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Psychotherapy notes ALL lectures Radboud

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Elaborate notes on all of the lectures of the course Psychotherapy. This is a second year course of the study Psychology at Radboud University.

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  • 12 de enero de 2022
  • 24
  • 2020/2021
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  • Leentje vervoort & ger keijsers
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Psychotherapy
Lecture 1 – 08/04/2021

Psychotherapeutic change
Few concerns in psychotherapy in the Western world;
- Gap between the academic psychology and clinical psychology, in the field there are still a
lot of questions patients have that have not been researched.
 Learn from other patients, experience and colleagues
- Psychotherapists are not bound to the academic world; not obliged to follow those
treatments which have been proven to be the best treatments.
- Little theoretical integration across psychotherapy schools, each school has its own way of
for example communicating with patients.
- There are strong positive effects for disorder-specific treatments; however, at many
universities theories for psychopathology are formed, but this does not only mean reducing
symptoms but is also about for example the relationship with the patient.

Whenever a patient comes into therapy, he/she experiences feelings, thoughts, behaviour
tendencies or bodily sensations as a problem.
- These issues are often unwanted, intolerable, abnormal, uncontrollable or absurd.
- People with these issues often feel like they aren’t in charge, they experience a fragmented
sense of self and psychotherapists have to change this feeling.
- Psychotherapy has to change subjective experiences

So, the goal of psychotherapy is to change unwanted subjective experiences.

Means
- Changing propositional representations; language-based, symbolic, deductive, reasoning
 The change component is pretty easy; change experiences through information,
reason and persuasion -> psycho-education or cognitive therapy
 Problems with this mean is that the therapist is authoritarian, the patients is passive,
and persuasion often is an ineffective or transient form of treatment.
- Discover who you are; self-knowledge in a classical philosophical proposition.
 Core of psychoanalysis and client-centred therapy; patients trying to discover
themselves
 Problem; form of therapy is completely unsupported by research and classical
psychoanalysis still is inefficient for treatment.
- Systematic exercise; change associative representations -> core in cognitive therapy,
behaviour therapy, systems therapy
 Change associations through exposure, systematically challenging negative
automatic thoughts, behavioural rehearsal, assertiveness training, role playing and
communications skills
 Has a lot of effectiveness but patients do have to participate, which they don’t
always want to.
- Patient activation and involvement; without involvement there is no change in the way a
client experiences things.
- High quality therapeutic alliance; used for motivation and involvement -> client-centered
therapy, psychoanalysis and CBT.
 No clear scientific evidence in psychology, but there is evidence in social psychology
and communication science.
- Reorganizing environment & social interaction; strong treatment packages for severe
psychiatric disorders, often last resort.

, Change through spouse and family support, enhance/increase social or daily
activities, reduce stress, set up a family care plan, alert plan and relapse prevention
plan.

, Lecture 2 – 12/04/2021

Psychotherapeutic change pt. II

Means
- Two possibilities in discovering who we are;
1. Change schematic representations
2. Changing narrative about yourself -> positive narratives/ideas about ourselves (don’t
have to be correct!) makes people happier in general
- Systematic exercise; change associative representations about something, often in cognitive
(behaviour) therapy and systems therapy
 Improvement often through exposure, challenging negative automatic thoughts,
behavioural rehearsal, assertiveness training, role playing and communication skills
 This form of therapy has a lot of evidence for effectiveness
 Only problem is that patients have to participate, so less effective when the patients
only watches and stays on the outside.
- Patient activation and involvement; therapeutic relationship -> therapy only works when
patient is activated and is part of the experience.
 There is activation within a session and between sessions
 In order to get patients involved, it is important that the patient discloses
him/herself and that there are emotional experiences.
- High quality therapeutic alliance; large differences in the way different psychology/therapy
school, but all research tells that the relationship between therapist and client is consistently
related to psychotherapy.
 Core ingredient in client-centred therapy and psychoanalysis
 Used for motivation and involvement in behaviour and cognitive therapy
 These are however untested theories in clinical psychology, but social psychology
and communications science does have good theories about social influence.
- Reorganizing environment and social interactions; reorganizing around the problems of the
patient -> you don’t change the patient, but adapt the environment in order to make the
person function better.
 Especially used in severe psychopathology; family support, enhancing social
environment, reduce stress or job-related interventions, alert plan or relapse
prevention plan
 Research – especially in regard to severe psychiatric disorders – that reorganizing
the environment is powerful in helping people reduce the effects of their disorders.

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