Rimondini Communication in Cognitive Behavioral Therapy

1. Auflage 2010
ISBN: 978-1-4419-6807-4
Verlag: Springer US
Format: PDF
Kopierschutz: 1 - PDF Watermark

E-Book, Englisch, 273 Seiten, eBook

Research has shown that the therapeutic alliance is a key factor in the success of treatment, and a critical component of establishing this alliance is the communication between therapist and client. The efficacy of treatment depends on the therapist’s ability to collect reliable client information and create the foundation for a good relationship that involves the client in the healing process. Communication in Cognitive Behavioral Therapy provides an overview of the research and theory underlying the importance of therapeutic communication with a specific focus on cognitive behavioral psychotherapy. It brings together an international group of experts from the relevant disciplines of communication, psychotherapy, research and teaching to create an integrated perspective of this crucial area.

The book offers a review of the main evidence-based theories, and is highlighted with specific examples and flow charts.Insight for trainers is given by providing learner-centered teaching methods that enhance the acquisition of these communication skills. For researchers, it offers both qualitative and quantitative analyses of the subject as well as a comprehensive review of the main analysis methods adopted in the field.

Zielgruppe

Research

Autoren/Hrsg.

Rimondini, Michela

Inhaltsverzeichnis

1;Communication in Cognitive Behavioral Therapy;3
1.1;Preface;5
1.2;Contents;7
1.3;Contributors;9
1.4;Chapter 1: Background Theories and Main Systems of Analysis of Communication in Cognitive-Behavioral Therapy;11
1.4.1;1.1 Introduction;11
1.4.2;1.2 Interpersonal Communication: Models, Definitions, and Key Notes;12
1.4.3;1.3 From Interpersonal Communication to Communication Skills;13
1.4.3.1;1.3.1 Communication Skills and Clinical Outcomes: Why Effective Communication Enhances the Quality of Care;14
1.4.4;1.4 Communication Skills in the Medical Setting;15
1.4.4.1;1.4.1 Translating Communication Skills and Patient-Centered Approach from the Medical Setting to Psychotherapy;16
1.4.4.1.1;1.4.1.1 The Biopsychosocial Model in Psychotherapy;16
1.4.4.1.2;1.4.1.2 Therapist-Centered vs. Person-Centered Approach;17
1.4.4.1.3;1.4.1.3 Shared Decision-Making Model;18
1.4.5;1.5 Communication Skills in Psychotherapy;19
1.4.5.1;1.5.1 Systems of Analysis of Therapist-Patient Communication;21
1.4.5.1.1;1.5.1.1 Rutter´s System of Analysis of Therapist´s Communication;21
1.4.5.1.2;1.5.1.2 Verona Coding Definitions of Emotional Sequences to Code Health Providers´ Responses;22
1.4.5.1.3;1.5.1.3 Verona Psychiatric Interview Classification System;23
1.4.5.1.4;1.5.1.4 Goldberg´s Classification System;24
1.4.5.1.5;1.5.1.5 The Three Interactograms of Cobb and Lieberman;25
1.4.5.1.6;1.5.1.6 Sheffield Psychotherapy Rating Scale;26
1.4.5.1.7;1.5.1.7 The Cognitive Therapy Scale Revised;27
1.4.6;1.6 Conclusion;28
1.4.7;References;29
1.5;Chapter 2: Assessment Stage: Data Gathering and Structuring the Interview;34
1.5.1;2.1 Introduction;34
1.5.2;2.2 Knowledge and Evidence on Doctor-Patient Communication in Medical Settings;35
1.5.2.1;2.2.1 Theoretical Background;35
1.5.2.2;2.2.2 Research Findings on Doctor-Patient Communication;37
1.5.3;2.3 The Data-Gathering Process;38
1.5.3.1;2.3.1 Setting and Barriers;39
1.5.3.2;2.3.2 The Data-Gathering Process: Aims and Contents;39
1.5.3.3;2.3.3 Data-Gathering Process: Communication Skills;42
1.5.3.3.1;2.3.3.1 Listening;43
1.5.3.3.1.1;Passive Listening;43
1.5.3.3.1.2;Active Listening;44
1.5.3.3.2;2.3.3.2 Facilitations;44
1.5.3.3.3;2.3.3.3 Reflections;45
1.5.3.3.4;2.3.3.4 Clarification;45
1.5.3.3.5;2.3.3.5 Open-Ended Questions;46
1.5.3.3.6;2.3.3.6 Closed Questions;47
1.5.3.3.7;2.3.3.7 Checking;48
1.5.3.3.8;2.3.3.8 Summarizing;49
1.5.3.3.9;2.3.3.9 Reformulation;50
1.5.4;2.4 Structuring the Interview in Psychotherapy;50
1.5.4.1;2.4.1 Structuring the Interview: The Goals;52
1.5.4.2;2.4.2 Communication Skills for Structuring the Interview;53
1.5.4.2.1;2.4.2.1 Setting the Agenda;53
1.5.4.2.2;2.4.2.2 Time Framing and Sequencing;54
1.5.4.2.3;2.4.2.3 Orienting Expressions (Transitions and Sign-Posting);55
1.5.4.2.4;2.4.2.4 Summarizing;55
1.5.5;2.5 Conclusion;56
1.5.6;References;57
1.6;Chapter 3: Building the Working Alliance in Brief Psychotherapies;61
1.6.1;3.1 Introduction;61
1.6.1.1;3.1.1 The Working Relationship and Other Communicative Functions;61
1.6.1.2;3.1.2 What Do We Mean by ``Working Alliance´´?;62
1.6.2;3.2 Alliance and Outcome: Some Selected Empirical Findings;64
1.6.3;3.3 What Communicative Behavior Is Relevant for the Working Alliance?;66
1.6.3.1;3.3.1 Alliance Building in the Assessment Interview;67
1.6.3.2;3.3.2 Communicative Interventions Contributing to Alliance over the Course of Psychotherapy;69
1.6.3.3;3.3.3 Alliance Ruptures and Critical Communication Incidents;71
1.6.4;3.4 Conclusion;74
1.6.5;References;75
1.7;Chapter4: Providing Information and Involving the Patient in the Therapeutic Process;78
1.7.1;4.1 Introduction;78
1.7.2;4.2 Knowledge and Evidence on Doctor-Patient Communication in the Medical Setting;79
1.7.2.1;4.2.1 Doctor-Patient Communication in the Medical Setting: Theoretical Background;80
1.7.2.1.1;4.2.1.1 The Patient-Centered Interview and the Three-Function Model;80
1.7.2.1.2;4.2.1.2 The Shared Decision-Making Model;81
1.7.2.1.3;4.2.1.3 The Motivational Interview;82
1.7.2.2;4.2.2 From Theory to Practice: Findings from Research on Doctor-Patient Communication in the Medical Setting;83
1.7.2.3;4.2.3 From Theory to Practice: Discussion on the Evidence from Psychiatric Literature;85
1.7.3;4.3 Providing Information and Involving the Patient in Cognitive-Behavioral Therapy;86
1.7.3.1;4.3.1 Setting;88
1.7.3.2;4.3.2 Objectives and Tasks of Providing Information and Involving the Patient;88
1.7.3.3;4.3.3 Communication Skills;89
1.7.3.3.1;4.3.3.1 Drawing Attention to Patient´s Problem(s) and Structuring Information;92
1.7.3.3.2;4.3.3.2 Exploring Patient´s Opinions, Preferences, Expectations, and Past Experiences;93
1.7.3.3.3;4.3.3.3 Providing Information;93
1.7.3.3.4;4.3.3.4 Focusing Patient´s Attention;97
1.7.3.3.5;4.3.3.5 Checking the Patient´s Understanding (Feedback);97
1.7.3.3.6;4.3.3.6 Exploring Patient´s Reaction to Received Information;98
1.7.3.3.7;4.3.3.7 Offering Opportunities to Ask Questions;100
1.7.3.3.8;4.3.3.8 Sharing Therapist´s Own Thoughts Feelings and Experiences (Self-Disclosure);100
1.7.3.3.9;4.3.3.9 Negotiating Skills;101
1.7.3.3.10;4.3.3.10 Exploring Patient´s Social Resources and Providing Support;104
1.7.3.3.11;4.3.3.11 Closing the Encounter and Planning Future Sessions;104
1.7.4;References;106
1.8;Chapter 5: Nonverbal Communication in Clinical Contexts;113
1.8.1;5.1 Introduction;113
1.8.1.1;5.1.1 A Definition of Nonverbal Communication;113
1.8.1.2;5.1.2 Child Development, Implicit Communication, and Nonverbal Behavior;114
1.8.1.3;5.1.3 The Psychophysiology of Nonverbal Behavior;115
1.8.1.4;5.1.4 Nonverbal Communication in Clinical Settings;117
1.8.2;5.2 Assessment of Nonverbal Communication;117
1.8.2.1;5.2.1 Assessment of Nonverbal Decoding;118
1.8.2.2;5.2.2 Assessment of Nonverbal Encoding;118
1.8.2.3;5.2.3 Assessment of Nonverbal Communication in Clinical Settings;119
1.8.3;5.3 Categories of Provider Nonverbal Behavior and Effect on Outcome;120
1.8.3.1;5.3.1 Eye Contact and Facial Expression;120
1.8.3.2;5.3.2 Bodily Posture;121
1.8.3.3;5.3.3 Tone of Voice;121
1.8.3.4;5.3.4 Silence as Nonverbal Behavior;122
1.8.3.5;5.3.5 Patterns of Nonverbal Behavior;122
1.8.3.6;5.3.6 Quality of Rapport;123
1.8.3.7;5.3.7 Context (Seating, Distance, Level);123
1.8.4;5.4 Nonverbal Communication in Psychiatric and Psychotherapy Contexts;124
1.8.4.1;5.4.1 A Review of the Literature;124
1.8.4.2;5.4.2 An Example of the Analysis of Nonverbal Behavior During Psychotherapy;127
1.8.5;5.5 Conclusions;127
1.8.6;References;129
1.9;Chapter6: Communication in Depressive States;135
1.9.1;6.1 Introduction;135
1.9.2;6.2 Depression According to Beck and Ellis;135
1.9.3;6.3 The Problem on the Problem;137
1.9.4;6.4 Communicative Styles of a Depressed Patient;139
1.9.5;6.5 The Case of Francesco;140
1.9.6;6.6 Conversation Analysis on the Case of Francesco: A Research Project on Linguistic Interactions in CBT;143
1.9.6.1;6.6.1 Method;144
1.9.6.1.1;6.6.1.1 Methodological Steps;144
1.9.6.2;6.6.2 Results;144
1.9.6.2.1;6.6.2.1 Analysis of the Conversation;147
1.9.7;6.7 Conclusion;152
1.9.8;References;153
1.10;Chapter 7: Interpersonal Vicious Cycles in Anxiety Disorders;154
1.10.1;7.1 Introduction;154
1.10.2;7.2 The Vicious Cycles;156
1.10.2.1;7.2.1 Luigi;156
1.10.2.2;7.2.2 Federico;157
1.10.2.3;7.2.3 Marta;158
1.10.2.4;7.2.4 Gianni;159
1.10.2.5;7.2.5 Brando;159
1.10.2.6;7.2.6 Valeria;160
1.10.2.7;7.2.7 ``Pat on the Back´´;162
1.10.2.8;7.2.8 ``White Lie´´;163
1.10.2.9;7.2.9 Rational Debating;165
1.10.2.10;7.2.10 Solution Prompter;167
1.10.2.11;7.2.11 Compliant Rescue;169
1.10.2.12;7.2.12 Blame;170
1.10.3;7.3 Acknowledgment of the Vicious Cycles;173
1.10.4;7.4 The Problem of Reassurance and the Importance of Acceptance;176
1.10.4.1;7.4.1 Federico;176
1.10.4.2;7.4.2 Luigi;177
1.10.4.3;7.4.3 Gianni;177
1.10.4.4;7.4.4 Drawing Out the Ineffectiveness of the Reassurance Attempts;179
1.10.4.5;7.4.5 Drawing Out the Disadvantages of Reassurance Attempts;182
1.10.4.6;7.4.6 Legitimizing the Relinquishment of Reassurance Attempts;183
1.10.5;7.5 Conclusions;186
1.10.6;References;186
1.11;Chapter 8: Cognitive-Behavioral Family Interventions in Psychosis;189
1.11.1;8.1 Introduction;189
1.11.2;8.2 Background;189
1.11.3;8.3 The Physical and Psychological Implications of Caregiving;190
1.11.4;8.4 The Relationship Between Carer Burden and Patient Functioning;191
1.11.4.1;8.4.1 Carer Burden and Coping Styles;191
1.11.5;8.5 Expressed Emotion and Families with Psychosis;192
1.11.6;8.6 Patient Appraisals of Caregiving Relationships;195
1.11.7;8.7 Cognitive-Behavioral Family Interventions with Patients with Psychosis and Their Families;196
1.11.8;8.8 Conclusion;198
1.11.9;8.9 Key Resources;198
1.11.10;References;199
1.12;Chapter 9: Learner-Centered Interactive Methods for Improving Communication Skills;206
1.12.1;9.1 Introduction;206
1.12.2;9.2 Can You Teach and Learn Communication Skills in Psychotherapy?;207
1.12.3;9.3 Why Use Experiential Learning Methods?;208
1.12.3.1;9.3.1 Systematic Delineation and Definition of Essential Skills;209
1.12.3.2;9.3.2 Observation;209
1.12.3.3;9.3.3 Well-Intentioned, Detailed, and Descriptive Feedback;209
1.12.3.4;9.3.4 Video and Audio Playback;210
1.12.3.5;9.3.5 Repeated Practice and Rehearsal;211
1.12.3.5.1;9.3.5.1 Practicing Skills in Safety;211
1.12.3.5.2;9.3.5.2 Enabling Ongoing Feedback and Rehearsal;212
1.12.3.5.3;9.3.5.3 Developing an Individual Approach;212
1.12.3.6;9.3.6 Active Small Group or One-to-One Learning;212
1.12.4;9.4 Why Use a Learner-Centered Approach to Communication Skills Teaching?;213
1.12.5;9.5 Why Use a Problem-Based Approach in Practice?;214
1.12.5.1;9.5.1 Discovering Learners´ Perceived Needs;214
1.12.5.2;9.5.2 Creating a Supportive Climate;215
1.12.5.3;9.5.3 Developing Appropriate Experiential Material;215
1.12.5.4;9.5.4 Taking a Problem-Based Approach to Analyzing the Consultation;215
1.12.6;9.6 What Place Is There for More Didactic Teaching Methods?;216
1.12.7;9.7 What Experiential Approaches Are Available?;216
1.12.7.1;9.7.1 Audio and Video Feedback;217
1.12.7.1.1;9.7.1.1 Practical Issues in the Use of Video Recording;217
1.12.7.1.1.1;Expense;217
1.12.7.1.1.2;Technology;217
1.12.7.1.1.3;Setting;217
1.12.7.1.1.4;Time;218
1.12.7.1.1.5;Apprehension;218
1.12.7.1.1.6;Patients´ Diagnoses;218
1.12.7.2;9.7.2 Real Patients;219
1.12.7.2.1;9.7.2.1 Prerecorded Videotapes of Real Consultations;219
1.12.7.2.2;9.7.2.2 Live Interviews of Patients Brought to the Communication Unit;219
1.12.7.2.2.1;Rehearsal Limitations;220
1.12.7.2.2.2;Restricted Types of Patients;220
1.12.7.2.2.3;Realism;221
1.12.7.2.2.4;Consent;221
1.12.7.3;9.7.3 Simulated Patients;221
1.12.7.3.1;9.7.3.1 Advantages of Simulated Patients;222
1.12.7.3.1.1;Rehearsal;222
1.12.7.3.1.2;Improvisation;223
1.12.7.3.1.3;Standardization;223
1.12.7.3.1.4;Customization;223
1.12.7.3.1.5;Specific Issues and Difficult Situations;225
1.12.7.3.1.6;Availability;225
1.12.7.3.1.7;Time Efficiency;225
1.12.7.3.1.8;Feedback;225
1.12.7.3.2;9.7.3.2 Challenges in the Use of Simulated Patients;226
1.12.7.3.2.1;Expense;226
1.12.7.3.2.2;Selection;226
1.12.7.3.2.3;Hidden Agendas;226
1.12.7.3.2.4;Administrative Time;226
1.12.7.3.2.5;Training;227
1.12.7.4;9.7.4 Role-Play;227
1.12.7.4.1;9.7.4.1 Difficult Cases;228
1.12.7.4.2;9.7.4.2 Problem Scenarios;228
1.12.7.4.3;9.7.4.3 Specific Issues;228
1.12.7.4.4;9.7.4.4 Disadvantages of Role-Play;229
1.12.8;9.8 Planning a Curriculum;230
1.12.8.1;9.8.1 A Curriculum Rather Than a Course;230
1.12.8.2;9.8.2 A Helical Rather Than Linear Curriculum;230
1.12.8.3;9.8.3 Integrated Not Separated from, the Rest of the Medical Curriculum;230
1.12.9;9.9 Conclusion;231
1.12.10;References;231
1.13;Chapter 10: Quantitative Methods for the Analysis of Verbal Interactions in Psychotherapy;235
1.13.1;10.1 Introduction;235
1.13.2;10.2 Quantitative Approach to a Verbal Interaction: An Overview;235
1.13.3;10.3 Moving from Recorded Interviews to Statistical Results;237
1.13.3.1;10.3.1 How to Turn a Psychotherapeutic Interview from a Taped Dyadic Conversation into a Systematic Observation of Coded Behavioral Sequences;239
1.13.3.2;10.3.2 Quality Standards in the Quantitative Approach to Qualitative Research: Validity and Reliability of the Coding System;240
1.13.3.3;10.3.3 Some Statistical Approaches to Analyze Conversation Sequences;241
1.13.3.4;10.3.4 How You Can Organize the Coded Text Sequences into a Database to Be Statistically Processed?;245
1.13.4;10.4 Conclusions;246
1.13.5;References;246
1.14;Chapter 11: Qualitative Methods for the Analysis of Verbal Interactions in Psychotherapy;250
1.14.1;11.1 Overview of Chapter;250
1.14.2;11.2 Introduction;250
1.14.2.1;11.2.1 Qualitative Studies of Psychotherapy;250
1.14.2.2;11.2.2 Qualitative vs. Quantitative Methodology;251
1.14.3;11.3 Examples of Qualitative Methods Used to Analyze Psychotherapeutic Interactions;252
1.14.3.1;11.3.1 Clinical Case Studies;252
1.14.3.2;11.3.2 Qualitative Interviews;253
1.14.4;11.4 Conversation Analysis;255
1.14.4.1;11.4.1 The Method of Conversation Analysis;255
1.14.4.2;11.4.2 CA and the Analysis of Consultations and Psychotherapy;255
1.14.4.3;11.4.3 Research Procedures in CA;256
1.14.4.4;11.4.4 Data Analysis in CA;257
1.14.4.5;11.4.5 Example of Analysis in CA;259
1.14.4.6;11.4.6 Some Limitations of CA;260
1.14.5;11.5 Quality Standards in Qualitative Research;260
1.14.6;11.6 Conclusions;261
1.14.7;References;262
1.15;Index;265