Comparative Short Term Therapy

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10.11.12
Psychodynamic STT

When someone isn’t making eye contact, is tapping, etc:
“I get the feeling that you’re uncomfortable being here talking to me/talking about it” *You actively address activity/affect you observe RIGHT AWAY “I notice you’re tapping/playing with your hair, etc, is there something about being here that makes you anxious?" “what’s going on right now that makes you want to shut me out?”

Don’t psychoeducate or norm the bx (IE: DON’T SAY “most ppl would be nervous, often people feel anxious in counseling” etc) *Norming will make them feel comfortable: we want to amplify the anxiety *The increased anxiety and your targeting the affect and defenses forces underlying issues out faster: you are trying the bx to an anxiety that’s serving the defensive function

Interpretation is the change agent
*even if someone doesn’t like who they’re working with, if the clinician says something on target, change can occur *Interpretation provokes a person’s acting out which activates a person’s historical experiences & engages the person’s emotions/affect

you interpret: Someone withholding, lateness, avoiding their emotions, etc- if you talk about what they are doing in the room with you, you are recreating what the do in general/outside of the office with others

O-------(T-------(P our insight helps the change

BE aware: lower functioning Pts can’t necessarily articulate bx they repeat: they usually SHOW you through action, reaction, bc

*The best way to make change is to acknowledge their patterns and draw out their affects
*If you can activate a feeling in relation to you, you can start to make a change

Keep in mind: Just BC someone has worked through something on an intellectual level does not mean they’ve worked through their emotions

Qts of Age, experience, etc:
“it seems like you’re nervous I can’t handle your feelings or emotions. Have you felt this way before?” *you’re looking at their anxiety etc to bring their past into the here and now & the room “what’s your concern? Are you worried that I can’t help you or I don’t have enough life experience?” *”Do you feel I can’t understand you?”

*Do you feel you can be helped?”
*”are you concerned about my life experience?”
When they ask a question about you:
*”help me understand why it’s important that you know” *Curiosity isn’t good enough, I’m curious about your curiosity” ANY ANSWER CAN CREATE COMPLICATIONS

If Social Work Student asks about your experience, it can be their way of telling you about their anxiety about being a provider! “Does your insecurity about ability to provide come up for YOU with clients?” We don’t have to tell them any info, but:

The younger the client, the more concrete we must be

If someone asks us something and we bristle and have anxiety they will sense it and clam up so we must be prepared for the questions

When someone asks if we have experienced something ourselves, even if it is something seemingly benign, we don’t have to answer IE: someone going abroad and asking us what we did/how we handled it “ It sounds like you’re curious to see if I’ve ever experienced that and how I handled it” Questions speak to fears for themselves

Our Qts can address their transference and be corrective

“How did you experience my question/response?” “I’m sorry you heard it that way, my intention was to understand your question”

SEE HANDOUT 10.11.12

In short term tx, we must link session to session: it shows you’re paying attention and provides structure for change

9.27.2012
Please review p. 4 of 9.20.12 handout
C.I cont’d
The work we do in C.I differs with the population: with college students the work is around transitions and developmental issues. Work with older adults will depend on the context With adults commonly: long-term relationships, life trajectory

We need to explore:
What brings someone to counseling NOW
This is usually something...
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