The human elements of psychotherapy: A nonmedical model of emotional healing.
... Mitchell, 2015). Sumado a lo anterior, estos autores propusieron que no era el insight cognitivo, sino la cualidad del vínculo terapeuta-paciente -los "elementos humanos de la psicoterapia" (Elkins, 2016)-el principal factor involucrado en la promoción del cambio terapéutico (Coderch, 2010;Sassenfeld, 2019Sassenfeld, , 2020. ...
... Una orientación similar se percibe en las propuestas del humanismo norteamericano. El punto de vista holístico que prevalece en las teorías psicológicas de la tercera fuerza subraya la profunda interdependencia del ser humano con su ambiente material e interpersonal (Elkins, 2016;Schneider y Krug, 2010;Yontef, 1995). El desarrollo de la personalidad y el carácter es entendido como un CeIR Vol. ...
... proceso que se despliega en el marco de las relaciones que mantiene el individuo con sus semejantes, destacando el papel formativo desempeñado por los primeros vínculos de cuidado (Mearns y Cooper, 2011;Rogers, 2007Rogers, , 2011. En este contexto, la psicopatología se concibe como el resultado de un proceso de adaptación y supervivencia psicológica ante contextos interpersonales formativos (familiares, sociales, etc.) sub-óptimos, hostiles o traumatizantes (Elkins, 2016;Moreira, 2001). En el plano terapéutico, los modelos humanistas sustentan la idea de que el vínculo terapeuta-paciente constituye el principal vector de cambio, estableciendo como una condición para la transformación del paciente la provisión de un clima emocional y relacional de aceptación, respeto y seguridad psicológica (Elkins, 2016;Mearns y Cooper, 2011;Rogers, 2011). ...
La psicología humanista y el psicoanálisis suelen ser representados como dos corrientes teóricas contrapuestas e irreconciliables. Ambos enfoques se presentan en forma dicotómica, reproduciéndose un relato equivocado acerca de la relación que la segunda y la tercera fuerza han mantenido a lo largo de su historia. Este relato tiende a omitir los numerosos lazos genealógicos que emparentan a estas dos tradiciones a través del intercambio personal y académico entre los fundadores del movimiento humanista norteamericano (Maslow, Rogers, May, Perls, etc.) y algunos destacados representantes del psicoanálisis post-freudiano (Adler, Rank, Horney, Sullivan, etc.). En este artículo se presenta un breve repaso por los principales vínculos que conectan a la segunda y la tercera fuerza de la psicología, demostrando que las bases conceptuales y clínicas de la psicología humanista se forjaron, en gran medida, a partir de la recepción de un conjunto de ideas provenientes del campo del psicoanálisis post-clásico.
... Mota (2014) refere que a ênfase a ser dada sobre o conceito de não-diretividade é a ausência de uma atitude intervencionista por excelência, colocando o cliente em uma posição de escolha e oportunizando uma relação terapêutica mais igualitária e dialógica. Elkins (2016), ao revisitar as reflexões contemporâneas sobre a não-diretividade e a relação desta com as mais recentes descobertas da PPBE, diz que o postulado rogeriano de que "o verdadeiro terapeuta em terapia é o cliente" (Elkins 2016, pg.24) não se perdeu nas mais recentes produções. Bozarth (2012) alerta para o fato de que a nãodiretividade não deve ser uma técnica sujeita à prescrição, mas sim um pressuposto ético da relação terapêutica. ...
... A produção científica oriunda do campo humanista começou então a ser vista com receio, pois sua ênfase, por tradição, voltava-se para os fatores humanos e relacionais (fatores comuns e transversais), e não para fatores específicos (técnicos e prescritivos), como se tornou a tendência a partir dos anos 1980. Este período foi marcado por uma invisibilidade da abordagem e logo seu esforço teórico e empírico passou a ser criticado e caricaturizado pela comunidade científica (Elkins, 2016). Consequentemente, ao longo dos anos 1980 e 1990, as abordagens humanistas declinaram muito em termos de popularidade entre psicólogos e psicoterapeutas em comparação com as terapias cognitivo-comportamentais, pois estas últimas estavam mais inclinadas a responder à demanda por evidências em relação aos diagnósticos psiquiátricos (Murphy & Joseph, 2016). ...
... Nos anos 2000, alavancados pelo trabalho da APA e de teóricos não filiados à abordagem humanista no estudo sobre a eficácia em psicoterapia, bem como pela constatação que os fatores comuns se sobrepõem aos fatores específicos em termos de eficácia (Wampold, 2015;Elkins, 2019), que os teóricos humanistas saíram das sombras para ocuparem a cultura mainstream em pesquisa. Desde esta época, a pesquisa no campo humanista, com toda sua diversidade, vem crescendo exponencialmente, como tem sido retratado pela literatura científica internacional (Elkins, 2016;Elkins, 2019;Hoffman et al., 2012, Angus, et al., 2015Murphy e Joseph, 2016, Parrow et al., 2019. Angus, et al. (2015) referem que pesquisadores humanistas conseguiram estabelecer, nos últimos 25 anos, um forte apoio científico às pesquisas relacionadas ao papel da relação terapêutica nos processos de mudança em psicoterapia; o que impulsionou um reconhecimento da importância da aliança terapêutica pelas mais variadas abordagens teóricas em psicologia. ...
The humanistic approach in the debate on evidence-based psychotherapy Abordaje humanista en el debate de la psicoterapia basada en la evidencia.
Resumo: Este estudo tem como objetivo abordar a convergência entre a abordagem humanista e as discussões contemporâneas acerca da Prática da Psicologia Baseada em Evidências (PPBE). Esta é uma temática permeada por dilemas éticos e epistemológicos que dificultam o engajamento de pesquisadores e clínicos nesse debate. Neste artigo são apresentadas recentes pesquisas que abarcam as diferentes correntes humanistas no desvelamento da pergunta sobre o que funciona em psicoterapia. São trabalhados os seguintes temas: os pressupostos da abordagem humanista mais diretamente envolvidos no debate; a influência histórica de teóricos como Carl Rogers nessa discussão; os embates em torno da articulação entre a teoria humanista e o tema da eficácia em psicoterapia; e a participação de teóricos humanistas na elaboração das recomendações práticas propostas pela Associação Americana de Psicologia (APA). Por fim, o estudo explora a necessidade de maior engajamento de pesquisadores brasileiros nessa discussão.
Abstract: The aim of this study is to approach the convergence between humanistic approach and contemporary discussions on Evidence-Based Practice in Psychology (EBPP). This is a topic permeated by ethical and epistemological dilemmas that hinder the engagement of researchers and clinicians in this debate. In this article, recent research that includes different humanistic approaches unveiling the question of what works in psychotherapy is presented. The following themes are dealt with here: the assumptions of the humanistic approach more directly involved in the debate; the historical influence of theorists such Carl Rogers in this discussion; the clashes over the articulation between humanistic theory and the theme of the efficacy in psychotherapy; and the participation of humanistic theorists in the elaboration of the practical recommendations proposed by the American Psychology Association (APA). At last, the study explores the need to engage Brazilian researchers in this discussion.
Resumen: El objetivo de este estudio es abordar la convergencia entre el abordaje humanista y las discu-siones contemporáneas acerca de la Práctica de la Psicología Basada en la Evidencia (PPBE). Los dilemas éticos y epistemológicos implicados en esta temática dificultan el comprometimiento de investigadores y psicólogos clínicos en el debate que suscita. En este artículo, se presentan investigaciones recientes que abarcan las diferentes corrientes humanistas buscando responder a la pregunta sobre qué es lo que fun-ciona en psicoterapia. Se trabajan estos temas: los presupuestos del abordaje humanista más directamente implicados en el debate; la influencia histórica de teóricos como Carl Rogers en esa discusión; los enfren-tamientos en torno a la articulación entre la teoría humanista y el tema de la eficacia en psicoterapia; y la participación de teóricos humanistas en la elaboración de las recomendaciones prácticas propuestas por la Asociación Americana de Psicología (APA). Por último, se explora la necesidad de un mayor comprome-timiento de investigadores brasileños en esa discusión.
... I have also made contributions to the common factors literature (e.g., see Elkins, 2007Elkins, , 2009Elkins, , 2012Elkins, , 2015. In my work, I have summarized research to show that theories and techniques have little to do with effectiveness in psychotherapy while common factors, particularly human and relational factors, are potent determinants of effectiveness. ...
... In my work, I have summarized research to show that theories and techniques have little to do with effectiveness in psychotherapy while common factors, particularly human and relational factors, are potent determinants of effectiveness. In The Human Elements of Psychotherapy (Elkins, 2015), I summarized findings from clinical psychology, attachment theory, neurological research, and evolutionary theory to show that humans are evolved to give and receive emotional healing through social means, and I suggested that psychotherapy, properly understood, is a subset of this evolved ability. I argued that common factors, particularly the human and relational factors, are the most potent determinants of effectiveness in psychotherapy because they draw on our evolutionarily derived ability to heal one another emotionally through social means. ...
... It is important to note that most, if not all, of the factors on Wampold's list are human and relational in nature. Of course, this should not be surprising because, in a sense, the entire common factors movement is about the human and relational core of effective psychotherapy (Duncan, 2010(Duncan, , 2014Duncan, et al., 2010;Elkins, 2015;Wampold, 2007Wampold, , 2015. This point is highly relevant to the second question posed in the title of this article, which is addressed next. ...
Although common factors have been widely discussed in the clinical literature, the two questions addressed in this article remain relevant: (a) What are the common factors? (b) What do they mean for humanistic psychology? The first question is important because there is no “definitive list” of common factors, and lists presented in the literature often differ dramatically. In response to this question, the article suggests that an evidence-based list of nine common factors by Wampold provides a useful and credible list. The second question is also important, particularly to humanistic psychologists. Among other answers, the article shows that research findings on common factors provide scientific support for humanistic psychology’s emphasis on the importance of the human and relational factors in psychotherapy.
... In other words, the ends do not justify the means, but the means are a part of the end. Elkins (2009Elkins ( , 2016 is one of the important champions of the non-medical alternatives. As will be discussed in more detail later, Elkins provided important critiques of the empirically supported treatment movement and narrow approaches to Evidence Based Practice in Psychology. ...
... As will be discussed in more detail later, Elkins provided important critiques of the empirically supported treatment movement and narrow approaches to Evidence Based Practice in Psychology. Building upon the work of influential researchers such as Bruce Wampold (Wampld & Imel, 2015) and Barry Duncan (Duncan, Miller, Wampold, & Hubble, 2010), Elkins (2009Elkins ( , 2016 has demonstrated both the empirical and theoretical support for humanistic and existential-humanistic therapy's nonmedical model as well as anyone. ...
... Some of the resistance to techniques is due to linguistic issues. Existential therapy stands firm against mechanized, linear, reductionist, and manualized approaches to therapy (see Elkins, 2008Elkins, , 2009Elkins, , 2016. Imposing a false structure on psychotherapy, although easing the therapist's anxiety and making research easier, is not beneficial to the overall therapy process. ...
This chapter provides an overview of existential-humanistic psychology, including a brief history, an overview of the theoretical foundations, and an overview of clinical applications. Consideration of cross-cultural applications, evidence-based practice in psychology, and integration with other approaches is included.
... Simply defined, the current paradigm shift is the transition from a medical to a nonmedical model of psychotherapy. Over the past two decades, extensive evidence has shown that specific theories and techniques have relatively little to do with effectiveness in psychotherapy and that common factors, and particularly human factors, are the primary agents of change (see, e.g., Baldwin & Imel, 2013;Bohart & Tallman, 2010;Duncan, 2014;Duncan, Miller, Wampold, & Hubble, 2010;Elkins, 2007Elkins, , 2009aElkins, , 2009bElkins, , 2012Elkins, , 2015Lambert & Barley, 2002;Laska, Gurman, & Wampold, 2014;Messer & Wampold, 2000;Norcross, 2010Norcross, , 2011Stiles, Barkham, Mellor-Clark, & Connell, 2008;Wampold, 2001Wampold, , 2010Wampold & Imel, 2015). This evidence undermines the medical model with its assumption that theories and techniques are the agents of change and calls for a new, nonmedical model that reflects the power of human and relational factors. ...
... Unfortunately, succeeding generations of psychotherapists also embraced the medical model so that today the model dominates almost every aspect of therapeutic psychology, particularly in the United States. (For a more detailed discussion of the medical model and how it has shaped our profession, see Elkins, 2009aElkins, , 2009bElkins, , 2015 But what, exactly, is the medical model? Elsewhere, I defined the term as follows: ...
... Elsewhere (Elkins, 2015), I summarized evidence from various disciplines to show that humans are evolved to give and receive emotional healing through social means and that psychotherapy is an expression of this evolutionarily derived ability. In other words, humans, who evolved in a social context, are evolutionarily sculpted to heal one another emotionally through human connection and social interaction. ...
The thesis of this article is that understanding the current paradigm shift in psychotherapy, which is the movement from a medical to a nonmedical view of psychotherapy, can provide perspective and guidance as authors critique the Diagnostic and Statistical Manual of Mental Disorders (DSM) and explore alternative ways to describe patterns of emotional distress. After defining the paradigm shift, the article presents four implications of the shift for the DSM. The article’s conclusion emphasizes the importance of developing and publishing a nonmedical system to describe patterns of emotional distress as an alternative to the DSM and other medical diagnostic systems.
... As we move into a new era of artificial intelligence (AI) with ChatGPT and other new forms of AI, it can be maintained that our humanity is at stake in the fight for a more inclusive and human understanding of EBPP. Elkins (2015), in his vitally important book The Human Elements of Psychotherapy, maintained that these human elements are an essential aspect of psychotherapy change. In fact, outside of client factors (i.e., client motivation, client belief that therapy will work, etc.), the relational human factors account for the greatest amount of change in psychotherapy outcomes (see also Wampold & Imel, 2015). ...
Evidence-based practice in psychology (EBPP) is the current zeitgeist in mental health practice. How EBPP is defined, understood, and applied in the field of psychology at large and by insurance companies and regulatory agencies has an influence on the practice of psychotherapy. It can impact how and if humanistic and existential psychotherapy are practiced in some settings. Humanistic and existential psychologists have been critical of this movement but often have not recognized its potential. This article offers a definition rooted in the understanding of EBPP presented in the seminal article in the American Psychologist by the American Psychological Association Presidential Task Force on Evidence-Based Practice (2006) and further informed by humanistic principles and values. Humanistic and existential psychologists are encouraged to join in the conversations about EBPP advocating for a broad, inclusive understanding of EBPP.
... For example, he emphasizes that shadow work-whereby projection of one's shadow potential onto otherness by homeostatically repudiating the foreign and clinging to the familiar is overcome via perspective-taking-is necessary for appreciating difference, both in oneself and in others. 19 Further, Schneider's emphasis on relational and depth therapies for assisting clients with showing up to life-enhancing anxiety underscores the imperativeness of the real relationship (Gelso et al., 2019; see also Elkins, 2016) necessary to meet the needs of clients in the current zeitgeist. An example that connects well with Schneider's (2019Schneider's ( , 2023 observations and cautions about technocracy, early evidence suggests that, despite their verbal prowess, emerging chatbot therapists may not be capable of handling nuance in client expression and, therefore, of offering a sense of healing presence needed for constructively dealing with crisis (Browne, 2022) in the ways described by Schneider. ...
An accessible introduction to existential-humanistic psychology for a new generation.
... Também se poderia invocar uma tradição que tem produzido evidência experimental de conceitos psicanalíticos e que remonta até Saul Rosenzweig, psicólogo experimental contemporâneode Freud, que inaugurou uma linha de investigação que continua até aos dias de hoje. Mas talvez a coisa pela evidência de um peso duas vezes maior para os primeiros, veio mostrar que a psicoterapia é de certo modo uma ciência da relação(Elkins, D. N., 2015).A teoria psicanalítica ajuda a compreender melhor esse factor de interacção humana e porque são efectivas as psicoterapias. E a psicanálise é testada pela sua capacidade de colocar em marcha um processo que é fiável o suficiente para que duas pessoas arrisquem lançar-se no trabalho de contenção e transformação da dor emocional de uma delas. ...
... Wyniki badań szeroko opisywane w literaturze wskazują na istotne znaczenie relacji oraz cech osoby pomagającej jako czynników wpływających na wynik podejmowanych interwencji w co najmniej takim stopniu, co zastosowane metody pracy (Norcross, Lambert 2011;Elkins 2016). Gerald Corey (2017) wskazuje na spektrum właściwości w funkcjonowaniu terapeuty, które umożliwiają efektywną pracę z klientem, tj. ...
Celem artykułu jest ukazanie znaczenia poradnictwa psychologiczno pedagogicznego w przezwyciężaniu skutków pandemii COVID-19 doświadczanych w polskich szkołach przez wszystkie podmioty związane z procesem edukacyjnym w szczególności uczniów, ich rodziców i nauczycieli. Zaprezentowano zatem poradnictwo psychologiczno-pedagogicznego jako formę wsparcia osób doświadczających sytuacji problemowych, trudności uczniów, rodziców i nauczycieli wynikające z sytuacji pandemii i postpandemii oraz rozwiązania wdrożone przez zespół merytoryczny Programu wsparcia psychologiczno-pedagogicznego uczniów i nauczycieli polegające m.in. na organizacji kompleksowej pomocy osobom jej poszukującym, którą zrealizowano w formie poradnictwa psychologiczno pedagogicznego online.
The purpose of the article is to show the meaning of psychological and pedagogical advising in fighting the effects of the COVID-19 pandemics appearing in the Polish schools and affected by all the entities connected with the educational process, in particular students, their parents and teachers. Therefore the psychological and pedagogical advising was presented as a form of support for persons experiencing problematic situations, students’ problems, pa- rents and teachers’ problems resulting from the pandemics and post-pandemic situation and solutions implemented by the special team „Program of psychological and pedagogical support of students and teachers” in the organization of on-line advising as an attempt of a complex support to persons in need.
... Wyniki badań szeroko opisywane w literaturze wskazują na istotne znaczenie relacji oraz cech osoby pomagającej jako czynników wpływających na wynik podejmowanych interwencji w co najmniej takim stopniu, co zastosowane metody pracy (Norcross, Lambert 2011;Elkins 2016). Gerald Corey (2017) wskazuje na spektrum właściwości w funkcjonowaniu terapeuty, które umożliwiają efektywną pracę z klientem, tj. ...
... Turning to oxytocin, research has shown this hormone to be associated with childbirth and lactation, mother-infant bonding (Kendrick, 2004), stress, and the regulation of social behavior (i.e., Elkins, 2016). Early life experiences, such as child abuse or any childhood trauma, was negatively correlated with oxytocin levels, suggesting those early experiences can cause social deficits in the future. ...
This chapter is designed to review much of the research on the neurobiology of well-being. A distinction between hedonic well-being and eudaimonic well-being is made. The brain reward center was discussed in relation to well-being, which was followed by an in-depth discussion related to drugs, neurotransmitters, and well-being. Neurochemicals related to hedonia and eudaimonia were then discussed, followed by another discussion on gene expression. Finally, brain structures involved in well-being were the discussed followed by concluding thoughts.
... This affirms common assumptions about what psychologists of different orientations think of DSM. The manual's medical model approach conflicts with many of the theoretical commitments adhered to by psychodynamic and humanistic psychologists, who have actively resisted it or developed alternatives to it (e.g.,Elkins, 2016;Johnstone et al., 2018;Kamens et al., 2017;Wallerstein, 2011); therefore, they dislike DSM and feel frustrated with each revision. By comparison, CBT psychologists, with their focus on observable and measurable behavior, are generally better aligned with DSM assumptions. ...
A survey of psychologists’ attitudes toward the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and its alternatives was conducted. Almost 90% of psychologists reported regularly consulting DSM-5, despite dissatisfaction with it. However, opinions varied by theoretical orientation. Cognitive- behavioral psychologists held positive attitudes about DSM, whereas psychodynamic and humanistic/constructivist/systems psychologists were negatively inclined toward it. Integrative/eclectic psychologists were in between. Diagnostic codes and identifying pathology were seen as DSM-5’s biggest advantages, and the medicalization of psychosocial problems and obscuring individual differences as its biggest disadvantages. Psychologists supported developing alternatives to DSM-5, but when asked about six alternatives—International Classification of Diseases (ICD), Research Domain Criteria (RDoC), Psychodynamic Diagnostic Manual 2 (PDM), Operationalized Psychodynamic Diagnosis (OPD), Hierarchical Taxonomy of Psychopathology (HiTOP), and Power Threat Meaning Framework (PTMF)—they were generally unfamiliar with them except for ICD. Although not wishing to abandon the medical model, psychologists (except for cognitive-behaviorists) said DSM-5 relies too much on medical semantics and questioned whether mental disorders should be considered a subset of medical disorders. Overall, psychologists use DSM for practical reasons (diagnostic categories and codes) more than scientific ones (validity and reliability). This finding affirms something remarkable: Despite ongoing attention to revising and improving DSM over the past four decades, psychologists remain lukewarm toward it and strongly interested in alternatives. However, until alternatives are better known and provide the necessary practical advantages, psychologists will likely continue to use DSM despite their mixed feelings about it.
... Importantly, therapeutic modalities that emphasize depth, process, and the therapeutic relationship as the vehicle for sustainable change over manualized techniques have been "neglected and marginalized" (Pfaffenberger, 2006, p. 337; see also Dewell & Foose, 2017) not because research data suggest they are ineffective. Indeed, more than 85 years of research has consistently demonstrated it is the most salient ingredient of sustainable therapy (Bland, under review;Elkins, 2009Elkins, , 2016. Instead, it is because the data that might support them could not be collected within the dominant paradigm. . . . ...
Fifteen years ago, Pfaffenberger (2006) applied five implicit paradigmatic assumptions identified by Slife of the dominant positivistic medical model paradigm—hedonism, universalism, atomism, materialism, and objectivism—to psychotherapy outcome research and its practice implications. Her applied theoretical essay revealed critical issues involving hidden power and privilege dynamics therein. Furthermore, Levitt et al.’s (2005) research examined nine then-common outcome instruments to determine the extent to which their item content reflected humanistic psychology principles in nine domains derived from the authors’ systematic review and thematic analysis of the humanistic literature. Their content analysis revealed that the majority of those domains were inadequately represented. In this article, using thematic discourse analysis (aka latent thematic analysis), I first identify how the philosophical and political assumptions summarized by Pfaffenberger are apparent in three outcome instruments that are commonly used in U.S. community mental health settings today: the Adult Needs and Strengths Assessment, the Ohio Mental Health Consumer Outcomes System, and the DSM-5 assessment measures. As part of my analysis, I contrast paradigmatic assumptions of the medical model with those of humanistic/existential psychology as a basis for contextualizing and understanding the implications of measurement-based care as articulated through the two discourses. Then, second, based on a summative content analysis of the three instruments, I report on the progress that both has been and remains to be made in their item content since Levitt et al. noted the general dearth of humanistic principles in mental health outcome measurement. Suggestions for future research and instrument development are discussed.
... Entretanto, nem sempre foi assim; a história científica e acadêmica retrata momentos em que as abordagens humanistas foram por vezes menos ou mais valorizadas. De uma crescente ascensão entre os anos 1950 e 1970, perderam força nos anos 1980, quando a pesquisa em psicoterapia se voltava para transtornos e diagnósticos específicos (Elkins, 2016;Murphy & Joseph, 2016). Quando as técnicas terapêuticas passaram a ser largamente valorizadas e os fatores relacionais foram considerados secundários às técnicas, o campo humanista passou a ocupar um lugar marginal nas pesquisas e práticas psicoterápicas. ...
Abstract
Interpersonal expertise is one of the central elements of clinical expertise
for evidence-based practice in psychology. Recent research shows a greater appreciation of the relational factors involved in the psychotherapeutic process, such
as, the value currently given to empathic understanding as a facilitator of psychotherapy. This work aims to demonstrate the existence of a convergence between
the Rogerian assumptions and these recent evidences. To this end, it is proposed
to analyze this confluence based on the resumption of the necessary conditions
for psychotherapy postulated by Carl Rogers, as detailed in three elements that
involve the complexity of interpersonal therapeutic skills: the person of the therapist; the way the client perceives the therapist’s attitudes; and the therapeutic relationship per se. Finally, it points to the potential of the humanistic approach and
mainly of Rogerian assumptions, which show a proposal of alterity and dialogicity for the psychotherapeutic process, for understanding and effecting relational
factors in clinical practice, as newly endorsed even by the most recent scientific
evidence of effectiveness in psychotherapy, present in the latest recommendations
of the APA, valid, therefore, for the entire psychological clinic, regardless of the
theoretical approach of choice of the therapist.
Keywords: interpersonal therapeutic expertise; evidence-based practice in psychology;
clinical expertise
... It is difficult , for example, to distinguish between the effect of the treatment itself and the effect of the therapist's confidence in the treatment or the client's assessment of its credibility or the client's attitude towards the therapist (Sprenkle & Blow, 2004a). Many other common factors are also associated with the therapeutic relationship, as they overlap and/or complement each other (Crits-Christoph & Mintz, 1991;Duncan et al., 2010;Elkins, 2016;Norcross & Lambert, 2018;Norcross & Wampold, 2019). ...
The common factors theory is based on the findings of studies claiming that characteristics common to all psychotherapeutic approaches account for most of the effectiveness of psychotherapy, which also applies to couple and family therapy (CFT). After describing the reasons for the relative neglect of common factors theory in the historical development of CFT, we present broad and narrow conceptualisations of common factors in CFT, and describe common factors that are unique to CFT compared with individual therapy. Citing the main criticisms of common factors theory in the field of CFT, we identify those elements of the criticism that are unfounded. We strive to overcome the polarisation between the advocates of specific and common factors, since the contextual model that was created on the basis of the common factors theory also includes specific factors. After describing the importance of common factors theory for education in psychotherapy in general as well as in CFT, we conclude with key guidelines for CF therapists based on common factors theory.
... ločiti med učinkom obravnave same po sebi in učinkom, ki ga ima terapevtovo zaupanje v obravnavo ali klientova ocena njene verodostojnosti ali klientova naravnanost do terapevta (Sprenkle in Blow, 2004a). Tudi s terapevtskim odnosom so povezani mnogi drugi skupni dejavniki, saj se le-ti med seboj prekrivajo in/ali dopolnjujejo (Crits-Christoph in Mintz, 1991;Duncan in dr., 2010;Elkins, 2016;Norcross in Lambert, 2018;Norcross in Wampold, 2019). ...
Teorija skupnih dejavnikov temelji na izsledkih raziskav, da k učinkovitosti psihoterapije prispevajo predvsem značilnosti, ki so skupne vsem psihoterapevtskim pristopom, kar velja tudi za partnersko in družinsko psihoterapijo (PDP). Potem ko opiševa razloge za relativno prezrtost teorije skupnih dejavnikov v zgodovinskem razvoju PDP, prikaževa širše in ožje konceptualizacije skupnih dejavnikov v PDP ter opiševa skupne dejavnike, ki so v primerjavi z individualno terapijo za PDP edinstveni. Ob navedbi glavnih kritik na račun teorije skupnih dejavnikov na področju PDP hkrati opozoriva, na katerih točkah je ta kritika neutemeljena. Zavzemava se za preseganje polarizacije med zagovor-niki specifičnih in skupnih dejavnikov, saj kontekstualni model, ki je nastal na podlagi teorije skupnih dejavnikov, vključuje tudi specifične dejavnike. Potem ko opiševa pomen teorije skupnih dejavnikov za izobraževanje iz psihoterapije nasploh in iz PDP, zaključiva s ključnimi vodili za partnerske in družinske terapevte, ki izhajajo iz teorije skupnih dejavnikov.
... Razprava okoli pomena in vloge skupnih dejavnikov ostaja raznolika in navdihuje številne raziskovalce in praktike (glej npr.Chwalisz, 2001; Craighead, Sheets in Bjornsoon, 2005;Cuijpers, Reijnders in Huibers, 2019;DeRubeis, Brotman in Gibbons, 2005;Drisko, 2013;Elkins, 2016;Garfield, 1997; Harwood in dr., 2006; Greencavage in Norcross, 1990;Jørgensen, 2004;Schroedter, 2005;Kazantzis in Ronan, 2006;Klostermann, Mignone in Mahadeo, 2019;Lampropoulos, 2000;Luborsky, 1995;McAleavey in Castonguay, 2015;Mulder, Murray in Rucklidge, 2017;Stamoulos, 2016;Tschacher, Junghan in Pfammatter, 2014; Ulvenes in dr. 2012) ...
Potem ko sem v predhodnem članku opisal Dodova zgodnja leta, to je razvoj teorije skupnih dejavnikov od Rosenzweiga do Frankovega kontekstualnega modela, tokrat nadaljujem s pregledom Dodovih mladostniških in odraslih let, ki se raztezajo od prvih metaanalitičnih raziskav o učinkovitosti psihoterapije do Schiepkovega nelinearnega dinamičnega modela. Tretja faza raziskovanja psihoterapije (med letoma 1970 in 1983) je prinesla velike izboljšave raziskovalne metodologije, ki so omogočile kakovostnejše preučevanje terapevtskega odnosa in razvoj metaanaliz, ki so potrdile visoko splošno učinkovitost psihoterapije. Po eni strani so se intenzivirala prizadevanja za standardizacijo psihoterapevtskih intervencij, po drugi strani pa je Dodo spodbudil prizadevanja za integracijo psihoterapevtskih pristopov in razvoj transteoretičnih modelov. V četrti fazi (od leta 1984 do danes) je tako v psihoterapevtski znanosti kot tudi klinični praksi prišlo do paradigmatskih premikov, npr. do prehoda od empirično podprtih terapij k na izsledkih temelječi praksi in na praksi temelječih izsledkov ter do razcveta integrativnih in transdiagnostičnih pristopov. Razvoj različnih konceptualizacij skupnih dejavnikov in njihovo empirično potrjevanje je Dodu omogočilo vstop v odrasla leta, tako da je v okviru Wampoldovega kontekstualnega modela prispeval k preseganju dihotomije med terapevtskim odnosom in tehnikami. Schiepkov sinergetični nelinearni dinamični model pa omogoča vpogled v dinamiko interakcij med skupnimi in specifičnimi dejavniki. Psihoterapevtska znanost in klinična praksa sta od svojih začetkov do danes, tudi zahvaljujoč Dodovi pomoči, dosegli visoko stopnjo razvoja. Na osnovi obilja kliničnih in raziskovalnih izsledkov psihoterapevtom različnih pristopov ponuja možnost paradigmatskega preskoka v novo, bolj integrirano razumevanje psihoterapevtske stroke kot samostojnega poklica, v učinkovitejše in uspešnejše oblike klinične prakse in preventive ter v celovitejše, didaktično naprednejše oblike izobraževanja. Hkrati pa Dodo onkraj različnih psihoterapevtskih šol kot meta integrator ponuja vizijo širše integracije znanosti in prakse (model znanstvenika praktika), biološkega, psihološkega in socialnega, kvantitativne in kvalitativne metodologije, nomotetičnosti in idiografičnosti, teoretičnih razlag in kliničnega razumevanja, personalizirane medicine in psihoterapije ter medicinskega in kontekstualnega modela.
... Indeed, positive psychology's "markedly self-centered" (Cabanas, 2018, p. 12) prescriptive interventions have been criticized (a) as promoting magical thinking (Hedges, 2009) and conformity to happiness as a trait that is falsely dichotomized from neuroticism (Ahmed, 2010) as well as (b) for their replication problems and inadequate statistical power (Wong & Roy, 2018). In contrast, decades of research conducted both qualitatively and quantitatively by humanistic psychologists (Angus et al., 2015;Cain et al., 2016;Cozolino, 2010;Elkins, 2009Elkins, , 2016Rogers, 1961Rogers, /1995 have consistently demonstrated that relationships-and not brief interventions which "seek a fast-food-like consumption of spiritual transformation that results in bypassing the depths of our being" (Sollars, 2016, p. 1)-are the vehicle for sustainable transformative change. Ironically, even Seligman (1995) himself arrived at a comparable conclusion. ...
Seligman and Csikszentmihalyi launched the "positive" psychology movement with a conspicuously negative strategy: the seemingly deliberate character assassination of humanistic psychology. Their critical remarks, not at all original, appeared designed to distance positive psychology from humanistic psychology and (ironically) to paint a portrait of positive psychology as being more original than it really was. Seligman has since apologized for disparaging humanistic psychology, and this article assesses both the content of that apology and its value in the ongoing discussion concerning the relationship between humanistic and positive psychologies. The apology was found to be superficial and laced with more extensive explicit and implicit negative assessments of humanistic psychology. These assessments were found to range from theoretically biased partial truths to completely unfounded claims, all unworthy of scientific discourse and in need of fact checking. The unabated dissemination of these arguably damning and unsubstantiated views is framed in terms of van Kaam's observations concerning the collectivist leanings of postindustrial psychological science, which fly in the face of the humanistic revolution.
... A lot of research has demonstrated that common factors within the therapeutic relationship are major determinants of successful therapeutic outcomes (Herman, 1993;Norcross;Elkins, 2016). The traits of openness to self-examination, awareness of self and others, genuineness, approachability, honesty warmth have all been identified as necessary for clinicians to establish positive interpersonal relationships in individual and small group contexts (Duba, Paez, and Kindsvatter, 2010). ...
Professional dispositions expected of counseling students has been a contested area within the counseling profession, and students challenging dismissal decisions have put counseling programs at risk of litigation. To better guide counseling programs’ evaluation and remediation efforts, the authors used a content analysis to investigate the most recurring professional dispositions of master’s level counseling students listed within
student retention policies, evaluations and rubrics of CACREP accredited counseling programs (n=224). The most common dispositional themes included; Openness to Growth, Awareness of Self and Others, Emotional Stability, Integrity, Flexibility, Compassion, and Personal Style. Implications for how the disposition themes can assist in student evaluation and remediation with specific regards to multicultural competence are discussed.
... There are a growing number of former service users who are speaking out against the current domination of the mental health professions by the medical model, which they feel defines them with diagnostic labels rather than as individuals (Elkins, 2015;Everett, 2000). The psychiatric survivor movement holds that there is a tendency for the psychiatric system to treat service users through paternalism and condescension rather than providing partnership and empowerment (Bassman, 2000). ...
It is not uncommon for individuals to disagree with their psychiatric diagnosis. The experience of perceived misdiagnosis can be challenging for service users, as mainstream psychiatric theory often views this disagreement as an indication of “poor insight” into their putative illness. Some researchers have suggested that labeling a service user as lacking insight can be detrimental to the service user’s recovery. Regardless of whether a person agrees with his or her diagnosis, persons labeled with “mental illness” sometimes internalize the discrimination and stigma that they encounter. However, few studies have examined the lived experience of disagreeing with a diagnosis. The present study investigated the first-person experiences of three individuals who believed that they were misdiagnosed with a psychotic disorder. As part of a larger study, participants completed in-depth interviews about their life history and experiences in psychiatric hospitals. Data were analyzed using phenomenological methods. Participants felt that their clinicians assigned an erroneous and stigmatizing label that did not match their self-experience. Diagnostic dissent, a form of perceived misdiagnosis, was a way for individuals to assert their self-experience against perceived invalidation and stigmatizing labels.
... Third, existential and constructivist perspectives tend to avoid techniques and overly structured or manualized approaches. Finally, in the therapy context, both attend to many of the common factors of psychotherapy, such as relationship factors (see Elkins, 2015). ...
... These resources and interventions were often less structured and more community-focused, and they trusted the wisdom that emerged within these communities. These findings suggest that what many clients may be looking for is something that falls outside of the realms of evidencebased practice in psychology and is more consistent with what David Elkins (2015) refers to as the human elements in psychotherapy. Walsh's findings suggest that what may be interpreted as resistance by many therapists is better understood as the therapist misunderstanding the client's needs and desires. ...
... These findings are interesting, especially when considering the efforts and advocacy that have been made over the last 15 years to operationalize the measurement of SDM from an observer standpoint (Elwyn and Blaine, 2016). One explanation to the prevalent of self-report methods over observer methods in SDM in mental health studies might be related to the delicate bond between mental health provider and patient; since medical encounters involve an intimate interaction that requires trust and partnership between the patient and provider (Laugharne et al., 2012;Schout et al., 2010), especially in mental health settings (Morant et al., 2015;Elkins, 2015), the use of observer measures may considered intrusive and may intimidate this delicate bond and thus, is less preferred and adopted compared to self-report method. A supplementary explanation to prefer self-report measures to assess SDM in mental health stems out of the person-centered care approach. ...
Purpose
Much of the existing literature on Shared Decision Making (SDM) in mental health has focused on the use of Decision Aids (DAs). However, DAs tend to focus on information exchange and neglect other essential elements to SDM in mental health. Therefore, the present work aimed to expand the review of SDM interventions in mental health by identifying important components, in addition to information exchange, that may contribute to the SDM process in mental health.
Design/methodology/approach
Systematic and scoping literature search.
Findings
A final sample of 31 records was systematically selected. Most interventions were developed and/or piloted in the US for adults in community psychiatric settings. Although information exchange was a central component of the identified studies, important additional elements were: eliciting patient preferences and values, providing patient communication skills training, eliciting shared care planning, facilitating patient motivation, and eliciting patient participation in goal setting.
Practical implications
Originality/value
Our review indicates that additional elements, other than information exchange such as sufficient rapport and trusting relationships, are important and needed as part of SDM in mental health. Future SDM interventions in mental health could consider including techniques that aim to increase patient involvement in activities such as goal settings, values, and preference clarification, or facilitating patient motivation, before and after presenting treatment options.
This chapter is part of a book honoring the psychologist Henrique Justo, a pioneer of Humanistic Psychology in Brazil, who shed light on various aspects of Carl Rogers' work. These aspects have spanned different historical periods and have influenced the work of multiple generations of Brazilian academics.
Justo explicitly articulated the innovative and integrative nature of the scientific research proposed by Carl Rogers in the field of psychotherapy, addressing contemporary themes related to the limitations and possible avenues for unifying psychotherapeutic schools. He primarily demonstrated Carl Rogers' interest in the application of psychological research methods in the psychotherapy process and his unique approach to the therapeutic relationship.
In this chapter, I explore the significance of Carl Rogers, not only in the comprehensive and theoretical-conceptual realm of psychotherapy, with his innovative perspective on the therapeutic relationship, human experience, and intersubjectivity, but also in the scientific and empirical domain, investigating psychotherapeutic processes.
RESUMO EM PORTUGUÊS: Este capítulo faz parte de um livro em homenagem ao psicólogo e Irmão Henrique Justo, um pioneiro da Psicologia Humanista no Brasil, que lançou luz sobre diversos elementos da obra de Carl Rogers. Esses elementos atravessaram diferentes períodos históricos e influenciaram o trabalho de várias gerações de acadêmicos brasileiros.
Justo explicitou o caráter inovador e integrador do tipo de investigação científica proposto por Carl Rogers no campo da psicoterapia, abordando temas atuais sobre as limitações e as possíveis vias de unificação das escolas psicoterapêuticas. Ele demonstrou, sobretudo, o interesse de Carl Rogers pela aplicação de métodos de pesquisa psicológica no processo de psicoterapia e sua maneira peculiar de abordar a relação terapêutica.
Neste capítulo, explora-se a importância de Carl Rogers não apenas no campo compreensivo e teórico-conceitual da psicoterapia, com sua visão inovadora sobre a relação terapêutica, a experiência humana e a intersubjetividade, mas também no campo científico e empírico, na investigação dos processos psicoterapêuticos.
Background
Despite the urban myth of “the divorce course,” there is little research to support this perception of counselling training programmes. Studies exploring the lived experiences of counsellors in training have referred to relationship changes, but none have made these their primary focus. Research is needed to enhance our understanding of this formative stage for counsellors.
Aims
The purpose of this ideographic study is to gain new perspectives on the perceived impact of counselling training on trainees' personal relationships by exploring the lived experiences of five counsellors who completed their training in the last 18 months.
Method
Through a process of volunteer and snowball sampling, qualified counsellors were invited to participate in individual semistructured interviews, which were recorded and transcribed. Due to the small sample size and the emphasis on how each participant made meaning of their own experience, interpretative phenomenological analysis was chosen to interpret the findings.
Findings
Detailed analysis and interpretation of the data filtered into two superordinate themes: permission to change; and
the challenge of integration.
Conclusion
The data revealed that training had a significant multifaceted impact on the personal relationships of all participants. Participants' experience of their training group and of personal therapy was found to be an important factor in this change, as were themes of agency and identity. The majority of ruptures in extant relationships took place early in training. Further research is needed, perhaps into the experiences of loved ones in relationships with student counsellors.
V članku s pomočjo ptiča Dodo prikažem razlike med kontekstualnim in medicinskim modelom ter kako Dodo poskuša v psihoterapevtski znanosti in klinični praksi s pomočjo integracije med različnimi psihoterapevtskimi pristopi in metodologijami raziskovanja spodbuditi prehod od znanstvenega monizma k dialoškemu pluralizmu. Prizadeva si za sožitje medicinskega in kontekstualnega načina védenja oziroma objektivistične/nomotetične in sistemske/konstruktivistične/hermenevtične epistemologije. Tako sožitje je možno v okviru integrativne psihoterapije, ki ne predstavlja nove psihoterapevtske šole oziroma pristopa, temveč meta-model na osnovi znanosti o kompleksnosti. Glede na obstoječe psihoterapevtske pristope gre torej za meta-raven, ki omogoča integracijo naslednjih dimenzij onkraj posameznih psihoterapevtskih šol: znanosti in prakse (model znanstvenika praktika); biološkega (še posebej živčnega), mentalnega (psihološkega) in socialnega delovanja; kvantitativne in kvalitativne metodologije; nomotetičnosti in idiografičnosti; teoretičnih razlag in kliničnega razumevanja; medicinskega in kontekstualnega modela. Hkrati z Dodovo pomočjo postaja jasno, da psihoterapija ni več samo uporabna psihologija, temveč samostojen poklic, stroka in znanstvena disciplina na stičišču več različnih disciplin, kot so psihologija, filozofija (epistemologija, hermenevtika), medicina (psihiatrija), biologija, nevroznanost, družbene vede, pa tudi metode linearne in nelinearne analize časovnih vrst, ki izhajajo iz fizike in matematike ter informatika (npr. z uporabo računalniško podprtih sistemov povratnega informiranja). Za medsebojne povezave in meta-teoretični okvir, vključno s transdisciplinarno terminologijo, služi znanost o kompleksnosti (ki med drugim vključuje teorijo kompleksnih dinamičnih sistemov in sistemske teorije). Predlagani koncept integrativne psihoterapije, ki, podprt s povratnim informiranjem v dejanskem času terapevtske obravnave, spodbuja procese samoorganizacije, omogoča sintezo klasičnega razcepa med medicinskim in kontekstualnim modelom.
This qualitative study of fifteen relational counsellors explores the experiences and ethical quandaries of counsellors working within an IAPT service. The data was analysed using the Voice Relational Method [Brown, L. M. & Gilligan, C. (1993). Meeting at the crossroads: Women's psychology and girls' development. Feminism & Psychology, 3(1), 11--35]. Three main themes were identified: client experience, counsellor experience and relationships. Findings indicate that the therapeutic relationship with clients is crucial, but there is often a disparity between working as a relational counsellor and the expectations and demands of working within IAPT; a pressure on doing and achieving goals rather than a focus on the therapy relationship. Supportive managers were essential to enable counsellors to balance IAPT expectations with ethical and therapeutic relationships with clients. This research also questions the ethical basis of the IAPT system.
Mainstream psychology is based on the epistemology that the domain for psychology exists in an independently pregiven reality (ontology) and that truth about such reality is attainable through empirical scientific investigation. This has become a position more or less taken for granted in mainstream psychology and psychotherapy research. Jan Smedslund has challenged this epistemology in a profound way. Inspired by this, the argument in this chapter is not only that this epistemology is false (as Smedslund does), but also expand on his conclusion about the bricoleur model of psychological practice by contextualizing psychotherapy culturally and historically and thereby classifying it as a kind that belongs to the art of healing. Necessary and sufficient conditions for the healing context are discussed. Furthermore, it is argued, this epistemological change could rescue psychotherapy from the problematic mismatch between what psychotherapy pretends to be, and what is really going on in practice.
This chapter advances the following definition of positive balance at the physiological level. Individuals characterized as as high in mental health tend to experience a preponderance of neurochemicals related to rewards (dopamine, serotonin, and oxytocin.) relative to negative neurochemicals related to stress (cortisol). This definition of positive mental health at the physiological level is based on much of the research literature on the neurobiology of hedonic well-being and the stress response system.
Writing one’s own obituary is a technique rooted in the theoretical/philosophical principles of existential-humanistic psychology that has long been endorsed by existential-humanistic psychologists for its value in promoting second-order change (existential liberation) and self-cultivation. These processes are pertinent for emerging adults, for whom a principal developmental task is self-authorship (transitioning out of uncritically following external formulas learned in childhood and toward making internally based decisions to meet the demands of complex work roles and interpersonal intimacy as adults). To date, literature on obituary writing has been limited to a half-dozen sources, none of which offer formal investigations of its process mechanisms/dynamics. This study provides research support for the technique’s theoretical underpinnings and contextualizes its effectiveness as demonstrated in extant case studies in order to preserve its integrity in the current evidence-based practice zeitgeist. In this study, 22 emerging adults in a college course completed obituaries and reflections on the lived experience thereof. Thematic and summative content analyses were used to assess the thematic content included in the obituaries and the process by which the participants made sense of the act of writing them. Findings suggest that, in this sample, consistent with extant theorizing and informal observations, the experience of completing one’s own obituary begins with emotional discomfort followed by a transformative shift in the direction of a greater sense of acceptance, appreciation, and awe toward the possibilities of living the life one envisions. Finally, connections with and contributions to the emerging
adulthood literature and suggestions for further inquiry are discussed.
The purpose of this article is to capture and illuminate a trauma-focused presence in psychotherapy treatment. The goal is to highlight an integrative approach that centers on the trauma survivor’s battle with freedom and limitation. Both the expansive and the constrictive tendencies of many traumatized clients are exemplified, focusing on the dichotomous or polarized positions that clients present. Key factors of evidence-based therapeutic relationships that can guide therapist stances and engagement efforts are explored. This approach moves away from an overemphasis on and strict adherence to the medical model framework and toward a contextual standard grounded in a humanistic blanket and characterized by a person-centered and relationally driven therapeutic approach. The trauma therapist chiefly fosters engagement and makes space or pathways for an assortment of therapeutic interventions that are congruent with the client’s theory of change and take shape organically. Developing intrapersonal and interpersonal presence are primary focal points that correlate with the importance of personal and interactive processes in successful psychotherapy outcome research. Meaning making is at the core of a trauma-focused presence and takes place through client and therapist dialogue.
Reviews the book, The Human Elements of Psychotherapy: A Nonmedical Model of Emotional Healing by David N. Elkins (see record 2015-20799-000). Elkins's book calls for a summit where the truths of various perspectives and needs can be addressed in his wonderfully integrative and progressive read, critique, and project of therapeutic care. The win–win possibility is a common factors model of psychotherapy predicated on the centrality of human elements. This book is also a great introduction for those unfamiliar with a common factors model of therapeutic care, as well as a catalyst for discussion among various professionals as the industry of care becomes more interdisciplinary and interprofessional. Elkins's book is accessible to novice practitioners, which is important for early exposure to training in the diversity of thought and praxis regarding therapeutic care. To this point, Elkins in his practical wisdom ends his book with a substantial chapter synopsizing his model and discussing its implications for clinical research, training, and practice. But his work is also stimulating and provocative for lively debate among seasoned scholars and practitioners. At the same time, this book is neither a devotional book of vapid generalities nor an injection of venom striking out at every dominant structure of power in mental health today. Elkins soundly defends his arguments with solid evidence from attachment and social interaction studies as well as from neuroscience and evolutionary psychology.
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