Counselling Psychology Zoltan Kovary PhD ELTE PPK Department of Clinical Psychology and Addictology 2015/16 Autumn Semester
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!