www.psychspace.com心理学空间网By Ryan Howes, Ph.D. on December 03, 2008
The project kicks off with Cognitive Behavior Therapy co-founder Donald Meichenbaum, Ph.D., voted one of the ten most influential therapists of the 20th century.
Donald Meichenbaum (Ph.D., University of Illinois, 1966) is Distinguished Professor Emeritus, University of Waterloo, Ontario, Canada and Fellow of both the American and Canadian Psychological Associations. Hisexperienceis as broad as you'll find in this field: teaching, research, theory development, writing books and articles, advocating public policy, clinical work with inpatient and outpatient populations, therapist supervision and specializations with trauma, PTSD, schizophrenia, etc. He is currently Research Director for theMelissa Institute, an organization that utilizes psychological research to educate government and the public about violence and trauma. Needless to say, it's an honor to include him in the project.
The Seven Questions introduction discussed the Three Approaches to Psychotherapy films from 1965. Dr. Meichenbaum read the post and sent along this statement:
"By the way there is a new set of Three Approaches to Psychotherapy where Hans Strupp, Aaron Beck and I all interview a very interesting and suicidal patient named Richard. You may wish to include this on your BLOG."
Indeed I will. It has not beenYouTubed,but you can find a copy for purchase here. There are actually three parts to the series: the original in '65, part two in '77 and Meichenbaum's in '86. Since this project was inspired by the Gloria films, it's only fitting that a participant in the series helps launch it.
As one of the original voices of Cognitive Behavioral Therapy, it's a thrill to have Dr. Meichenbaum begin this discussion. His answers reflect many central tenets of CBT, including what and how trumping why. I personally enjoyed his advice for fellow therapists (Question 5). Read on and check back each Wednesday. The value in this series comes from comparing answers to see the diversity in the field of psychotherapy. Enjoy.
Seven Questions for Donald Meichenbaum:
1. How would you respond to a new client who asks: "What should I talk about?"
I would ask the client to share with me what brings him/her to therapy and how does he/she think I could be of help. Early on in the session, I would explain to the patient what I do for a living:
"Let me tell you what I do for a living. I work with folks like yourself and try and find out how things are now in your life. Then I try to find out how you would like them to be. What can WE do to help you achieve these goals?"
Moreover, I would like to know what he/she has already tried to bring about these changes and what has worked and not worked, as evidenced by what outcomes? What difficulties, if any did he/she have and how did he/she handle these obstacles?
"If WE work together and I hope WE can, how would WE know WE were making progress? What would change? What would other people notice?
"One last question, if I may. Can you (the client) foresee or envision any particular obstacles or barriers that could get in the way and what could WE do to anticipate and address these should they arise?"
NOTE: Several items about these questions.
They all are WHAT and HOW questions. WHY questions are NOT very productive.
The tenor of the session is very COLLABORATVE and the WE is always highlighted.
2. What do clients find most difficult about the therapeutic process?
Keep in mind that the research data on psychotherapy indicates that the quality of the THERAPEUTIC ALLIANCE is the most important aspect of therapy. There is a need to address any behaviors and beliefs and barriers that can undermine and interfere with the ability to work together. There is a need for the psychotherapist to monitor and address what have been called "ruptures" in this alliance.
The therapist should ask clients the following questions on a regular basis:
"What did he/she think of the session? What did he/she take away from the session that he/she can work on between now and the next time we meet?"
"Is there anything I (the therapist) did or did NOT do that he/she (the client) found particularly helpful or unhelpful?"
NOTE: The specific psychotherapeutic procedures account for only a small proportion of the outcome.
3. What mistakes do therapists make that hinder the therapeutic process?
I have trained and supervised psychotherapists all over the world and the major challenge is that they DO NOT LISTEN to their clients. Instead, they act as what I call "Surrogate Frontal Lobes" for their clients by giving explicit advice. The most valuable tool that the psychotherapist possesses is the "ART OF QUESTIONING." They should use Socratic-style discovery-oriented questions. I am at my therapeutic best when the clients I see are one step ahead of me offering the observations or advice that I would otherwise offer.
NOTE: Clients are more likely to follow through on what they come up with than what the therapist offers. The therapist needs to be STRENGTHS-BASED.
4. In your opinion, what is the ultimate goal of therapy?
I would not focus on the so-called Ultimate goal, but rather work with clients to establish COLLABORATIVLEY short-term, intermediate and long -term goals that are behaviorally objective, achievable, and measureable. The goal of psychotherapy is to have the client "become his or her own psychotherapist."
The project kicks off with Cognitive Behavior Therapy co-founder Donald Meichenbaum, Ph.D., voted one of the ten most influential therapists of the 20th century.
Donald Meichenbaum (Ph.D., University of Illinois, 1966) is Distinguished Professor Emeritus, University of Waterloo, Ontario, Canada and Fellow of both the American and Canadian Psychological Associations. Hisexperienceis as broad as you'll find in this field: teaching, research, theory development, writing books and articles, advocating public policy, clinical work with inpatient and outpatient populations, therapist supervision and specializations with trauma, PTSD, schizophrenia, etc. He is currently Research Director for theMelissa Institute, an organization that utilizes psychological research to educate government and the public about violence and trauma. Needless to say, it's an honor to include him in the project.
The Seven Questions introduction discussed the Three Approaches to Psychotherapy films from 1965. Dr. Meichenbaum read the post and sent along this statement:
"By the way there is a new set of Three Approaches to Psychotherapy where Hans Strupp, Aaron Beck and I all interview a very interesting and suicidal patient named Richard. You may wish to include this on your BLOG."
Indeed I will. It has not beenYouTubed,but you can find a copy for purchase here. There are actually three parts to the series: the original in '65, part two in '77 and Meichenbaum's in '86. Since this project was inspired by the Gloria films, it's only fitting that a participant in the series helps launch it.
As one of the original voices of Cognitive Behavioral Therapy, it's a thrill to have Dr. Meichenbaum begin this discussion. His answers reflect many central tenets of CBT, including what and how trumping why. I personally enjoyed his advice for fellow therapists (Question 5). Read on and check back each Wednesday. The value in this series comes from comparing answers to see the diversity in the field of psychotherapy. Enjoy.
Seven Questions for Donald Meichenbaum:
1. How would you respond to a new client who asks: "What should I talk about?"
I would ask the client to share with me what brings him/her to therapy and how does he/she think I could be of help. Early on in the session, I would explain to the patient what I do for a living:
"Let me tell you what I do for a living. I work with folks like yourself and try and find out how things are now in your life. Then I try to find out how you would like them to be. What can WE do to help you achieve these goals?"
Moreover, I would like to know what he/she has already tried to bring about these changes and what has worked and not worked, as evidenced by what outcomes? What difficulties, if any did he/she have and how did he/she handle these obstacles?
"If WE work together and I hope WE can, how would WE know WE were making progress? What would change? What would other people notice?
"One last question, if I may. Can you (the client) foresee or envision any particular obstacles or barriers that could get in the way and what could WE do to anticipate and address these should they arise?"
NOTE: Several items about these questions.
They all are WHAT and HOW questions. WHY questions are NOT very productive.
The tenor of the session is very COLLABORATVE and the WE is always highlighted.
2. What do clients find most difficult about the therapeutic process?
Keep in mind that the research data on psychotherapy indicates that the quality of the THERAPEUTIC ALLIANCE is the most important aspect of therapy. There is a need to address any behaviors and beliefs and barriers that can undermine and interfere with the ability to work together. There is a need for the psychotherapist to monitor and address what have been called "ruptures" in this alliance.
The therapist should ask clients the following questions on a regular basis:
"What did he/she think of the session? What did he/she take away from the session that he/she can work on between now and the next time we meet?"
"Is there anything I (the therapist) did or did NOT do that he/she (the client) found particularly helpful or unhelpful?"
NOTE: The specific psychotherapeutic procedures account for only a small proportion of the outcome.
3. What mistakes do therapists make that hinder the therapeutic process?
I have trained and supervised psychotherapists all over the world and the major challenge is that they DO NOT LISTEN to their clients. Instead, they act as what I call "Surrogate Frontal Lobes" for their clients by giving explicit advice. The most valuable tool that the psychotherapist possesses is the "ART OF QUESTIONING." They should use Socratic-style discovery-oriented questions. I am at my therapeutic best when the clients I see are one step ahead of me offering the observations or advice that I would otherwise offer.
NOTE: Clients are more likely to follow through on what they come up with than what the therapist offers. The therapist needs to be STRENGTHS-BASED.
4. In your opinion, what is the ultimate goal of therapy?
I would not focus on the so-called Ultimate goal, but rather work with clients to establish COLLABORATIVLEY short-term, intermediate and long -term goals that are behaviorally objective, achievable, and measureable. The goal of psychotherapy is to have the client "become his or her own psychotherapist."