Download CHAPTER 6: Basic Features of Clinical Intervention

New Era University
College of Arts and Sciences
Psychology Department
CHAPTER 6: BASIC FEATURES OF CLINICAL
INTERVENTION
PREPARED BY:
GROUP 3
(Members)
Aguinaldo, Kenneth
Delos Santos, Riza
Guillermo, Gem Charmagne
Lado, Richelle
Pineda, Kristi
(PSYCH 111/4-B THURS 3-6PM)
I.
Objectives:
1. To describe features common to most clinical interventions, focusing
primarily on psychotherapy.
2. To examine what psychotherapy is and contrasting its characteristics with
those portrayed in popular media.
3. To describe what research tells us about clients and therapists and which of
their characteristics influence therapy outcomes.
4. To examine the goals and basic processes involved in clinical interventions,
as well as the professional and ethical codes that help guide practitioners in
conducting treatment.
5. To consider certain practical aspects of treatment such as fees, treatment,
duration, record keeping, treatment planning and termination.
II.
Activities:
A. Game: “PSYCH - HENYO”
Mechanics: The class will be divided into to 2 groups each will choose a
representative who will guess the “mystery” word pasted in his/her forehead.
The representative in front will make an effort to guess what the “mystery” word
is by asking first for categories such as (name of person, place, things, etc.) then
going into particular names and so on until he/she is able to guess the word. The
rest of the group can answer the representative’s question “Yes, No or Maybe.”
Each group will only be given 2mins. To guess the “mystery” word correctly. Best
time wins.
Hint: The “mystery” words to be guess are related to the field of Psychology
particularly Clinical Psychology and the like.
B. Trivia: Questions and Answers About Mental Disorders
Psychiatrist Nancy C. Andreasen, chair of psychiatry at the University of Iowa College of Medicine in Iowa
City and the author of The Broken Brain: The Biological Revolution in Psychiatry (1984), holds a National
Medal of Science for her work on mental disorders. In this question-and-answer format, Andreasen touches
on a variety of issues involving mental disorders.
Q: How quickly do the moods of people with manic depression (bipolar
disorder) swing back and forth?
A: There is no simple answer to this question. In general, most people with
manic-depressive illness have discrete episodes of either mania or depression,
with long periods of normality in between. A manic episode may last for a few
weeks but will abate quickly if appropriately treated. Depressions may take a bit
longer to clear, and some people remain in a state of relatively chronic mild
depression. Most, however, have essentially normal moods in between episodes.
These periods of normal moods can last from months to years. There does seem
to be a pattern of shorter periods of normal moods in those people who have
many repeated episodes. A small subgroup of people with manic-depressive
illness has a pattern known as “rapid cycling.” These people move quickly from a
short episode of mania to a short episode of depression, with almost no period of
normality in between. Eventually, however, most people who are rapid cyclers
achieve a normal or near-normal mood state.
III.
Lecture Proper:
A. OVERVIEW OF CLINICAL INTERVENTIONS.
CLINICAL INTERVENTIONS
 Occurs when clinicians acting in a professional capacity, attempt to change a clients
behavior, thoughts, emotions, or social circumstances in a desirable direction.
WHAT IS PSYCHOTHERAPY
 Psychotherapy is a treatment offered by a trained mental health professional
relationship to help clients overcome psychological problems.
 Psychotherapy participants (clients and therapies),
 the basic framework (professional relationship)
 treatment’s main goal (reduction of suffering).
PUBLIC (mis) PERCEPTION OF PSYCHOTHERAPY
 Popular images of psychologists and other mental health professionals in movies and
televisions are often inaccurate, like the popular images of the police detectives, medical
personnel, attorneys and judges.
PORTRAYALS OF PSYCHOTHERAPISTS IN FIVE POULAR MOVIES
Portrayal:
Movie:
 Analyze this
 Goodwill Hunting
Billy Crystal Plays a psychotherapist treating a mobster
the therapist breaks the confidentiality.
Robbin Williams plays a psychotherapist treating a gifted but
troubled young man. The therapist is caring and helpful but
at one point assaults and threatens his client the most would
consider well outside bounds professionalism.
 Prince of Tides
Barbara Streisand plays a psychotherapist who
romantically involved with the brother of a suicidal client
she is treating, a violation of ethical conduct.
 Prime
Meryll Stripp, psychotherapist providing supportive therapy
to a young woman recovering from a divorce. The
therapist no longer to deny that her effectiveness is
severely compromised.
 As good as it gets
Psychotherapy portrayals play a minor part in this movie a
challenging character with obsessive-compulsive disorder
played by Jack Nicholson. The therapist calmly but firmly
explains to the client that he needs first to make an
appointment - positive portrayal of a therapist setting
boundaries with a demanding and difficult client.
HOW MANY PSYCHOTHERAPY APPROACHES ARE THERE?
Investigators have identified as many as 400 brand name therapist and they literally run the
gamut from (A) Aikido to (Z) Zaraleya psychoenergetic technique. There are important
similarities of these variants they are rarely used or even known to most clinicians.
Trivia: Questions and Answers About Mental Disorders
Q: Should psychiatric patients be hospitalized against their will?
A: The term “psychiatric patients” covers very broad territory, ranging from people who seek help
when dealing with a difficult personal situation such as divorce to the relatively rare cases of people
who have committed an act that endangers others or themselves. The vast majority are not candidates
for hospitalization, not to mention involuntary hospitalization. Only a tiny minority of psychiatric
patients is potentially vulnerable to being hospitalized against their will. A psychiatrist does not usually
make the decision, and it does not depend on the diagnosis a person receives. It depends primarily on
how much the person’s illness poses a risk to the person or to society as a whole. The rules covering
involuntary hospitalization vary from one state to another, but most states use “dangerousness to self
or others” as the criterion. Most also require that an external reviewer—often a lawyer—make the final
decision, rather than a psychiatrist.
B. THE PARTICIPANTS IN PSYCHOTHERAPY.
Psychotherapy – Involves at least one client and one therapist, though it can involve more
than one client at a time (e.g., couples therapy, group therapy) or more than one therapist
at a time (e.g., co-therapists, therapeutic teams).
Clients and Therapists can vary in many ways:
Gender
Age
Racial/ Ethical Background
Belief System
Personal Strengths
Weaknesses
Communication Styles
The Client.
 People seek psychological help for a variety of reasons like:
An unhappy marriage
Lack of self – confidence
Nagging fear
Identity crisis
Depression
Sexual problems
Coping with injury or trauma
Insomnia

People are motivated to enter psychotherapy because:
1.
2.
3.
4.
Disturbance is so great that day to day functioning is impaired.
There is a risk of suicide or harm to others.
Disturbance may be less extreme but still, very upsetting.
The person’s usual coping strategies are no longer sufficient to deal
with the problems – such as utilizing support from friends and family or
taking a vacation.
Client Problems and Treatment Utilization.

Most common disorder when clients are given DSM Diagnoses:
1. Anxiety disorder
2. Mood disorder
3. Impulse control disorder
4. Substance abuse disorder
(Symptoms often appear by age 14 and if untreated, disorders are more likely to recur.)
Treatment Utilization.

Not everyone who experiences psychological disorders seeks treatment;
treatment utilization rates are relatively low.

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The failure to obtain treatment is more common in minority and lower
socioeconomic groups.
Seeking outpatient psychotherapy are more likely to be middle-aged, educated,
white, female and divorced or separated.
Client Variables and Treatment Outcomes.

Demographic variables (sex, age, ethnicity, socioeconomic, status, intelligence,
religious attributes) have been considered related to psychotherapy outcome.
But there is no strong evidence that it is related to psychotherapy outcome.

2 client variables important in psychotherapy outcome:

Other client characteristics that are variables affecting treatment
outcomes:
1. Cooperation vs. resistance
2. Openness vs. defensiveness
Client Motivation – Clients who are more invested and try harder tend to do
better.
“Internal representations” of their therapists – Defined as how clients
brought to awareness the image of their therapist (including the therapist’s
physical appearance, verbalizations, emotional tone).
Client’s level of distress, expectations for treatment success and coping
style – (e.g., externalizing or internalizing) as important client dimensions.
“It is frequently more important to know what kind of patient has the disorder
than what kind of disorder the patient has.”
- Messer (2006)
The Therapist.

As a general rule, broad demographic variables (of the therapist) play relatively
insignificant roles in overall effectiveness of the therapy.
Traits and Skills of Effective Therapists.
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Psychotherapist must possess strong interpersonal skills, including those related
to communication, relationship building, and self-monitoring.
Therapist should recognize differences and intensities in clients’ emotional
experiences and who also have a verbal repertoire – capable of putting these
shadings into words (psychological vocabulary) to effectively communicate their
understanding to their clients.
The therapist’s relationship – building skills affects therapy outcome – sincerity
and warm support for troubled clients without judging them at the same time.

Therapists need skills in self – awareness/ self-management/ Self – monitoring
skills – ability to monitor internal variables that might interfere with performance.
Rogerian qualities (necessary, sufficient conditions for bringing about therapeutic
change according to Carl Rogers):
 Genuineness
 Empathy
 Unconditional positive regard
Macroskills (broad skills):
 Communication
 Relationship – building
 Self – monitoring
CHARACTERISTICS OF EFFECTIVE PSYCHOTHERAPISTS
Characteristics of Master Therapists
(Adapted from Jennings & Skovholt, 1999)
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Voracious learners
Draw heavily on accumulated experience
Value cognition complexity and ambiguity
Emotionally receptive
Mentally healthy, mature, and attend to their own well – being
Aware of how their emotional health impacts their work
Possess strong relationship skills
Believe in the working alliance
Experts at using their exceptional relational skills in therapy
Selected traits of Effective Mental Health Professionals
(Adapted from Brems, 2001)

Self – esteem and competence
 Willingness for introspection and self- reflection
 Cognitive complexity and tolerance for ambiguity
 Cultural sensitivity and respect for others
 Personal mental health, self – respect and appropriate use of power
 Awareness and expression of personal style
 Empathy and capacity for intimacy
 Good personal boundaries, ability to delay expression of affect
 Sense of ethics and professionalism
Therapists’ Training and Experiences.



Clinicians/ Therapists with less 5 years of experience were more likely to work in public
health and/or mental health settings than were those with more practice
Clinicians/ Therapists with more experience were more likely to be in private practice.
Clinicians/ Therapists are more likely to begin their careers in public, community mental
health settings before moving into private practice.
Challenges of Therapeutic Work.
The difficulties that therapists most often face in their work:
1. Competency – related difficulties. These were relatively transient difficulties
resulting from situations in which therapists questioned whether they had the knowledge
or skills to be effective in a given situation.
2. Personality – based difficulties. This category involved therapists questioning the
degree to which their own enduring personal characteristics compromised their
effectiveness.
3. Situational difficulties. These resulted from characteristics of the therapists’ client
base or work situation.
The Therapeutic Relationship.

“Third participant” – the relationship that develops between client and therapist. It
is the impressions, feelings, and cognitions about each other from the moment they
meet. And these begin to coalesce into sense of what it is like to be with this other
person. This third participant is important because it affects treatment outcomes.
2 dimensions of therapeutic relationship also called therapeutic alliance:
(a) The emotional bond that develops between the therapist and client (liking, trust,
etc.).
(b) The shared understanding of what is to be done (tasks) and what is to be
achieved (goals).
Varying Views of the Therapeutic Alliance.
1. Client – Centered therapy (Carl Rogers) – Client – therapist relationship is the
crucible in which all the necessary and sufficient ingredients for therapeutic change are
generated. Rogers saw the relationship itself, rather then the technique employed by the
therapist as the main curative factor in psychotherapy.
2. Humanistically oriented therapists – Share a similar view with Rogers, the
therapeutic relationship is not merely the context for treatment, it is the treatment itself.
3. Psychoanalysts and psychodynamically oriented therapists – They regard the
alliance as critical but are less inclined to believe that the relationship itself is the main
ingredient in therapy. The therapeutic techniques are still critical.
4. Behavioral and Cognitive – behavioral therapists – View the therapeutic
relationship as an important but not sufficient condition of therapy. It is a context for
treatment and is crucial in bringing about beneficial change because it gives the
therapist the opportunity to model new skills and reinforce improvements in the client’s
behavior.
Research on Therapeutic Alliance.
Researchers have used these and other scales in many studies on the influence of the
alliance on therapy outcome. These scales are all designed with specific theoretical views of
the alliance in mind. It measures the alliance generally and scales are highly intercorrelated
which suggests that they measure essentially the same thing. They also have acceptable
internal consistency and interrater reliability.
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Working Alliance Inventory
California Psychotherapy Alliance Scales
Vanderbilt Psychotherapy Process Scale
Therapeutic Bond Scales
The Settings for Psychotherapy.
1. Outpatient settings –
 Includes therapists’ offices (most common setting for psychotherapy), spaces in
community centers or anywhere else clients and therapists agree to meet.
 Requirements for therapist’s office are minimal but certain features are of
importance like: privacy (soundproof or nearly so, office should not so far away from
other people if working with potentially aggressive client), comfortable (sitting are
also essential and on approximately equal levels), Office décor and accommodation
(designed to maximize therapeutic goals).
 Not all therapy occurs in an office, group therapy is often conducted in larger
spaces. Some types of treatment can even take place in public settings like for
instance, treating a client with panic disorder.
2. Inpatient settings –
 Includes facilities such as hospitals, prisons, or residential treatment centers, where
patients reside for days, weeks, months, or years.
 Clients have the right to expect privacy and professional treatment but have
differences with outpatient settings.
 Clinicians/therapists are treating disorders that are particularly severe like
schizophrenia and major depressive disorder.
 Clinicians/therapists often work as a part of a treatment team that includes
physicians, psychiatrists, social workers, etc.
 Psychotherapists must therefore coordinate psychotherapy with other treatments,
such as medications, physical therapy, or psychosocial rehabilitation.
Trivia: Questions and Answers About Mental Disorders
Q: Can exercise help alleviate depression?
A: If people who are depressed can rouse the energy to become involved in
an exercise program, it is quite likely that it will help them. First, it will take
their minds off the symptoms of depression. Second, it will build up their selfconfidence and self-esteem. Third, it will make them feel better physically,
since they will probably sleep better, be more relaxed, and have a more
normal appetite. Being physically active on a regular basis is one way that
everyone can gain control over his or her mental life.
C. THE GOALS OF CLINICAL INTERVENTIONS.
Reducing Emotional Discomfort
A common method for reducing client discomfort is to use the therapeutic relationship to
boost the client’s emotional strength. Some therapist offer direct reassurances such as “I know
things seem hopeless right now, but I think you will be able to make some important changes
in your life.” In their study of master therapist, Sullivan, Skovolt and Jennings (2005) found that
the ability to provide a safe, collaborative, and supportive atmosphere was one of the key ways
that master therapist understood the therapeutic alliance.
Fostering Insight
Clients are expected to benefit from learning why they behave in certain ways, because
such knowledge is presumed to contribute to development of new behavior. The
psychotherapist’s rational for fostering a client’s insight is like the well-known value of studying
history: knowing about the errors of the past helps to avoid repeating them.
A common technique for developing insight is for the therapist to interpret the client’s
behavior. The purpose of interpretation is not to convince client that the therapist is right about
the significance of some event but to motivate clients carefully to examine their own behavior
and thoughts and draw new and more informed conclusions about them.
Encouraging Catharsis
Clients are usually encouraged to express emotions freely in the protective presence of
therapist. This technique is known as catharsis, and it involves the release pent-up emotions
that the client has not acknowledged for a long time, if ever. The therapist encourages the
client to give voice to those emotions. Believing that through their release they will be eased. At
the very least, catharsis may help the client become less frightened of certain emotions.
Providing New Information (Education)
Psychotherapy is often educational. Certain areas of a client’s adjustment may be
plagued by means information, sexual functioning being a notable example and therapists can
often provide valuable information in this areas. Therapists are also educators in the sense that
they provide new ways for the client to understand problems. As educators, part of a therapist’s
skill is in presenting information in ways the client can best understand. When client understand
how their disorder developed, are maintained, and can be overcome they improve. Some
therapist offer direct advice and information to their clients adopting a teacherlike role.
Assigning Extratherapy Tasks (Homework)
Therapists often ask clients to perform task outside of therapy for the purpose of
encouraging the transfer of positive changes to the “real world.” Behavioral and cognitivebehavioral therapists have always been advocates of homeworks assignments, believing them
to be an effective way to promote the generalization of new skills learned in the therapist’s
office (Nietzel, Guthrie and Susman, 1991). Homework assignments are often made, too, by
psychodynamically oriented practitioner, systems- oriented psychotherapists, and even clientcentered therapists (Allen, 2006; Ronan and Kazantzis, 2006).
Developing Faith, Hope, and Expectations for Changes
Of all the procedures common to all system of therapy, raising clients’ faith, hope, and
expectations for change is the ingredient most frequently mentioned as a crucial contributor to
therapeutic improvement. The curative power of positive expectation is not restricted to
psychotherapy.
Clinicians are accustomed to think bout placebo effects in psychotherapy that many
attribute much of psychotherapy’s success to it rather than to specific techniques that therapist
uses. Recognizing placebo effects in psychotherapy does not eliminate the importance of the
specific techniques, nor does not eliminate the need to understand the specific techniques work
differently. Clients often begin a psychotherapy that they are about to engage in a unique,
powerful experience conducted by an expert who can work miracles.
Having structured therapy to increase client’s motivation and expectations for success,
the therapist attempts to ensure that the client actually does experience some success as soon
as possible. This success might be minor at first- a limited insight after a simple interpretation
by the therapist or the successful completion of a not-too-difficult homework assignment.
Trivia: Questions and Answers About Mental Disorders
Q: If a client is interested in group therapy, but worried about confidentiality.
What assurances do the client have that other people in the group won’t talk
about their problems to others?
A: Most group therapy involves an explicit agreement that whatever happens within the
group will stay within the group and will not be discussed with anyone else. Passing on
information (transforming it into “gossip”) is a serious violation of the rule of confidentiality
that guides most group therapy programs. This rule is the major reassurance that people
who participate in group therapy have. However, nothing in life is ever 100 percent. People
who are very concerned about preserving confidentiality would probably do better to receive
help through individual psychotherapy.
D. ETHICAL GUIDELINES FOR CLINICAL INTERVENTIONS.
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The ethical guidelines protect the client and insulate the relationship from the negative
influence of the outside forces and protect the clients and therapists from legal hazards.
Ethical principles are intimately tied to the clinician’s day-to-day and even moment-tomoment decision making.
Each of the situations involves the ethical issues, and some involve balancing
competing ethical issues (e.g., a duty of care against the requirement to maintain appropriate
professional boundaries).
The APA Ethics Code
Main source of ethical guidelines for clinical psychologists is the Ethical Principles of
Psychologists and Code of Conduct (APA Ethics Committee, 2002b). This work consists
of two main sections: (a) General Principles and (b) Ethical Standards. And there are
five General Principles:
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Beneficence and Nonmaleficence
Fidelity and Responsibility
Integrity
Justice
Respect for People’s Rights and Dignity
There are 10 Ethical Standards, each of which is divided into sections and
subsections resulting to 151 ethical rules for psychologists.
Four ethical concerns are the most important to the psychotherapists also called the
“four horsemen” of professional ethics; they are confidentiality, informed consent, and conflict
of interest.
Four ETHICAL concerns (Four Horsemen)
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CONFIDENTIALITY means that the therapists protects the client’s privacy and, except
in specific circumstances, does not reveal information that the client shares in therapy.
Confidentiality obligates the clinicians to regard the welfare of their clients as their main
priority.
COMPETENCY means that clinicians will be professionally responsible and practice only
within their areas of expertise. Clinicians will not engage in assessment or therapeutic
practices unless they have appropriate education, training, and or supervised experience
to do so, nor will they conduct therapy with populations they are unfamiliar with.
INFORMED CONSENT obligates therapists to tell clients about the limits of
confidentiality, about potential outcomes of treatment, and about anything else that
might affect the clients’ willingness to enter treatment.
CONFLICT OF INTEREST refers to the therapist obligation to maintain therapeutic
boundaries or therapeutic framework. This occurs when the therapist’s personal
interests compete with the best interests of the client.
ETHICS and the THERAPIST’S VALUES
When clients struggle with value-related issues, the therapist as well struggle with
his/her values that are different from those of the client. Therapist must be aware of their own
values and how those values can influence treatment, and when confronted with values
conflicts, the therapist must make decisions.
Examples of ETHICAL DELIMAS that THERAPISTS may face
Situation Arousing ethical concerns
Applicable sections of the APA Code
During therapy a client says he has
4.01 Maintaining Confidentiality
been thinking about killing his girlfriend.
4.02 Discussing the Limits of Confidentiality
A client who tested positive for HIV reveals
to his therapist that he continues to have
unprotected sex.
4.01 Maintaining Confidentiality
4.02 Discussing the Limits of Confidentiality
During group therapy, a therapist learns
that a group member has broken
confidentiality by talking to friends about
other group members.
10.03 Group Therapy
The court has ordered the client to obtain
treatment or face jail time, so the client
enters treatment but is unwilling to
commit to or invest in it.
3.07 Third-party request for service
A therapist who has been treating a
married couple is now called upon to be a
witness for one party in a divorce proceeding.
10.02 Therapy involving Couples or families
A therapist would like to present the case of
a client at a seminar, but the client wants to
be anonymous.
4.07 Use of Confidential information for
didactic or other purposes
A therapist considers becoming romantically
involved with the ex-husband of a client.
10.06 Sexual intimacies with relatives or
significant others of current therapy
clients/patients
a therapist learn that a colleague has been
using a controversial therapy that research
suggests may produce more harm than good.
1.05 Reporting ethical violations
2.04 Bases for scientific and professional
Judgments
VALUES-LADEN TOPICS THAT CAN ARISE DURING PSYCHOTHERAPY
Abortion
domestic violence
sexual practices
career choices
religious practices
assisted suicide
use of power in relationships
Child abuse and neglect
environmental practices
birth control choices
Health care choices
Suicide
death and dying
substance abuse
Marriage and cohabitation
premarital sex
Gang membership
weight and weight loss
criminal activity
religious belief
animal rights
medical ethics
gender roles
Dietary choices
Racism and sexism
sexual orientation
politics
Trivia: Questions and Answers About Mental Disorders
Q: Do people really lie down on couches during psychotherapy sessions?
A: Austrian physician and neurologist Sigmund Freud invented Psychoanalysis, the earliest form of
psychotherapy, about 100 years ago. He discovered that if he asked people to stretch out on a couch and think
about whatever came into their minds, they seemed likely to “free associate” and come up with memories of
experiences that they had previously repressed. He believed that the release of these repressed memories helped
relieve or reduce the various symptoms for which they were seeking help—so called neurotic symptoms such as
anxieties, compulsions, and unexplained paralyses. Lying down on a couch, with the psychoanalyst sitting behind
the patient so that there was no interaction or eye contact, was believed to enhance the psychotherapeutic
process. Some classically trained psychoanalysts still use the couch for their clients, but this practice has
markedly diminished over the last several decades. These days most psychotherapists talk to the patient face-toface—or, more correctly, listen to the patient face-to-face. Most psychotherapists also tend to place less
emphasis on releasing repressed memories and more emphasis on figuring out how to help their clients cope
with their immediate problems.
E. SOME PRACTICAL ASPECTS OF CLINICAL INTERVENTION.
Treatment Duration and Fees
The duration can result to one session to several years, depending on the type and severity of
the disorder, the motivation and other characteristics of the client, the skill and orientation of the
therapist, and the availability of funding for treatment.
A variety of factors, including location, clinicians’ level of training, and funding sources affect
fees. Psychologist or their employing agencies often provide free services or reduced payments for
clients in need.
Record Keeping
Psychotherapists are ethically to keep good records of their services to clients.
The APA Record Keeping Guidelines outlined the basic content of records, control and
retention of records, and disclosure of records. Psychologists should keep records of:
 Their clients’ identifying information
 Date and types of services
 Fees
 Assessments results
 Treatment plans
 Consultation with others about clients
Good record keeping is designed to benefit clients, clinicians, and their institution. Can also be
valuable if clinicians are involved in legal proceedings, and reviewing records, especially records of
effectiveness, can motivate clinicians to find ways to improve their services.
Case Formulation and Treatment Planning
Assessment for the purposes of treatment leads to the clinicians’ case formulation, a
conceptualization of the client’s problem. Case formulation may vary depending on the clinicians’
theoretical orientation.
1.
2.
3.
Three approaches to treatment planning
Therapist-based treatment
In this approach, the therapist learns a basic theoretical orientation to
psychotherapy and uses it for every client.
Diagnosis-based treatment
In which the client’s diagnosis, not the therapist’s orientation, determines
the mode of treatment.
Outcome-based treatment
It is an attempt to base treatment planning on all the factors that can affect
treatment outcome. Some of those factors are related to the client, some to
the therapist, and some to situational or emergent qualities, an example is
Systematic Treatment Selection(STS).
Therapist Objectivity and Self-Disclosure
Therapists must decide whether to share personal information such as their emotional
reactions, incidents from their own lives, and the like. Such sharing is called therapist self-
disclosure.
Traditionally psychoanalytic therapists have advocated strict prohibitions against disclosing
personal information. But utter nondisclosure is an impossible ideal because therapists are always
revealing something about themselves in their verbal and nonverbal behavior.
Termination
Termination of psychotherapy can occur in two ways :
 With treatment completed or
 With treatment incomplete, attrition or premature termination
Premature termination can occur when the client decides to discontinue therapy before the
treatment has finished.
Clients typically experience termination as evidence of their independence and growth.
After successful treatment, termination is a positive experience for both.
IV.
Evaluation: (25pts.)
1. Involves a deliberate attempt to make desirable changes in clients’ behavior.
____________
2. Initiated when a therapist with special training sees a client in need of help.
_____________
3. Persons trained in clinical psychology, counseling psychology, psychiatry and a variety of
other specialty areas. _____________
4. __________ is a treatment offered by trained mental health professionals and
administered within the confines of a professional relationship to help clients overcome
psychological problems.
5. The participants of psychotherapy: _____________ and
6. _____________.
7. The treatment’s main goal is the ___________________.
8. The psychotherapy’s basic framework is _______________.
9. Found to be one of the most common disorder when clients are given DSM diagnoses.
_________________
10. It is defined as how clients brought to awareness the overall image of their therapist.
_______________
11. One of the Rogerian qualities necessary for bringing about therapeutic change.
_____________
12. The ability to monitor internal variables that might interfere with performance.
_____________
13. The relationship that develops between client and therapist in any therapeutic encounter.
____________
14. The founder of client – centered therapy. ______________
15. Most common setting for psychotherapy in an outpatient setting. ___________
16. This therapy doesn’t necessarily take place in an office. _____________
17. The most common problem in an inpatient setting. ______________
18. He was interested in a particular type of insight – unconscious influences.
______________
19. Involves the release of pent- up emotions that the client has not acknowledged for a long
time. ____________
20. Therapist suggests reading material about a topic. ____________
21. Said to be the curative power of positive expectations. _____________
22. It means that the therapist protects the client’s privacy and does not reveal information
that the client shares in therapy. _____________
23. It means that the clinicians will be professionally responsible and practice only within their
areas of expertise. _____________
24. Obligates therapists to tell clients about the limits of confidentiality, potential outcomes of
treatment, etc. _____________
25. Refers to the therapist’s obligation to maintain therapeutic boundaries or a therapeutic
“framework”. ______________
ANSWER KEY:
1. Clinical Intervention
2. Treatment
3. Therapist/ Clinician
4. Psychotherapy
5. Client
6. Psychotherapist/ therapist/
clinician
7. Reduction of Suffering
8. Professional relationship
9. Anxiety disorder
10. Internal representations
11. Genuineness/ empathy/
unconditional positive regard
12. Self- monitoring skills
END
13. Third participant
14. Carl Rogers
15. Office
16. Group therapy
17. Schizophrenia / Major depressive
disorders
18. Sigmund Freud
19. Catharsis
20. Bibliotherapy
21. Placebo effect
22. Confidentiality
23. Competency
24. Informed Consent
25. Conflict of Interest