Fall 2024 SOWK 581 Week 07 - Objects Relations Theory & Self-psychology
Fall 2024 SOWK 581 Week 07 - Objects Relations Theory & Self-Psychology
title: Fall 2024 SOWK 581 Week 07 - Objects Relations Theory & Self-psychology date: 2024-10-05 00:02:00 location: Heritage University tags:
- Heritage University
- MSW Program
- SOWK 581
presentation_video: description: >
Week seven is synchronous class week, with an in-person session on Saturday (10/05/27). Having spent time in class looking at the theoretical basis of an integrated approach to clinical practice, the assessment process, biopsychosocial assessments, the DSM-5-TR, and multicultural practice, we will focus more on specific practice implementations within the integrated approach. This week’s readings include two chapters of the Cooper and Granucci Lesser (2022) with two relational psychodynamic models, object relations theory and self-psychology.
The learning objectives this week include
- Develop an appreciation of the evolution of relational psychodynamic models
- Understand the concepts of object relations and self-object
- Discuss the concept of trauma bonding
- Apply self-psychology to a brief group intervention
- Develop the context of attachment theory
- Learn a simple model for sharing about the functions of the brain
Agenda
- Discuss the psychosocial assessment assignment
- Example of understanding and applying object relation theory to a client
- Reviewing components of self-psychology
- Empathetic responding practice
- Examining the diagnosis of ADHD
Agenda
- Discuss the psychosocial assessment assignment
- Example of understanding and applying object relation theory to a client
- Reviewing components of self-psychology
- Empathetic responding practice
- Examining the diagnosis of ADHD
Psychosocial Assessment (1 of 3)
Review rest of semester and how it can fit in
Psychosocial Assessment (2 of 3)
Review assignment description
Meta: Points 100 pts (20% of final grade); Deadline Monday 10/07/24 at 08:00 AM TBD; Completion via MyHeritage Assignments.
Purpose: Assessment is a key aspect of direct practice, and a social worker’s ability to effectively engage with a client is vital to completing a meaningful assessment. Psychosocial assessments are a common tool and provide a framework for evaluating cultural factors.
Task: The psychosocial assessment is a key assignment for SOWK 581. The assignment is one of the building blocks for the student’s case study paper. Students will demonstrate their competency in engagement. Heritage’s MSW Program includes two practice behaviors in assessing engagement. First is related to evaluating cultural factors, and second is using culturally responsive engagement methods.
For this assignment, students will conduct a psychosocial assessment with a client they are using in their case study. The final product will have two broad components. The majority of the content will be the actual evaluation documentation. Cooper and Granucci Lesser (2022) include a discussion regarding the implementation of psychosocial assessment. Students will develop their own form but will follow the headings listed in chapter three (e.g., Identifying Information, Referral Source, Presenting Problem, cultural/spirituality, etc.). Students can use the same chapter’s section, “The Case of Vincent,” as an exemplar. This psychosocial assessment is related to the case study assignment. The documentation will be based on your interview with a client at your practicum placement. The second component is a section at the end reflecting on the experience of assessing the client and how you built meaningful engagement and used culturally responsive methods. The assessment should include evaluating those cultural factors at all levels of interaction (e.g., individual, family, groups, organizations, and communities).
Success: Students will be assessed using the Psychosocial Assessment and Competency Six Rubric. A successful assessment will include following documentation best practices, gathering comprehensive data about the client’s needs, demonstrating alignment throughout the assessment, and following the assignment description. Students also need to demonstrate competency in evaluating cultural factors and using culturally responsive engagement strategies.
Psychosocial Assessment (3 of 3)
Review highly developed on the rubric
The Psychosocial Assessment and Competency Six Rubric is used to evaluate the psychosocial assessment that students complete in SOWK 581. it serves to parts. First is evaluates Heritage Universities Specialized Practice behavior for engaging with clients evaluating cultural factors to develop engagement and the use culturally responsive engagement. Second it evaluates the assignment looking at best practices are followed for documentation, that the evaluation was comprehensive, that there is alignment throughout the evaluation, and the assignment task is followed.
| Description | Initial | Emerging | Developed | Highly Developed |
|---|---|---|---|---|
| Evaluating cultural factors to develop engagement | There is little to no reflection on cultural factors and no apparent connection to building engagement with diverse client populations. Context is generally ignored. | The reflection makes a minimal attempt to discuss cultural factors and their implications for working with diverse clients. Some essential contextual factors are missing or underdeveloped. | The reflection discusses cultural factors, but connections to working with diverse client populations or building engagement may lack depth or clarity. Contexts are mentioned but not fully explored. | The reflection includes a clear, understandable discussion of how cultural factors were evaluated. It connects the evaluation to the implications of working with diverse client populations and details how engagement was built. Contextual factors such as family, groups, organizations, and communities are fully explored. |
| Using culturally responsive engagement | The reflection lacks a straightforward and precise application of culturally responsive methods. | There is minimal evidence that the student tailored their interventions to promote healing and well-being, and any attempts to do so lack depth or clarity. The reflection provides little consideration of multiple levels of interaction (e.g., individual, family, groups, organizations, and communities). | The reflection describes using culturally responsive methods but may lack specific examples or depth. The student may have tailored their interventions but have not clearly articulated them. The student did not fully consider multiple levels of interaction (e.g., individual, family, groups, organizations, and communities). | The reflection comprehensively describes how they engaged in culturally responsive methods. At least three examples of how you tailored your practice to promote healing and well-being. The reflection highlights the student’s ability to modify and tailor interventions at multiple levels (e.g., individual, family, groups, and organizations) to ensure the client’s dignity and empowerment throughout the process. |
| Documentation follows best practices | The psychosocial evaluation does not follow the general norms for clinical documentation, and the documentation contains many major problems. | The psychosocial evaluation generally follows the norms for clinical documentation but has some more significant errors or problems found in the documentation. | The psychosocial evaluation generally follows the norms for clinical documentation but has a couple of areas with more minor errors or problems. | The psychosocial evaluation follows general norms for clinical documentation in how it is written. Examples include using professional and neutral language, writing with clarity and precision, balanced use of subjective and objective information with clear distinctions, use of client-centered language, and a cogent organizational style. |
| The evaluation will be comprehensive gathering the necessary information about client needs | The psychosocial assessment greatly lacks the information needed for a comprehensive psychosocial evaluation. | The psychosocial assessment is missing one or two of the required sections to provide a comprehensive evaluation. Many of the sections seem underdescribed and appear to be missing relevant information that should have been gathered. | The psychosocial assessment gathers information about the client’s needs in all required areas. One or two sections are underdeveloped and appear to be missing relevant information. | The information gathered in the psychosocial evaluation will provide a comprehensive overview of the client’s needs. It will include information collected related to identifying information, referral source, presenting problem, developmental assessment, family background, personal history, medical history, educational/learning history, social class, cultural history, religion/spiritual, mental status and current functioning, summary, recommendations, and intersection client/worker relationship. |
| The evaluation contains alignment and develops a deep understanding of the client | There is a lack of alignment between what is presented in the client’s history/presenting problem and the interpretations and recommendations made in the assessment. | The assessment has more significant problems with alignment between the client’s history/presenting problem and the interpretations and recommendations made in the evaluation. | The assessment generally aligns with the description of the client’s history/presenting problem and the clinician’s interpretations and recommendations. There are some minor discrepancies, where it appears the information was not collected or was unnoticed by the writer. | The assessment develops a complete picture of the client. The information gathered about the client’s history/presenting problem sections connects to the social worker’s interpretations and recommendations (e.g., mental status, summary, and recommendations). Any significant discrepancies are discussed. |
| Following Assignment | The case study does not follow the assignment description and requirements. | The case study somewhat follows the assignment description, but significant errors exist. | The case study follows the assignment description and requirements but has minor errors. | The case study closely follows the assignment description and requirements. |
Five Assumptions of Time Limited Dynamic Psychotherapy
There are five basic assumptions in time limited dynamic psychotherapy
- Maladaptive relationship patterns are learned in the past: Relationships with early caregivers will become organized and both affectively and cognitively encoded as interpersonal schemas through which the child, and later the adult, filters the world.
- Such maladaptive patterns are maintained in the present: Although a dysfunctional interactional style is learned in childhood, it must be supported in the adult’s current life for the interpersonal difficulties to continue.
- Dysfunctional relationship patterns are re-enacted in vivo in therapy: The patient interacts with the therapist in the same dysfunctional way that characterizes her interactions with others in her life and tries to enlist the therapist to play a complementary role.
- The therapeutic relationship has a dyadic quality: The relational-interactionist position of TLDP is that the therapist will experience an “interpersonal countertransference” that involves her acting in a way that the patient expects. The therapist must recognize this replication of the patient’s earlier dysfunctional relational pattern and use this information to change the nature of the interaction in a more positive way.
- The TLDP focus is on the child problematic relationship pattern: The emphasis in TLDP is on assessing and intervening in the patient’s most pervasive and problematic style of relating.
(Cooper & Granucci Lesser, 2022)
Framing the Client
Sections used in case example
use Example of ML-41901
Client info History of presenting problem Family and social history Case assessment Acts to self Expectations of others reactions Actions of others towards self Acts of the self towards the self Goals of treatment Treatment Working with internal blame (specific client problem) Working to gain Mastery of abuse experience (specific client problem) Working with abuse experience (specific client problem) Working with the theraputic relationship
Self-Psychology: General Overview
Self-psychology can be understood within the conceptual frame of developmental psychology with links to attachment; mentalization (the growth of a child’s capacity to understand interpersonal behavior in terms of mental states;
- The Self: The self is considered the core of an individual’s personality, encompassing one’s sense of identity, coherence, and continuity.
-
Selfobject Needs: Selfobjects are people or things that fulfill essential psychological functions for the self, helping maintain its cohesion and vitality.
- Mirroring: The need to have one’s abilities and accomplishments recognized and affirmed by others. This validation fosters self-esteem and confidence.
- Idealization: The need to look up to significant others (parents, mentors) for strength and guidance. Idealizing others helps individuals internalize values and standards.
- Twinship (Alter Ego): The need to feel a sense of likeness or belonging with others. This connection fosters a sense of community and acceptance.
(Cooper & Granucci Lesser, 2022)
Role of the Therapist in Self-Psychology
- Patient’s feelings are viewed as being determined by past experience and the relationship with the therapist in the present
- Kohut suggested that patients come to therapy to learn to self-sooth, self-comfort and self-empathize; these capabilities are initially provided by the therapist as the self-object
- Optimal frustration: minor experiences of the therapist’s empathic failures
- Optimal frustration experiences help the patient learn to tolerate frustration and cope with ungratified needs
- Optimal frustration has been reframed to “optimal responsiveness,” which stresses empathic understanding as fundamental to the therapeutic process
(Cooper & Granucci Lesser, 2022)
Every aspect of self-psychology as a therapeutic approach is framed within the context of empathy
(Cooper & Granucci Lesser, 2022)
Reviewing Parts of Empathic Communication
To review, that is…
- Perspective taking and recognizing their perspective as truth
- Staying out of judgment
- Recognizing emotion in other people
- Communicating emotion with people
What becomes challenging about implementing this?
Wiseman, T. (2007). Toward a holistic conceptualization of empathy for nursing practice. Advances in Nursing Science, 30(3), E61–E72. https://doi.org/10.1097/01.ANS.0000286630.00011.e3
Levels of Empathetic Responding
There are three levels of empathetic responding…
Surface empathy: A direct reflection of the feelings and concerns that the clients express, usually using the same vocabulary
You are feeling down.
Reciprocal empathy: Focus on the direct feelings that clients express to you, but extends perspective taking and speculate about feelings and emotions.
You sound like you are feeling depressed and like you don’t have a lot of control.
Additive empathy: The process of reflecting the full range and intensity of the surface and underlying feelings that a client conveys through verbal and nonverbal communication
Includes high levels of inatimate sharing from client and well developed assessment by social worker
(Hepworth et al., 2022)
Practice with Empathetic Responding (1 of 3)
Jamal, 16 years old
Client: Jamal has recently moved to a new city with his mother after his parents’ divorce. He is struggling to adjust to his new school, feeling isolated and anxious. His grades have dropped, and he has become withdrawn at home.
Social Worker: The a school social worker a high school setting. Jamal’s name came up in a report showing his grades have dropped. You pulled him from classto see how you can support him. One objective you will have is to help Jamal navigate his emotional and academic challenges.
Practice with Empathetic Responding (2 of 3)
Sarah, 35 years old
Client: Sarah is a survivor of domestic violence who has recently left an abusive relationship. She is feeling conflicted about her decision, as she still loves her partner and is unsure how to move forward with her life.
Social Worker: The social worker is a case manager at a domestic violence shelter. Sarah has been living at the shelter for a few days and is starting to settle in. You’ve pulled Sarah in for an individual meeting to start developing a plan. Your objective is to work with Sarah to provide emotional support and safety planning for her future.
Practice with Empathetic Responding (3 of 3)
Jasmine, 17 years old
Client: Jasmine is a high school student who recently experienced the sudden death of her best friend in a car accident. She is struggling with grief and guilt and has difficulty expressing her emotions to those around her.
Social Worker: The social worker is a therapist at a local couseling agency. You have been working with Jasmine before the accident and have a positive rapport with her. You will be aiming to support Jasmine to express her emotions after her friend’s death.
Examining Diagnosis of ADHD
Review criteria in the DSM-5-TR and Small Group Discussion of relationship with Self-Psychology
When a child is not able to make sense of her experiences, and when there is additionally a discordance between the personal meanings the child ascribes to her experiences and the beliefs others (including parents, family members, and educators) have about the child’s experiences, the child becomes vulnerable to problems ranging from struggles with self-esteem to disorders of the self. Treatment of children with learning disorders from a self-psychological perspective revolves around the centrality of the child’s self-experience. This includes working with children (and their caregivers) to identify the development of maladaptive defenses before they become part of the structure of the personality. (Cooper & Granucci Lesser, 2022, p. 100)