BMFT 602: Internship I March 9, 2010

agenda MFT research and common factors (8:00-9:15) Break (9:15-9:30) Big change moments (9:30-10:50)

MFT Research & common factors

Extratherapeutic change Dropout rates higher for lower SES & higher when clients & therapist are of different race Behavioral Marital Therapy (BMT) more effective with younger clients BMT most successful with couples with high commitment, low traditionality, & convergent goals High degree of client collaboration, active participation, & homework compliance associated with treatment success Relapsers experience more stressful life events Social support

Relationship factors Ability of therapist to establish positive relationship with clients Clients require respect, understanding, warmth, & positive regard Importance of supportive supervisors

expectancy factors Outcome optimism Self-efficacy Therapist credibility

techniques Only two schools with substantial research - BMT & EFT Helpful generic techniques Reattribution Reinforcement Desensitization Information & skills training

unique common factors in MFT Relational conceptualization Expanded treatment system Expanded therapeutic alliance Behavioral Facilitation of changing interactional patterns Modifying boundaries & changing family structure Becoming more supportive of each other Learning to empower self & others

unique common factors in mft Cognitive - facilitation of insight about interactional processes Affective - facilitation of emotional connections with self, therapist, & each other

clinical implications Extratherapeutic Become change focused Future orientation Emphasize client competence Use outside resources

clincal implications Relationship Accommodate to client’s motivation & readiness to change Accommodate to client’s view of the alliance

clinical implications Expectancy Use healing rituals Focus on possibilities

clinical implications Therapeutic techniques Structure & focus New ways to look at problems Respect client’s theory of change

break 9:15-9:30

big change moments

Have you seen any “big change moments” as you’ve observed/participated in therapy sessions? Have you ever experienced a “big change moment”? Did change continue from that point, or did you lose momentum? Are you vulnerable to becoming addicted to “big change moments”? How can you prevent this addiction? How do you, as a therapist, maintain excitement for gradual change? Respond: “Therapy is the only profession that gives you five or six chances a day to feel like a failure.” Keys to change - imagination & repetition

case study

Next week No class - Spring Break!!! March 23 Exam #2 Topics - therapeutic challenges; termination; case summaries Reading - Cozolino, 11-13; Patterson et al, 11 Sara teaching