The Core Competencies:
Domain 5: Various Techniques & Interventions
A European Psychotherapist is competent to: -
- §5.1: Utilise ‘Standard’ Techniques & Interventions
- 5.1.1: Establish a Functional ‘Working’ Alliance: which involves – utilising the contractual elements and the planned strategies; re-assuring the patient/client that, whilst they might currently be feeling unwell or having a crisis, they may not be ‘mentally ill’, and that they can or will probably get better (i.e. there will probably be a reduction in distressing symptoms); that distressing symptoms may be indicative of an underlying process that needs resolution; and that there maybe even a form of ‘healing’ in their underlying problems) as a result of these sessions; generally engaging the patient/client in collaborative team work to explore and resolve their difficulties; listening carefully to what the patient/client has to express and occasionally & appropriately reflecting back what you have heard and/or understood; seeing the patient/client as a “person” and not as a ‘set’ of symptoms; utilising one’s empathy and resonance towards the patient/client, whilst retaining a professional position; recognising the autonomy of the patient/client and respecting their boundaries, whilst balancing this with one’s professional knowledge skills and experience; dealing with any transference phenomena; centring any work around the wants and needs of patient/client; utilising feedback constructively; monitoring, positively supporting and reflecting back on their progress; being aware of any social and/or cultural diversity issues, and/or potential power and equality issues, and working with these constructively; supporting hopes for improvement; etc.
- 5.1.2: Identify which techniques or interventions are appropriate: which involves – utilising the previously performed assessment of the patient/client’s problems or difficulties and deciding which of the ‘standard’ techniques or interventions may be appropriate for that person with those problems (for example: a depressed person may need motivational techniques, and an anxious person may need relaxation techniques); being aware of any contra-indications for those ‘standard’ techniques or interventions; informing the patient/client about these techniques and interventions, and exploring those that seem appropriate for them; affirming the patient/clients’ strengths and supporting progress with their difficulties; remembering that it will almost certainly not be one single technique and/or intervention that is appropriate or successful, but that there will probably be a series, or several layers of application, uniquely applied for that patient/client; etc.
- 5.1.3: Identify which modes of interaction are appropriate: which involves – being flexible in one’s approach; being able to modify or adapt one’s approach; sometimes being supporting and reassuring, sometimes being more directive or educational, and sometimes even confronting the patient/client, all as and when appropriate; finding a healthy balance between professional intervention and the patient/client’s own self-empowerment – a balance that will constantly change with time and circumstances; being aware of the differences between the traditional ‘medical model’ of a patient requiring treatment and the more ‘humanistic model’ of client choosing to utilise your professional services; etc.
- 5.1.4: Monitor and manage the process of change: which involves – being aware of the patient/client’s development and process, and of their different needs at different times; acknowledging changes that have already happened, and anticipating possible future changes; being flexible with strategies and interventions, as appropriate in a changing process and environment; working consistently with guidelines, standards, ethics, and sensitivities; (see also §2.2.6) etc.
- 5.1.5: Manage any difficulties: which involves - working clearly within the framework of the psychotherapeutic alliance; identifying and analysing any difficulties, as they arise; managing any interventions that may cause confusion, embarrassment, anxiety or offense; managing situations where the patient/client feels distress or discomfort at values, beliefs or behaviours in others (including the psychotherapist); being flexible with interventions, phrasing and timing (brief, medium or long-term psychotherapy and with different frequency of sessions, where needed); being aware of other possible techniques and interventions, and exploring the possibility of utilising these; (see also §2.2.7) etc.
- §5.2: Manage the Emotional Content of the Sessions
- 5.2.1: Facilitate the Processing of Emotions: which involves – acknowledging the patient/client’s emotions, at many different levels; assisting them to overcome inhibitions and resistances in expressing feelings, where and when relevant and appropriate; helping them to contain any emotional levels that are too high or too low for sustained comfort; dealing with emotional issues that interfere with the therapeutic relationship or the process of the therapy (e.g. anxiety, hostility, excessive anger, avoidance of affect, etc.); assisting the patient/client to experience and explore emotions in a way that facilitates their process; encouraging the patient/client to differentiate emotions that are repetitive, negative or unproductive; assisting the patient/client to integrate their emotions in comprehensive and productive ways; etc.
- 5.2.2: Maintain a Psychotherapeutic 'Presence': which involves – being 'present' for the patient/client in whatever emotional state that they are in at any one moment; not being caught up into any of the patient/client's emotional complications; having a reasonable degree of one’s own sensory and bodily receptivity; being aware, alert and focussed; being available and not being distracted by one’s own internal processes or concerns; not necessarily responding to any specific patient/client interjections; remaining - as far as possible - in a present (in-the-moment), non-judgmental, accepting, empathic 'state' of being; being as authentic (non-defensive; congruent) as possible; trying to ensure that one's own emotional 'presence' does not impinge upon the patient/client's - or to find a healthy balance with (between) one's own emotional state with that of the patient/client's; etc.
- 5.2.3: Handle Extreme Emotions: which involves – being able to make a risk assessment; having an awareness what to do if a patient/client becomes hyper-manic, panicky, violent or suicidal; getting appropriate training if working in situations where patients/clients experience extreme emotions regularly; etc.
- §5.3: Utilise ‘Other’ Techniques & Interventions
- 5.3.1: Use research-based techniques and interventions: which involves – being aware of up-to-date developments in psychotherapy, new methodologies and approaches, and research studies on the effectiveness and efficacy of these; utilising only those techniques and interventions that seem appropriate to this patient/client and their situation; ensuring that these are only using in a proper and professional manner, from a sound basis of training, supervision and experience; etc.
- 5.3.2: Ensure proper training & supervision in these: which involves – where appropriate, engaging in additional training from proper training courses and getting supervision from appropriately qualified supervisors in these new and/or different techniques and interventions, so that they can be applied professionally and safely; etc.
Footnote:
[1] All these Core Competencies should be read in conjunction with the relevant sections of the EAP Statement of Ethical Principles (see Appendix 6 (see here) or the EAP website (see here)