Interpersonal Reconstructive Therapy: Promoting Change in Nonresponders


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You can change your ad preferences anytime. Upcoming SlideShare. Like this presentation? Normals show the most copying. Their profiles most often involve a pattern consistent with securely-attached relating, involving friendliness, low hostility, and moderate degrees of enmeshment and differentiation. The high BR of friendly relating in the normal sample poses an analytic and conceptual challenge.

From a clinical standpoint, patterns that deviate from the profiles of well-attached individuals are of primary interest. We found that deviant patterns of relating were present in the Intrex profiles of nearly all patients in our sample. Many normal cases also show deviant patterns, but at a lower rate. Only patients copy deviant patterns at rates that exceed BR expectation. Normal cases, by contrast, copy deviant relating at low rates, often less than would be expected from their already low BRs. One possible explanation for apparent resiliency against deviant copying among normals may be greater availability of benign or friendly attachment figures e.

Additional study is necessary to replicate and further explore this possibility. As shown at the bottom of Table 2 , actual data sets tend to produce many examples of copying for each individual, rather than the one or two profile matches observed in randomly generated cases.

One implication is that assessors can be more confident that copying has occurred when multiple profile comparisons suggest repetition. CP only holds up well for actual case data as the threshold for similarity is raised. This observation also has implications for individual assessment with Intrex. False positives may occur, and so any evidence should be viewed as tentative until checked out directly with respondents or established by convergence with other information about case history.

Deviant patterns are detected in patients beyond the BR expectation at this level. A higher threshold may be considered in settings where a normative, well-attached profile is expected but, for reasons already discussed, this risks throwing out important CP data since replication of secure attachment is a key component of the theory. Clinicians or researchers working in non-clinical settings should choose a threshold for CP that best reflects the questions being asked of data. Not all those with disturbed relationships showed copying. In some cases, the reason may be that the most important figures were not assessed.

Intrex is often tailored in clinical settings to provide ratings of figures known in advance to be important, such as grandparents, step-parents, siblings, teachers, coaches, religious leaders, or particular romantic partners.

Interpersonal Reconstructive Therapy

Additional time periods or contexts may also be assessed to best capture potential interface between patient history and the nature of the presenting problems. For example, consider an individual whose parent was chronically absent, leaving the rater alone to fend for him or herself in frightening circumstances SASB-defined Ignore.

This type of copying would appear in Intrex assessments as a strong, negative, profile correlation e. In that study, subjects who reported having very hostile mothers were more likely to show opposite i. A preliminary inspection of data used in this study shows that copying in reverse exists in some profiles, but is less common than the other types. Assessing repeating relational themes using a questionnaire method has its challenges. As noted above, the assessment might not include all relevant figures.

Also, the method relies on the phenomenology of an individual as he or she remembers and rates relationships from the vantage point of the present. The perspectives of other family members and outside observers about patterns of interaction are especially interesting in the degree to which perspectives may or may not converge across time. Planned extensions of the present work in the clinical setting involve comparison of copy process assessments generated by Intrex versus interview methods, and tests to see whether use of copy process in IRT is associated with predicted changes in symptoms, personality, self-concept, and relationships.

Preliminary work is promising and shows that copy process-based case formulations are reliable Hawley et al. Both samples used in this study were supported by grants to L. Both samples have been used in different ways by Dr. Benjamin in several publications e. The Intrex manual explains how to quickly generate within-subject correlations for all profiles after primary scoring is complete.

Users can organize output from the program in a spreadsheet to allow easy visual inspection for presence of CP. Europe PMC requires Javascript to function effectively. Recent Activity. In this study, raters college students, inpatients provided data on the Intrex questionnaire Benjamin, about self-treatment, relationship with a significant other, and remembered interactions with parents in childhood. Within-subject profiles were inspected for precise behavioral matches conforming to 3 "copy process" CP patterns: identification behaving like an important other , recapitulation behaving as if the other person is still present and in charge , and introjection treating the self the way another did.

We observed CP evidence in most individual ratings. Consistent with expectation, nonclinical raters tended to copy a securely attached pattern of affiliation, low hostility, and moderate degrees of enmeshment and differentiation. We discuss implications and provide recommendations for use of Intrex in individual assessment of CP.

The snippet could not be located in the article text. This may be because the snippet appears in a figure legend, contains special characters or spans different sections of the article. J Pers Assess. Author manuscript; available in PMC Nov 1. PMID: Kenneth L. Critchfield and Lorna Smith Benjamin. Correspondence concerning this article should be addressed to Ken Critchfield, Ph. Copyright notice. See other articles in PMC that cite the published article. Abstract Repeated interpersonal patterns are central to case conceptualization and treatment planning in interpersonal and attachment-based approaches to therapy.

Adaptive and maladaptive copying of interpersonal patterns Copying is adaptive if it helps meet the demands of current circumstances in reality-based ways. Copy processes Benjamin identifies three primary ways that early relational learning is copied and shown behaviorally in the present. Aims Past research has shown that CP is observable at the group level in normal and clinical settings.

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Method Subjects and Procedure This study used data from two existing archives. Open in a separate window. Figure 1. Identifying copy process Summary data from any Intrex battery includes a wide variety of parameters. Figure 2. Table 1 Intrex ratings used to define each copy process. Statistical Analysis In each analysis, copy process is assessed by correlating an 8 point profile for an aspect of one figure e. Results Rate of observed CP in normal and patient samples The top half of Table 2 presents the percentage of cases showing copying for normal, patient, and random data.

Table 2 Percent rate of CP and mean number of profile comparisons exceeding thresholds for r. Copying relative to sample-specific base rates Odds ratios presented in Table 3 compare the rate of copy process detection in actual versus shuffled data sets. Table 3 Odds ratios OR comparing the number of cases with and without CP in actual versus shuffled data. Table 4 Comparison of deviant CP between actual and shuffled data sets.

Also by Lorna S. Benjamin

Normative copying of adaptive patterns Expected differences exist between normal and clinical samples in terms of the total amount of copying as well as the nature of patterns copied. Maladaptive copying From a clinical standpoint, patterns that deviate from the profiles of well-attached individuals are of primary interest. Use of per-case evidence and varying thresholds for profile similarity As shown at the bottom of Table 2 , actual data sets tend to produce many examples of copying for each individual, rather than the one or two profile matches observed in randomly generated cases.

Exceptions to the rule? Limitations and future directions Assessing repeating relational themes using a questionnaire method has its challenges. Acknowledgments Both samples used in this study were supported by grants to L. Footnotes 1 Additional predictive principles have been defined, but their description is beyond present purposes. References Arata CM. Child sexual abuse and sexual revictimization. Benjamin LS. Structural analysis of differentiation failure. Psychiatry: Journal for the Study of Interpersonal Processes. Journal of Personality Disorders.

Interpersonal diagnosis and treatment of personality disorders. Guilford Press; New York: University of Utah; Salt Lake City: Interpersonal Reconstructive Therapy: Promoting change in nonresponders.

Account Options

American Psychological Association; Washington, D. Annual Review of Clinical Psychology. Defining relational disorders and identifying their connections to Axes I and II. American Psychiatric Press; Washington, D. Bowlby J. Attachment and loss, Vol. Basic Books; New York: Psychopathology and early experience: A reappraisal of retrospective reports.

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Psychological Bulletin. The relationship between family of origin violence and dating violence in college men. Journal of Interpersonal Violence. The relationship between family aggression history and expressed aggression among college males. I challenge my supervisees to describe both the overt and covert processes happening in the therapy while also being mindful of their own interpersonal needs and motives. I find that the Interpersonal Circumplex IPC; Leary, is a useful nomological net to use in supervision to help trainees understand psychopathology and the therapeutic process.

I teach my students how to use the IPC to inform their interventions and their understanding of the issues that may arise in the therapeutic relationship. In addition, the IPC offers a way for trainee therapists to understand how their client may perceive them and how they may in turn respond to their client via the principles of interpersonal complementarity Kiesler, For example, a client may be responding to therapist warmth with fear, suspicion, anger, or indifference.

This may unsettle a beginning therapist, but if they understand these interpersonal processes via the IPC and interpersonal complementarity, then they are able to intervene in more meaningful ways. This indicates a high degree of interpersonal complementarity in our interpersonal situation, but as a supervisor, I want my supervisee to learn to become more confident in their clinical ability and so I try to foster their agency by sometimes being more interpersonally submissive.

This gives them a chance to be more agentic with me, which will help to foster their agency in the therapeutic relationship as well.

Benjamin gives trainees a way to describe what is happening to the client so that the client can begin to understand and change. As an interpersonal situation, therapy will not always go smoothly. Evidence-based interpersonal psychotherapy with personality disorders: Theory, components, and strategies.

Interpersonal Reconstructive Therapy: Promoting Change in Nonresponders Interpersonal Reconstructive Therapy: Promoting Change in Nonresponders
Interpersonal Reconstructive Therapy: Promoting Change in Nonresponders Interpersonal Reconstructive Therapy: Promoting Change in Nonresponders
Interpersonal Reconstructive Therapy: Promoting Change in Nonresponders Interpersonal Reconstructive Therapy: Promoting Change in Nonresponders
Interpersonal Reconstructive Therapy: Promoting Change in Nonresponders Interpersonal Reconstructive Therapy: Promoting Change in Nonresponders
Interpersonal Reconstructive Therapy: Promoting Change in Nonresponders Interpersonal Reconstructive Therapy: Promoting Change in Nonresponders
Interpersonal Reconstructive Therapy: Promoting Change in Nonresponders Interpersonal Reconstructive Therapy: Promoting Change in Nonresponders
Interpersonal Reconstructive Therapy: Promoting Change in Nonresponders Interpersonal Reconstructive Therapy: Promoting Change in Nonresponders
Interpersonal Reconstructive Therapy: Promoting Change in Nonresponders Interpersonal Reconstructive Therapy: Promoting Change in Nonresponders

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