(a) treatment strategies and techniques
Personal-centered therapy does not pursue special strategies and skills, but focuses on creating a good relationship atmosphere, allowing the parties to explore their inner feelings freely. The therapist's biggest strategy is to use himself as a means to put the whole person into the relationship and create the needed good relationship by showing his sincerity, care, respect and understanding. From this perspective, instead of treating individual-centered therapy as "therapy", it is better to treat it as a heart-to-heart communication between two sincere friends.
There are two main forms of personal center therapy: one is individual talk therapy, and the other is small group therapy through "making friends" group, which mainly solves communication obstacles and psychological problems in social life.
(2) Common skills of individualized treatment.
In psychotherapy, the main skills used in personal center therapy are listening skills: open inquiry, emotional reflection, clarification, concise and specific response, acceptance, confrontation, respect, understanding, sharing, explanation, encouragement, self-disclosure and so on. Influence techniques are rarely used. In practice, therapists often encounter pressure from clients for guidance and explanation, especially when clients are not used to this kind of treatment without guidance and guidance at the beginning. In the face of pressure, the therapist expressed his understanding of the other party's dissatisfaction on the one hand, and "stubbornly" refused to give guidance on the other. Until the end, the parties finally realized that the guidance of others did not have much effect, or that they no longer had hope for guidance, but had a correct attitude, relied on themselves and was responsible for exploration. By this time, the talks will be more efficient. Here are some tips to illustrate.
1, listen
The therapist listens enthusiastically and carefully, and understands him with the eyes of the client. Therapists must be able to distinguish the feelings of clients, accurately understand the information they convey and reflect the deep meaning they want to communicate. Active listening can not only make the listener really understand a person, but also have a strange effect on the confidante. When the confidante finds that she is really understood, there will be a series of changes: first, she feels that she can finally be understood, eliminating her loneliness and showing her inner gratitude, and then, she seems relieved and talks more. This is the beginning of the transition to rehabilitation.
Step 2 feel the same way
Resonance means that the therapist has an accurate understanding of the inner world of the client, just like feeling himself, and conveys his feelings and knowledge to the other party. To achieve empathy, therapists must put down their own personal reference standards, put themselves in the position of seeing and feeling things from the client's reference standards, unconditionally accept the feelings and attitudes of the client, and express their understanding of the client through verbal and nonverbal forms. Rogers believes that when the therapist can master the real experience of the client's inner world, such as what the client sees and feels, without losing his self-identity and independence, the constructive changes of the client will occur.
(1) Understand the patient's feelings.
(2) convey feelings to patients
(3) Understand the meaning of feelings
(4) Try to feel from the standpoint of the parties.
(5) Assist patients to express, explore and understand.
(6) Different from sympathy (condescending)
Understanding in the sense of * * * should include three aspects:
1. Consultants put down their own reference standards, put themselves in the visitors' shoes and understand their inner feelings.
2. Counselors use counseling skills to convey their understanding of the visitors' inner experience to each other.
3. Guide visitors to think about their feelings further, so as to promote the recovery of their internal psychological mechanism.
Step 3 respect
(1) unconditional respect
(2) Non-possessive care
(3) Acceptance is the premise.
(4) Enthusiasm
(5) Pay attention to listening and responding.
(6) does not mean that the views are consistent.
Step 4 be sincere
(1) Truthfulness, honesty and reliability
(2) Enlightened, open and integrated.
(3) Match words with deeds.
(4) express yourself freely and naturally.
(5) You can expose your failures and shortcomings.
(6) Not superficial and too long self-expression.
Step 5 observe
In order to avoid the obstacle of therapeutic relationship, therapists must improve their observation ability. Observation is the premise and way to promote understanding. During the treatment, the therapist's observation is as follows:
First, look for clues from the behavior of the parties, including his verbal and nonverbal expressions;
Second, learn about the emotional state of the parties, especially the vocabulary used;
Third, pay attention to the priority of the tone of the parties; Fourth, understand the inner feelings of the parties through their facial expressions, eyes, gestures and sitting posture.
Step 6 confront
When the therapist finds that the expression, understanding and behavior of the client are inconsistent, uncoordinated and contradictory, he points out the problem and clarifies it for him. The premise of using confrontation is that acceptance, respect, empathy, sincerity and warmth have emerged.
Otherwise, it will threaten the therapeutic relationship and lead to a crisis. The role of confrontation is to help the parties improve their feelings, beliefs, behaviors and situations, and consciously promote understanding; Assist the parties to discover and understand their confused feelings and attitudes towards others; Give the parties a chance to wake up to their wrong assumptions or imaginary world, and rebuild reasonable assumptions or have a correct understanding of reality; Anticipate and avoid crises and reduce mistakes; Let the parties learn to have the ability to confront others and themselves when necessary; Point out the contradiction when the customer uses resources, and then assist him to make good use of neglected resources; Help the parties not only stay in the awareness stage, but also realize the importance of action and take action.
Second, understand group psychotherapy.
Understanding group is a form of humanistic group psychotherapy initiated by Rogers. It is suitable for eliminating social maladjustment such as interpersonal communication barriers.
The members of the understanding group are composed of people with similar backgrounds or problems. For example, people who are not good at interacting with people, have certain social fears, or people who are not used to getting along with and interacting with the opposite sex, and so on. The number of participants is about ten. Although the participants have certain psychological barriers, the condition is not too serious. He can sit down and participate in group conversations without being influenced by delusions or strange behaviors. The understanding group should be chaired by 1-2 people. The host should be a therapist or psychologist.
The activity process goes through three stages: the stage of mutual understanding and acceptance; Formal activities and treatment stages; The end stage of the activity.
The number of activities of the Zhihu Group can be decided according to the specific situation. At least three or five times, more than ten times. Generally, activities are held 1-2 times a week, and it is best to arrange them on weekends, combining the activities of the understanding group with the extracurricular activities on weekends. When the activity achieves the expected purpose and can come to an end temporarily, everyone can talk about when it will end and prepare to leave each other. If there is a need to meet again to exchange experiences, you can also appoint a meeting time, such as one week, half a month, one month, two months or six months later.
Therapeutic indication
People-centered therapy is mainly used for individual therapy and group therapy. In principle, it is suitable for everyone, whether normal or mentally retarded. Not suitable for parties who can't communicate orally.
People-centered therapy is not limited to the process of psychological counseling and therapy, but also widely used in areas other than therapy, such as people-centered teaching, parent-child relationship, interpersonal relationship training, international relations research and so on. It is especially suitable for the initial stage of crisis management and also for administrative management. It has application value in multicultural environment.
Representative technology-supportive therapy
General psychotherapy does not need to analyze the patient's subconscious, but mainly supports and helps patients adapt to the current reality, so it is also called non-analytical therapy. When the seeker is faced with serious psychological setbacks or trauma, such as finding that he has cancer and cannot be cured, or finding that his spouse is unfaithful, or facing unexpected events such as injury or death of a loved one, it is difficult to control his feelings, his spirit almost collapses, and he feels at a loss, and he needs to rely on the "support" of others to cope with psychological difficulties, the therapist provides support to help him cope with the crisis. Mental support therapy was founded in 1950, and was first proposed by Thorne. It is a widely used concept of psychotherapy in China. The connotation of this treatment method is very rich. Generally speaking, doctors use reasonable conversation methods such as persuasion, inspiration, encouragement, sympathy, support, reasoning, persuasion, dispelling doubts, and providing guarantees to help patients understand problems, improve their emotions, boost their confidence, and thus promote the process of physical and mental rehabilitation.
Another meaning of supportive treatment is that patients seeking treatment are immature, emotionally fragile or suffering from chronic mental disorders or degenerative diseases, and need long-term support and care of patients to reduce the possibility of recurrence or deterioration and enhance their ability to cope with reality. The treatment principle of supportive therapy is:
(1) provide appropriate support. When a person is frustrated psychologically, what he needs most is the comfort, sympathy and care of others. Therefore, this principle is to provide necessary psychological support, including sympathy and consideration, encouragement and comfort, and provide directions for dealing with problems. In order to help medical practitioners tide over difficulties, deal with problems and cope with psychological setbacks. However, it should be noted that the support for those seeking treatment should be moderate and selective, just as parents should not blindly love or protect their children. Generally speaking, "support" is not "arrangement". Therapists should consider the seriousness of psychological setbacks, their own personality and self-maturity, and give appropriate support according to the way of dealing with problems and the process of coping with difficulties. In addition, support is not just lip service, but should be truly expressed in attitude, so that people seeking treatment can realize that things are not as bad as they think. At the same time, patients are encouraged to have a factual basis for what they say, and they should not talk nonsense or make things up, otherwise the other party will not believe and accept it.
(2) Adjust the view of "frustration". Help people seeking treatment to correct their views on difficulties or setbacks, so as to adjust and improve their psychological problems. For example, parents are often angry because their children contradict or disobey, and the healer can help parents understand the psychological characteristics of their children during adolescence, which shows that it is gratifying for children to express their opinions to their parents or even put forward the opposite opinions. This shows that children have grown up and started to have their own opinions, not completely disrespecting their elders. If we can treat children's behavior in this way, we can treat young people's words and deeds with a steady attitude without being particularly angry. In short, reviewing one's views on problems and difficulties and adjusting one's feelings about setbacks can often change one's attitude towards difficulties, so as to face them in an appropriate way and get out of the predicament.
(3) Be good at using all kinds of "resources". This principle is to help those who seek treatment analyze the available internal and external resources to see if they make full use of the "resources" to cope with the psychological difficulties and setbacks they face. The so-called resources, its scope is quite extensive, including the care and support of family members and relatives, the family's financial resources and background, the surrounding living environment and the supporting conditions that society can supply, and so on. When a person is faced with psychological setbacks, he often forgets the available resources instead of making full use of them, often underestimates his own potential and ignores the help that others can provide. Psychologists should give guidance in this regard and help them tide over the difficulties.
(4) Guidance on "adaptation" methods. One of the key points is to analyze with the seeker, seek suitable methods to deal with difficulties or problems, and guide the seeker to choose correctly. For example, it is an adaptive way to avoid the problem that parents are afraid to show their parents notices of average or poor grades because they are afraid of their parents being angry; Without self-confidence, I suspect my spouse is unfaithful, so I often quarrel and destroy the relationship between husband and wife. These are all unwise and unhealthy treatments. Therefore, it is a positive adaptation method to guide seekers to face the reality of poor homework, consult their parents and catch up; Try to make up with your spouse and maintain good feelings, which can not only maintain the relationship between husband and wife, but also enhance your self-confidence. Support therapy can focus on analyzing and guiding patients to cope with psychological difficulties and considering how to use scientific and effective adaptation methods.
Supportive therapy is a basic psychotherapy. No matter what kind of psychotherapy mode is adopted, the principle of supportive therapy should be adopted. However, more precisely, supportive therapy is particularly suitable for the following situations:
(1) Suffering from serious accidents or psychological trauma, seeking treatment, facing mental breakdown, and in urgent need of support from others to tide over psychological difficulties;
② Patients seeking treatment are weak or immature, and need long-term psychological support from others to avoid mental deterioration; Or, just recovered from a serious mental illness, facing a rehabilitation period to cope with the real environment and need to adapt to reality;
③ Supportive psychotherapy should be adopted before psychoanalytic therapy or other special modes of treatment, so as to establish a good doctor-patient relationship, stabilize patients' emotions and prepare for special treatment;
④ Patients who are not suitable for trying analytical or other special psychotherapy should adopt basic and stable supportive therapy;
⑤ When the therapist has not received special psychotherapy training or has insufficient clinical experience, basic supportive therapy should be adopted.
When using supportive therapy, therapists should also pay attention to the fact that excessive care, sympathy and long-term maintenance for patients may make patients lose the opportunity of self-adaptation, rehabilitation and growth; Or cause the treated person to misunderstand the motivation of the therapist, resulting in a non-therapeutic relationship. Therefore, even the most basic and general supportive psychotherapy must be properly trained, experienced and supervised.
5. Understand the development of groups in China.
Fan Fumin, a group leader who is inclined to education, inherited some essential parts of understanding groups. He has made contributions to psychological education groups and psychological prevention groups.
The leaders of psychotherapy-oriented groups headed by Wei Zhizhong inherited some essences of understanding groups, especially the current dynamic understanding principle. It also combines the characteristics of phenomenology, art and local culture to integrate a local understanding group with another style.
Reference book:
Fan Fumin's group psychological consultation
The Practice of Group Counseling in Our Association: Wei Zhizhong.