Therapeutic

1
Extratherapeutic Change 40
Therapeutic Relationship 30
Expectancy (Placebo) 15
Technique 15
Lambert Bergin (1994) Asay Lambert
(1999) Bernstein Ratner (2005) Franken,
Kielstra-Van der Schalk Boelens (2005)
2
Signature Strengths - Seligman,
2002

• An important construct in Positive Psychology
• (www.authentichappiness.org)
• Are seen across cultures
• Are psychological traits seen across different
  situations over time

3
Signature Strengths - Seligman,
2002

• Are valued in their own rite
• Can be acquired and measured
• Contribute to adaptive coping
• - Curiosity, interest in the world
• - Love of learning
• - Judgment, critical thinking,
  open- mindedness
• - Ingenuity, practical intelligence
• - Emotional intelligence

4
Signature Strengths - Seligman,
2002

• - Perspective
• - Bravery
• - Perseverance
• - Integrity, honesty
• - Kindness, generosity
• - Loving, and allowing oneself to be loved
• - Citizenship
• - Fairness
• - Leadership

5
Signature Strengths - Seligman,
2002

• - Self-control
• - Discretion
• - Humility
• - Appreciation of Beauty
• - Gratitude
• - Optimism
• - Sense of Purpose
• - Forgiveness
• - Humor
• - Enthusiasm

6
PARENT STRENGTHS

• Congruence
• Signature Strengths
• Able to Shift the Parenting Perspective

7
Congruence

• Congruence helps parents to respond to a
  situation with both intellect (rational
  intelligence) and emotion.
• An idealized situation that is difficult to
  attain.
• As people, we all need to work continually to
  attain congruence as clinicians, we want to help
  our clients to attain it.

8

• Different styles of internal organization
• - high or low in intellect
• - high or low in affect
• High intellect focus on facts deny or repress
  emotions
• High affect difficulty in processing information

9

• We want to help a parent who is intellectually
  oriented to gain access to and express feelings
• We want to help a parent who is affect oriented
  to express feelings so he/she can begin to
  process information

10
Able to Shift the Parenting Perspective

• Fix or force vs ally and advocate
• Refocus comes about through
• - planned communication
• - objective understanding
• - active acceptance

11
THERAPEUTIC RELATIONSHIP

• Shared goals, agreement on methods, means and
  tasks for treatment, and an emotional bond
  (Bordin, 1979).

12

• Child and Family Education and Preparation
• Attending to the Childs and Parents Theory of
  Change
• Family Perception of Improvement in Therapy

13
Child and Family Education and Preparation

• Limited understanding of clinical process OR
  mismatch between child and family expectations
  and realities encountered leads to poor
  therapeutic relationship
• AND
• Puts child and family at greater risk for
  dropping out of therapy

14
Child and Family Education and Preparation

• Child and family will respond positively to
  treatment when engaged in an exploration of
  various topics, including
• - nature of stuttering
• - contemporary theories of etiology
• - why children come for therapy
• - the general structure of therapy
• - some specifics of behavior change

15
Child and Family Education and Preparation

• - what will be taught and why
• - the importance of active participation
• - self-expression
• - trust and confidentiality
• - child, parent and clinician roles and
  responsibilities
• - examples of positive outcomes and how they
  were achieved

16
Child and Family Education and Preparation

• Coleman, D. Kaplan, M. (1990). Effects of
  pretherapy video preparation on child therapy
  outcomes. Professional Psychology Research and
  Practice, 21(3), 199-203.

17
Attending to the Childs and Parents Theory of
Change

• Within the client is a theory of change waiting
  for discovery, a frame-work for intervention to
  be unfolded and accommodated for a successful
  outcome
• (Hubble, Duncan Miller, 1999)

18
Attending to the Childs and Parents Theory of
Change

• What ideas do you have about what needs to happen
  for improvement to occur?
• Often people have a hunch about what is causing a
  problem, and also how they can resolve it. Do you
  have a theory of how change is going to happen
  here?
• In what ways do you see me and this process
  helpful in attaining your goals?
• - Hubble, Duncan Miller, 1999

19
Attending to the Childs and Parents Theory of
Change

• How does change usually happen in your life?
• What do you do to initiate change?
• What have you tried to help with stuttering so
  far? Did it help? How did it help? Why didnt it
  help?
• - Hubble, Duncan Miller, 1999

20
Attending to the Childs and Parents Theory of
Change

• Each client and family presents the clinician
  with a new theory to learn and a new,
  client-directed intervention to suggest.
• Research in psychotherapy has shown that what the
  client and family want from treatment, how these
  goals are accomplished , and their perception of
  improvement may be the most important factors in
  therapy.

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HOPE or EXPECTANCY
26

• Pathways Thinking
• Agency Thinking
• Expectancy Theory

27
Hope or Expectancy

• Pathways thinking developing one or two ways to
  accomplish change
• Agency thinking the ability to begin and
  persist in doing what is necessary to change.
• Inability to experience either pathways or agency
  thinking causes stress and difficulty in coping

28
Hope or Expectancy

• The positive emotion that stems from the ability
  to successfully engage in both pathways and
  agency thinking is the essence of hope. Hope is
  not a purely emotional phenomenon it is an
  emotional response that is rooted in cognition.
• - Barnum, Snyder, Rapoff, Mani Thompson, 1998).

29
Hope or Expectancy

• Expectancy Theory With hope for change comes
  expectancy that change can and will take place.
  An individuals belief that a certain treatment
  will yield a certain effect either triggers or
  correlates to that effect.
• Expectancy Theory has long been used to explain
  the placebo effect in medicine.

Hope or Expectancy
30
Hope or Expectancy

• A more positive treatment outcome is likely to
  be predicated on the clients hopefulness, but
  also on the clinicians hope and expectation that
  the client has the ability to change, and that
  they will be able to help the client bring about
  such change.