Counselling Psychology

Zoltan Kovary PhD

ELTE PPK
Department of Clinical Psychology and Addictology
2015/16 Autumn Semester

Phases of psychotherapy
process

Antecedents of first
encounter
Preliminary
phase
Preparatory phase
Introductory phase
Middle/ main/ working
phase
Termination - Closure
After closure Follow up

Interventions of the Preliminary

Phase

The role is more

important
Low intensity
Not healing, but part of
the treatment
If its inefficient or
inadequate: worsening
Continuing with
psychotherapy

The Types of the Preliminary Phase

Interventions

Keeping up contact
Patient management
Psychiatry Departments
&
ambulances
Somatic Departments &
ambulances (health ps.)
Consultation-counselling
Supportive therapy
Crisis intervention

What is counselling?

What is counselling?

Consultation - counselling

People on the edge of

Illness
1-5 sessions
Focused & demarcated
problem
Goal: to unfold the
individual solution
Situations

Because of relatives
Being sent
Insecurity of roles

Overlaps with PT (Rogers)

Differences between
Psychotherapy and Counselling
PSYCHOTHERAPY

COUNSELLING

Pathological States

Sine morbo, life conducting problems

Psychotherapist education is required

Counselling psyhology education is required

Clinical psychological knowledge

Personality psychological, crisis psychological and

conflict management knowledge

Goal: healing, lack of symptoms

Goal: increasing the level of coping and selfefficiency

Goal: the recognition and regulationof the hidden

motivational powers behind personality
functioning and conflits

Goal: taking responsibility, increasing of activity

Targeting the conflict: exploration and working

throuugh

Targeting understanding, insight , chaniging of

approach

Limit of activity is the psychological workload and

developmental potential of the client

Limit of activity is the terrain demarcated by

problem focus

Practical learning, identification, reflexivity,

introspective ways

Practical learning, interpersonal and action

learning, understanding,reflexivity

Effects: condition improved, self-awareness

Effects: improving of problem solving and decision

making skills

Szupportv terpia

Goal: strengthening egofunctions

How does it help?

Strengthening
Increasing well-being
Supressing negative parts
Load shedding

Indication

The supporting of positive parts

(what is still functioning)
without unfolding the negative

No real contraindications

Timing

One session/week, even for years

Crisis Intervention

The emergence of crisis

paradigm

Emergency psychiatry care

E. Lindemann:
Symptomatmatology
and management of
acute grief (1944)
War neuroses
Short term therapies
Mental hygiene
(preventions)
E. Eriksons theory

Features of psychological
crises

Trigger events
Endurance
Phases
Types (Erikson, 1963)

Normative, developmental
Paranormative, accidental
(~ trauma)

Crisismatrix (Jacobson,1979)
Crisis and sickness

Danger
Chance

Crisis possible outcomes

RESTORTATION OF HOMEOSTASIS

PROGRESSIVE CREATIVE SOLUTION

REGRESSIVE SOLUTION

PRE-CRISIS STAGE

CRISIS

POST CRISIS STATE

Non-specific forms of crisis

solution

Spontanous
improvement
Supportive
relationships (family,
friends)

Attention and support

without defence
Clarifying issues
Herding towards an
expert

Continuum of short term psychological

interventions

Emergency crisis support

Crisis intervention

Short term dynamic PT

Basic ideas of Crisis

Inetrvention

Instancy
Spatial demarcation
Commitment
Building relationships
with social
envireonment

Features of Crisis Intervention

I.

Dynamic and flexible

Complexity
Special diagnoses
Coping, problem
solving
Holistic approach
Contextualism

Features of Crisis Intervention

II.

The clients
competence
Activity
Focusing on crosssectional part
Here and now
Environmental
adaptation

Frames of crisis intervention

Duration
Frequency and
endurance of sessions
Support and
confrontation
Experience
Focus

Phases of Crisis Intervention

I.

Motivation
Establishing relationship
(raport)
Preparation
Support, safety, holding
Unconditional positive
regard
Therapeutic activity

Phases of Crisis Intervention

II.

Reconstructions
Involvement of social
network
Social care
Analysis of relational
patterns
Redefinition of goals and
values
Reworking of problem
solving strategies
Summaries from time to
time

Phases of Crisis Intervention

III.

Separation
Discussing continuation
new goals, new
contract
Summary - a new life
narrative
Possibility of renewing
contact

Thank you for your

attention!