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CA (170,000)
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Chapter 11

ch.11 textbook notes for Clin Psych

Course Code
Paul Frewen

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Intro to Interventions and Therapeutic Mechanisms to Change Ch. 11
-psychological interventions used
-ethical issues in selection of treatments, informed consent, requirement for ongoing assessment of treat-
ment usefulness
-psychologist cannot proceed with services w/o client agreement to receive services
-careful evaluation of clients ability to understand services and informed consent
-children or older clients with dementia etc
-psychological has ethical responsibility to monitor effectiveness of services and usefulness to each client
-pay attention to changing fit btwn treatment plans, clients needs and responses to treatment
-evidence based practice only requires the psychologist base treatment for a client is based on best
available data rather than based on highly controlled, internally valid and replicated studies
Lilienfeld (2007)
psychological treatments that can cause harm
“Scared straight” - programs tht try to frighten adolescents at risk for ongoing criminal bhvr actually in-
crease odds to subsequent criminal offending
“Rebirthing therapy” - children wrapped in blankets and squeezed repeatedly to “stimulate” the “trauma” of
birth has resulted in number of deaths
short-term psychodynamic psychotherapies
-treatment approach tht brings awareness to unconscious processes, esp. as they are expressed in inter-
personal relationships and helping client understand and alter these processes
ego psychology (anna freud): focused on processes by which the very young child learns to construct a
model of the world.
transference: unconscious application of expectations and emotional experiences based on impt early re-
lationships to subsequent interpersonal relationships
-STTP is considered a process of understanding stages of psychological development, bringing to aware-
ness unconscious processes, and re-enacting in the relationship with the therapist issues that have trou-
bled the client in the past
-active, engaging in dialogue, challenging the client
-first task is to foster development of a therapeutic alliance and positive transference
-techniques used to alter maladaptive patterns:
Reflection: paraphrasing clients’ statements or commening on emotional states in roder to enhance their
awareness of current epxeriences
Clarification: asking clients to attend more closely to some aspects of their experience in order to see
connections or patterns
Interpretation: commenting on a problem or experience and relating it to the use of defence mechanisms
or underlying core conflictual
Confrontation: challenging clients to recognize that defence mechanisms are interfering with their opti-
mal functioning or tht core conflictual themes are responsible for aspects of their experience
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Intro to Interventions and Therapeutic Mechanisms to Change Ch. 11
Interpersonal Psychotherapy for Depression
-interpersonal elements in the development, maintenance and alteration of psychological problems (esp.
grief, role disputes, role transitions and interpersonal deficits)
-sullivan suggested problems were often related to difficulties in comm. and to dysfunctional relationships
-focuses on changing interpersonal problems related to the onset, maintenance and relapse of depressive
-weekly meeting over 3-4 months
Distinct phases:
Phase 1 (sessions 1-3)
-involves assessing the symptoms of depression and patients current and past relationships
-inventory constructed becomes the focus of therapy
-At end of this phase, therapist diagnoses patient and provides an interpersonal formulation of the pa-
tients difficulties
-patient is absolved of responsibility for symptoms as these are ascribed to the disorder of depression
-therapist explains ways tht interpersonal issues maintain the depression and invites patient to participate
in changing current relationships
Phase 2 (Sessions 4-12):
Addresses one or more of the follwing themes:
Grief: helps patient deal with loss and develop new relations
Role disputes:
-identify dispute, find solution to resolve dispute, mod comm. and/or change expectations to resolve dis-
Role transitions: leave old role and mourn its loss if necessary
-develop skills, coping stats, support for transition
Interpersonal deficits:
-build social skills
-increase social movement
Termination Phase (sessions 13-16):
-acknowledge worries and sadness related to ending therapy
-encourage awareness and practice of new skills
-anticipate future challenges in which new skills are employed
-IPT-LL (Weissman et al.) was developed to meet the needs of adults in late life
-IPT-A (Mufson et al.) for adolescents
-IPT in combo. w/ bhvr therapy elements proven effective in treatment of bipolar disorder
Process-Experiential Therapies
-importance of becoming aware of, understanding and expressing emotions and transforming maladaptive
to adaptive emotions
-humanistic and experiential approaches include; client-centred, gestalt and existential therapy
-assumes human nature is growth-oriented
-PE treatment should include;
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