期刊
JOURNAL OF PSYCHOTHERAPY INTEGRATION
卷 31, 期 2, 页码 115-128出版社
EDUCATIONAL PUBLISHING FOUNDATION-AMERICAN PSYCHOLOGICAL ASSOC
DOI: 10.1037/int0000185
关键词
plan formulation methods; case formulation; psychotherapy techniques; psychotherapy relationship; relational difficulties
Most therapy sessions are conducted with a top-down approach based on therapists' theories, rather than focusing on individual patient's unique problems. We suggest using a bottom-up approach that tailors therapeutic interventions to the individual patient's specific needs and issues, leading to more effective treatment outcomes.
Most patients present with a combination of symptoms and relational problems, but often psychotherapies are not conducted in a way to deal with both. Many therapists take a top-down approach to treatments. That is, the techniques they use are based on their theories of therapy (that suggest how certain diagnoses should be treated) rather than on an understanding of the unique problems and issues of the individual patient. We suggest that what is needed is a bottom-up approach, in which the individual patient's goals, conflicts, inhibitions, and so forth are identified and therapeutic interventions are designed accordingly on a case-specific basis. The foundation of such an approach is a case-specific clinical formulation. There are a number of formulation methods; we focus on the plan formulation method to illustrate how to evaluate the individual needs and specificities of the therapy patient and then how to tailor a therapy to the individual patient, regardless of the therapist's theoretical or technical predilections. Finally, we report examples of therapies conducted in this bottom-up approach to demonstrate how symptoms and relational problems can and should be addressed.
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