Maladaptive relationship patterns that are learned in early attachment relationships can be replicated with others in adulthood in many forms that are described in Lorna Benjamin’s Structural Analysis of Social Behaviors (SASB). 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 coded in the therapy relationship during psychotherapy, through clinical interview in which clients describe behaviorally specific interactions, and with self-report assessments of relational patterns. Such measurement can result in identification of relational patterns that contribute to non-response and guide therapist and client in creating conditions for response to CBT. This can be accomplished through the integration of IRT methods and produce dramatic transformation to support attainment of treatment goals. 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. Lorna Smith Benjamin’s (2003/2006; 2018) 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 an overview of research supporting validity of the IRT case formulation as well as the GOL as a mechanism of psychopathology and change. NOTE: Attendees of this training will have the opportunity to attend an intermediate level follow-up CE event on 11/12/2022 from 2:00 to 4:00 p.m. ET where dialogue grounded in case examples following implementation will be offered.
CE Learning Objectives
Following this presentation, participants will be able to:
- Describe copy process theory and the IRT approach to case conceptualization
- Identify how patterns learned with attachment figures can shape and motivate problem behaviors in the present
- Describe how to enhance therapeutic responsiveness by addressing “family in the head”, especially with stuck or nonresponsive patients
- Describe the relational dimensions of SASB that form the basis of IRT conceptualizations.
- Practice applying SASB and IRT elements to a specific case example.
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 beginner.
- Philadelphia Behavior Therapy Association is approved by the American Psychological Association to sponsor continuing education for psychologists*. Philadelphia Behavior Therapy Association maintains responsibility for this program and its content.
- This program provides two (2) hours of CE credits.
- PBTA is also an authorized provider of CE credits for Professional Counselors, Marriage and Family Therapists, and Clinical Social Workers licensed in the state of Pennsylvania.
- ZOOM VIDEO LINK WILL BE SENT TO REGISTRANTS, WITHOUT OUTSTANDING BALANCE, 2 DAYS BEFORE & MORNING OF EVENT
- Full attendance with video display is required to obtain CE credit for this program. APA guidelines do not permit PBTA to issue partial CE credits. No refunds are provided for CE programs. No exceptions allowed.
- * PBTA does not currently offer CE to practitioners licensed in the state of New York.
- All events are Eastern Time Zone
- Contact PBTAcontinuingeducation@philabta.org if you need any learning accommodations no later than one week before event.
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., 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., 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