Papers by Luc Vandenberghe
O presente artigo oferece uma reflexão, baseada em alguns autores brasileiros, acerca da prática ... more O presente artigo oferece uma reflexão, baseada em alguns autores brasileiros, acerca da prática da análise dos sonhos, com o intuito de delinear seus aportes para a terapia comportamental. O conteúdo do sonho reflete os efeitos das contingências que moldaram os repertórios do cliente. O relato do sonho, porém, está sob o controle da relação com o terapeuta. Argumentamos que a análise dos sonhos pode contribuir de três formas para a terapia. Primeiro, pode trazer à luz problemas ou necessidades do cliente que escaparam à atenção, sendo possível, pelo esclarecimento destes, definir melhor as metas para o tratamento. Segundo, comparar o conteúdo dos sonhos ou o comportamento de relatá-los com outras informações sobre o cliente pode ajudar a identificar contingências relevantes que devem ser incluídas na formulação do caso. Em terceiro lugar, o trabalho com os sonhos pode fornecer material para ser trabalhado ao vivo na sessão, a saber, as dificuldades evocadas pelo material do sonho, bem como as dificuldades evocados pela interação com o terapeuta ao analisar o sonho.
Revista Brasileira de Terapia Comportamental e Cognitiva, Feb 1, 2007
Resumo O presente trabalho é um esforço por explorar algumas possibilidades de aplicação da FAP (... more Resumo O presente trabalho é um esforço por explorar algumas possibilidades de aplicação da FAP (Psicoterapia Analítico-Funcional) como metodologia de supervisão. Participaram deste trabalho quatro terapeutas comportamentais que atendiam clientes borderlines. As supervisões foram feitas mensalmente, com cada terapeuta individualmente. Cada uma delas foi gravada, transcrita e sujeita a uma análise qualitativa indutiva. Emergiram, desta análise, duas categorias de comportamentos de terapeutas que ocorreram nas interações entre supervisora e supervisonandas, e que eram diretamente relevantes para problemas que os terapeutas tinham na relação com os clientes: (1) Dar razões / esquiva experiencial e (2) desespero. Conclui-se que atenção particular para os padrões interpessoais durante a supervisão pode produzir oportunidades de aprendizagem ao vivo para terapeutas. Isto tornará a FAP uma abordagem viável para melhorar a supervisão de clientes borderlines. Palavras chaves: Supervisão; Transtorno de Personalidade Borderline; Psicoterapia Analítico Funcional. Sumary This paper is an effort to explore some possibilities of FAP (Functional Analytic Psychotherapy) as a method of supervision. Four behavior therapists treating borderline patients took part in this study. The supervison sessions were individual and monthly. They were recorded, transcribed and submitted to a qualitative inductive analysis. From this analysis, two categories of relevant therapist behavior emerged. Both occurred in the interactions between therapist and supervisor, but were directly relevant for problems that the therapists experienced in relation their borderline clients: (1) Reason giving / experiential avoidance and (2) despair. It is concluded that close attention to interpersonal patterns that occur during supervision can produce in-vivo learning opportunities for supervisees. This makes FAP a viable approach to enhance supervision for therapists with borderline clients.
Revista Brasileira de Terapia Comportamental e Cognitiva, Apr 5, 2023
Contextos Clínicos, Jul 22, 2015
Resumo. O presente estudo aborda o papel dos sentimentos do terapeuta e como estes podem ser rele... more Resumo. O presente estudo aborda o papel dos sentimentos do terapeuta e como estes podem ser relevantes no processo terapêutico. Pretende-se verifi car como a consideração cuidadosa dos sentimentos do terapeuta ajuda a fazer opções terapêuticas bem direcionadas. Para isso, momentos específi cos de dois casos conduzidos de acordo com a psicoterapia analítica funcional são discutidos. A análise se concentra nos conceitos de T1 e T2 que caracterizam os comportamentos do terapeuta no modelo teórico da psicoterapia analítica funcional. Fragmentos dos casos são analisados para verifi car como comportamentos improdutivos da terapeuta (T1) e comportamentos terapêuticos efetivos (T2) se relacionam com a discriminação dos sentimentos da terapeuta. O material ilustra que a observação dos sentimentos da terapeuta pode ajudar a detectar contingências problemáticas no relacionamento com o cliente e prevenir condutas terapêuticos inefi cientes. Além disso, a discriminação adequada dos sentimentos que o cliente evoca na terapeuta pode ajudar na escolha de intervenções terapêuticas mais produtivas. Conclui-se que terapeutas devem cultivar uma atenção especial aos seus sentimentos, porque estes podem conter dicas sobre os problemas do cliente, podem esclarecer o que está ocorrendo na sessão e podem ajudar a atuar com sensibilidade.
British Journal of Medical Psychology, Sep 1, 2007
This paper is about the use of an unconventional intervention for treatment-resistant OCD that we... more This paper is about the use of an unconventional intervention for treatment-resistant OCD that we describe as 'Therapist Assumes Responsibility' (TAR). The use of TAR in this paper as a clinical treatment parallels an experimental analysis by Lopatka and Rachman (1995). Two case studies are used to illustrate TAR and the use of the therapist-client relationship in the treatment of OCD. These include learning to trust others and accepting reasonable levels of insecurity. It is proposed that the addition of an interpersonal factor to CBT theories of OCD helps to explain the role of inflated responsibility and how the client-therapist relationship can be used during treatment. It is further proposed that reassurance seeking might also be the result of this same interpersonal factor.
Journal of Psychotherapy Integration, Sep 1, 2009
Several major schools of psychotherapy require a genuine emotional presence from therapists in-se... more Several major schools of psychotherapy require a genuine emotional presence from therapists in-session, as well as a nondefensive awareness of their emotional responses to the client. The present article addresses the part played by upsetting experiences in the context of these requirements. In order to identify relevant issues for a discussion of the literature, grounded theory analysis is presented of a series of conversations with four psychotherapists about their experience with in-session distress. The participants reported client confrontation and rejection evoked a variety of negative emotions ranging from helplessness to anger. Besides traditional professional resources like supervision and personal therapy, they discussed several coping strategies that focused on emotions. One strategy that stood out was to analyze how the emotional impact occurred in order to clarify client issues. This strategy was reported to yield information that improved therapeutic effectiveness in the case at hand, but it also was an effective method for overcoming therapist distress and a means of promoting broader professional growth. These observations suggest issues for integrative psychotherapy research into emotional risk taken by therapists and its payoff.
Behavior Analyst, Apr 1, 2008
Functional analytic psychotherapy (FAP) is defined as behavior-analytically conceptualized talk t... more Functional analytic psychotherapy (FAP) is defined as behavior-analytically conceptualized talk therapy. In contrast to the technique-oriented educational format of cognitive behavior therapy and the use of structural mediational models, FAP depends on the functional analysis of the moment-to-moment stream of interactions between client and therapist. This distinctive feature makes FAP particularly sensitive to the challenges posed by cultural differences between client and therapist. Core elements of FAP philosophy are invoked to argue that this vulnerability paradoxically implies an increased ability to capture and use relevant issues in the therapy process with culturally different clients. This argument focuses FAP's preference for concrete behavior over theoretical modeling, its emphasis on functional principles rather than topographically defined techniques, and its inclusion of the therapist's behavior in the assessment of clients' clinically relevant behavior. Suggestions are given concerning how academic and practical training and personal experience may be used to foster sound multicultural practice.
Group, Sep 1, 2021
Abstract:Functional analytic group therapy uses natural occurrences of clients' problems in t... more Abstract:Functional analytic group therapy uses natural occurrences of clients' problems in the group to promote change. It focuses on parallels between the daily life issues for which clients seek treatment and their experience in session. When an issue shows up in the group interaction, the leader helps make it into an in vivo learning experience. The rationale is that unrehearsed experiences offer opportunities for learning that are more genuine and better tailored to the client's needs than prepared treatment activities. However, many prospective clients expect to talk about their problems instead of experiencing them and working on them in the moment as they arise. This article describes an experiential prescreening strategy that prepares for solid informed consent to a treatment that seeks therapeutic change through unplanned experiences in the group. Candidates engage in the construction of a working case conceptualization that anticipates how in-the-moment learning in the group can promote their therapeutic goals. During the interaction with the screening clinician, they learn to track target behavior and experiment with in-the-moment disclosure, acquiring experience with the tasks they will perform in the group. These elements are presented in a how-to framework, with examples based on the authors' experience.
Journal of Contemporary Psychotherapy, Mar 21, 2018
The present study unpacks an important dimension of clinical practice from the therapists' vantag... more The present study unpacks an important dimension of clinical practice from the therapists' vantage point. We interviewed 26 therapists in private practice about how the personal relationship with the client works from their perspective and conducted a grounded theory analysis. Three categories emerged. One refers to scope, aims and corollaries of the connection with the client; a second to preventing harm and managing drawbacks; and a third to taking therapeutic advantage of challenges related to closeness. Together, these categories form a model that describes how the close connection modifies therapeutic effects and generates challenges the therapist needs to deal with. The closer the dyad, the easier therapists will affect and be affected by the client. Therapists try to direct closeness to where it can nourish client process without harming the relationship, the client or themselves, and when closeness backfires, they may still try to harness uninvited effects for the benefit of therapy. This model concerning therapists' lived experience is offered to inform research on the therapist-client relationship and as a contribution to clinical competency models.
Revista Brasileira de Terapia Comportamental e Cognitiva
Um grupo de psicoterapia comportamental, para pacientes com dor crônica orofacial, é apresentado ... more Um grupo de psicoterapia comportamental, para pacientes com dor crônica orofacial, é apresentado com o intuito de superar a noção de um grupo de apoio com base num modelo, no qual aspectos fisiológicos e psicológicos interagem. A análise aplicada do comportamento e a terapia comportamental cognitiva são duas abordagens que sustentam a construção de terapias de grupo, com formato didático, para a aquisição de melhores formas de lidar com a dor. A análise clínica do comportamento, por sua vez, procura, a partir de uma análise funcional do processo psicoterapêutico, proporcionar mudanças profundas de cura. A junção dos dois (o formato didático e a psicoterapia analítico-funcional) se realiza quando, durante as sessões, episódios verbais não são compreendidos como trocas de informação, mas analisados como atos em contextos.
Journal of Contemporary Psychotherapy, 2018
The present study unpacks an important dimension of clinical practice from the therapists' vantag... more The present study unpacks an important dimension of clinical practice from the therapists' vantage point. We interviewed 26 therapists in private practice about how the personal relationship with the client works from their perspective and conducted a grounded theory analysis. Three categories emerged. One refers to scope, aims and corollaries of the connection with the client; a second to preventing harm and managing drawbacks; and a third to taking therapeutic advantage of challenges related to closeness. Together, these categories form a model that describes how the close connection modifies therapeutic effects and generates challenges the therapist needs to deal with. The closer the dyad, the easier therapists will affect and be affected by the client. Therapists try to direct closeness to where it can nourish client process without harming the relationship, the client or themselves, and when closeness backfires, they may still try to harness uninvited effects for the benefit of therapy. This model concerning therapists' lived experience is offered to inform research on the therapist-client relationship and as a contribution to clinical competency models.
The Behavior Analyst, 2008
Revista Brasileira de Terapias Cognitivas, 2006
O presente artigo aborda um conceito com origem nas práticas meditativas orientais, que passou a ... more O presente artigo aborda um conceito com origem nas práticas meditativas orientais, que passou a fazer parte da medicina comportamental a partir dos programas de redução de estresse de Kabat-Zinn. Mindfulness é definida como uma forma específica de atenção plena-concentração no momento atual, intencional, e sem julgamento. Significa estar plenamente em contato com a vivência do momento, sem estar absorvido por ela. Só durante a década passada ganhou destaque nas literaturas comportamentais e cognitivas, enquanto anteriormente estava implicitamente presente nas práticas clínicas destas tradições. O artigo apresenta Mindfulness da forma em que é praticada em diferentes terapias contemporâneas. Discute-se ainda, as possibilidades terapêuticas que este conceito traz a partir de diferentes perspectivas teóricas. Palavras-chave: meditação; terapia cognitivo-comportamental; aceitação.
International Perspectives in Psychology, 2012
Twenty-seven Brazilian psychotherapists were interviewed about how religion and spirituality inte... more Twenty-seven Brazilian psychotherapists were interviewed about how religion and spirituality interface with psychotherapy. Transcripts of unstructured interviews were subjected to open analytical coding and categorization according to grounded theory. Two categories emerged. The first category, the more complex one, saw religion as a therapeutic challenge in that therapists must respect client religion, tackle clients' religious issues, and understand how therapists' own religion influences their behavior. The second category depicted religion as providing cultural resources, including healthy activities, teachings and social support, and spirituality as providing a broader sense of meaning. Therapists used clients' religion and spirituality as therapeutic aids. Therapists' own spirituality also served as an asset in improving their interventions and coping with the emotional strains of doing therapy. Applied to practice, the findings can help clinicians deal success...
Psychology and Psychotherapy: Theory, Research and Practice, 2007
This paper is about the use of an unconventional intervention for treatment‐resistant OCD that we... more This paper is about the use of an unconventional intervention for treatment‐resistant OCD that we describe as ‘Therapist Assumes Responsibility’ (TAR). The use of TAR in this paper as a clinical treatment parallels an experimental analysis by Lopatka and Rachman (1995). Two case studies are used to illustrate TAR and the use of the therapist‐client relationship in the treatment of OCD. These include learning to trust others and accepting reasonable levels of insecurity. It is proposed that the addition of an interpersonal factor to CBT theories of OCD helps to explain the role of inflated responsibility and how the client‐therapist relationship can be used during treatment. It is further proposed that reassurance seeking might also be the result of this same interpersonal factor.
Mental Health, Religion & Culture, 2009
The secular, acceptance-based philosophy of third wave behaviour therapy has easily absorbed the ... more The secular, acceptance-based philosophy of third wave behaviour therapy has easily absorbed the notion of mindfulness that originated in Eastern spirituality, entailing a secularised approach to transcendence. The present article seeks to connect mindfulness with existing efforts to integrate the Western client's spirituality into psychotherapy. For that purpose, we show how Christian grace theology and mindfulness theory overlap in the way they construe transcendence and self. Both approaches enhance openness to experience and deemphasise verbal control as a tool for personal progress. It is argued that awareness of this overlap can make it easier for the therapist to understand and appreciate the client's religious perspective. It can also help turn a client's spirituality into a relevant personal strength for therapy. Finally, explaining the overlap can enhance the credibility of mindfulness interventions with traditional Christian clients and make these interventions relevant to their spiritual concerns.
Journal of Psychotherapy Integration, 2009
Several major schools of psychotherapy require a genuine emotional presence from therapists in-se... more Several major schools of psychotherapy require a genuine emotional presence from therapists in-session, as well as a nondefensive awareness of their emotional responses to the client. The present article addresses the part played by upsetting experiences in the context of these requirements. In order to identify relevant issues for a discussion of the literature, grounded theory analysis is presented of a series of conversations with four psychotherapists about their experience with in-session distress. The participants reported client confrontation and rejection evoked a variety of negative emotions ranging from helplessness to anger. Besides traditional professional resources like supervision and personal therapy, they discussed several coping strategies that focused on emotions. One strategy that stood out was to analyze how the emotional impact occurred in order to clarify client issues. This strategy was reported to yield information that improved therapeutic effectiveness in the case at hand, but it also was an effective method for overcoming therapist distress and a means of promoting broader professional growth. These observations suggest issues for integrative psychotherapy research into emotional risk taken by therapists and its payoff.
Journal of Contemporary Psychotherapy, 2013
This article discusses how the way the therapist relates to his or her personal responses to clie... more This article discusses how the way the therapist relates to his or her personal responses to client material during the session contributes to making the relationship with the client an effective tool for treatment. Ideas from third wave behavior therapy are used to describe aspects of therapist involvement in the relationship and modes of therapist awareness of inner responses. In two vignettes, negative client reactions to an intervention bring problematic therapist material to the fore. Both cases highlight how the stories the therapists spun about themselves as professionals and persons could easily have limited their effectiveness in responding to the material. The vignettes also illustrate how clinicians can overcome personal meanings and judgments to access a more productive mode of interacting with the feelings a critical incident in the relationship evokes in them. It is argued that observing their own content from a psychological distance makes it possible for clinicians to use their feelings without getting caught up in them. These same feelings may then help the therapist perceive how the incident relates to the client's daily life problems. The therapist's engagement in a sense of self-as-context is described as a therapeutic stance that provides the psychological distance needed to help overcome alliance ruptures and other potential gridlocks and which may transform the therapist's inner response to client content into a tool for addressing important client issues.
Estudos e Pesquisas em Psicologia
De acordo com a visão vigente, aprende-se a ser psicoterapeuta comportamental em cursos, onde se ... more De acordo com a visão vigente, aprende-se a ser psicoterapeuta comportamental em cursos, onde se ensinam teoria, intervenções e técnicas; e na supervisão, onde a atuação do terapeuta é aprimorada. O objetivo deste estudo foi examinar uma terceira via de aprendizagem. O que os terapeutas aprendem na relação com seus clientes? Foram entrevistados 14 terapeutas analítico-comportamentais, cognitivo comportamentais ou comportamentais contextuais, a respeito do que aprenderam com seus clientes para sua prática clínica. A análise das transcrições foi pautada nos preceitos da grounded theory analysis. Os resultados sugerem que os terapeutas aprendem sobre algumas coordenadas importantes do processo terapêutico: a singularidade de cada cliente, a responsabilidade do cliente e do terapeuta para o processo e sobre as suas limitações como terapeuta. Expandem suas competências clínicas: como enxergar além de rótulos e julgamentos, assumir uma postura terapêutica, flexibilidade e autenticidade. A...
Perspectivas em Análise do Comportamento
A Psicoterapia Analítica Funcional (FAP) apresenta características que dificultam e outras que fa... more A Psicoterapia Analítica Funcional (FAP) apresenta características que dificultam e outras que facilitam o trabalho com clientes que não pertencem à mesma cultura que o terapeuta. Após uma breve consideração de algumas tendências na literatura a respeito da psicoterapia culturalmente sensível e responsiva, características da FAP são discutidas que são aptas a favorecer o atendimento culturalmente competente. São oferecidas sugestões sobre como otimizar essas características para tornar o tratamento mais culturalmente responsivo. Isto ocorre (1) pela utilização dos pontos de vista e os recursos do cliente, (2) pelo foco na resolução imediata dos problemas que ocorrem na relação terapêutica e (3) pela intensificação da auto-observação e das vivências diversas do terapeuta. Visto pelas lentes da FAP, ao invés de ser um problema, diferenças culturais podem se tornar aliadas do processo terapêutico.
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Papers by Luc Vandenberghe