5.3. Exercise:
Analyzing Treatment Principles and Experiential Response Modes
Select a therapy session on which to practice the concepts in this chapter. If possible, use a session in which you are the therapist and are trying to carry out PE therapy; otherwise, use a tape in which you are engaging in some other form of therapy, or borrow one from a PE-oriented colleague or trainer. Take process notes on the session, leaving two inches of right margin. You don’t need to transcribe the session; just take notes as you listen to the tape, without stopping (you may want to pay more attention to the therapist’s responses than to the client’s). Next, go through your process notes and record two pieces of information: (a) the treatment principles (see Chapter 1) expressed by each therapist response; and (b) therapist experiential responses. Keep in mind that more than one type of treatment principle or therapist response may occur in the same speaking turn. The Transcript Analysis Example: Rebecca presents an illustration of this process, using parts of a key session with Rebecca, a 19-year-old client with severe crime-related PTSD.
5.3.1.
Transcript Analysis Example:
Treatment
Principles and Therapist Experiential Responses: Rebecca
Abbreviations: Treatment Principles (see book: Chapter 1, Table 1.1): Attune = Empathic Attunement; Bond = Therapeutic Bond; Collaboration = Task Collaboration; Processing = Experiential Processing; Completion = Task Completion/Focus; Growth = Growth/Self-determination. Therapist Experiential Responses: Understand = Empathic Understanding; Explore = Empathic Exploration; Evocative = Evocative Reflection; Conjecture = Empathic Conjecture; Question = Exploratory Question; Fit = Fit Question; Direct = Process Direction; Action = Action Suggestion; Nonexper = Nonexperiential
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Process Notes: |
Annotations: T= treatment principle R=experiential response |
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C: ... I wanna be able to go to the bathroom, I mean I'm terrified of bathrooms at restaurants. In shopping malls I won't even go by myself to the bathroom. |
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T: Is there some connection for you to the grief? and the fear- [=> rewritten as Empathic
Conjecture: Do you have a feeling inside, of connection to the grief?] |
T: Processing; Completion R: Nonexper (Interpret) |
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C: I mean that's the biggest grief, that's my biggest sadness. |
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T: That's what you grieve for, is the loss of independence. |
T: Attune; Bond R: Understand |
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C: Oh yeah, independence. It's just, I mean if I was to sit down and just cry and cry and cry, and feel sad and think “What are you so sad about?”... |
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T: That's where the pain is. |
T: Attune; Bond R: Explore (Evocative) |
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C: The thing that would probably scream out the most is would be, “I'm not living a normal life.” You know, “Am I ever going to live a normal life?” |
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...... |
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T: So it's almost like you want something from that part of you. It's like the part of you that died, it wants something back from her. Is that right? Can you, imagine her there and ask her for that? "I want back, what? What do I need from you?" |
T: Processing; Completion, Attune; Collaboration; Growth R: Explore (Conject, Fit); Direct (Action) |
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C: I don't really want to have that much, cause I was just stupid back then. |
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T: Tell her, “I don’t want that much from you. You were stupid.” |
T: Processing; Completion R: Direct (Action) |
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C: I don’t want that much. I just, want half of it, (nervous laugh). I just want enough to live normal. I just want enough not to be so afraid. I just want enough that I could feel, decent because I could live like a human being. |
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T: “I don’t feel like a human being right now. I feel like some kind of something else that’s not human.” |
T: Attune; Bond R: Explore (Evocative) |
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C: Like a paranoid little girl, you know. |
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T: OK. Paranoid little girl. “I feel like some little animal that’s always terrified.” And what you want from that part is some of the courage, is that right? Can you ask her for that? |
T: Attune; Processing; Collaboration; Completion; Growth R: Understand; Explore (Evocative, Fit); Direct (Action) |
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C: Uh-huh. Can I use the courage?, some strength, some unafraidness. |
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T: (to the lost “strong self”:) Can you give her enough of that strength to let her let go of you? |
T: Processing; Growth R: Direct (Action) |
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C: I would but I wouldn’t know how. |
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.... |
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T: Tell her “I’d like you to have that strength.” |
T: Completion; Growth R: Direct (Action) |
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C: I’d like you to have, my strength. |
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T157: What’s that feel like to give that to Beth (=client)? |
T: Processing; Completion R: Explore (Question) |
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C157: Like a- like a mom. |
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Note. Elliott,
R., Urman, M., Jersak, H. & Gutiérrez, C. (June 1998). “I’d Like You to Have My Strength”: A
Conversational Analysis of the Process of Re-owning the Lost Self in
Process-Experiential Traumawork. Paper presented at meeting of Society for Psychotherapy
Research, Snowbird, Utah.
Materials designed to
accompany the book Learning Emotion-Focused Therapy: The
Process-Experiential Approach to Change from APA Books.
©2003 Robert Elliott, Jeanne Watson, Rhonda Goldman, and Leslie Greenberg
http://www.process-experiential.org/learning