Auswahl der wissenschaftlichen Literatur zum Thema „Personal construct therapy“

This thesis explores the use of adapted Dialectical Behaviour Therapy (DBT) with individuals with Intellectual and Developmental Disabilities (ID/D). DBT is a multi-modal psychological intervention that aims to increase skills in interpersonal effectiveness, distress tolerance, emotional regulation and mindfulness. It was initially developed for individuals who presented with parasuicidal behaviours, and is recommended for the treatment of Borderline Personality Disorder (BPD). This thesis is presented in five papers; a systematic literature review, three empirical papers (a, b &c), and a critical review and reflection of the research process. The systematic literature review provides a narrative review of published research regarding the adaptations and outcomes of DBT for individuals with ID/D. Seven studies were reviewed using the Evaluative Method for Determining Evidence Based Practice (EBP) (Reichow, 2011). The findings detail the adaptations, results and critical appraisal of the research to date. The empirical papers consider the outcomes of adults with ID/D who received adapted DBT in a community psychological therapies service. The papers present different methodologies, and combined produce a consilience of evidence regarding the suitability of DBT for this population. Paper 2a found significant reductions on measures of depression, anxiety and anger, and increased mindfulness skills amongst 18 participants following DBT. Paper 2b uses repertory grid technique to explore the psychological changes that occur following DBT for seven participants, and found overall changes in personal construing and improvements in self-esteem. Paper 2c considers the psychological changes that occur in further depth through the presentation of two case studies. The case studies consider the complexity and idiosyncrasy of the individuals and gives consideration to the use of repertory grids to identify implicative dilemmas as part of clinical assessments. The final paper provides a critical review with personal reflections of the thesis. The author considers the research and clinical implications of the study.

<p> The literature was studied with a historical consideration to examine trends that began with analysts being required to undergo their own analysis, to modern day where a recommendation holds firm to suggest personal therapy for therapists, but is not always enforced. This study bridges the gap on a quantitative study on the effect of personal therapy on self-perceived clinical self-efficacy and other psychodynamic constructs. Self-perceived clinical self-efficacy, confidentiality and the importance of therapy in a clinical psychology graduate program were analyzed with respect to those participants in a clinical psychology program who had personal therapy and those who had not. Results showed that there was an overall benefit to personal therapy on clinical practice and that students believed that personal therapy should be part of clinical psychology programs. The data findings suggest that personal therapy is valuable for professional practice, that students believe it should be part of an academic program in clinical psychology, and that fears of confidentiality being breached are mostly unfounded.</p><p>

Thesis (MPhil)--Stellenbosch University, 2012.<br>ENGLISH ABSTRACT: The development of professional behaviour is one of the core components of occupational therapy education. The assessment of professional behaviour poses a problem as the constructs and expectations are not clearly defined; this results in compromised inter-rater reliability. The purpose of the study was to investigate assessors’ understanding of the constructs and the expectations deployed during the assessment of professional behaviour of third and fourth year occupational therapy students during clinical practice. A case study design was used in the qualitative study. Clinical supervisors were involved in: (1) a focus group interview to scrutinise the usefulness of the current assessment instrument and (2) a participatory discussion to determine their understanding of the constructs of professional behaviour and the level of expectations to be set for third and fourth year students respectively. This study confirms that the development of effective assessment of professional behaviour entails a number of pivotal steps that include developing a shared definition of the constructs thereof and the expectations at different levels of undergraduate training, the refinement of the assessment instrument and training of assessors in the use of this assessment instrument.<br>AFRIKAANSE OPSOMMING: Die ontwikkeling van professionele gedrag is een van die kern komponente in arbeidsterapie opleiding. Die assessering daarvan bied egter uitdagings aangesien die konstrukte en verwagtings nie duidelik gedefinieer is nie; dit het gekompromiteerde geldigheid en betroubaarheid tot gevolg aangesien verskillende assessore die professionele gedrag van studente verskillend assesseer. Hierdie studie het die ondersoek van kliniese toesighouers se begrip van die konstrukte en hul verwagtings tydens die assessering van professionele gedrag van derde- en vierdejaar arbeidsterapiestudente tydens kliniese prakties ten doel gehad. ‘n Gevallestudie ontwerp het die basis van ‘n kwalitatiewe ondersoek gevorm. Kliniese toesighouers is betrek in: (1) ‘n fokusgroeponderhoud om die bruikbaarheid en gebruikersvriendelikheid van die huidige assesseringsinstrument te bepaal; en (2) ‘n deelnemende groepbespreking om hul begrip van die konstrukte van professionele gedrag en die verwagte vlakke van funksionering vir onderskeidelik derde- en vierdejaar studente te ondersoek. Hierdie studie bevestig dat die ontwikkeling van effektiewe assessering van professionele gedrag ‘n aantal essensiële stappe behels. Hierdie stappe sluit die ontwikkeling van ‘n gedeelde definisie van die konstrukte en verwagtinge van professionele gedrag in, asook die verskil in verwagtinge op die onderskeie vlakke van voorgraadse opleiding, die verfyning van die bestaande assesseringsinstrument en die opleiding van assessore in die gebruik daarvan.

Tese de doutoramento em Psicologia (área de conhecimento em Psicologia Clínica)<br>In a personal construct psychology perspective, human beings are continually construing their experience of themselves and their reality, and continuously reconstructing it to make sense of new events. Psychological disorders represent some failure in this ongoing process, as the individual cannot make sense of the world with their constructions nor change them. Therapeutic change is of itself a form of reconstruction that allows clients to recover their ability to create alternatives. Implicative dilemmas are one kind of blockage in construction, characterized by the association between a problematic construction and some positive dimensions of the self. Thus, change in the problematic areas implies undesired changes in other aspects of the self. Previous research has shown that implicative dilemmas are quite prevalent in general population, but significantly more frequent in people seeking psychotherapy. Implicative dilemmas are crosssectional to clinical syndromes, representing a matter of structure of the construction system more than one of content. It has also been shown that implicative dilemmas tend to diminish with psychotherapeutic intervention. Departing from previous proposals, we have developed a manual for the intentional and systematic treatment of implicative dilemmas, standing on personal constructivist assumptions and techniques. This treatment proposal has been applied to psychotherapy in a university clinic, and eight clients have completed the treatment and research procedures, including a variety of qualitative and quantitative measures of therapeutic process and outcome, assessed at several moments of their treatment. This thesis presents a detailed study of one of those cases, analysed through hermeneutic single case efficacy design, which shows that the treatment proposal was helpful for the treatment of this client, causing significant changes. In addition, we constructed an explanation for the observed changes, in light of personal construct theory. A clinical replication series added seven more cases to that first study in order to refine our explanation of the personal reconstruction processes that occur while resolving an implicative dilemma in personal construct therapy for implicative dilemmas. In addition, it found positive signs of this treatment’s efficacy when applied to clinical practice. In our final study, we tried to identify and understand the processes of personal reconstruction that occur while resolving an implicative dilemma, at the episode level. We focused on significant events identified by clients to create a tentative model of dilemma reconstruction. Our findings were generally consistent with the previous theory, applying it at a micro-analytic level.<br>Na perspectiva da teoria dos construtos pessoais, o ser humano continuamente constrói a sua percepção de si e do mundo, e continuamente a reconstrói para dar sentido às novas experiências. A perturbação psicológica representa uma falha neste processo, já que o indivíduo não é capaz de dar sentido ao mundo com as suas construções, nem de as mudar. A mudança terapêutica é em si mesma uma forma de reconstrução, que permite aos cliente recuperar a sua capacidade de criar alternativas. Dilemas Implicativos são um tipo de bloqueio no processo de construção, caracterizado pela associação entre uma construção problemática e algumas dimensões positivas do self. Assim, mudar nas áreas problemáticas implica mudanças indesejadas em outros aspectos do self. Estudos prévios mostraram que os dilemas implicativos são bastante prevalentes na população geral, mas significativamente mais frequentes em clientes de psicoterapia. Os dilemas implicativos são um fenómeno transversal às diferentes síndromes clínicas, uma vez que se trata mais de uma dimensão de estrutura do sistema de construtos do que de conteúdo. Também tem sido demonstrado que estes dilemas tendem a diminuir com a intervenção psicoterapêutica. A partir de propostas prévias, desenvolvemos um manual para o tratamento intencional e sistemático dos dilemas implicativos, baseado nos pressupostos e técnicas da psicologia dos construtos pessoais. Esta proposta de tratamento foi aplicada à prática numa clínica universitária, e oito clientes completaram o tratamento e procedimentos de investigação, incluindo uma variedade de medidas qualitativas e quantitativas de processo e resultados terapêuticos, avaliados em diferentes momentos do tratamento. Esta tese apresenta o estudo detalhado de um desses casos, analisado através da metodologia hermeneutic single case efficacy design, que demonstrou que o tratamento foi útil para o tratamento desta cliente, causando mudanças significativas. Construímos também um modelo explicativo das mudanças observadas, à luz da teoria dos construtos pessoais. Uma série de replicação clínica considerou mais sete casos, com o objectivo de refinar o nossa explicação dos processos de reconstrução pessoal que ocorrem na resolução de um dilema implicativo em terapia construtivista pessoal centrada em dilemas implicativos. Esta série deu também sinais positivos relativamente à eficácia deste tratamento quando aplicado à prática clínica. O nosso último estudo tenta identificar e compreender os processos de reconstrução pessoal que ocorrem na resolução de um dilema implicativo, ao nível episódico. Centramo-nos em eventos importantes identificados pelos clientes para criar um modelo tentativo de reconstrução dos dilemas. Os resultados foram em geral consistentes com a teoria, aplicando-a ao nível micro-analítico.<br>Fundação para a Ciência e a Tecnologia - Bolsa de Doutoramento SFRH/BD/23846/2005.

What is going on in a therapeutic setting when one person tells a story to another? Is it really as it appears to be, with the story being told in order to communicate some information, either affective or factual? Or is this way of thinking about the business of therapy limiting, both for the people concerned (therapist and patient) and for those who theorise about the therapeutic process? These are the questions around which this work is organised. The thesis itself takes the form of a story being told, the story of a therapist, his client, and his clinical supervisor.The story of these relationships is used to argue that stories are told more to create something (a relationship) and forge something (a more vital connection to an animating world) than to communicate something.The author draws on both a philosophical, and a psychoanalytical tradition to show what he suggest are more vital ways of thinking about human behaviour in general and the therapeutic encounter in particular.

Research report submitted to the Wits School of Arts University of the Witwatersrand, Faculty of Humanities In partial fulfillment of the requirements for the Degree of Master of Arts in the field of Drama therapy April 2016<br>The aim of this research was to evaluate Narradrama as a drama therapy method in assisting South African domestic workers to shift their identity towards a more positive one, so they will be able to better deal with their current socially oppressive issues. I postulated, based on research done by sociologists and anthropologists, that domestic workers still feel oppressed marginalised and differentiated even to date, twenty years after the apartheid era; the racial discrimination that was perpetuated by the doctrine of the apartheid regime and cemented the master-servant relationship as the only possible relationship between domestic worker and employer was normalised within the harsh realities of minimum wages, long working hours and appalling living conditions; oppression of women by women, sexism and racism. Moreover, the domestic workers legal rights that were established after 1994 in the Bill of Rights have not changed their lives and working conditions. These working conditions continue to affect them and are a risk to their physical and mental health. (Mohutsioa-Makhudud, 1989; Williams, 2008; Ally, 2009). The risk that is inherent in chronic perceived discrimination to one’s mental health (Mohutsioa- Makhudu ,1989:40) and the risk of developing a negative identity and self hatred by internalising the negative views of a dominant society(Phinney, 1989:34) has influenced the decision to do this research. The method of Narradrama chosen for this study was researched by Dunne (as cited in Leveton 2010) and found to be effective in working with marginalised groups but has not yet been researched with a marginalised stratum within the South African context. Narradrama, became the preferred method as it is centred on story (Dunne and Rand, 2013:7) which led to the thought it would be effective when working with a group of African women who are considered to be story tellers in the African culture. (Scheub, 1970: 119-120). Thematic data analysis was used in analysing the results. Identity shift was measured by comparing the change between the initial negative themed stories, that substantiated the hypothesis that participants do feel oppressed and marginalised, with the new, positive themes that appeared later in the research processes The Narradrama processes were analysed through the theoretical lens of Landy’s role theory, who proposes that for a person to have a healthier identity he needs to take on a variety on new roles, and to be able to play them proficiently. The playing of new roles assists participants to enlarge their perspectives, discover new identity descriptions and experience what it would feel like to move forward in life in preferred ways towards a more manageable, hopeful future. (Landy, 1994:93-97) This parallels the Narradrama notion which claims that by re-storying a client’s narrative, the client opens up to new preferred choices; a new landscape of identity and action (Johnson and Emunah, 2009:182). The research results show the start of a shift, in the participants’ re-authored stories and their assumed choices of new roles- these changes signify that the group has benefited from processes. As the researcher, I therefore recommend that these processes be resumed in order to allow these identity shifts inclusive of the suggested roles to become more substantial, and more integrated in the participants’ identity within their current living and working context. However, though Narradrama proved to be a method that can assist this group, the results of this research cannot be generalised, and further research with different groups of domestic workers will need to be done in order to be able to generalise to the wider context of the stratum of South African domestic workers.