common Characteristics of

“Proven” Therapies (O'Donohue et al, 2000)

APA "empirically valid" therapies:

  • Involved skill building rather than insight or catharsis;
  • Had a specific focus rather than a general one;
  • Included regular , ongoing assessment of progress ;
  • Relatively brief in duration (20 visits or less).

Understanding the

Working Alliance: (Bordin, 1980)

  • Integrates both the relational and technical aspects of therapy
  • Strongly associated with outcome across all forms of treatment and intervention

Characteristics:

  • Strength of alliance is predictive
  • Strength of alliance fluctuates throughout relationship (ruptures and repairs)
  • Early Vs. late scores as a marker of success
  • Strength of early alliance allows strains and ruptures to be addressed

Phases:

  • Phase one occurs in the initial session/s (Bond phase)
  • Phase two begins as therapist starts addressing client issues (Work phase)
  • Phase two is characterized by one or more strains and ruptures
  • Direct therapist focus on ruptures can repair the alliance

Client Behaviours

that Strain the Alliance:

  • Overt and indirect expression of negative feelings toward the therapist or the process
  • Disagreement about the goals or tasks
  • Over-compliance or avoidance manoeuvres
  • ‘Self’-enhancing communication that is based in power conflicts (e.g., boasting)
  • Non-responsiveness or continued Docsity.com

Clients’ perceptions of

non-alliance minded Therapists :

  • critical, hostile
  • non-attentive
  • non-empathic
  • forgetful, suspicious
  • belief that the therapist is not clear about their expectations and goals