SWTP II-lecture 1 & 2(PT) PDF

Lecture 1 Interplay between theory and practice & Introduction to Emotion Focused Therapy Office: HHB 1501 Tel: 3746-0120 Email: [email protected] Mail-box: (HHB 15/F 010) Consultation Hours: Every Mon: 3:30pm-4:30pm; Every Thur: 4:00pm-6:00pm (Please make appointments) My expectations...

Lecture 1 Interplay between theory and practice & Introduction to Emotion Focused Therapy Office: HHB 1501 Tel: 3746-0120 Email: [email protected] Mail-box: (HHB 15/F 010) Consultation Hours: Every Mon: 3:30pm-4:30pm; Every Thur: 4:00pm-6:00pm (Please make appointments) My expectations In you concept, what’s the relationship between theory and practice? PollEv.com/vivienkwan037  h a t is T h e o r y? W Dictionary definition includes both scientific and everyday uses. Scientifically, a theory is a general principle explaining a phenomenon. Everyday use refers to abstract thoughts or speculations. A theory is a generalized set of ideas and should explain an aspect of the world in an organized form. Theory helps rise above immediate observations to find hidden patterns Howe (2009: 1) uses the analogy of early balloon flights changing perspectives. FUNK Y TUNES 8 Introduction to EFT  28 Historical Development of EFT 🐠 Leslie Samuel Greenberg (born 30 September 1945) , a Canadian psychologist 🐠 Instinctively recognized emotion as a fundamental source of motivation and regulation in human functioning, aligning with humanistic theories by Rogers, Perls, and others. 🐠 He emphasized that emotional responses, rather than cognitions or beliefs, played a crucial role in evaluating goal attainment success and signaling the personal significance of events for clients. 🐠 Providing an initial articulation of principles for working with emotions in therapy. 🐠 Emotional experience was viewed as influencing processing, attention, memory, and behavior in service of emotional regulation and attachment.  29 Historical Development of EFT 🐠 Gestalt Therapy Interest: 🐬 Originated during graduate studies, focusing on two-chair dialogue. 🐠 Key EFT Tasks Identification: 🐬 First 6 process-experiential tasks, including two-chair dialogue, empty chair dialogue, systematic evocative unfolding, focusing, empathic affirmation. 🐠 Therapist as Facilitative Coach: 🐬 Guides emotional processing with an emphasis on EFT tasks. 🐠 Co-constructive Therapy Process: 🐬 Therapists guide without imposing, applied to treat depression. 🐠 EFT's Neo-Humanistic Principles: 🐬 Adoption of neo-humanistic principles, providing a modern perspective on emotional processing. 🐠 Human Potential and Motivators: 🐬 People have creativity, agency, awareness, and choice, driven by survival and growth. 🐠 Development of EFT Approaches: 🐬 Two innovative, research-supported psychotherapy approaches, specifically designed for individuals and couples.  30 EFT development Timeline Greenberg using the The 1st client-centered gestalt therapy technique to EFT task, "evocative Greenberg & Paivio introducing the resolve internal conflicts unfolding for a problematic fundamental change process of and developed “theory of reaction point," was Greenberg & Jeremy transitioning from secondary to emotions” with Jeremy mapped by Rice and Safran published "Emotion primary maladaptive to adaptive Safran Saperia in Psychotherapy" emotions. 1945 1970s 1975 1980s 1984 1985 1987 1993 1997 1997 Laura Rice & With Sue Johnson Greenberg, Elliott & "Facilitating Emotional Emotion-Focused Greengberg : developed Emotionally Rice leading to the Change" outlined 6 guiding Therapy was officially Therapeutic Focus therapy(情緒導向夫 development of therapeutic principles & 6 named by Greenberg & Task Analysis 婦治療) process-experiential core therapeutic tasks. Paivio. therapy 31  32 EFT is……  33 EFT beliefs 🐠 The client is the expert of his/her problem. 🐠 People have the ability for self-discovery and self-healing. 🐠 The client's current emotional experience in the present moment is important. (Moment-by-moment experiencing) 🐠 Changing emotion with emotion  34 Who benefits from EFT? 🐠 Individuals who can establish a working alliance. 🐠 Clients with a GAF* score of 50 or above. 🐠 Those without active substance abuse behaviors. 🐠 Individuals without impulse control disorders. 🐠 Individuals without a history of violent behaviors. 🐠 Clients whose “self” is not extremely fragile(e.g. children< age 6). * GAF stands for Global Assessment of Functioning. It is a numeric scale (ranging from 0 to 100) used by mental health professionals to subjectively assess an individual's overall level of psychological, social, and occupational functioning. The GAF score provides a broad overview of a person's ability to function in various aspects of life, considering both symptoms and the impact of mental health on daily activities. A higher GAF score indicates better overall functioning, while a lower score suggests more significant impairments. It is important to note that the GAF scale has been phased out in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), and clinicians may use alternative methods for assessing functioning.  35 EFT’s 30 years of proven effectiveness ★ Depression ★ Social anxiety ★ Emotional injuries ★ Interpersonal problems ★ Post-traumatic stress ★ Violence in intimate relationships ★ Marital challenges Recent Applications of EFT: Eating disorders Generalized anxiety disorder Avoidant personality Borderline personality Addictive behaviors  36 Foundations of Emotion-Focused Therapy  37 Foundations of EFT 🐠 Dialectical Constructivism: 🐬 Philosophical approach combining dialectical thinking and constructivism. 🐬 Emphasizes dynamic, self-organizing systems. 🐬 Theory of Self: 🐟 Informed by dialectical constructivism. 🐟 Views the self as actively constructed. 🐟 Incorporates opposing forces and ideas in self-concept. 🐬 Therapeutic Approach: 🐟 Influenced by dialectical constructivism. 🐟 Emphasizes dynamic interactions in therapy. 🐟 Considers ongoing constructive processes in therapeutic practices. 🐠 Refining Emotion Theory: Emotions as a Compass 🐬 Integration into evolving emotion theory. 🐬 Emotions as adaptive, guiding actions for provide access to needs, wishes, or goals. 🐬 Pathology linked to lack of awareness or disavowal of needs. 🐬 Differentiation from thought in cognitive-behavior therapy (CBT). 🐬 Emotion's unique neurochemical and physiological basis.  38 Foundations of EFT (cont’d) 🐠 Experiential Constructivist View of Emotion and Change: 🐬 Evolution in understanding emotion formation and change. 🐬 Dialectical view: People constantly make sense of emotions. 🐬 Biologically hardwired yet shaped by cultural and lived contexts. 🐬 Updating Views on non-aware Emotions (e.g. “I have been angry, but I wasn’t aware of it” 🐟 Constructivist update on non-aware emotions. 🐟 Gendlin's perspective on completing blocked feelings. 🐟 Constructivist sees the anger being constructed in the moment from constituent parts that were previously there, but not yet organized or configured into a coherent form (Greenberg, 2010). 🐠 Theory of Emotional Change: 🐬 Development from dialectical constructivism. 🐬 Emotion schemes as basis for human functioning and pathology. 🐬 Therapeutic focus on activating emotional processing. 🐬 Principles: Awareness, regulation & transformation. 🐬 Evolution towards importance of emotion processing and regulation.  39 Emotion Processing Perspective  40 Foundations of EFT (cont’d) 🐠 Construction of Meaning, Narrative Shifts, and the Process of Change: 🐬 EFT emphasizes the importance of the meaning-making process in contributing to change. 🐬 Rooted in the humanistic-existential* tradition, meaning creation is central to the therapeutic process. 🐬 Eugene Gendlin's focusing method, integrated into EFT, facilitates emotional awareness and meaning-making engages the exploration of the “bodily felt sense”. 🐠 Narrative Focus and Therapeutic Progress: 🐬 Capacity to narrate, understand, and integrate life stories is crucial for adaptive identity development, establishment of self. 🐬 A coherent, emotionally differentiated account of self fosters self-reflection, agency, and new interpersonal outcomes. 🐬 Addressing discrete event stories is vital, especially in traumatic or conflict-related situations. 🐬 Events must be described, re-experienced emotionally, and re-storied(reconstruct). * Humanistic-existential therapy combines the humanistic and existential perspectives to create an integrative and holistic approach that seeks to understand and address the complexities of the individual's experience and journey toward self-discovery and fulfillment.  41 Foundations of EFT (cont’d) 🐠 Therapeutic Principles Reexamined: 🐬 Process-experiential therapy integrates client-centered relationships with gestalt and experiential methods. 🐬 Core therapeutic conditions of empathy, genuineness, and unconditional positive regard are fundamental. 🐬 Therapists maintained an empathic attitude at all times but were selectively responding on a moment-by-moment basis to core aspects. 🐬 Chair dialogues and focusing techniques have roots in the works of Fritz Perls and Eugene Gendlin. 🐬 Process-experiential therapy(later known as EFT) was seen as directive in process but not in content. 🐬 Empathy is maintained as both an attitude and technique, adapting to client communication. 🐬 Therapists respond selectively to core aspects of client communication. 🐬 Therapy is marker-driven, responding to verbal and nonverbal indicators with tasks for emotional processing.  42 Foundations of EFT (cont’d) 🐠 Therapist Processes: 🐬 Goldman and Greenberg identified six therapist relational attitudes and 14 actions. 🐬 Response Empathy Rating Scale, which consisted of : 1.Intention to enter client’s frame of reference 2.Accuracy 3.Here and now 4.Topic centrality 5.Choice of words 6.Voice quality 7.Exploratory manner 8.Impact. 🐬 Experiential teaching emphasized observation of emotionally alive moments 🐬 Empathic conjecture : the therapist remains in an empathic framework but speculates, guesses, or feels what the client is experiencing, offering what he or she senses about what was not quite expressed.  43 Foundations of EFT (cont’d) 🐠 Outcomes of EFT: 🐬 Clients with better outcomes expressed significantly more productive, highly aroused emotions than did clients with poor outcomes,that is important in facilitating change. 🐬 Positive outcomes linked to clients' ability to navigate from "global distress" (high arousal, low meaningfulness). 🐬 Articulation of needs and negative self-evaluations is a crucial step. 🐬 Followed by expressions of assertive anger, self-soothing, hurt, and grief.  44 Case formulation in EFT: An integration of emotion and narrative 🐠 Redefined Case Formulation in EFT: 🐬 Maintained core relational principles of client-centered and gestalt therapies. 🐬 Case formulation viewed as a dynamic, process-oriented, and evolving narrative structure. 🐬 Emotion cannot be understood outside the context of the narrative, and the narrative does not have meaning without emotion. 🐬 Focus on co-constructing a narrative that guides therapeutic exploration. 🐠 Humanistic Definition of Case Formulation: 🐬 Grounded in the client's emotional pain. 🐬 Therapists operate with a "pain compass" to navigate emotional narratives. 🐬 Dual tracks of emotion and narrative/meaning making throughout the therapy process. 🐠 Three Stages of Case Formulation in EFT: 🐬 Stage 1: Understanding the client's narrative, attachment relationships, identity formation, and emotional processing style. 🐬 Stage 2: Identifying maladaptive emotion schemes and thematically focusing on them. 🐬 Stage 3: Formulating emotional state and process to move forward; revisiting and reforming the narrative.  45 Case formulation in EFT: An integration of emotion and narrative(Cont’d) 🐠 Development of Specific Therapeutic Tasks: 🐬 EFT utilizes specific tasks at in-session markers. 🐬 Two primary tasks: two-chair dialogue for internal conflict splits and the empty chair for unfinished business. 🐬 Other tasks and subtasks are supplementary, facilitating access to core therapeutic material. 🐬 Tasks are highly specified with models to guide therapists through each step. 🐠 Examples of Specific Therapeutic Tasks: 🐬 Two-chair dialogue addresses intrapersonal processes. 🐬 Empty chair for unfinished business focuses on interpersonal issues. 🐬 Various subtasks (evocative unfolding, meaning creation, focusing, self-soothing) serve specific therapeutic purposes.  46 Development of EFT for specific disorders and populations 🐠 EFT for Depression: 🐬 Initially conceptualized and validated for depression. 🐬 Theoretical basis includes failures in affect regulation, avoidance, traumatic learning, and emotion processing. 🐬 Empirically supported principles: awareness, regulation, and transformation. 🐬 EFT for depression is now considered an empirically supported treatment. 🐠 EFT for Trauma: 🐬 Effectiveness demonstrated for unresolved relationship issues and emotional injuries. 🐬 Adapted for complex trauma showing positive outcomes. 🐬 EFT with empty chair work found to produce better outcomes. 🐬 Integration of trauma-focused tasks in EFT. 🐠 EFT for Social Anxiety: 🐬 EFT tested and found significantly more effective than client-centered therapy. 🐬 Importance of a strong interpersonal relationship and structured tasks. 🐬 Two-chair task for anxiety initially emphasized, leading to unfinished business resolution.  47 Development of EFT for specific disorders and populations 🐠 EFT for Generalized Anxiety: 🐬 Proposed model suggests anxiety and worry protect against overwhelming painful emotions. 🐬 Dysfunction in Gad attributed to core painful maladaptive emotion schemes. 🐬 Focuses on accessing, experiencing, and transforming these emotion schemes. 🐠 EFT for Couples: 🐬 Initially developed by Greenberg, later continued and emphasized attachment theory by Susan Johnson. 🐬 Resurgence of EFT for couples, focusing on emotion's role in marital therapy. 🐬 It emphasizes self-soothing, system change, and working with various emotions. 🐠 Emotion-Focused Family Therapy and Eating Disorders: 🐬 EFT found helpful in treating eating disorders. 🐬 Integration of family-based therapy for improved outcomes. 🐬 Approach includes transforming maladaptive emotions, emotion coaching for parents, and relationship repair.  48 Conclusion 🐠 The Evolution of Emotion-Focused Therapy (EFT) 🐬 40 Years of Development: 🐬 Originated in the humanistic tradition. 🐬 Transformed into a powerful therapeutic approach. 🐠 Transformed into a powerful therapeutic approach.Events-Based Paradigm: 🐠 Integration of Traditions: 🐬 Initially integrated client-centered and gestalt traditions. 🐬 Evolved to synthesize a comprehensive theory of emotion. 🐠 Theory of Emotion: 🐬 Describes and explains how emotions change in sessions and therapy. 🐬 Principles for guiding emotion change developed.  49 Conclusion(Cont’d) 🐠 Theory of Case Formulation: 🐬 Allows therapists to maintain focus and productivity. 🐬 Collaborative understanding with clients to structure ongoing therapy. 🐠 Therapeutic Process: 🐬 Establish empathic relationships. 🐬 Experientially unfold client problems. 🐬 Conceptualize core emotions for focus. 🐬 Guide clients through emotional change process. 🐬 Recognize markers and implement specific tasks. 🐠 Practice-Scholarship Synergy: 🐬 Ongoing interplay between research and practice. 🐬 Ensures adaptability and evidence-based approach. 🐠 Positive Outcomes: 🐬 EFT as a versatile tool for addressing a wide range of psychotherapeutic issues. 🐬 Stands as a testament to integrating theory, research, and practice for effective interventions  50 References: Greenberg, L. S., & Goldman, R. N. (Eds.). (2019). Clinical Handbook of Emotion-Focused Therapy. American Psychological Association. http://www.jstor.org/stable/j.ctv1chrr6j Payne, M. (2021). Modern social work theory. Palgrave Macmillan.