Basic Therapeutic Skills (BTS) Lectures – Leiden University 2021-2022
Week 1: Introduction
What is psychotherapy? The treatment of mental, emotional or behavioral problems by
psychological means. What types of problems? Depression, anxiety, personality disorders,
relational/family problems, behavioral problems, coping with difficult/traumatic events, etc.
Variety in psychotherapies: psychoanalytic, cognitive, behavioral, systematic, marital, group,
problem solving, acceptance and commitment, etc.
Goals of psychotherapy
Establishing new ways of relating to others
Less symptomatic distress
Changes in behavioral patterns contributing to suffering
Better self-understanding and insight
Accepting and valuing oneself
A common principle in many forms of psychotherapy consists of helping clients to become
aware of and challenge their self-criticism.
What do you think is the most effective factor in psychotherapy?
Therapeutic relationship (40% - or more?)
Extratherapeutic factors (30%)
Intervention, techniques (15%)
Placebo, hope and/or expectancy (15%)
Effective factors in psychotherapy: study examining therapist effect sin the treatment of
depression:
- 18 psychiatrists
- 57 pts received psychopharmacological treatment; 57 pts received placebo
- Larger amount of variance explained by the psychiatrist than by the treatment
- The most effective psychiatrists achieved larger treatment effects with the placebo than
the least effective psychiatrists with the actual medication
Basic therapeutic skills (course): from reproduction to introspection. Learn How To:
- Establish rapport
- Create meaningful contact
- Use your powers of observation
- Manage the initial interview
- Communicate essential information
- Manage difficult moments
- Balance the personal with the professional
- Communicate with colleagues/supervisors
- Evaluate your own development
Establish rapport
Clients are in a difficult position:
o Overwhelmed with feelings
o Possibly anxious talking about personal matters
1
, Basic Therapeutic Skills (BTS) Lectures – Leiden University 2021-2022
o Not clear about what is wrong
o Scared things will not improve
o Worried about bothering friends and family
o Confused about what to do
o Apprehensive about being judged by the therapist
First impression counts
Our clients need hope
Are you a good listener? Are you accepting and non-judgmental? Do people trust you with
their secrets? Do you easily get people to open up?
Create meaningful contact
Generate hope
Provide an opportunity for emotional release
Offer explanations and interpretations of problems
Modify cognitions
Give support and advice
Try out new behavior
Sharpen your Powers of Observation
Non-verbal cues (e.g., clothing, facial expression, proxemics)
Verbal expressions
The relationship between verbal and non-verbal expression
Your own feelings and reactions to the client
Manage the initial interview
Keep the focus: clients can be evasive or resistant
Pace the session: “If we spend all our time on this, I am afraid we won’t get to the other
things you wanted to discuss today” & “How does that sound to you”
Communicate information
Who are you?
What do you want to know? To what purpose?
Have you asked for permission to ask certain questions?
Does your client know why you ask all these things?
Idem: How much information do you need?
Did you make clear what you do not know?
Who will have access to the information?
Manage difficult moments: Your client: shows resistance, does not want to live like this
(suicidal thoughts), wants to do harm to others (or to you), is unable to engage in self-care,
abuses others (children, elderly), experiences an accident or assault or loss (prevention of
PTSD).
Balance the personal with the professional
The client needs me: he/she has no one to talk to.
The client needs extra time: I will extend the hour.
My client is so shy: it will probably help to talk outside the office.
2
, Basic Therapeutic Skills (BTS) Lectures – Leiden University 2021-2022
My client is so funny: I would like to continue contact.
Communicate with colleagues
You will react emotionally, cognitively, and behaviorally to your clients.
Your reactions stem from your own history and your perceptions about the present.
There is no right way to feel or think.
Our choices have consequences.
Self-awareness increases therapeutic options.
Your obligation is to pursue self-awareness throughout your career.
Getting a feel for the course
Literature – Skills lab – Assignments – Papers – Supervised sessions – Unsupervised sessions
– Self-assessment.
Skills Lab: training in basic psychotherapeutic skills (role playing, observation, individual and
group tasks), simulation of psychotherapy (minitherapy (2 sessions)), log about your
professional development (the ‘self-reflective diary’).
All the assignments, monitoring progress, practicing and lectures are preparations for the
minitherapy. Keeping a self-reflective diary: log about your professional development based
on your leading-objectives and the training matrix.
In the end of the BTS course, these questions should sound familiar:
- What do patients need to benefit from psychotherapy?
- How does a therapist facilitate the process of psychotherapy?
- How does a therapist evaluate psychotherapeutic processes?
- How does a therapist evaluate his/her own progress?
Week 2: The Therapeutic Relationship
3
