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Samenvatting Psychotherapy Radboud Universiteit (SOW-PSB3DH50E-2023-PER4-V)
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Overkoepelend schema stromingen (lessen + boek): Psychologische Modellen van de Hulpverlening
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PsychotherapyCourse overview & recommended literature 2
Lecture 1 — Psychotherapeutic change: Introduction and Course Framework
3
Class 1 — Readings: 6
Class 2 — Reader: Behavior Therapy: An Overview 10
Lecture 2 — Behavior therapy 15
Lecture 3 — Psychodynamic Psychotherapy 18
Class 4 — Readings 22
Lecture 4 (½)— Interactive supervision meeting 31
Lecture 4 (2/2) — Cognitive Therapy (CT) 33
Lecture 5 — Carl Rogers and Client-centered Psychotherapy 36
Lecture 6 — Family, spouse and systems therapy 41
Class 6 — Readings 42
Lecture 7 — Group therapy 52
Lecture 8 — How to motivate people to change? 57
Lecture 9 — Treating personality disorders 61
Lecture 10 — Empirically supported treatments and scienti c research 64
Lecture 11 — Me, a therapist? 67
Week 1 — Psychotherapeutic change 69
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,Course overview & recommended literature
,Lecture 1 — Psychotherapeutic change: Introduction
and Course Framework
A few concerns and praises:
• There is a gap between academic psychology and clinical practice: in the eld you are
completely free to do what you want. It’s not mandatory to follow scienti c research.
• There are strong e ects for disorder-speci c treatments
• There is little theoretical integration between psychotherapy schools
Mental disorders
Experiences of…
• Feelings, thoughts, behaviors, tendencies, bodily sensations — these are out of control
• As a problem: unwanted, intolerable, abnormal, uncontrollable, absurd
• Who is in charge? Fragmented sense of ‘self’ = you do not feel like you can live
the life you want to live. A sense of lost control.
Psychotherapy schools
➡ Psychoanalysis: the struggles you have come from the unconscious. You do not know the
causes of the symptoms.
➡ Client-centered therapist / Rogerian therapy / person-oriented therapy / humanistic
psychotherapy: you cannot change these automatic feelings because you are alienated from
yourself. The therapy is about nding out who you are.
➡ Cognitive-behavior therapist: the idea is that you have developed a strong pairing between
stimulus and response. There is a learned reaction that needs to be unlearned. You have to
have exercises to do this.
➡ Family therapy: disorders exist because of patterns in the family. You have to change these
roles in order to x the disorder.
What is the goal of psychotherapy?
To change unwanted patterns of subjective experiences — or (from medical model) to reduce
agreed upon symptoms, disorders, etc…
NOT: to make patients happy (again) or to help patients understand reality
Means of psychotherapy
1. Changing propositional (semantic memory) representations?
• Using rationale and logic based arguments isn’t going to help a patient with for example a
phobia. They are aware that their phobia isn’t rational, so telling them its not will not help.
• Change isn’t as easy as providing correct information and trying to persuade
• Problems with this type of psychotherapy is that (1) the therapist is authoritarian here, (2) the
patient is likely to be passive; (3) persuasion is often ine ective or transient.
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, 2. Discover who you are, necessary?
• Problem 1: its not possible to “know” yourself. Mental processes are hardly accessible —
fragmented sense of self. We don’t have access to these things in our brain. Within the brain
there are automatic processes — “English butlers”
• Problem 2: It’s too propositional, it’s like pub talk — rather: changing one’s narrative may be
moderately helpful
2. Maybe it’s about insight into who you are?
• You have a dominant idea = schema (or a sort of neural network that has been activated many
times, now it’s easily accessible).
To get rid of these schemas:
- Some might say it’s not possible because these connections have been there for a very long
time
- BUT you could connect these ideas with other schemas, so that one would in uence the other
and have connections together.
- For example when somebody believes “everyone hates me” could be corrected with the idea
that the person hates themselves. This can be xed. You have built up a new salient
experience in connection with the old schema.
1. The person needs to distance oneself from the problem, and identify it as a problem
2. Then build up new (or reuse) salient experiences —> to do this make it more salient by
inducing emotions: connect the past present and future, images (picture yourself…), previous
experiences.
A problem is that the process usually takes place within sessions, which is very limiting.
3. Systematic exercise necessary?
• You have associative (procedural memory) representations about something
• The exercise is exposure to the problem, the patient builds up experience. This is the essence
of CBT
• The exercise should be rehearsed to make it e ective. Think of exercises like: exposure,
systematically challenging negative automatic thoughts, behavioral rehearsal, assertiveness
training, role playing, communication skills.
• The problem is: the patient needs to participate actively!
4. Patient activation and involvement necessary?
• Without involvement there is no change in the way we experience things
• Preferably in and between sessions
• For example: disclosure, emotional experiences, training, etc…
5. High quality therapeutic alliance/relationship necessary?
• It’s really important (trustworthy, capability)
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