Psychological Interventions.

The basic forms

Zoltan Kovary PhD
ELTE PPK
Department of Clinical Psychology and Addictology
2015/16 Autumn Semester

Classifications of
psychotherapies

Profoundity

From supportive to dynamic

Basic forms
Individual, group & system
approaches
Based on trends
From PA to cognitive, etc..

Different aims

Time

Symptoms, personality or
relationship
Short term or long term

Verbality

From verbal to expressive

Individual Psychotherapies

Psychoanalysis & dynamic

psychotherapies

Historical antecedents

Freuds personal and

professional
development
Hysteria
Charcot & hypnosis

Breuers Anna Ocase

Cathartic technique

Understanding the Unconscious

Analysing symptoms

Analysing dreams

Interpretation of Dreams
(1900)

Analyisng parapraxes

Studies on Hysteria
(1895)

Psychopatology of
Everyday Life (1901)

Repetition Compulsion

The mind in conflict: the

psychoanalytic model of pathologies

Symptoms

Intrapsychic conflicts
Anxiety
Defence
Constructions
(Compromise)
Primary gain of illness
Pathologic balance

Suffering pressure

Motivation for therapy

Methods and rules of

psychoanalytic therapy

Neutrality
Abstinence
Fundamental rule Free associations

Symptoms
Dreams
Parapraxes

Interpretation
Insights or Resistance
(defence)

Gains from illness

The process of
psychoanalysis

The infantile origins of

neuroses
Fixation and regression
Transference
The repetition of infantile
conflict
Working through
Emotional insights
Releasing libido to achieve
the goals of the ego
Contertransference

Training therapy

The goals of psychoanalytic

therapy

Where id was, ego

shall be
Pleasure and reality
principles
Restart stalled
development
Love and work

Famous case studies of Freud

Dora
1905 - hysteria
Little Hans
1909 - phobia
Ratman
1909 - obsessional
neurosis
The Schreber-case
1911 - paranoia
The Wolfman
1918

Further developments of
psychoanalytic (dynamic) therapies

Sndor Ferenczi and the

Budapest School

The antecedent of relational

psychoanalysis
Trauma therapies

Ego-analysis
Time limited dynamic
therapies
Object relational therapies
Psychoanalytic Selfpsychology

Jungian therapy

Four basis of time limited

dynamic therapies

Good first interview

(Argelander) with test
interpretation
Right psychodinamic
focus
Active treatment of
reistence
Active treatment of
detachmentt

The central relational conflict in time limited

dynamic psychotherapy according to Luborsky

Actual
therapeutic
al
relationship

Actual
external
relationships

Former
relationships
Central relational conflict

The focus the triangle of conflict

Defence

Anxiety

Hidden
feeling

The focus the triangle of persons

Others

O/P

O/T

Therapist

T/P

Parents
The triangle of conflict has to be assigned
to every peak of the triangle

Behavior therapies

Behaviorism
The phases of BT
Analysis of promlematic
behavior
S=f(S,O,C,C)
Precise targets
Therapeutic plan
BT methods

Systematic desenzitization
Operant conditioning
Flooding
Self-control
Negative practise

Blended into cognitive therapy = CBT

Cognitive Therapies

Cognitive approach to
pathologies
Cognitive distortions
The cognitive triad in
depression
Conceptualization
Characteristics
Time limited
Structured with exact
aims
Needs active
cooperation (home
works)

The evolution of psychological disorders according

to cognitive paradigm
Early life events
Dysfunctional basic assumptions
Significant life event
activation

Basic assumptions
Circulus
vitiosus

Spontanous negative thoughts

Cognitive distortions

Symptoms
(Cognitive, affective, motivational, somatic, behavioral)

The most inportant methods

in CBT

The five coloumns techique

Person Centered Therapy

Carl Rogers, humanistic

psychology
Non specific factors

Specific factors

Empathy
Congruency
Unconditioned positive regard
Nondirectivity
Encounter
Mirroring & Verbalization
Concentrating on the here
and now
Avoiding authority

No contraindications

Hypnotherapy

Historical background
Theories about
hypnotic state
Susceptibility
Techniques
Direct
Indirect
Indications and fields
of application

Relaxation and imagination therapy

History

Background

Physiological changes detected

Archaic consciousness-techniques
Transformation and integration of experiences

Forms

Jung - Imagination
Schultz AT
Desoilles Directed waking dream
Leuner Kathatym imaginated psychotherapy

Autogenic training, progressive relaxation

Application

Broad indications; contraindications

Indipendent and combined forms individually
and in groups; short & long versions

Group Therapies

Features of group therapies

Interpersonal processes are in

focus
Group leader
Handling individual,
interpersonal and group
processes at the same time
The client has to go beyond
medical models of functioning
Socialization is lower
Fear of the group

The types of groups

Size

Small (6-15 p.)

Medium large (1540)
Large (over 40)

Composition

Homogenous vs
heterogenous
Open or closed

The nonspecific effects of groups

according to I.D. Yalom

Hope
Universality
Information
Altruism
Socialization
Modeling
Interpersonal learning
Catharsis
Existential factors
Primary group
Group cohesion

The proportion of individual and group processes in

the cases of different techniques

Group focus

Individual
focus

Analytic, Interpersonal, Gestalt, Psychodrama, Person Centered,

Cognitive

Therapeutic and group

leading consequences

Individual, interpersonal
and group processes
system approach required
Relational conflicts are
dramatized
Group as a psychological
training ground
The destructive effects of
absenteeism, failure and
aftergroups
Modeling co-therapy

Group analysis

The 1920s: Burrow - neurotic

groups
The 1930s: Slavson childrens
groups
Lewin Group dynamics
1940s Group analysis

W. Bion

Foulkes

Working group and basic assumption group

Unconsciuos group fabtasies
The group s primacy
The matrix-model

The process of therapy

Advantages and disadvantages

The foundations of
psychodrama

Jacob Levi Moreno (1889-1974)

Focusing on personality, not
symptoms
The group as a micro social medium
Framework and spontaneity
Reorganizing psychological universe
Exploring and resocializing aspects
Indication and contraidnication
Composition of groups

The structure of a
psychodrama session

System Approaches in
Psychotherapy:
Couple & Family therapies

System approach in
psychotherapy

Open and closed systems

The principle of
nonsummativity
Homeostasis
Circular reasoning
Set of rules
Levels of communication
Coevolution

Couples and
marriage
therapies

The pair as a system and its disorders:

Jrg Willis collusion-theory

Pair: a new system

Choice of partner: intrapsychic
needs
We bring it from our childhood
experiences
The aim of choice is establishing
balance
Collusion

Mutual and covert satisfaction of

unconsciously determined needs
Forming a joint neurosis constructed
from wishes, anxiety and defence
Forms of collusion: narcissistic, oral,
anal, phallic

Couples and marriage

therapies

Joint participation
Indications
Couple & marriage: explicit
and implicit set of rules
Brought from childhood
family
Conflicts
Resistence - loyality
Intervention a third
person out of the system

Family therapies

The family life cycle

Family dynamics

System

Hierarchies
Borders
Roles

Stability and change

Coevolution
Normative and
paranormative crises
The index patients

Family therapy trends

Psychodynamic approach
Contextual approach

Theory of familial systems

Liebermann, Stuart, Patterson

Structual approach

Carl Whitaker, Virginia Satyr

Behavior therapeutic
approach

Bowen

Experimental school

Ivn Bszrmnyi nagy

Salvador Minnuchin

Strategic approach

Palo Alto, Millano School (SelviniPalazzoli), McMaster modell

Thank you for your

attention!