Cognitive Evolutionary Therapy for Depression by Cezar Giosan

Author:Cezar Giosan
Language: eng
Format: epub
ISBN: 9783030388744
Publisher: Springer International Publishing

5.1 Conceptualization in Psychotherapy

Clinical conceptualization is an explanation of problems and their causes provided by the therapist to the patient. To be efficient, this explanation should provide an accurate description of the: (1) mental problem; (2) probable causes of the mental problem; (3) ethiopathogenetic processes involved; (4) positive/adverse effects of the treatment. When the therapist successfully addresses these areas, she creates sense of prediction and control in the patient, raising the hope of getting better and leading to positive expectancies of the treatment’s outcome (John & Segal, 2014; Kuyken, Padesky, & Dudley, 2008a, 2008b).

The first record of clinical conceptualization was Freud’s interpretation of neurotic symptoms and latent content of the dreams. This interpretation, Freud argued, could unravel parts of the unconsciousness, thus leading to catharsis and healing (Freud & Brill, 1915).

Miller, Duncan, and Hubble (1997) argued that there are four common factors to all psychotherapies that determine their success: client factors, therapist factors, placebo and specific techniques. Asay and Lambert (1999) evaluated these factors and showed that the therapeutic success is 40% due to client factors, 30% to therapist factors, 15% due to placebo, expectancy and hope, and 15% due to specific psychotherapeutic techniques. The third factor (placebo, expectancy and hope) refers to the client’ and therapist’s belief in the rationale and efficiency of the treatment – i.e., conceptualization. A good understanding of the problem and the link between the problem and the treatment suggested by the therapist can make the treatment more credible and the patient more involved, leading to better treatment outcomes, such as reduced dropout rate and increased treatment adherence.

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