Tentamen Psychologie Samenvatting PowerPoints

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1 Tentamen Psychologie Samenvatting PowerPoints College 1, Intro. Changing Behavior What Works? What Works? What works? Research in psychotherapy points out the demonstrably effective variables: Alliance between client and professional Empathy Collecting client feedback Positive regard (Norcross et al, 2011 Working alliance Or collaboration to change, is equally important in all models of change It is composed of three elements: 1. The bond between professional and client 2. The extent to which they agree on goals 3. The extent to which they agree on tasks Every change occurs within the relationship, through the dynamic process of weakening and repairing of the relationship Working alliance main features 1. The professional should possess certain facilitating qualities 2. These facilitating qualities are the basis for power of the professional. The desire to change is the client s power. These must be balanced, promoting a balanced power relation. 3. The relationship allows experiential learning experiences 4. The success of the relationship-based learning experiences depend on the ability from the client to permit a level of trust and openness

2 Working alliance main factors Empathy main ways of defining Collecting client feedback 1. DESIRES OR GOALS What do you want or hope? What are you looking for? 2. IMPORTANCE How important is what you are looking for? How much of a priority is it? 3. POSITIVITY Did you feel good about the experience? Did you feel welcomed, valued and respected? Were you treated in a warm and supportive manner? 4. EXPECTATIONS What did you think was going to happen? Did the experience fit your expectations? 5. HOPE Do you think that this relationship can help you get what you are looking for? Do you believe it will help you? 1. CREATING A SUPPORT RELATIONSHIP Professional shows a compassionate attitude and tries to demonstrate he understands 2. BEING IN TUNE Active, ongoing effort to stay attuned on a moment-to-moment basis 3. PERSON EMPATHY Understand the persons world, both historically and in the present, that form the background for all experience IMPORTANT TO: Evaluate the quality and effect of the session / process Measure the impact of the work Measure the outcomes Inform our practice Create evidence based practice and practice based evidence Positive regard No conditions for accepting Means a caring for the person, and never for the facts, situation or problem Also called a non-possessive warmth The person is not judged, and is separated from the eventual positive or negative aspects of his/ hers experience Psychological approaches Which is going to help you more in making your patient stronger? Changing behavior Cognitive-Behaviorist Behavior; rationality; skills; beliefs Transtheoretical Behavior; skills; beliefs; motivation Positive Behavior; rational; performance Systemic Bio-psycho-social Person Centered Holistic; attitudinal; non directive Professional in the centre Behavioral models Transtheoretical model Cognitive models Client in the center Person centred model Personalisation model Positive psychology Ecletic approaches

3 From surface to core Behavior Roles / Skills Attitudes Beliefs Values

4 College 2, being person centered Being person centered Basic premiss 1 Every person, given the right conditions, has a tendency to use personal resources to adapts to its environment, developing Self awereness Self-concept Openness to experience Incongruence vs congruence Basic premiss 2: If we are able to communicate some attitudes toward the patient, if he feels them from us, we are facilitating his / her process: Congruence Empathic understanding Unconditional positive regard Congruence Unconditional positive regard Ability to separate the person from the problem Unconditional positive regard Professional is congruent / genuine Professional is deeply involved not acting and can draw on his own experiences (self-disclosure) to facilitate the relationship Professional has an attitude of being true, genuine and transparent Two dimensions: Internal Professional s conscient access to all the aspects of his experience External Verbal and non-verbal communication by the professional of his perceptions, attitudes and feelings. This we call transparency Professional accepts the client unconditionally, without judgment, disapproval or approval. Belief that it is impossible to judge someone. You never can comprehend one enough to consider all the variables and be fair. Your judgment is always limited by your frame of reference Professional works from the assumption that he/she has no answers. He/ she can facilitate the process of finding them.

5 Empathic understanding To sense the person s private world as if it were your own, but without ever loosing the as if quality. (Carl Rogers) To be able to leave aside (for that time only) your values, so you can enter the other s world without prejudice. Empathy (understand suffering) Vs Simpathy (suffer with) Empathic understanding Attitude of constant checking: Did I get that right? Understanding of the content but also of the relation aspect By using reformulations, you and the other person know if they are in the same page. Gestalt: the whole is more than the sum of its parts Conclusions What I communicate in the relationship with a person is not within total control What I want to communicate in the professional relationship (my intention) is central for my professional identity I can only help if that is a personal and genuine

6 attitude. This points to a certain personal engagement. Total separation between personal and professional does not show effective My attitude towards the other only has value to him/her if I can communicate it within the relationship To really be client centered, most of my working ground is myself. I should be constantly checking my own identity.

7 College 3 Phases of a process The relational process Three phases identified, each one with specific tasks for the professional guidance phase identity emerging phase / working phase conclusion phase / the letting go Guidance phase Facilitate the building of trust in the relationship the attitudes of respect, autenticity and empathic understanding will allow a gradual abandoning of the resistances and raise the level of sharing and self-exploration Clarify each person s roles in the relationship both must share their expectations, perceptions of each other inside the relationship Follow the client when he formulates his need of support recognize his suffering or problem; help him/her defining, explaining and take action over it Identity emerging phase / working phase Conclusion phase / the letting go Define the strategies that might respond to the client s needs They both know each other, so they re more involved (afections can be more or less present in the relationship) Enable the learning and expression of new behaviors Encourage atmosphere of openness and search for alternative solutions; desmistify the mistakes; discuss the needs and emotions envolved; help to modify habits Comunicate your opinion about the relationship that was established Put the relationship in perspective; associated feelings. Must be made in what concerns the goals that were established Ensure the client s transition between his present condition and his immediate future Prepare the patient for a new stage; enable the building of his autonomy

8 College 4 Personalization Definitions Enabling people to lead the lives that they choose and achieve the outcomes they want in ways that best suit them Simpson, 2010 A Government led national policy to ensure everyone who uses support should have the choice and control to shape their own lives and the services they receive In Control, 2011 Means starting with the person as an individual with strengths, preferences and aspirations and putting them at the center of the process Carr, 2010 Putting users at the heart of the service, enabling them to become participants in the design and delivery of the services they use Leadbetter, 2004 Definitions Strong link with person centered care More recent, it has been specially used in contemporary social care Considers how services can be transformed to meet the needs of the individuals Principles The individual should be at the center of assessment and planning Support planning should focus on the desired outcomes of the individual, not the professional s convenience Individuals should be recognized as experts in their own care equal input Focus on solutions rather than problems, strengths rather than deficits Core values Putting people first Respect for self-determination Listening and empowering Addressing potential conflict Safeguard needs and the individual capacity Being sensitive to diversity and putting people in control The dimensional approach CAPACI TIES CONNEC TIONS PERSONAL RESILIENCE ACCESS CONTR OL The dimensional approach CAPACITIES: Ability to exercise and develop own personal strengths; support expressing dreams, hopes and wishes; ensure people recognise where they have solved a dificulty. Strengthen the personal resolve. CONNECTIONS: Develop relationships that enable growth; create strong personal networks; know others in similar circumstances

9 ACCESS: Provide wider access to the community; promote open and inclusive environments. CONTROL: Let people shape their own lives. Feeling of expert of own life. Without control people become vulnerable, subject to power by others. The seven P s Partnership Families, communication, health, social care, support services Prevention Keeping people as independent as possible Plurality Increase diversity in service provision Protection Ensure safety and security of the more vulnerable Productivity More accountability should drive more innovation and quality People The workforce should work alongside service users PERSONALISATION Personalization Early intervention and prevention Self determination Choice and control Dignity Support and empowerment Citizenshop Families and communities Personalization, Why? CHANGING DEMOGRAPHICS: People live longer and have more complex needs. Dilemma between financial aspects and rising expectations to higher quality in lifestyle. Personalization IMPACT FOR SERVICE USERS: According to Edwards and Waters (2008): 55% stated they spent more time with people they wanted to be with 77% reported better quality in life 63% felt they took more part in community life 47% improved general wealth and wellbeing 72% reported more choice and control 59% reported more personal dignity Personalization, Why? ONE SIZE FITS ALL: Services were not tailored to the needs of the individual. People had no choice than to accept or decline the services that they were provided or commissioned by their local authorities. ONE SIZE FITS ALL: By defending tailor-made approaches, personalisation challenges the one size fits all. Users should have choices and control the design of the service. Having a personal budget, they gain financial control over their care, and more choice in their lives. THE GIFT MODEL: The provision of care seen as a gift negates choice and control. The recipient is given care, and society expects that they are grateful and make no demands. Active support enables people to take part in all the actions of care.

10 THE HOTEL MODEL: Everything is done by the staff. Guests do not get the opportunity to engage in activities that contribute to the running of the hotel. Example: inflexible meal times, bed times, etc. HOW? HOW? DIGNITY AND RESPECT EMPATHY RESPONDING TO INDIVIDUALITY Name, life story, family, friends, what we like/ don t like, accent, sexuality, way we dress, body language, habits, preferences, religion, culture, dreams, hobbies IN SOME WAYS WE ARE ALL UNIQUE SOME PEOPLE ARE THE SAME IN SOME WAYS (EG. GENDER) IN SOME WAYS WE ARE ALL THE SAME (Eg. Biology) HOW? Discussion THE VIPS APPROACH Brooker (2007) illustrates the four main elements of personalised care: V VALUE of all human lives regardless of age or cognitive ability I INDIVIDUALISED approach, recognising uniqueness P Understanding the world from the PERSPECTIVE of the service user S Providing a SOCIAL environment that supports psychological needs In which ways a PAL professional could work according to the PERSONALISATION principles? Think of examples of practices that can enrich your discussion.

11 College 5 Person centered tools The one page profile is a tool that allows you to know the person you work with It can be a manager, a colleague, or a client Not focusing on needs or disabilities, it brings you insight about: who the other person is how you can both respect and support him/her Tells you what needs to be present for increasing quality of life Helpfull for team work and work alliance Brings clarity about goals and aspects to avoid Gives you insight about what course of action to take

12 Allows you to make a balance about your relationships You evaluate what s working or not working: For you With your family With the health care staff Helps to get significant other s perspective Allows to plan on building upon the positive and rebuilding the negative What is important to a person is what they say through their own words and behaviors about what really matters to them. What is important for people are the things that help people become or stay healthy and safe, whether it is important to them or not. The balance between the two is the compromise that we experience in life.

13 Getting a good match between the person supporting and the person being supported is crucial. The Matching Tool is a simple way to record what is needed to give a person the best match between those who use services and those who provide them. Four columns: support that the person wants and needs the skills required to support them personality characteristics shared common interests. These questions are powerful to use in meetings and reviews, or to reflect on a particular area of someone's life when they face a particular situation or challenge. It can be an easy way to update onepage profiles and develop more detailed person-centred descriptions. Staff are less likely to continue to do what is on the 'what are we concerned about' list.

14 College 6 Cognitive theories Protection motivation theories Describes health behaviors as a product of five components SEVERITY Cancer is a serious illness SUSCEPTIBILITY My chances od getting cancer are high RESPONSIVE EFFECTIVENESS Changing my diet would improve my health SELF-EFFICACY I am confident that I can change my diet FEAR I am scared of getting cancer Example Using the protection motivation theory to change a diet THESE COMPONENTS PREDICT BEHAVIORAL INTENTIONS INFORMATION CAN BE ENVIRONMENTAL OR INTRAPERSONAL INFORMATION INFLUENCES THE 5 COMPONENTS AND ELICIT ADAPTATIVE OR NONADAPTATIVE COPING RESPONSES Theory of planned behavior

15 Example Theory of planned behavior THEORY OF PLANNED BEHAVIOR EVIDENCE SUPPORT: Condom use in both gay and heterosexual populations (Godin et al) Blood donation for blood transfusion and organ donation (Godin et al 2007; 2008). Predict smoking (Higgins and Conner 2003) Exercise during pregnancy (Hausenblas and Downs 2004) Walking (Scott et al. 2007) Speeding behavior using a driving simulator and an onroad speed camera (Conner et al. 2006) Deliberate self-harm and suicidality (O Connor et al. 2006) In Ogden, 2012 MAIN CRITICS: Norman and Conner (1996) have argued that concepts such as perceived behavioural control, behavioural intentions, perceived vulnerability and attitudes overlap. Armitage and Conner (2000) have argued for a consensus approach The models describe associations between variables which assume causality. Sutton(2002a) argues that these associations are causally ambiguous and cannot be concluded unless experimental methods are used. In Ogden, 2012 MAIN CRITICS: Research shows that these models are not that successful at predicting behavioural intentions. Sutton (1998a): social cognition models only manage to predict between 40 and 50 per cent of the variance in behavioural intentions. Such models are even less effective at predicting actual behaviour. In 2010, Webb and Sheeran carried out an extensive meta-analysis of the TPB and concluded: diet and physical activity were the better predicted behaviours (23.9 and 21.2 per cent respectively)

16 risk, safer sex and abstinence from drugs (between 13.8 and 15.3 per cent of the variance explained). In Ogden, 2012 THE COGNITION BEHAVIOUR GAP Rational emotional model RATIONAL EMOTIONAL MODEL RATIONAL EMOTIONAL MODEL RATIONAL EMOTIONAL MODEL Cognitive research assesses behavioral intentions as a means to predict behavior: I THINK, THEREFORE I INTEND TO, THEREFORE I DO This link is not always that straightforward: PAST BEHAVIOUR Yesterday I had a healthy breakfast and I felt energy, so I ll do it again today HABIT Future behavior automatically influenced by past behavior. No questioning. QUALITY OF PLANS OF ACTION VIABILITY OF THE GOALS ACTION CONTROL People are disturbed not by things, but by their view of things THE A-B-C MODEL A: Activating event B: Belief Sistem C: Emotional and Behavioural Consequences An irrational belief often creates difficult emotional and behavioural consequences THE A-B-C MODEL BECOMES A-B-C + D A MAJOR ROLE FROM THE PROFESSIONAL IS TO DISPUTE THE IRRATIONAL BELIEFS Intends to help people using efficient, flexible and logic ways of attempting to achieve values and goals How can people get more from life by being rational EXAMPLES OF IRRATIONAL BELIEFS Because I desire to get A s in all subjects, I must have all A s at all times Because I desire to be loved by Sarah, I must always have her approval Because I strongly desire to have a safe, confortable life, I must find life easy and gratifying at all times IRRATIONAL BELIEFS 1. Demands about self 2. Demands about others 3. Demands about the world or life conditions MUSTURBATION Term for all types of must statements Causes low frustration tolerance more likely to become disturbed THE A-B-C-D MODEL BECOMES A-B-C-D-E A ACTIVATING EVENT B IRRATIONAL BELIEF C EMOTIONAL AND BEHAVIOURAL CONSEQUENCE D DISPUTING THE IRRATIONAL BELIEF

17 E EFFECTIVE RATIONAL OUTLOOK ACCOMPANIED BY EMOTIONAL AND BEHAVIOURAL CHANGE

18 College 7 positive psychology Strengths and resources Solving problems by improving, not curing or healing Flourishing / optimal functioning Satisfaction of life Subjective level subjective experiences Individual level enhancing the good, the capacities Meaning, satisfaction and wisdom What should be the main goal? WELL BEING? HAPPINESS? An alternative to the more classical approaches, focused on problems People want more than just not suffering Environmental (families, schools, work places, communities) Education, promotion Aim is to develop, to build, and not to cure Interventions 3 positive things Gratitude diary Resilience Focusing on positive emotions Measuring tests Applied positive psichology Physical activity: not focusing on why they couldn t, or barriers, or previous attempts Tries to create positive feelings in new behaviours Enhancing performance means dealing with psychological dimensions State of flow Teaching positive psycology Foster calm Foster intrinsic motivation Foster internal locus of control Foster respect for happiness Foster mindfulness and flow Results / research Depression Mental health

19 Giving creates happiness Social relationships Wich definition of health and wicht intervention goals? BRESLOW (1999): Health is not simply the absence of disease: it is a joyful attitude towards life, and a cheerful acceptance of the responsibilities that life puts upon the individual Points for discussion? Philosofical approach interesting but intervention might not be efficient for all problems or all people More happy more healthy? How does it relate? In which phase of the process can it be a good model for intervention?