Clinical Psychology

Lecture 12 – Intervention
Dr Hazem Al-Agha MD MFOM DAvMed
Assistant Professor , Hebron University
Consultant Physician in Occupational and Aviation Medicine
Glasgow- United Kingdom.
Short-Term Psychodynamic Psychotherapies 1
• Psychodynamic theories assume that individuals are prone to conflicts
between id and ego.
• These conflicts are resolved when the ego learns to accept and tolerate the id
impulses.
• Most current forms of psychodynamic assist clients in understanding their
problems and making changes in their lives
• Patients are helped to see how their core interpersonal conflicts are
influencing the relationship with the therapist, how these conflicts
developed, and how these conflicts have affected, and continue to affect,
their lives.
• STPPs involve face-to-face sessions conducted once or twice a week for
between 16 and 30 sessions
 Short-Term Psychodynamic Psychotherapies 2
• Compared with traditional psychoanalytic therapists, STPP therapists are active, engaging in
dialogue and challenging the client.
• Among the techniques used by the STPP therapist to alter maladaptive patterns are:
1. Reflection (paraphrasing clients’ statements or commenting on emotional states in order to
enhance their awareness of current experiences).
2. Clarification (asking clients to attend more closely to some aspects of their experience in order to
see connections or patterns).
3. Interpretation (commenting on a problem or experience and relating it to the use of defence
mechanisms or underlying core conflictual themes),
4. Confrontation (challenging clients to recognize that defence mechanisms are interfering with
their optimal functioning or that core conflictual themes are responsible for aspects of their
experience)
Interpersonal Psychotherapy for Depression 1
• Focuses on changing interpersonal problems that are related to the
onset, maintenance, and relapse of depressive symptoms
• The construction of an inventory of current and past relationships is
essential in identifying the interpersonal themes that will be the focus
of therapy.
• The patient is explicitly absolved/ forgiven of responsibility for
symptoms, as these are attributed to the disorder of depression
• An important difference is that IPT is designed to alter relational
functioning, whereas STPPs use information about relationships to
alter intrapsychic variables.
Interpersonal Psychotherapy for Depression 2
Cognitive-Behavioural Therapies 1
• Behavioural approaches are based on the assumption that problem
behaviours are learned and that faulty learning can be reversed through
the application of learning principles.
• Emphasize the role of thoughts and beliefs in the development and
maintenance of psychological problems.
• A cognitive-behavioural approach combines both behavioural and
cognitive elements in understanding and treating mental disorders.
Cognitive-Behavioural Therapies 2
• Therapists focus on present functioning as opposed to childhood history.
• Behavioural interventions focus on specific targets by :
-Reducing undesirable behaviours (e.g., intrusive thoughts about a traumatic event,
self-harming behaviours, and avoidance),
as well as by
-increasing desirable behaviours (e.g., engaging in pleasant activities, calmly
presenting a seminar, or assertively dealing with an angry customer).
• An essential feature is the application of scientifically derived principles in the
treatment of problems.
• Throughout therapy, progress is assessed to determine whether the strategy should
be modified.
• BT requires clear identification of goals and is oriented toward the future
Cognitive-Behavioural Therapies 3
Cognitive-Behavioural Therapies 3
• They focus on identifying automatic thoughts and changing
maladaptive patterns of thinking that are associated with distress,
anxiety, and depression.
• The therapist and client work together to identify problems, test
hypotheses, and re-evaluate beliefs.
• CBT therapists structure each session, setting an agenda, and teaching
new skills.
• Throughout treatment, the therapist uses a blend of didactic teaching
methods (i.e., directions and instructions) and Socratic questioning
(i.e., asking questions that encourage the client to examine his or her
beliefs and to be self-directed in skill acquisition) to help the client.
Intervention/Therapy
• By encouraging self-examination and then working with the client to test the
validity of his or her beliefs, the therapist actively encourages a process of
guided discovery for the client.

• The most important changes are presumed to take place not in sessions but
between sessions as the client completes and learns from homework
assignments.

• The vast majority of people who receive psychotherapy attend fewer than 10
sessions, and evidence-based treatment across orientations requires a very
active therapist.