Pre-therapy

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The pre-therapy was founded in 1966 by the American psychologist Garry Prouty. It is a further development of the client-centered psychotherapy founded by Carl Rogers . Pre-therapy is a method of establishing psychological contact with clients who are contact-impaired.

background

Carl Rogers described six conditions for psychological change in a client. The first three conditions describe the basic attitude that the therapist should adopt. So that healing changes can take place in the client, personal appreciation , empathy and authenticity (also known as " congruence ") must be lived by the therapist . These three conditions are the most well-known features of client-centered psychotherapy. Often the other conditions mentioned by Rogers are less considered or taken for granted.

The fourth condition is that there is psychological contact between the client and the therapist.

The sixth condition is: The therapeutic offer of the basic postures (1 - 3) must be at least partially perceived by the client.

In the case of clients with intellectual disabilities or with acute psychotic disorders , the fourth and sixth conditions are often not met because they are not able or are limited in establishing contact with their counterpart.

The pre-therapy describes a method how the therapist can make contact offers with such clients, which make it easier for the client to establish contact with the therapist. If this assistance enables the client to come into contact with the therapist, then the three known basic attitudes of the therapist can be perceived by the client and a beneficial change can begin.

Prouty has reported cases in which patients who had active flare-ups of schizophrenia (e.g., catatonic schizophrenia ) were completely unresponsive . To this day, such patients - at least as long as they are in the acute phase - are mostly treated exclusively with medication. Prouty reports of cases in which the acute psychotic symptoms clearly decreased within a few hours and without the administration of medication as a result of the pre-therapy. As soon as the patient had basically regained the ability to contact, Prouty then continued the treatment through classic conversation psychotherapy .

Working method

According to Prouty, psychological contact comprises three levels:

  • the therapist's contact reflections
  • the client's contact functions
  • the contact behavior that is measurable

Contact reflection

Contact reflection is a method by which the therapist offers empathic contact with the client when there is not enough contact for therapeutic work. The therapist expresses very precisely and specifically what is expressed in the client. He verbalizes the expression and behavior of the client.

Prouty has formulated four types of contact reflections and an overarching principle:

  • addressing the situation: situation reflection (SR)
  • Addressing the facial expression: facial expression reflection (GR)
  • the reproduction of posture: posture reflection (KR)
  • the word-for-word repetition: word-for-word reflection (WWR)
  • the principle of revisiting: revisiting reflection (WR)

Situation reflection (SR)

The therapist looks at the current situation and environment of the client and expresses it in his own words.

Example: If the client looks at a picture on the wall, the therapist can say, "Paul is looking at the picture".

Another example: It is raining outside and the client is looking at the window where the raindrops are running down. Then the therapist can say: "It's raining" or "The raindrops are running down the window."

This type of reflection encourages contact with reality.

Facial Expression Reflection (GR)

The therapist looks at the client's face and notices what feelings are implied in it. He can express these perceived or suspected feelings. So he can z. For example, say: "Paul is smiling" or "Paul looks angry."

These kinds of reflections stimulate affective contact, contact with one's own feelings.

Posture Reflection (KR)

Psychotic and mentally disabled people often adopt strange postures. The therapist can adopt the same posture or address the client's posture.

Example: The therapist can say: "Paul's body is very stiff." or "Paul rocks."

This reflection helps the client to regain his body awareness, which is often split off, especially in psychotic patients.

Word-for-word reflection (WWR)

Psychotic patients sometimes fall back to a pre-linguistic stage of development. You no longer speak connected sentences, but only individual words, sentence fragments or word fragments. (See Echolalia , Neologism ). The therapist listens carefully and repeats the recognizable words, even if he does not always get the meaning. It expresses that he is listening to the client and that he recognizes that he wants to communicate something. Often it is possible to grasp what the client wants to express. The client notices that his communication attempts were successful, which can encourage him to continue and intensify communication.

Revisiting Reflection (WR)

If the contact is completely broken off, then a reflection which has taken place once and which has caused contact can be repeated. A reminder from the client of the previous contact is used to revive this contact.

Contact functions

Prouty describes three functions that enable a person to contact his ego :

  • the reality contact
  • the affective contact
  • the communicative contact

The aim of pre-therapy is to strengthen and train a client in these three contact functions.

See also

Web links

  • project violence - A six page brief introduction to pre-therapy
  • www.focusing-igf.de - pre-therapy - working on contact or a form of “being together” by Oliver Kreim, igf - Institute 2010
  • www.Springermedizin.de - Pre-Therapy in Elderly Care. New approaches to people with severe dementia

Other sources in English

Individual evidence

  1. ↑ Garry Prouty, Marlies Pörtner, Dion van Werde: Pre-Therapy. Page 23 3rd edition 2011 ISBN 978-3-608-94632-1
  2. ↑ Garry Prouty, Marlies Pörtner, Dion van Werde: Pre-Therapy. Page 33 3rd edition 2011 ISBN 978-3-608-94632-1