IPT Background Influences

Slides:



Advertisements
Similar presentations
Developing a Nurturing School
Advertisements

Depression in adults with a chronic physical health problem
Attachment Theory and Psychopathology. What is Attachment? Enduring emotional tie Internal working model Secure base for exploration Foundation for future.
3 High expectations for every child
Working Models Self in relation to others.. Working Models  Primary assumption of attachment theory is that humans form close bonds in the interest of.
Assessment and eligibility
Potential for interventions in the early years to tackle health inequalities Karen MacNee Health ASD.
Chapter 5: Entering the Social World
Attachment Attachment in Parent and Adolescent Conflict Calvin MA Social Work.
L1:Apply the concepts of health and wellness to identify health behaviours and factors influencing choice and change in health using an holistic approach.
Write down what you think is meant by the term Write down what you think is meant by the termATTACHMENT.
Student Mental Health and Well-being September 2014 “Improving student achievement and student engagement is directly linked to ensuring that we work collaboratively.
Lesson 2 – Bowlby’s Theory of Attachment
1 Psychosocial Support Programming: Applied Practice in HIV Programs Shannon Senefeld Naomi Van Dinter Daphyne Williams.
Resilience and its Relationship with the 5-Step Method Professor Richard Velleman Emeritus Professor of Mental Health Research, University of Bath, UK.
Attachment and Family Therapy Byng-Hall, J. (1999). Family therapy and couple therapy: Toward greater security. In J. Cassidy & P. R. Shaver (Eds.), Handbook.
© 2012 McGraw-Hill Companies, Inc. All rights reserved.McGraw-Hill/Irwin© 2012 McGraw-Hill Companies, Inc. All rights reserved. Health Psychology 8 th.
The scope of psychology Research psychology Applied psychology.
Interpersonal Therapy Slides adopted from Dr. Lisa Merlo.
Client and therapist attachment styles and the working alliance Annily Seymour-Hyde, Katherine Berry and Alison Harris University of Manchester Greater.
1 Integrative Treatment of Complex Trauma (ITCT) and Self Trauma Model for Traumatized Adolescents Cheryl Lanktree, Ph.D. and John Briere, Ph.D. MCAVIC-USC.
Implementing NICE guidance
Minding the Baby. Summary Minding the Baby is an intensive home-visiting programme for vulnerable, first-time pregnant women and their families. It is.
Social Relationships and their Impact on Early Brain Development Bonny J. Forrest, J.D., Ph.D. Chief Operating Officer, Jewish Family Service.
OPERATION Life Online Protective factors against suicide There are many factors in our lives that can help to protect us and others against suicide.
Creating Emotionally Resilient Children and Young People
HEALTH, WELLNESS, ILLNESS & DISABILITY
The Gingerbread and One Plus One Seminar funded by the Nuffield Foundation The legal and emotional implications of shared parenting-
Massachusetts Home Visiting Initiative A Department of Public Health led state agency collaborative Introduction to Social.
Aetiology of Psychiatric Disorders Dr. Fatima Alhaidar Professor & Consultant Child & Adolescent Psychiatrist College of Medicine, KSU.
Intensive Therapeutic Service A joint initiative by: Berry Street Victoria & the Austin CAMHS In partnership with La Trobe University Faculty of Health.
PSYC 2314 Lifespan Development Chapter 7 The First Two Years: Psychosocial Development.
Parents with learning disabilities
Model of Maltreatment Explain pattern of occurrences and non- occurrences of maltreatment Describe process by which maltreatment is transmitted from one.
ATTACHMENT From Alan Sroufe University of Minnesota.
Chapter 16 Socioemotional Development in Late Adulthood.
Copyright © 2005 Mosby, Inc. All rights reserved. Slide 0.
Social Capital. This is a paradigm used to explain differences in health and illness between social groups. It is a sociological theory that states that.
HNC Social Care Psychology for Care.
Early Child Development (ECD)
Depression Goals: What it is how its diagnosed prevention/interventions Depression Goals: -What depression is -How it can be diagnosed -Preventions/interventions.
What I need people to think about
TOPIC 9 FAMILY RESILIENCE INSTRUCTOR: SITI NOR BINTI YAACOB, PhD. KEL Development of A Resilient Individual DPM-PJJ,
Developmental Standards: A Presentation by Megan Bilbo For Educational Psychology 251.
1 Birth to Six Initiative Topic Two: The Emotional and Developmental Needs of Young Children.
Interpersonal Psychotherapy Introduction and Overview.
PMH & Child Welfare Guideline Family Model – service implications Dorian Cole and Adrian Falkov.
Resiliency, Protective Processes, Promotion & Community Chapter 7.
Childhood Neglect: Improving Outcomes for Children Presentation P12 Childhood Neglect: Improving Outcomes for Children Presentation Assessing parental.
A STUDY OF INFANT ATTACHMENT IN GLASGOW Schaffer and Emerson [1964]
Cognitive Behavioural Therapy
Dr.Ali Kareem Al-Masrawi Assist. Professor Ph D. Mental Health Nursing.
Chapter 3 Birth to Thirty-Six Months: Social and Emotional Developmental Patterns ©2014 Cengage Learning. All Rights Reserved.
ATTACHMENT THEORY AND THE KEY PERSON APPROACH
Continuity of Care in Infant and Toddler Programs: Lessons Learned From Teacher Training, Program Practices and Teacher Interviews Melissa Wilhelm, M.A.
BOYS AND YOUNG MEN One Wrong Turn February, Feb, 2 nd, 2016.
CENTRE FOR WOMEN’S MENTAL HEALTH
Attachment style and condom use across and within dating relationships
Criteria for Assessing MHPSS Proposals Submitted through the CAP, CERF and HRF Funding Mechanisms to the Protection Cluster.
Opener: Is there a difference between love and attachment?
Nature of Resiliency The process by which people not only endure hardship but also create and sustain lives that have meaning and contribute to those around.
Supporting the best start in life for children in Northern Ireland
Year 13: PSYA3: Relationships
Introduction to Emotional development LO: to explore how emotional development changes through the life stages.
Social connections What it looks like
Notes 4-2 (Obj 9-16).
Attachment Theory: What Does It Mean for Children in the System?
Music Therapy
Resilience and its Relationship with the 5-Step Method
LEARNER-CENTERED PSYCHOLOGICAL PRINCIPLES. The American Psychological Association put together the Leaner-Centered Psychological Principles. These psychological.
Presentation transcript:

IPT Background Influences Adolf Meyer Swiss trained psychiatrist, practical pragmatic approach, move away from abstraction. Famous for the psychobiological life history approach, developed the LIFE CHART father of modern life events research. LIFE SPAN APPROACH. Sets the scene for a genuine integration of the biological, the psychological and the social.

Background Influences Harry Stack Sullivan Founder of the Interpersonal School of Psychoanalysis. Emphasised importance of social and cultural context. Use of basic language, emphasised the drive for attachment, sceptical of too much emphasis on unconscious processes. Real experience more important.

Background Influences Harry Stack Sullivan Therapist should adopt the role of expert. As this would inspire confidence and motivate the patient to continue with therapy. Sullivan saw the therapeutic relationship as a real relationship with some reciprocal elements. Not a blank screen.

Background Influences Sullivan’s view was that anxiety does not stem from the frustration of biological need but is introduced through interaction with the care giver. Early on the child learns what type of interaction produces a positive response as oppose to an anxiety producing response in close relating with a care giver.

Background Influences Sullivan used the term parataxic distortion to describe how new relational experiences will always repeat the relational patterns of the past.

Background Influences Sullivan identified two competing needs a person has in interpersonal relationships through the life course: 1.The need for satisfaction 2. The need for security The relative balance between these needs is a key factor in determining emotional Health

Background Influences John Bowlby Founder of attachment theory Move away from stage theories of development, many recent developments regarding implications for therapy examining attachment patterns and their potential for change even in adult life.

Background Influences Attachment theory can be seen to bring Object relations, internal working models of relating into main stream psychology and research in psychotherapy . Attachment styles inform our understanding of relating through out life.

Principles of Attachment Theory Relationship is primary need Attachment is a biological drive Attachment is dyadic

Definition of Attachment “The propensity of human beings to make strong affectional bonds to particular others” throughout the life-cycle (Bowlby, 1977) “It is a primary motivational system with its own workings and interface with other motivational systems” (Bowlby, 1973)

The Role of Relationships “Not only young children.., but human beings of all ages are found to be at their happiest and to be able to deploy their talents to best advantage when they are confident that, standing behind them, there are one or more trusted persons who will come to their aid should difficulties arise.” (Bowlby, 1973:359)

Patterns of Attachment in Adults Secure Insecure Dismissing Insecure Preoccupied Unresolved

Adult Psychopathology in Secure Attachment Secure Attachment Associated With: Lower anxiety & hostility, greater ego resilience, greater ability to regulate affect through interpersonal relatedness; relationships are relatively unambivalent In therapy: Favourable outcomes (good response to brief interventions & strong therapeutic alliance); linked to ability to reflect on mental states of both others and self & metacognitive monitoring

Features of Secure Attachment Coherent, collaborative discourse Values attachment relationships Objective regarding relationships and events Description of attachment-related experiences is consistent, whether favourable or unfavourable

Adult Psychopathology in Insecure Attachment Insecure Attachment Associated with: more depression, anxiety, hostility, psychosomatic illness: less ego resilience, perceived levels of interpersonal support In therapy: initial anxiety in response to making changes leads to resistance. Work needs to address alterations in attentional, emotional & relational patterning. Use of the therapeutic relationship

Features of Insecure-Dismissing Attachment Dismissing of attachment–related experiences and relationships Normalising of early unsupportive relationships Description of attachment related experiences very brief

Features of Insecure-Preoccupied Attachment Not coherent discourse Preoccupied by or with past attachment relationships or experiences. Description of attachment experiences long, entangled

Features of Unresolved Attachment During discussion of loss or abuse individual shows striking lapses in the monitoring of reason or discourse, eg that someone dead is alive

Adult Psychopathology in Insecure Attachment Insecure Attachment Associated with: more depression, anxiety, hostility, psychosomatic illness: less ego resilience, perceived levels of interpersonal support In therapy: initial anxiety in response to making changes leads to resistance. Work needs to address alterations in attentional, emotional & relational patterning. Use of the therapeutic relationship

Adult Psychopathology in Insecure (Unresolved) Attachment Unresolved attachment associated with: intense and unstable relationships, identity disturbance and other features of BPD In therapy: 16 session IPT unlikely to be effective because identity disturbance militates against short-term interventions. However there is a modification of IPT for BPD.

The Secure Base (SB) Phenomena Initially SB is care-giver to whom the child turns when distressed. Infants & young children experience SB behaviourally; at times of threat or illness infant turns to caregiver/s. Their protection ensures the child’s survival.

The Secure Base Phenomena in Adults In adulthood SB is internalised and experienced as a representation within the individual’s mind. Under stress individuals regulate affect by self-soothing (using the representation) and/or make contact with attachment figures Psychological survival impossible without an SB. SB exists within both secure and insecure attachment style. The relationship with a therapist provides the opportunity for a new SB representation.

IPT and Neurological Change IPT emphasises importance of a positive therapeutic alliance and of interpersonal relationships. Positive and attuned interpersonal / therapeutic relationships enhance neural plasticity and learning. IPT encourages the expression of affect in the context of cognitive appraisal. Optimal levels of emotion and stress stimulate production of neuro-transmitters and neural growth hormones, enhancing learning and cortical reorganisation.

Background Influences There is also a third type of life event that is referred to in the literature: History graded events – these are events that a whole cohort or community experiences. Examples would be the Great Depression, World War 2, 9/ 11 , the current recession. Consider age of patient when event experienced and social context.

Background Influences Two Main types of life events we are interested in. Normative or transition events that characterise the life course. Non Normative events that are usually unexpected are always stressful and upsetting they involve long tern threat to the individual.

Background Influences Social approach, especially the role of LIFE EVENTS and CHRONIC STRESSORS to cause and exacerbate mental health problems. See the work of George Brown and Tirrel Harris, Michael Rutter, Jean Paykel and many others important in 1970’s and 80’s

Research developments on the link between life events and illness are relevant to IPT. Severe events and chronic difficulties often precede the onset of depression. These stressors also impede recovery. Stressors are often interpersonal in nature. Events that disrupt key social roles are particularly important. A confiding relationship, particularly with a partner, reduces the vulnerability to depression when severe stressors occur. Lack of a confiding relationship with a partner is associated with an increase in the occurrence of the type of events that are known to precede depression.

Background Influences We can’t usually prevent stressors in the form of life events and chronic difficulties form occurring . Social support protects against stressors IPT aims to intervene by improving social support.

Background Influences Rutter demonstrated that a child’s relationship with others beside the Mother can also create attachment bonds and the disruption of these bonds can contribute to the onset of depression. This supports IPT’s focus on the importance of the wider network and relationships with close others in a broader sense.

Background Influences Rutter also demonstrated that forming positive, supportive relationships with peers and others at school and work can be protective particularly for those at risk as a result of early adversity . One way they can protect is to help the individual make positive choices and effectively plan important transitions such as co-habitation and marriage

Background Influences Rutter also demonstrated that forming positive, supportive relationships with peers and others at school and work can be protective particularly for those at risk as a result of early adversity . One way they can protect is to help the individual make positive choices and effectively plan important transitions such as co-habitation and marriage

Background Influences Rutter also demonstrated that forming positive, supportive relationships with peers and others at school and work can be protective particularly for those at risk as a result of early adversity . One way they can protect is to help the individual make positive choices and effectively plan important transitions such as co-habitation and marriage

Background Influences Rutter also showed that: Events are less important than the chronic stressors or difficulty to which they give rise. It is the lack of care or chronic discord that follows events such as the loss of a parent that is more likely to lead to later problems. Most of these chronic stressors concern poor social relationships in the individual’s immediate social network.

Background Influences The literature on the impact of social support on mental health is vast and complex but also very useful for IPT. IPT is all about understanding and using the client’s network and the potential for support within it to promote better mental health.

Background Influences Robert Weiss, Scott Henderson , Cohen and Wills Understanding of the role of SOCIAL SUPPORT in mental health, especially its protective function in the face of adversity (conceptualised as life events and chronic difficulties.) More about this when doing inventory

What can we take from the literature on social support? Social support needs to be assessed across a range of life domains that are important to the individual e.g. family, friends, work, other interests, neighbours, school/college, church etc. What these domains are will be influenced by the individual. Types of social support are effected by wider social factors such as sex, class and culture. Social support assessment needs to include both: availability adequacy. The perceived adequacy of support is a better predictor of mental health than availability.

What type of network? There is some evidence that diffuse networks are more protective than dense networks. Reciprocity is important. Social support can be both negative and positive. Social support is influenced by personality. To what extent can individuals make use of the support that is offered?

Provides reassurance about a person’s worth. SUPPORT FUNCTIONS EMOTIONAL SUPPORT Provides reassurance about a person’s worth. Linked to concept of unconditional positive regard. Synonymous with confiding. Usually provided by close relationships of long standing. INSTRUMENTAL SUPPORT The provision of direct assistance or practical help. SOCIAL COMPANIONSHIP Being in the company of known others while engaging in activities - often for pleasure or leisure. MOTIVATIONAL SUPPORT (Wills 1985) Consistently helps to maintain hope in chronically difficult circumstances. Helps to sustain a belief in a chosen course of action (plan).

Background Influences A more recent article on the importance of social factors so topical in the 1980’s. Entitled “Slings and arrows: Depression and Life Events” Even in an age of genomics, neuro imaging and Prozac, our understanding of emotional disorders continues to involve the ups and downs of everyday experience. That’s what IPT’s about. (Oatley, 2007)