1. Introduction to Clinical Psychology: Science, Practice and Ethics Chapter 12 Humanistic, Experiential and Family Therapies This multimedia product and its contents are protected under copyright law. The following are prohibited by law: Any public performance or display, including transmission of any image over a network; Preparation of any derivative work, including the extraction, in whole or in part, of any images; Any rental, lease, or lending of the program Copyright ©Allyn & Bacon 2005

2. Gestalt Therapy Conceptualizes person as an organized whole Conceptualizes person as an organized whole People engage in self-defeating behaviors which deflect them from expressing their true selves 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 The Now – anxiety, depression, etc. result from being diverted from the now Copyright ©Allyn & Bacon 2005

3. Gestalt Therapy Focus upon increasing awareness of the now (“being mindful of current reality”) Focus upon increasing awareness of the now (“being mindful of current reality”) Focus upon non-verbal behavior Focus upon non-verbal behavior Focus upon accepting responsibility Focus upon accepting responsibility Focus upon confrontation Focus upon confrontation Insight – awareness of one’s experience such that things appear in a meaningful pattern Insight – awareness of one’s experience such that things appear in a meaningful pattern

4. Copyright ©Allyn & Bacon 2005 Gestalt Therapy Techniques Empty chair Empty chair Topdog – Underdog Topdog – Underdog

5. Copyright ©Allyn & Bacon 2005 Gestalt Therapy: Evaluation Gestaltists tend to oppose research Gestaltists tend to oppose research Very little research Very little research Research is methodologically poor Research is methodologically poor Absence of contemporary research Absence of contemporary research Technique-centered (although Gestalists say this is not so) Technique-centered (although Gestalists say this is not so) Treatment goals are vague Treatment goals are vague

6. Copyright ©Allyn & Bacon 2005 Carl Rogers’ Client-Centered Therapy: Theory Phenomenology Phenomenology –Phenomenal field –Phenomenal self Key Assumptions Key Assumptions –Self-actualization –Need for positive regard –Conditions of worth

7. Copyright ©Allyn & Bacon 2005 Client-Centered Therapy Unconditional Positive Regard Unconditional Positive Regard –Care about the client –Accept the client –Trust the client’s capacity to change Empathy Empathy Genuineness (congruence) Genuineness (congruence)

8. Copyright ©Allyn & Bacon 2005 Client-Centered Therapy: Evaluation + Positive alternative to psychodynamic therapy (Empathy, nonjudgemental stance are standard for therapists now) + Positive alternative to psychodynamic therapy (Empathy, nonjudgemental stance are standard for therapists now) + Emphasis upon research + 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 + Some support for efficacy particularly with adjustment problems

9. Copyright ©Allyn & Bacon 2005 Client-Centered Therapy: Evaluation - monolithic – every client treated in the same way (consequently not much research since the 1980s) - monolithic – every client treated in the same way (consequently not much research since the 1980s) - not effective with more serious psychopathology - not effective with more serious psychopathology - evidence of improvement weak on external validity - evidence of improvement weak on external validity - esoteric terminology (e.g., congruency, organismic experience, genuine) - esoteric terminology (e.g., congruency, organismic experience, genuine)

10. Copyright ©Allyn & Bacon 2005 Eclectic Treatment Combinations Three-Stage Model of Helping Three-Stage Model of Helping Process-Experiential Therapy Process-Experiential Therapy

11. Copyright ©Allyn & Bacon 2005 Three-Stage Model of Helping Hill and O’Brien (1999) Hill and O’Brien (1999) Exploration Exploration Insight Insight Action Action

12. Copyright ©Allyn & Bacon 2005 Process-Experiential Therapy (Emotion Focused Therapy) Leslie Greenberg & Robert Elliott Leslie Greenberg & Robert Elliott Focus on helping clients understand their inner experience Focus on helping clients understand their inner experience Focus on clients making choices Focus on clients making choices Elements of client-centered, existential and Gestalt therapies Elements of client-centered, existential and Gestalt therapies

13. Copyright ©Allyn & Bacon 2005 Emotion-Focused Therapy: Assumptions Psychological distress results from inability to find words or images to understand/express one’s experience Psychological distress results from inability to find words or images to understand/express one’s experience And when interpretation of experiences is dysfunctional And when interpretation of experiences is dysfunctional Emotional Schemes – “implicit, idiosyncratic organizational structures that serve as the basis for human experience and self-organization” Emotional Schemes – “implicit, idiosyncratic organizational structures that serve as the basis for human experience and self-organization”

14. Copyright ©Allyn & Bacon 2005 Emotion Focused Therapy: 6 principles Relationship principles Relationship principles –Empathic attunement –Therapeutic bond –Task collaboration Task facilitation principles Task facilitation principles –Experiential processing –Growth and choice –Task completion

15. Copyright ©Allyn & Bacon 2005 Emotion Focused Therapy: Therapeutic Tasks (examples) Empathic exploration Empathic exploration Two chair work Two chair work –Experiencing chair –Other chair Empty chair dialogue Empty chair dialogue Meaning work Meaning work

16. Copyright ©Allyn & Bacon 2005 Process-Experiential (or Emotion Focused) Therapy: Evaluation Research-based (strategies and assumptions based upon process psychotherapy studies) Research-based (strategies and assumptions based upon process psychotherapy studies) Treatment clearly described (compared to other humanistic therapies) Treatment clearly described (compared to other humanistic therapies) Model for training Model for training Most helpful for relatively mild distress and minor psychopathology Most helpful for relatively mild distress and minor psychopathology

17. Copyright ©Allyn & Bacon 2005 Process-Experiential (or Emotion Focused) Therapy: Research on Outcome Clients show therapeutic change (in uncontrolled studies) Clients show therapeutic change (in uncontrolled studies) These changes appear to be stable over time These changes appear to be stable over time Treated clients improve more than untreated clients (in controlled studies) Treated clients improve more than untreated clients (in controlled studies) Compared to other therapies (in controlled trials) clients show comparable gains Compared to other therapies (in controlled trials) clients show comparable gains

18. Copyright ©Allyn & Bacon 2005 Process-Experiential (or Emotion Focused) Therapy: Research on Outcome Large “researcher allegiance” effects Large “researcher allegiance” effects Questionable outcome measures (biased toward treatment type) Questionable outcome measures (biased toward treatment type) Results from uncontrolled studies of questionable validity Results from uncontrolled studies of questionable validity Most studies no treatment manuals Most studies no treatment manuals Clients with unspecified (or unclearly specified e.g., “neuroses” ) problems Clients with unspecified (or unclearly specified e.g., “neuroses” ) problems

19. Copyright ©Allyn & Bacon 2005 Family Therapy Systems Perspective Systems Perspective Interdependent Interdependent Triangles Triangles Feedback Feedback –Negative –Positive

20. Copyright ©Allyn & Bacon 2005 Schools of Family Therapy Communication Approaches Communication Approaches –Gregory Bateson –Don Jackson –Jay Haley –Mara Selvini Palazzoli Psychoanalytic Multigenerational Systems Psychoanalytic Multigenerational Systems –Family Systems Model –Murray Bowen

21. Copyright ©Allyn & Bacon 2005 Schools of Family Therapy Experiential Systems Experiential Systems –Carl Whitaker –Virginia Satir Structural Family Therapy Structural Family Therapy –Salvadore Minuchin

22. Copyright ©Allyn & Bacon 2005 Family Therapy: Criticisms Assumption that if one member is mentally ill, the family system is sick. Assumption that if one member is mentally ill, the family system is sick. Difficult to research Difficult to research

23. Copyright ©Allyn & Bacon 2005 Group Therapy Group Analytic Psychotherapy Group Analytic Psychotherapy Behavior Therapy in Groups Behavior Therapy in Groups Humanistic Group Therapy Humanistic Group Therapy