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Handbook of Psychotherapy Integration, Second Edition Part 4

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Tham khảo tài liệu 'handbook of psychotherapy integration, second edition part 4', kỹ năng mềm, tâm lý - nghệ thuật sống phục vụ nhu cầu học tập, nghiên cứu và làm việc hiệu quả | 152 Integrative Psychotherapy Models FIGURE 7.1 Integration of Pros and Cons by Stages of Change Across 43 Behaviors is exactly what we found in predicting more than 90 of premature termination from psychotherapy those in precontemplation were highly likely to discontinue. Those in the action stage were likely to finish therapy quickly but appropriately as judged by their therapists Brogan Prochaska Prochaska 1999 . Faced with clients who recently took action by quitting an addiction the clinical plan for most clinicians would be relapse prevention. But would relapse prevention be appropriate for patients in precontemplation Here our clinical plan would be dropout prevention. Fortunately there are a growing number of studies that indicate that by matching processes of change to stage of change patients in precontemplation can complete a treatment program at the same high rates as those in preparation e.g. Prochaska Velicer Fava Rossi Tsoh 2001 Prochaska DiClemente Velicer Rossi 1993 Prochaska etal. 2001 . Levels of Change At this point in our analysis it appears that we are discussing only how to approach a single well-defined problem. However as all of us realize reality is not so accommodating and human behavior change is not so simple. Although we can isolate certain symptoms and syndromes these occur in the context of complex interrelated levels of human functioning. The fourth element of the transtheoretical approach addresses this issue. The Levels of Change rep resents a hierarchical organization of five distinct but interrelated levels of psychological problems that can be addressed in psychotherapy Symptom Situational Problems Maladaptive Cognitions Current Interpersonal Conflicts Family Systems Conflicts Intrapersonal Conflicts. Historically systems of psychotherapy have attributed psychological problems primarily to one or two levels and focused their interventions on these levels. Behavior therapists have focused on the symptom and situational .