PS275 Lecture Notes - Unconditional Positive Regard, Brief Psychotherapy, Personality Disorder

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Published on 1 Feb 2013
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Modifications in psychoanalytic therapy
One innovation was to apply it to groups of ppl rather than only to indiv. Some therapists focus on the
psychodynamics of indiv in the group
The key issue is whether the group format dilutes the transference to the therapist and thus makes the therapy
ineffective
Other current analytic therapies include ego analysis, brief psychodynamic therapy and interpersonal
psychodynamic therapy
Ego analysis-------approach is sometimes described as psychodynamic rather than psychoanalytic
Those who subscribe to ego analysis place greater emphasis on a persons ability to control the environment and to
select the time and the means for satisfying instinctual drives contending that the indiv is as much ego as id
They focus more on the persons current living conditions than did Freud
Ego analysis belief in a set of ego functions that are primarily conscious, capable of controlling both id instincts
and the external environment and that significantly do not depend on the id for their energy
They assume that these egos functions and capabilities are present at borth and develop through experience.
Ego functions have energies and gratifications of their own usually separate from id impulses
Freud viewed society negatively, ego analysts hold that an indiv social interactions can provide their own special
kind of gratification
Brief psychodynamic therapy----Freud originally conceived of psychoanalysis as a relatively short term process.
Freud envisioned a more active and briefer psychoanalysis than what eventually developed
They found that 59% of those receiving psychoanalysis were women and that the mean # of current diagnoses
was four. On average each patient had one diagnosable personality disorder.
Overall 82% of the patients had tired other forms of therapy including drug treatment. Most patients had received
psychoanalytical treatment for many years. A follow up study found that the average length of treatment was 4.8
yrs
Patients from Canada, US and Australia and found many similarities across countries. The most common
diagnoses were mood disorder, anxiety disorder, sexual dysfunctions and personality disorders
Time limited psychotherapy is available as an alternative to the many years sometimes required for classic
psychodynamic treatment.
Brief therapy was developed to meet the expectations of the many patients who prefer therapy to be fairly short
term and targeted to specific problems in their everyday lives
The growth of brief therapy also evolved from the need to respond to psychological emergencies. Cases of shell
shock during the 2nd world war led to classic short term analytic treatment of what is now called post traumatic
stress disorder
Insurance companies and government health plans have played a role in shortening the duration of treatment by
encouraging therapists to adapt their ideas to brief therapy. They gave become increasingly reluctant to cover
more than a limited # of psychotherapy sessions in a given year and set limits on reimbursement
Stronger focus on time limit psychodynamic therapy. Brief therapies share several common elements:
Assessment tends to be rapid and early
It is made clear right away that therapy will be limited and that improvement is expected within a small # of
sessions ----6 –25
Goals are concrete and focused on improving the patients worst symptoms helping the patient understand what is
going on in their life and enabling the patient to cope better in the future
Interpretations are directed more toward present life circumstances and patient beh than on the historical
significance of feelings
Development of transference is not encouraged but some positive transference to the therapist is fostered to
encourage the patient to follow the therapists suggestions and advice
There is a general understanding that psychotherapy does not cure but that it can help troubled indiv learn to deal
better with life’s inevitable stressors
Interpersonal psychodynamic therapy------a variant of brief psychodynamic therapy, emphasizes the interactions
between a patient and his or her social environment.
HUMANISTIC AND EXISTENTIAL PARADIGMS:
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