The Contribution of the Greek Model of Supervision in Psychological Assessment

Transcription

1 The Contribution of the Greek Model of Supervision in Psychological Assessment Panayota Theodorou Christina Mastrandrea, Hara Haritaki, Evdokia Lagakou, Ioannis K. Tsegos 11 th European Conference in Psychological Assessment at Riga, Latvia Thursday, 01/09/2011

2 Contents The Open Psychotherapy Center The Greek Model of Supervision Application of the Greek Model in Psychological Assessment: a Case Study analysis

3 The Open Psychotherapy Center

4 The Open Psychotherapy Center Therapy Department Adults Therapy Unit Child and Family Therapy Unit Training and Research Department Seminars and Training Activities Unit (Athens and provinces) Institutes and Post- Graduate studies Group Analysis Diagnostic Psychology Psychodrama- Socio-therapy Family Therapy Research Activities Publications/ Administrative Department Set of books Contemporary Psychotherapy Articles (in journals, books) Newsletters Organizing open lectures and conferences

5 Therapy Department Individual Psychotherapy Holistic Assessment (psychiatric, psychological, family, pharmacotherapy) Psychotherapeutic Community Daily Community Fortnight Community Summer Community Family Therapy Group-Analytic couples Psychodrama for children and adolescents Parents Groups Group of individuals with menta retardation

6 The Group-Analytic Supervision and the Greek Model

7 The Greek Model of Supervision The «Greek Model of Supervision», an innovative variation of the groupanalytic supervision, was introduced by I.K.Tsegos and is applied since 1983 at the four (4) institutes and post- graduates studies at the Open Psychotherapy Center. Characteristics of the Greek Model The supervisory group express their feelings and their phantasies instead of their comments. The role of the supervisory group is dual: therapeutic and tutorial. Contributes to the development, maturation and differentiation of the trainee by reinforces the self-esteem, the creativity and the strength of the Ego of the trainee (Tsegos, 1993a). Supervision is a therapeutic art which is characterized by a personto-person, mutual communication and has a clear and structured process through which portraits with accuracy the role and the contribution of the psychotherapist as well as the whole psychotherapeutic procedure (Tsegos, 1993b).

8 The Supervisory Process

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10 Application of the Greek Model of Supervision: Case Studies Analysis

11 The survey: case studies analysis Purpose to investigate the degree in which the supervisory group can function as a diagnostic instrument. Method The supervision protocols of 4 Psychological Assessments (two adults and two adolescents). Comparison between the reactions of the supervisory group - as those were expressed through the emotions and the phantasies- and the results from the quantitative and qualitative analysis of the tests protocols (Rotter, Rorschach,Thematic Apperception Test - T.A.T.).

12 The Case Study of a 17 year-old girl Background Information Family Background A 17 -year -old girl, High School student High achievements at school Various extra curriculum activities mainly artistic (painting, music, singing) Difficulty in peer relationships Symptomatology of depression, suicide thoughts, self- destructive attitude, frequent sexual relationships and abuse of cannabis Parents Divorced; Lives with her mother and her younger sister Father: High position at a University and independent business consultant; married again and has a child from his 2 nd marriage o good man but firm and rigid, distant and rather ego-centric (more focus on career rather than family matters) Mother: Higher Education- Professional o dynamic, sensitive, strongly opinionated, determined and worrying too much about her children and their well- being Younger sister: 2 years younger- good sibling relations

13 Comparing Emotions

14 Comparing Emotions Tests Supervisory Group Depressive and dysphoric Feelings (disappointment, sorrow, grief, desperation, withdrawal and boredom, loneliness, tiredness, feeling Depressive Feelings (grief, sorrow, desperation, disappointment, tiredness, boredom, feeling pressure, fatigue) pressure, stifling) Feelings of Fear (fear of attack, threat, feeling guilty, being in Feelings of Fear (agony, anxiety) doubt, turmoil) Aggressive Feelings (hate, envy)

15 Comments about the emotions In both situations the focus is on feelings of discomfort ( negative ) rather than on positive feelings. More specifically: o o Emotions of guilt, stress, agony, pressure, fear and doubt Emotions of depression such as sorrow, grief, frustration, fatigue, pain The results from the tests reflects feelings of aggression such as envy and hate, which were not expressed by the supervisory group The results from the group reflects strong feelings of depression, desperation and disappointment in a more clear way than the tests

16 Comparing Phantasies

17 Using the Rorschach factors to code phantasies: Similarities Quantitative Analysis Rorschach M=4 M=7 S(Y)=3,5 MOR=2 H%=29% Hx=3 Anx%=33% Phantasies S(Y)=3 MOR=3 H%=60% Hx=3 Anx%=20% Qualitative Analysis Sufficient expression and utilization of the inner potential (M) Strong feelings of depression (SY and MOR) Strong interest for others (H) Satisfactory ability to build close relationships and empathy (Hx) High stress and feelings of anxiousness (Anx)

18 Using the Rorschach factors to code phantasies: Differences Quantitative Analysis Qualitative Analysis Rorschach Phantasies M=4 M=7 FM=10 FM=1 m=0 m=2 M:FM+m=4:10 M:FM+m=7:3 S(C)=5,5 S(C )=2,5 M:S(C )=4:5,5 M: S (C )=7: 2,5 The higher number of M responses in the supervisory group, may reflect a strong need for inner organization and structure due to high anxiety. Although the data from the supervisory group seem to reflect an ability of inner control of impulses, better structure and tolerance to disappointment/frustration (FM=1), the Rorschach responses indicate a strong need for immediate satisfaction of the primitive needs/desires (FM=10). The supervisory group identified the threat of the disorganization of the Ego and the feelings of anxiety and tension (m) but without feeling of diluteness, in contrast with the Rorschach responses. The supervisory group seem to identify efficient control over impulses and emotional needs in contrast with the Rorschach responses which reflect impulsiveness (SC and FM).

19 Using the Rorschach factors to code phantasies: Differences Quantitative Analysis Qualitative Analysis Rorschach Phantasies m=0 m=2 Hd=4 Hd=2 The supervisory group indicates that the feelings of anxiety are expressed through inner tension (m) rather than in the relationships with others(hd) as in the Rorschach responses. The high number of Hd in the Rorschach seem to reflect difficulties in building mature relationships and having autonomy, needs for dependence and emotionally immatureness. A%=63% A%=20% The supervisory group did not indicate high number of A, while in the Rorschach responses the high number of A reflects compliance with rules and social acceptable ways, submissiveness, resistance as well as dependency needs.

20 Indicative Phantasies Rorschach Answers Supervisory Group A monster with black wings and two hands that are trying to grasp you and eat you. Really scary A woman s face and blood. It has the mouth open and it screams and blood is coming from the chin and the eyes are closed and are bleeding Two waiters serving someone The red in the middle is a butterfly These hanging on the side are like embryon of a human being or ape hanging from the umbilical cord An old, empty cage of a bird : the cage is made of steel, reckon, rusty and its door is closed. I see it from a distance hanging over a veranta A whirlpool which sucks a man who screams in mute: the water is dark A maze in which a young girl is running and trying to go out: The maze is a black wall like those in the crossword puzzles A dress in a dummy, without a head in an isolated room

21 Comments about the phantasies The supervisory group: expressed the negative feelings (depression and anxiousness) in a more clear way recognized the stress and tension but without the fear of breaking into pieces. indicated that the Ego is vulnerable, but it did not reflect the inner conflict, the impulsiveness and the compliance the girl expressed through the Rorschach responses. highlighted the healthy elements of the personality (m low=inner potential and M high) because of the ability of the group to control the anxiety and the impulses.

22 Comparing the Themes

23 Comparison of the Themes Tests Difficulty in relationship with others (parents, peers, opposite sex) Underlying needs for approval and dependency Strong feelings of loneliness (mainly in the T.A.T) Fear of abandonment, feelings of desperation and anxiety Strong impulsive, and aggressive behavior Issues of Ego identity Concern for the future Difficulty in concentration, feeling of pressure Emotionally distant Supervisory Group Relationship with others (parents, peers, opposite sex) (3) Stories of abandonment/desertion Loneliness Themes of despair (2) Stories about death (2) Fear and concern for the future (2) Lack of concentration Low responsibility and low aspiration and achievement goals

24 Comments about the Themes The themes that the supervisory group have indicated are similar to the themes derived from the qualitative analysis of the tests. However, the supervisory group focus more on : Issues about relationships with parents, peers and the opposite sex Loneliness Needs for support and dependency, fear for abandonment and aggressive impulsiveness Need for achievement and fear of failure

25 Overall Findings of the case study High agreement between the reflections of the supervisory group and the qualitative and quantitative analysis of the tests Dominance of unpleasant feelings- and lack of positive ones- in both situations which have mainly an isolated and depressive content (i.e. Feelings of depression, dependency needs and fear of abandonment) Common Themes/Topics in both situations: mainly familial, interpersonal and sexual relationships and themes of self - identity and differentiation. The Supervisory group gives rich data about the difficulty of differentiation, the feeling of loneliness and the inner void through vivid and descriptive phantasies.

26 Overall Conclusion The supervisory group: casts light in the emotional and social state of the patient/client in a more descriptive, rich and vivid way brings to surface issues that are sometimes underestimated or hidden in the tests confirms symptomatology and also gives rich data about the ego strength, contact with reality and personality traits and structure. The trainee/psychologist learns: to organize, understand and record an integrated picture of the patient/client. to verbalise without fear and censorship by realizing his/her own feelings, phantasies and abstract thoughts (integrated mental procedure).

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