Counselling Psychology

Zoltan Kovary PhD

ELTE PPKDepartment of Clinical Psychology and Addictology

2015/16 Autumn Semester

Phases of psychotherapy process

Antecedents of first encounter

Preparatory phase Introductory phase Middle/ main/ working

phase Termination - Closure After closure – Follow up

Preliminary phase

Interventions of the Preliminary Phase

The role is more important

Low intensity Not healing, but part of

the treatment If it’s inefficient or

inadequate: worsening Continuing with

psychotherapy

The Types of the Preliminary Phase Interventions

Keeping up contact Patient management

Psychiatry Departments & ambulances

Somatic Departments & ambulances (health ps.)

Consultation-counselling Supportive therapy Crisis intervention

What is counselling?

What is counselling?

Consultation - counselling People on the edge of

Illness 1-5 sessions Focused & demarcated

problem Goal: to unfold the

individual solution Situations

Because of relatives Being sent Insecurity of roles

Overlaps with PT (Rogers)

Differences between Psychotherapy and Counselling

PSYCHOTHERAPY COUNSELLINGPathological States Sine morbo, life conducting problems

Psychotherapist education is required Counselling psyhology education is required

Clinical psychological knowledge Personality psychological, crisis psychological and conflict management knowledge

Goal: healing, lack of symptoms Goal: increasing the level of coping and self-efficiency

Goal: the recognition and regulationof the hidden motivational powers behind personality functioning and conflits

Goal: taking responsibility, increasing of activity

Targeting the conflict: exploration and working throuugh

Targeting understanding, insight , chaniging of approach

Limit of activity is the psychological workload and developmental potential of the client

Limit of activity is the terrain demarcated by problem focus

Practical learning, identification, reflexivity, introspective ways

Practical learning, interpersonal and action learning, understanding,reflexivity

Effects: condition improved, self-awareness Effects: improving of problem solving and decision making skills

Szupportív terápia Goal: strengthening ego-

functions The supporting of positive parts

(„what is still functioning”) without unfolding the negative

How does it help? Strengthening Increasing well-being Supressing negative parts Load shedding

Indication No real contraindications

Timing One session/week, even for years

Crisis Intervention

The emergence of crisis paradigm

Emergency psychiatry care E. Lindemann:

Symptomatmatology and management of acute grief (1944)

War neuroses Short term therapies Mental hygiene

(preventions) E. Erikson’s theory

Features of psychological crises

Trigger events Endurance Phases Types (Erikson, 1963)

Normative, developmental Paranormative, accidental

(~ trauma) Crisismatrix (Jacobson,1979) Crisis and sickness

Danger Chance

RESTORTATION OF HOMEOSTASIS

PROGRESSIVE – CREATIVE SOLUTION

REGRESSIVE SOLUTION

CRISISPRE-CRISIS STAGE POST CRISIS STATE

Crisis – possible outcomes

Non-specific forms of crisis solution

Spontanous improvement

Supportive relationships (family, friends) Attention and support

without defence Clarifying issues Herding towards an

expert

Continuum of short term psychological interventions

Emergency crisis support Crisis intervention Short term dynamic PT

Basic ideas of Crisis Inetrvention

Instancy Spatial demarcation Commitment Building relationships

with social envireonment

Features of Crisis Intervention I. Dynamic and flexible Complexity Special diagnoses Coping, problem

solving Holistic approach Contextualism

Features of Crisis Intervention II.

The client’s competence

Activity Focusing on cross-

sectional part Here and now Environmental

adaptation

Frames of crisis intervention

Duration Frequency and

endurance of sessions Support and

confrontation Experience Focus

Phases of Crisis Intervention I.

Motivation Establishing relationship

(raport) Preparation Support, safety, holding Unconditional positive

regard Therapeutic activity

Phases of Crisis Intervention II. Reconstructions Involvement of social

network Social care Analysis of relational

patterns Redefinition of goals and

values Reworking of problem

solving strategies Summaries from time to

time

Phases of Crisis Intervention III.

Separation Discussing continuation

– new goals, new contract

Summary - a new life narrative

Possibility of renewing contact

Thank you for your attention!