Lecture 4: Case conceptualisation

Question 1

psychotherapy case formulation is=

Answer 1

• a process
• for developing a hypothesis about,
• and a plan to address,
• the causes, precipitants, and maintaining influences of
• a person’s psychological, interpersonal and behavioral problems
• in the context of that individual’s culture and environment

Question 2

wat zijn de onderdelen van case conceptualisation model

Answer 2

problem
maintaining factors
inducing factors
predispositional factors
treatment considerations

Question 3

welke onderdelen beinvloeden de problemen & maintaining factors

Answer 3

strengths (skills, coping, personality)
Vulnerabilities
Stressors
Support

Question 4

vulnerabilities

Answer 4

pitfalls
beliefs
habits
emotionality

Question 5

support

Answer 5

what resources can you use?

social
help
activities
medication

Question 6

stressors

Answer 6

what is currently weighing on you

events
social, family
occupation
living conditions
finances

Question 7

welke dialogue gaat dit over (uit lecture 2)

Answer 7

the intersubjective dialogue, attunement to the first person perspective. interest in personal narratives and processes of meaning making.

Question 8

hoe meot je de DSM eigenlijk gebruiken

Answer 8

DSM 5 -> prototype conceptualisation, kijken of het specifieke individu daarbij fit. anders aanpassen naar de case conceptualisation

Question 9

wat is de rationale tijdens het uitwerken van de case conceptualisation en wat zijn 3 vragen die je jezelf hierbij moet stellen

Answer 9

Working hypotheses developed in collaboration between therapist and client

1. Credible enough?
2. Acceptable for the client?
3. Useful for treatment?

Question 10

multiple sources for constructing hypotheses

Answer 10

theories and research, client experience and narrative, clinical experience of therapist

individual case formulations, individualised treatment, evaluation of outcomes

Question 11

what knowledge do we have for creating valid conceptualisations?

Answer 11

1. Diathesis-stress model
2. Evidence-based treatments
3. ‘Common factors’
4. Theories and proposed mechanisms

Question 12

diathesis-stress model

Answer 12

heritable predispositions -> genotype, temperament

early experiences -> nurture, care, trauma, deprivation

strengths and vulnerabilities -> fenotype, schemas/cognitions/attributions, neuro-endocrine, attachment style, personality)

support and stress -> social, medication, psychotherapy, daily stress, trauma, life events)

links is diathesis, rechts is stress.
boven is distal-past, onder is proximal-present

Question 13

kijken naar diathesis stress model

Answer 13

oke

Question 14

hoe gebruik je evidence based treatments

Answer 14

EBT -> prototype CC + intersubjective dialogue -> personal CC

obv research kunnen we EBTs opstellen waardoor we weten dat ‘mensen met X usually benefit from treatment Y’, en daarna bespreken met de client zelf en op hen aanpassen

Question 15

common factors

Answer 15

• Therapeutic alliance
• Collaboration
• Goal consensus
• Adapting treatment to specific client characteristics
• Empathy
• Promoting treatment credibility
  etc

Question 16

common factors and CC

Answer 16

• Adaptation to specific client needs and characteristics
• A person-specific rationale why a certain therapy fits and will work
• Validation and empathy
• Indications for alliance ruptures to take care of
• A shared ground for setting goals
• A starting point for adequate collaboration

Question 17

waar gebruik je therapeutic knowledge vooral bij in CC

Answer 17

maintaining factors

Question 18

waar ben je bij inducing factors in geinteresseerd

Answer 18

wat er is gebeurd, maar ook wat dat betekende voor die persoon!!! (bv naast scheiding ook angst om alleen met het leven om te moeten gaan, andere sociale rollen, etc)

Question 19

theories die we hebben

Answer 19

behaviourism
cognitivism
schemata
psychoanalysis
mentalization
emotion-focused
attachment
body oriented
system-based

Question 20

problems =

Answer 20

• initially indicated by the client
• uncovered during the interview
• indicated by other sources

behaviours, emotions, cognitions, experiences, consequences, interpersonal issues, symptoms, etc

Question 21

maintaining factors=

Answer 21

vicious cycles
interactions between problems
effects of…
- core beliefs
- coping
- emotion regulation

Question 22

inducing factors

Answer 22

how did the problems start?

• events
• personal context at the time (how does the client interpret this event?)

Question 23

predisposing factors

Answer 23

• temperament
• learning history
• skill deficit

Question 24

treatment considerations

Answer 24

what is needed to get better?

• request for help
• motivation
• intervention options
• obstacles

Question 25

current personal context=

Answer 25

strengths (skills, coping, persoonlijkheid)
kwetsbaarheid (valkuilen, overtuigingen, gewoontes, emoties)
support (sociaal, hulp, activiteiten, medicatie)
stressors (events, sociaal, familie, werk, leefcondities, financieën)

Question 26

waarom is CC belangrijk

Answer 26

omdat we moeten nadenken over persoonlijke context, omstandigheden en ontwikkeling en doelen

Question 27

a good-working theory and rationale is supportive for the common factors that are crucial in promotoing a good treatment outcome

Answer 27

oke

Question 28

bv bij helplessness gevoelens: geen behavioural activation want deze personen hebben al negatieve cognities over hulp

Answer 28

oke

Question 29

case conceptualisation is intersubjective dialogue, interest in personal narratives and processes of meaning making

Answer 29

oke

Question 30

meestal zouden verschillende psychologen verschillende case conceptualisations hebben

Answer 30

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