Transcript American Journal of Orthopsychiatry, 6

Psikoterapi:
Karakteristik psikoterapi
cleostudies.lecture.ub.ac.id
Traditional view of helping professions
– So yesterday?
Educational
Supportive
Situational &
developmental
Problem solving
Conscious awareness
Focus
on present
Reconstructive
Emphasis
“normals”
Depth on
emphasis
Analytic
Focus on past
Emphasis on “dysfunction”
Traditional characteristics of psychotherapy
– So yesterday?
1. Terkait dengan gangguan mental yang serius.
2. Peran terapis adalah sebagai ahli, bukan
sharing partner.
3. Menekankan pada insight.
4. Perubahan yang bersifat rekonstruktif.
5. Relasi jangka panjang (20-40 sesi).
Anda merasa tidak berdaya dan
sedih yang berkepanjangan.
Problem Anda berlanjut
meski Anda sudah berupaya
dan sudah dibantu oleh
teman dan keluarga.
Perilaku Anda mengganggu
diri sendiri dan orang lain.
When should
you consider
psychotherapy?
Anda kerja berlebihan, namun
berharap hasil yang terburuk.
Anda sulit konsentrasi dengan
pekerjaan dan aktivitas sehari-hari.
http://www.apa.org/helpcenter/understanding-psychotherapy.aspx
What is psychotherapy?
“Any of a group of therapies,
used to treat psychological
disorders, that focus on changing
faulty behaviors, thoughts,
perceptions, and emotions that
may be associated with specific
disorders.”
American Psychological Association.
(n.d.). Glossary of psychological
terms. Retrieved from
http://www.apa.org/research/action/glossa
ry.aspx
“A treatment that involves a
relationship between a therapist
and patient. It can be used to
treat a broad variety of mental
disorders and emotional
difficulties. The goal of
psychotherapy is to eliminate or
control disabling or troubling
symptoms so the patient can
function better.”
American Psychiatric Association. (n.d.).
Psychotherapy (Let's Talk Facts
Brochures). Retrieved from
http://www.psychiatry.org/File%20Libra
ry/Mental%20IIlness/Lets%20Talk%20F
acts/APA_Psycotherapy.pdf
What is psychological disorders/mental illness?
7 challenges of psychotherapy
1. Butuh waktu untuk mencari terapis yang tepat.
2. Terapi adalah kombinasi relasi yang tidak natural
(sangat personal + setting profesional).
3. Therapists leave and therapy ends.
4. Terapi hanya berlangsung 50 menit/pertemuan.
5. Kadang relasi dengan terapis sama efektifnya dengan
relasi pertemanan.
6. Efek samping dari terapi sulit diprediksi.
7. Therapists can be just as crazy as any of their clients.
http://psychcentral.com/blog/archives/2008/05/29/7-challenges-ofpsychotherapy/
What should we expect from psychotherapy?
http://cleostudies.lecture.ub.ac.id/files/2015/03/Goldfried-2014-What-to-expectfrom-psychotherapy.pdf
Dodo bird verdict
Modalitas terapi (perilaku, kognitif,
psikodinamika) tidak relevan, yang penting
adalah faktor terapis (kehangatan,
genuineness), faktor klien (insight, reaksi
terhadap stres), dan interaksi keduanya.
Rosenzweig, S. (1936). Some implicit common factors in diverse methods
of psychotherapy. American Journal of Orthopsychiatry, 6(3), 412–15.
Wampold, B.E., Mondin, G.W., Moody, M., Stich, F., Benson, K., & Ahn, H.
(1997). A meta-analysis of outcome studies comparing bona fide
psychotherapies: Empirically, ‘‘All have won and all must have prizes.
Psychological Bulletin, 122, 203–215.
Potentially harmful therapies (PHTs) /
Iatrogenic treatment
35% - 40% klien tidak
memeroleh manfaat
apapun dari psikoterapi.
5% - 10% klien mengalami
kondisi yang lebih parah
akibat psikoterapi.
28% psikolog tidak
menyadari dampak negatif
yang muncul akibat
psikoterapi.
https://thepsychologist.bps.org.uk/volume-21/edition-1/when-therapy-causes-harm
http://www.theguardian.com/society/2014/may/26/misjudged-counselling-psychologicaltherapy-harmful-study-reveals
Kriteria potentially harmful therapies (PHTs)
1. Mengakibatkan dampak psikologis atau fisik yang
mengganggu klien atau orang lain.
2. Dampak tersebut berkelanjutan, bukan hanya akibat
simtom jangka pendek yang muncul selama terapi.
3. Dampak tersebut telah direplikasi oleh tim peneliti
yang independen.
Making things worse through treatment: Iatrogenic psychological interventions.
http://www.psychotherapybrownbag.com/psychotherapy_brown_bag_a/2009/04/
making-things-worse-through-treatment-iatrogenic-psychologicalinterventions.html
Psychological treatments that cause harm.
http://pps.sagepub.com/content/2/1/53.abstract
A list of harmful therapies. http://files.eric.ed.gov/fulltext/EJ911995.pdf
Psychological assessments that cause harm
http://www.emory.edu/EMORY_MAGAZINE/summer2001/rorshach.html
Psychologist or psychiatrist?
Psychiatry and psychotherapy: A troubled relationship
http://ejop.psychopen.eu/article/view/717/html
Why choose a psychologist for psychotherapy?
“Psychologists who specialize in psychotherapy and other
forms of psychological treatment are highly trained
professionals with expertise in mental health assessment,
diagnosis and treatment, and behavior change. After
graduating from a four-year undergraduate college or
university, psychologists spend an average of seven years in
graduate education and training to earn a doctoral degree.
That degree may be a PhD, PsyD or EdD. As part of their
professional training, psychologists must complete a
supervised clinical internship in a hospital or organized
health setting. In most states, they must also have an
additional year of post-doctoral supervised experience
before they can practice independently in any health care
arena. It is this combination of doctoral-level training and
clinical internship that distinguishes psychologists from
many other mental health care providers.”
http://www.apa.org/helpcenter/understanding-psychotherapy.aspx
Choosing a psychotherapist
“Psychiatrists, psychologists, social workers, and some others
may have specialized training in psychotherapy. However,
only psychiatrists are also trained in medicine and are able to
prescribe medications. Psychiatrists are medical doctors who
are specially trained to treat individuals for a broad range of
emotional and behavioral problems. They are uniquely
qualified to diagnose and treat emotional difficulties because
they understand the mind, brain and body and their
interactions. They are trained to use psychotherapy,
medications, and the two in combination.”
American Psychiatric Association. (n.d.). Psychotherapy (Let's Talk Facts
Brochures). Retrieved from
http://www.psychiatry.org/File%20Library/Mental%20IIlness/Lets%20Talk%20Fact
s/APA_Psycotherapy.pdf
Medication,
psychotherapy, or
combined treatments?
Cuijpers, P., Reynolds, C. F., Donker, T., Li, J., Andersson, G., & Beekman, A. (2012).
Personalized treatment of adult depression: Medication, psychotherapy or both? A
systematic review. Depression and Anxiety, 29, 855-864. doi:10.1002/da.21985
Pre-requisites of an efficient integration of
psychiatry and psychotherapy in practice
Common
theoretical grounds
on the definition of
mental illness,
classification of
mental illnesses
and general
etiological model of
psychological
disorders/mental
illness.
Common
understanding
about the role of
pharmacotherapy
and psychotherapy
in the treatment of
mental illness.
Sustained
communication
and collaboration
at the level of the
therapeutically
team, based on a
clear definition of
roles, responsibility
and collaboration
protocols.
Psychiatry and psychotherapy: A troubled relationship
http://ejop.psychopen.eu/article/view/717/html