This workshop focuses on unique aspects of the Interpersonal Reconstructive Therapy (IRT) approach used for working with chronically or recurrently suicidal patients. Most research to date with IRT (Benjamin, 2006) involves application with patients who qualify for the acronym “CORDS”: Comorbid,Often Rehospitalized, Dysfunctional, and Suicidal. A case formulation (CF) based on interpersonal copy process theory, an attachment-based understanding of learning overt & covert behavioral habits, defines links between presenting symptoms and patterns of affect, cognition, and behavior. Such learning occurs in early relationships with significant others and invokes safety or threat perceptions derived from rules and values communicated implicitly and explicitly in close relationships that are internalized. The “gift of love” (GOL) hypothesis, that is part of copy process, reflects the wish to receive love and acceptance from specific internalized attachment figures. The GOL organizes and propels problem patterns and their associated symptoms. Through a series of steps, IRT seeks to help patients become aware of and learn about their copied patterns, including where they were learned, the role they play in maintaining connection with internalized attachment figures, and their functions in the present. The goal of IRT is to help a patient differentiate from their “family in the head” and pursue healthy behaviors and self-concepts. With awareness and differentiation comes the possibility of letting go of problematic quests for love and acceptance from internalized attachments and to choose healthy alternatives instead. As an integrative method, safety planning in IRT shares much with other approaches. What is unique is how therapists utilize the CF to guard against unsafe behavior in the short term, and to pursue reconstructive change in the long term to pursue lasting resilience to the specific stressors most salient to a given patient.
CE Learning Objectives
Following this presentation, participants will be able to:
1. Identify how patterns learned and internalized with key attachment figures can shape and motivate problem behaviors in the present, including suicidality.
2. Use awareness of copy process to help block suicidal action and develop long-term resilience against suicidality.
Ken Critchfield, Ph.D. is a tenured Associate Professor and Program Director of the Clinical Psychology Program of the Ferkauf Graduate School of Psychology of Yeshiva University in New York City. 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, 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 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 is Director of the Interpersonal Reconstructive Therapy Institute, which provides resources and training in use of Structural Analysis of Social Behavior (SASB) and IRT.
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.
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