L17 Humanistic Psychotherapy & Motivational Interviewing?

參考文獻：Pomerantz, A. (2013). Clinical psychology: science, practice, and culture (3rd ed.). Thousand Oaks, CA: SAGE Publications.

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17.1 Humanistic Psychotherapy

17.1.1 Philosophy and Goals - Carl Rogers

? Goal of therapy: Self-actualization

- Achieving your full personal potential

? Names used to describe humanistic therapy:

- Client-centered therapy

- Person-centered therapy

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17.1.2 Humanistic Theory

? Tendency toward self-actualization is innate and linked to:

- Positive Regard: Warmth,?Love, Acceptance

- Prizing: Experience of positive regard

? Problems arise when movement toward?self-actualization is thwarted by:

- Conditions of Worth: Prizing is linked to?specific behaviors/conditions

? Conditions of worth produce discrepancy between one’s:

- Real Self: The self you currently are

- Ideal Self: The self you could be at full potential

Incongruence

? Discrepancy between?real and ideal self

? Distress &?Psychopathology

Congruence

? Consistency between?real and ideal self

? Self-Actualization

17.1.3 Humanistic Psychotherapy

? Therapeutic relationship?(alliance) is THE key to?humanistic?psychotherapy and?provides corrective?emotional experiences

? Training focuses on?therapist attitudes?rather than on?techniques

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? Three Essential Conditions?- These conditions are necessary and sufficient!

- Empathy

? Deep, nonjudgmental?understanding of client’s?experience

- Unconditional Positive Regard

? Fully accepting another person?“no matter what”

- Genuineness

? Authenticity in the therapeutic?relationship

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? IF?the therapist creates a relationship with…

- Genuineness and transparency and real feelings

- Warm acceptance and prizing of the other individual

- Sensitive ability to see the client and their world

? THEN the client will experience…

- Understanding aspects of themselves

- Improved ability to function effectively

- Increased self-confidence and self-direction

- More understanding and acceptance of other people

- Ability to cope with life’s challenges and problems

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? Reflection of Feeling

- Restating clients’ ideas in a way?that highlights

- Not mechanistic

-?Not just parroting facts

- Should include an opportunity?for the client to correct?misperceptions

- Conveys empathy, unconditional?positive regard, and?genuineness

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17.2 Motivational Interviewing

? Developed by Miller & Rollnick (1991)

- Humanistic orientation

- Originally developed for substance use disorders but?now used for a wide range of problems

- Explicit focus on stages of change

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17.2.1 Prochaska & DiClemente:

- Transtheoretical Model of Change

Stages of Change

Pre-Contemplation

? No intention to change

? Haven’t even started?thinking about change

Contemplation

? Aware of the problem

? Thinking about changing

? But ambivalent

Preparation

? Intend to take action soon

? Started planning

? May have taken some?small initial steps

Action

? Committed to goal

? Actively changing behavior

? Sustained effort

Maintenance

? Maintain gains

? Prevent relapse

? At least 6 months

Termination

? Gains sustained

? No longer at risk for?relapse

17.2.2 Motivational Interviewing

? Primary Goal: Enhance client’s intrinsic motivation to alter?behavior by helping to resolve ambivalence about changing

? Assumptions:

- Ambivalence about behavior change:

? Is a normal, motivational obstacle

? Can be resolved by working with client’s intrinsic motivations?/ values

- The therapeutic alliance

? A collaborative partnership

? Provides an empathic, supportive?environment that facilitates change

? Therapist roles:

- Express empathy

- Highlight discrepancies between?client’s behaviors and their values

- Avoid arguing

- Roll with resistance

- Identify sustain and change talk

- Support self-efficacy and optimism

? Many RCTs support MI

- Most empirically supported therapy?that has come out of the humanistic?movement