临床与咨询心理学导论 17 - Humanistics and Motivation
L17 Humanistic Psychotherapy & Motivational Interviewing
参考文献：Pomerantz, A. (2013). Clinical psychology: science, practice, and culture (3rd ed.). Thousand Oaks, CA: SAGE Publications.
17.1 Humanistic Psychotherapy
17.1.1 Philosophy and Goals - Carl Rogers
• Goal of therapy: Self-actualization
- Achieving your full personal potential
• Names used to describe humanistic therapy:
- Client-centered therapy
- Person-centered therapy
17.1.2 Humanistic Theory
• Tendency toward self-actualization is innate and linked to:
- Positive Regard: Warmth, Love, Acceptance
- Prizing: Experience of positive regard
• Problems arise when movement toward self-actualization is thwarted by:
- Conditions of Worth: Prizing is linked to specific behaviors/conditions
• Conditions of worth produce discrepancy between one’s:
- Real Self: The self you currently are
- Ideal Self: The self you could be at full potential
Incongruence
• Discrepancy between real and ideal self
• Distress & Psychopathology
Congruence
• Consistency between real and ideal self
• Self-Actualization
17.1.3 Humanistic Psychotherapy
• Therapeutic relationship (alliance) is THE key to humanistic psychotherapy and provides corrective emotional experiences
• Training focuses on therapist attitudes rather than on techniques
• Three Essential Conditions - These conditions are necessary and sufficient!
- Empathy
• Deep, nonjudgmental understanding of client’s experience
- Unconditional Positive Regard
• Fully accepting another person “no matter what”
- Genuineness
• Authenticity in the therapeutic relationship
• IF the therapist creates a relationship with…
- Genuineness and transparency and real feelings
- Warm acceptance and prizing of the other individual
- Sensitive ability to see the client and their world
• THEN the client will experience…
- Understanding aspects of themselves
- Improved ability to function effectively
- Increased self-confidence and self-direction
- More understanding and acceptance of other people
- Ability to cope with life’s challenges and problems
• Reflection of Feeling
- Restating clients’ ideas in a way that highlights
- Not mechanistic
- Not just parroting facts
- Should include an opportunity for the client to correct misperceptions
- Conveys empathy, unconditional positive regard, and genuineness
17.2 Motivational Interviewing
• Developed by Miller & Rollnick (1991)
- Humanistic orientation
- Originally developed for substance use disorders but now used for a wide range of problems
- Explicit focus on stages of change
17.2.1 Prochaska & DiClemente:
- Transtheoretical Model of Change
Stages of Change
Pre-Contemplation
• No intention to change
• Haven’t even started thinking about change
Contemplation
• Aware of the problem
• Thinking about changing
• But ambivalent
Preparation
• Intend to take action soon
• Started planning
• May have taken some small initial steps
Action
• Committed to goal
• Actively changing behavior
• Sustained effort
Maintenance
• Maintain gains
• Prevent relapse
• At least 6 months
Termination
• Gains sustained
• No longer at risk for relapse
17.2.2 Motivational Interviewing
• Primary Goal: Enhance client’s intrinsic motivation to alter behavior by helping to resolve ambivalence about changing
• Assumptions:
- Ambivalence about behavior change:
• Is a normal, motivational obstacle
• Can be resolved by working with client’s intrinsic motivations / values
- The therapeutic alliance
• A collaborative partnership
• Provides an empathic, supportive environment that facilitates change
• Therapist roles:
- Express empathy
- Highlight discrepancies between client’s behaviors and their values
- Avoid arguing
- Roll with resistance
- Identify sustain and change talk
- Support self-efficacy and optimism
• Many RCTs support MI
- Most empirically supported therapy that has come out of the humanistic movement
