Transcript The Case Approach, Psycho, FOO

The Case Approach:
Psychodynamic and Family of
Origin (FOO)
Meeting 3
© Cheung, M., & Leung, P. (2008). Multicultural practice and evaluation: A case
approach to evidence-based practice. Denver, CO: Love.
Instructors who adopt this book may use this PowerPoint to teach your course
without prior permission. Please address questions and comments to
[email protected].
(c) Love Publishing: Monit Cheung
& Patrick Leung
1
Mary’s DSM Diagnoses—
An Example
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Axis
Axis
Axis
Axis
I: Clinical disorder
II: Personality disorder
III: General medical conditions
IV: Psychological & environmental
problems
Axis V: Global assessment of
functioning
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& Patrick Leung
2
Mary’s
Axis I: Clinical Disorders
300.01 Panic Disorder
300.04 Dysthymic Disorder
313.82 Identity Problem
307.1 Eating Disorder: Anorexia
Nervosa–Binge Eating Type
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& Patrick Leung
3
Mary’s
Axis II: Personality Disorders
309.28 Adjustment Disorder with
Mixed Anxiety and Depressed Mood
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& Patrick Leung
4
Mary’s Axis III: General Medical
Conditions
None
Unexplained Headaches
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& Patrick Leung
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Mary’s Axis IV: Psychosocial &
Environmental Problem
V61.1
Partner Relational Problems
Want to Complete Graduate School
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& Patrick Leung
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Mary’s Axis V: Global Assessment of
Functioning
GAF=60 Moderate Symptoms
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DSM-IV-TR?
Joe’s DSM Diagnoses?
Do we also need one for each family
member?
One for the entire family?
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& Patrick Leung
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Psychodynamic and FOO
Theories &
Applications
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& Patrick Leung
9
Psychodynamic Practice
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Goal
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To free clients of unconscious restrictions
so that they will be able to interact with
family members and become healthy
persons on the basis of current realities
rather than unconscious images of the
past.
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& Patrick Leung
10
Psychodynamic Stems
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Freudian Drive Psychology
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Self Psychology
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Sexual and aggressive drives
Anxiety is an unpleasure associated with
punishment because of a particular wish
DM use
Human beings crave appreciation
Object Relations Theory / Attachment
Theory
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Need for attachment and relationships
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& Patrick Leung
11
Joe and Mary
Assign two role plays in pairs
 First two persons: Issue 1:
Unstable Relationship (pp. 93–94)
 Next two persons: Issue 2:
Children as the Focus (pp. 95–96)
In groups of 4 discuss what it is like
to use only psychodynamic as your
approach
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& Patrick Leung
12
Tic-Tac-Techniques
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& Patrick Leung
13
Psychodynamic Techniques:
Write down 9 techniques (i.e., the corresponding number) on the bingo sheet. No
repeats!!
You need to get all 9 to win a prize.
1.
2.
3.
4.
5.
6.
7.
8.
9.
Analysis of Anxiety
Root
Confrontation
Dream Analysis
Enactment
Exploration
Free Association
Interpretation
Intrapsychic conflict
analysis
Projection
10.
11.
12.
13.
14.
15.
16.
Reexperiencing
Resolving past
issues
Seeking the
Unconscious
Transference
Using Past Feelings
Universalization
Investigating the
Family of Origin
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& Patrick Leung
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Practice
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Form a group of two students
Take turns and practice each technique
(from 1–9)
Process what social workers would do
with these techniques
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& Patrick Leung
15
Psychodynamic Techniques
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DM analysis
Genogram
Object relations evaluation
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Cultural values and norms
Central egos
Unconscious forces
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& Patrick Leung
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DM Analysis: pp. 114–115
In pairs, read each example and find the DM
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A. Compensation
B. Denial
C. Displacement
D. Introjection
E. Projection
F. Rationalization
G. Reaction Formation
H. Regression
I. Repression
J. Sublimation
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& Patrick Leung
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DM Analysis: Applications
Direct Approach: You said you ___; that sounds
like a psychological defense. What are you
worried about?
Indirect Approach: People usually hide their
feelings behind what they talk about; what
kind of feeling do people have when they
hide it?
Game: Let’s try this game to see if you have
use any DM in the past in your relationship.
(Pay attention to contrast healthy vs.
unhealthy DM’s)
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& Patrick Leung
18
Families of Origin Theories
FOO Principles
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Primary motivation is to establish a
successful relationship.
Early relationships with parents create
frustrating experiences that the child
couldn't change.
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& Patrick Leung
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Families of Origin Theories
FOO Principles
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Introjects may surface later in life
through:
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Forming close relationships through marrying and
having children
Allowing the frustrations experienced in the family
of origin (FOO) in childhood to be recreated
Resulting intrapsychic problems because of
unresolved conflicts in the FOO
Selecting partners who will precipitate the reexperiencing of unresolved FOO conflicts
Projecting unresolved issues from FOO onto
children, which causes symptoms in children.
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Families of Origin Theories
FOO Principles
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Problems are best resolved by taking
them back to the FOO source by:
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Exploring the past to resolve issues with the FOO
Relating to their own spouse and children as they
actually are, rather than as symbols of unresolved
conflict in the FOO.
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& Patrick Leung
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James Framo’s Techniques
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Meet with both partners in couple sessions
Focus on events occurring in each FOO
Initiate “group” family sessions
Prepare couples who are reluctant
Draw the couple's attention through preparation for
“FOO sessions”
Develop an agenda of issues to be discussed with the
FOO
Spouses are not included in the initial FOO session
Spouses may be included in a later FOO session
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& Patrick Leung
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Limitations
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Not designed for couples with minor
marital difficulties
May not have access to their FOO
Highlight the need for individual
therapy, which may not be the original
intent of the family
Assumptions are based on past
experiences in the FOO
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& Patrick Leung
23
Joe and Mary Again…
In the same group,
 Three members role-play; one member
observes, reading the technique line
 Issue #3: Unresolved Conflict (pp. 96–99)
 Issue #4: Family of Origin Issues (pp.99–
101)
Discuss: What techniques you would use with
your clients?
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& Patrick Leung
24
FOO Techniques
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Using past feelings and experience
to gain insight
Seeking the unconscious
Universalization
Investigating the Family of Origin
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& Patrick Leung
25
Practice
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Form groups of two students
Take turns and practice each technique
(from 10–16 in your Tic-tac game) by
reading the line to your partner
Process what social workers would do
with these techniques
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& Patrick Leung
26
How does a genogram help your
client?
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Find the most significant relationship issue
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Beware of repeated incidents
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Conflict patterns
FOO Transmission
Health/Illness Issues
Job
Causes of Death
Role & Responsibilities
Identify life cycle perspectives
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& Patrick Leung
27
Daily Affirmation
Today I continue to seek and find
people who are positive, healthy
and nurturing.
Fishel, R. (1988). Time for joy. Deerfield Beach, FL: Health Communications.
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& Patrick Leung
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