Maladaptive relationship patterns that are learned in early attachment relationships can be replicated with others in adulthood in many forms conceptualized by the Structural Analysis of Social Behaviors (SASB: Benjamin et al., 2006). Such patterns, referred to as “copy process” in Interpersonal Reconstructive Therapy (IRT, Benjamin, 2003/2006; 2018), can provide barriers to response in Cognitive-Behavioral Therapy (CBT). Both overt and covert behaviors can be identified through SASB-based assessments of relational patterns and targeted with IRT procedures. This can guide therapist and client in facilitating attainment of treatment goals in CBT. Such response depends upon identification of the conditioning history that reinforces maladaptive and recurrent patterns of relating with self and others. Briefly, in IRT, views of self and others are understood to reflect rules, values, and experiences internalized in close attachment relationships. A case formulation (CF) guides intervention choices by clarifying links between presenting symptoms and learning that occurred in those relationships. The “gift of love” (GOL) hypothesis is that wishes to receive love and acceptance from specific internalized attachment figures, or learned ways to obtain reinforcement, shape problem patterns and associated symptoms. Clinical problems thus reflect, and are maintained by, desires for love and acceptance from cognitive representations of “family in the head.” Ultimately, IRT seeks to help patients become aware of copied interpersonal and intrapsychic patterns, and the role they play in maintaining connection with internalized attachment figures. From there, the goal is to help a patient differentiate from the “family in the head” and pursue healthy behaviors and self-concepts. With awareness comes the possibility to let go of problematic quests for love and acceptance from internalized loved ones and instead to choose healthy alternatives. The IRT treatment paradigm is grounded in and integrates the seminal work of Bowlby, Harlow, Graham, Rogers and others. IRT theory frames optimal intervention in terms of a “core algorithm” and five therapeutic “steps” keyed to the individual CF. This workshop describes IRT theory and method, from conceptualization to treatment, and includes guidance in developing a basic IRT case formulation with a focus on the GOL as a mechanism of psychopathology and change. NOTE: Part II is an intermediate level follow-up CE event to the 11/12/2022 training - attendees who missed it are welcome but it is especially important that they complete the required reading (CTRL click on link to download) - citation below - in advance. Dr. Critchfield will respond to questions regarding SASB and the implementation of IRT to specific challenging cases for which CBT has not supported attainment of treatment goals.
CE Learning Objectives
Following this presentation, participants will be able to:
Required Reading (click reference below to download):
Critchfield, K. L., Panizo, M. T., & Benjamin, L. S. (2019). Formulating key psychosocial mechanisms of psychopathology and change in interpersonal reconstructive therapy. In Case formulation for personality disorders (pp. 181-201). Academic Press.
About Presenter
Ken Critchfield, Ph.D. is a tenured Associate Professor and Program Director of the Clinical Psychology Program of the Ferkauf Graduate School of Psychology. Dr. Critchfield’s research, teaching and clinical work all emphasize interpersonal and attachment-based principles of change implemented in Interpersonal Reconstructive Therapy (IRT: Benjamin, 2003; 2018). IRT is an integrative, psychosocial treatment that uses an attachment-based case formulation to tailor treatment for patients having severe and chronic problems characterized comorbid depression, anxiety, PTSD, bipolar disorder, and/or chronic suicidality, often accompanied by personality disorder. Dr. Critchfield earned his Ph.D. in clinical psychology from the University of Utah in 2002, with an internship at the San Francisco VA Medical Center, and post-doctoral training at Weill-Cornell Medical College. He was co-director of the IRT clinic at the University of Utah Neuropsychiatric Institute and was most recently directed the Combined-Integrated Clinical and School Psychology program at James Madison University. Dr. Critchfield is a Fellow of APA’s Society for Advancement of Psychotherapy (Div. 29). He has held leadership roles with the Society for Exploration of Psychotherapy Integration (SEPI), and has long been a member of the Society for Psychotherapy Research (SPR). He maintains a psychotherapy practice and frequently consults on issues of methodology, design, and analysis for work at the interface between interpersonal measurement (especially Structural Analysis of Social Behavior), personality, and psychopathology.
This presentation is intended for licensed mental health professionals and advanced graduate student trainees seeking licensure and with some clinical experience. The instructional level of this presentation is INTERMEDIATE.
Benjamin, L. S., Rothweiler, J. C., & Critchfield, K. L. (2006). The use of structural analysis of social behavior (SASB) as an assessment tool. Annu. Rev. Clin. Psychol., 2, 83-109.
Critchfield, K. L., Mackaronis, J. E., & Benjamin, L. S. (2017). Integrative use of CBT and Psychodynamic techniques in Interpersonal Reconstructive Therapy. Journal of Psychotherapy Integration, 27(4), 460-475. http://dx.doi.org/10.1037/int0000092
Critchfield, K. L., Thapa, P., Panizo, M. T., & Conceição, N. (2022). Using interpersonal reconstructive therapy to address comorbid problems organized by attachment-based learning: The case of Don. Journal of Clinical Psychology, 78, 396– 408. https://doi.org/10.1002/jclp.23292
Critchfield, K. L., Mackaronis, J. E., Thapa, P., & Cechak, P. (2022). A brief overview of safety planning in interpersonal reconstructive therapy. Psychotherapy, 59(2), 168–173. https://doi.org/10.1037/pst0000415
Critchfield, K. L., Benjamin, L. S., & Levenick, K. (2015). Reliability, sensitivity, and specificity of case formulations for comorbid profiles in Interpersonal Reconstructive Therapy: addressing mechanisms of psychopathology. Journal of Personality Disorders, 29(4), 547-573. doi: http://dx.doi.org/10.1521/pedi.2015.29.4.547
At this virtual CE journal club from 12:00 to 1:30 p.m. ET, Marvin R. Goldfried, Ph.D., will guide us through Self-Controlled Coping Desensitization for strengthening assertive behaviors. Required reading includes: "Assertiveness training: A forgotten evidence‐based treatment" and suggested includes: "Psychotherapy as Coping Skills Training".
Wisdom Wednesday CE events often include experiential practice of evidence-based procedures. Dr. Goldfried will model guiding a client in the Self-Controlled Coping Desensitization (SCD) for cueing assertive behaviors -- SCD is described in the chapter, "Psychotherapy as Coping Skills Training". Dr. Goldfried will also describe the movement from unconscious incompetence to conscious incompetence, conscious competence and, following practice, unconscious competence -- a process he also describes in episode 6 of Talking Therapy in dialogue with Allen Frances, M.D.
The ongoing wisdom Wednesday series focuses on some of the transtheoretical constructs and processes of change that continue to emerge as therapeutic trans-diagnostically, including assertiveness, compassion, and other factors that support exposure to corrective emotional experiences that promote learning and intentional change efforts. This is a continuation of the CE event where the focus was his article, Obtaining Consensus in Psychotherapy: What Holds Us Back?.
Attendees are required to read the journal article, "Assertiveness training: A forgotten evidence‐based treatment" and come prepared for respectful dialogue.
Speed, B. C., Goldstein, B. L., & Goldfried, M. R. (2018). Assertiveness training: A forgotten evidence‐based treatment. Clinical Psychology: Science and Practice, 25(1), e12216.
Suggested Reading
Goldfried, M. R. (1980). Psychotherapy as coping skills training. In Psychotherapy process (pp. 89-119). Springer, Boston, MA.
This presentation is intended for licensed mental health professionals and advanced graduate student trainees seeking licensure and with some clinical experience. The instructional level of this presentation is Beginner.
Posttraumatic stress disorder (PTSD) is a prevalent and debilitating disorder. Although effective treatments for PTSD have been identified, there are barriers to both delivering and receiving these treatments. From the patient perspective, the treatments are time consuming (e.g., number of sessions and between session assignments), which leads to nearly one third of patients dropping out of treatment prematurely. Written Exposure Therapy (WET; Sloan & Marx, 2019) represents an alternative, evidence-based PTSD treatment approach that is efficient, effective, associated with low treatment dropout rates (e.g., less than 10%), and works for a variety of individuals with PTSD.
This workshop is a follow-up to that offered on 2/2/22 and provides an opportunity for consultation to support implementation of WET. Attendees who missed the initial training are invited contingent upon reading the manual or having completed a basic level of training in WET elsewhere. Part II is an intermediate level follow-up CE event to the initial training. Dr. Sloan will respond to questions regarding implementation of WET with specific cases. Strategies for conceptualizing and dealing with psychiatric co-morbidity, managing avoidance, and keeping patients optimally engaged will be provided.
If you did not yet read Dr. Sloan's EBP article it can be accessed HERE or by pasting https://philabta.org/EBP/12902286 into browser. Registrants will also receive resources for implementation that those who completed Part I of this training have already received.
1. Using specific case consultation examples, describe how to address challenges implementing WET.
2. Using specific case consultation examples, identify an instance how to make modifications to the scripted approach when needed.
Denise M. Sloan, Ph.D. obtained her doctorate in clinical psychology from Case Western Reserve University in 1998. She currently serves as the Associate Director, Behavioral Science Division, National Center for PTSD and a Professor of Psychiatry, Boston University School of Medicine. She is an expert on psychosocial interventions for traumatic stress disorders and has a specific interest in efficient treatment approaches for PTSD. Dr. Sloan conducted a series of studies that lead to the development of Written Exposure Therapy and has conducted multiple large-scale treatment studies examining the effectiveness of this treatment. She has published over 100 scientific articles and has received funding for her work from several organizations, including the Department of Veterans Affairs, National Institute for Mental Health, Department of Defense. Dr. Sloan is past Editor of Behavior Therapy and current Editor of Journal of Traumatic Stress and a consulting editor for six scientific journals. Dr. Sloan has over 25 years of experience treating individuals with PTSD, and she has extensive experience training mental health providers in the delivery of trauma-focused treatments.
Sloan, D. M., & Marx, B. P. (2019). Written exposure therapy for PTSD: A brief treatment approach for mental health professionals. American Psychological Association.
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