UNIVERSITATEA DIN ORADEA

FACULTATEA DE TIINE SOCIO-UMANE

MASTER: PSIHOLOGIE EDUCAIONAL, CONSILIERE COLAR VOCAIONAL

Plan de interventie

Student:

Ovanescu Ana Ioana

Plan de interventie terapeutic

"Oamenii sunt perturbati nu de imprejurari, ci de modul cum le interpreteaza "- EPICTET

CAZUL:Elena este o femeie de 45 de ani. Este foarte religioasa si sufera de anxietate generala si teama de inaltimi. Ea este casatorita si are trei copii. Frica de inaltimi este demonstrata prin evitarea de a zbura cu avionul si de refuzul de a calatori cu masina pe varfurile muntilor. Anxietatea generala este exprimata prin sentimente de tensiune ori de cate ori este criticata sau este pusa in situatii sociale in care trebuie sa poarte conversatii cu persoane straine. Ea crede ca nu este o persoana competenta si de multe ori gandeste despre ea ca este o ,,mama rea. Cand este in astfel de situatii ea de obicei simte tensiune musculara , simte palpitatii la inima , incepe sa transpire si simte ca in stomacul ei este un nod.

Terapia cognitiv-comportamentala abordeaza toate cele 3 sisteme ale anxietatii:

* Componenta fiziologica: ex. training de relaxare musculara

* Componenta cognitiva: ex. restructurarea cognitiva

* Componenta comportamentala: ex. managementul timpului, , expunerea, experimente comportamentale

Planul de interventie se realizeaza de comun acord cu clientul si in functie de nevoile acestuia.

OBIECTIVE:

- Identificarea si modificarea schemei cognitive care directioneaza organizarea si procesarea informatilor, precum si interpretarea experientelor de viata. Schemele cognitive sunt cele care produc distorsionarile cognitive, generatoare de stari afective si comportamente disfunctionale (Beck, 1967, 1976), accentuand sau diminuand vulnerabilitatea persoanei in anumite imprejurari de viata. - Cunoasterea si modificarea modului de raportare a subiectului la ceilalti. Se urmareste identificarea si evaluarea particularitatilor atitudinale si motivelor circumstantiale care dezvolta comportamentele subiectului in registrele relationarii si comunicarii cu ceilalti. - Achizitionarea de catre subiect a unor abilitati de a face fata mai eficient situatiilor stresante ale existentei. Subiectul isi va insusi noi modele de comportament, va testa efectele punerii in actiune a acestora si va dezvolta disponibilitatile psihice latente.

CUM INTERVENIM

Obiectivul prioritar este cel de reducere a simptomelor,

In aceasta idee, Greenstone si Levinton (1993) prescriu urmatoarele recomandari care trebuie respectate la interviul cu pacienti aflati in criza:- Terapeutul trebuie sa inceapa interventia imediat ce intalneste persoana aflata in criza. Acesta trebuie sa inteleaga semnificatia situatiei, sa reduca anxietatea, sa amelioreze dezorientarea si sa se asigure ca pacientul nu- si va face rau lui insisi sau celorlalti. - Terapeutul isi asuma controlul asupra pacientului aflat in criza, in sensul ajutarii acestuia sa realizeze o anumita ordine in viata psihica si in situatia psihica in care se gaseste (structureaza universul psihologic al pacientului pana cand acesta isi gaseste autocontrolul, face eforturi sa structureze situatia si exercita un anumit control emotional asupra pacientului, pe fondul mentinerii unui comportament calm si suportiv). - Terapeutul cauta sa inteleaga cum si de ce a intrat persoana in criza, care sunt elementele specifice carora trebuie sa le acorde prioritar atentie si sa identifice acele variabile care impiedica mentinerea situatiei sub control.

DEMERSUL TERAPEUTIC

Demersul terapeutic in aceasta etapa se va centra, cu precadere, pe ajutorul acordat pacientului de a-si defini problema. 3) Ajutarea pacientului sa-si evalueze si sa-si mobilizeze resursele pentru a-i face fata (resursele de natura interna - disponibilitatile psihologice latente; resursele de natura externa - familie, rude, prieteni). 4) Alcatuirea unui plan de actiune pentru rezolvarea problemei, pe baza unui acord comun intre terapeut si pacient. Terapeutul evalueaza totodata motivatia si dorinta pacientului de a duce la indeplinire planul stabilit. 5) Directionarea pacientului. Terapeutul, intr-o maniera directiva, il ajuta pe pacient sa adopte decizii si sa testeze noile strategii de a face fata situatiei stresante.

Interventia psihoterapeutica:

Tehnici cognitiv comportamentale care pot fi utilizate:

- Tehnica adresarii intrebarilor cu caracter provocativ;- Tehnica metaforelor;- Tehnica utilizarii unor scale de evaluare a asteptarilor;- Tehnica examinarii avantajelor si dezavantajelor;- Tehnica transformarii unui eveniment negativ intr-un avantaj;- Tehnica descoperirii dirijate;- Tehnici de relaxare; - Tehnica sarcinilor pentru acasa.

Structura sedintelor:

Prima sedinta

Obiectivele fixate pentru prima sedinta sunt:o Dezvoltarea relatiei terapeutice. o Conceptualizarea problemelor pacientului si stabilirea prioritatilor, etc.

- Ca tema pentru acasa, ii solicit subiectului sa intocmeasca o lista cu planurile pe care si le-a facut si sa le ordoneze prioritar.

Sedinta a II-a:Obiectivul sedintei Il constituie identificarea listei de prioritati ale subiectului (asteptarile, prioritatile si incadrarile temporale pe care aceasta si le asuma).

Judecata sa negativa, privind imposibilitatea rezolvarii unor probleme, faptul ca se considera o mama rea i-a influentat modul de gandire, sentimentele si comportamentele

Sedinta a III-a: Obiectivul sedintei Il constituie identificarea, modificarea si acceptarea de catre subiect a gandurilor si sentimentelor negative.

- Analiza gandurilor, si proiectia actiunilor subiectului. O ajut sa-si restructureze gandurile si sa caute permanent argumente valide la gandurile care o nelinistesc. Introducerea unor tehnici de relaxare

Sedintele a IV- a si a V- a: In aceste sedinte fixam gandurile si convingerile pozitive dobandite in sedintele anterioare. Exploram situatii si intaresc convingerea ca n-are motive de ingrijorare privind anumite subiecte care o nelinistesc. Sedintele a VI-a si a VII-a: Explorarea unor posibile evenimente de viata, ale caror ganduri asociate sa-i restructureze increderea in sine si in ceilalti.

Sedinta a VIII-a: Scopul sedintei este de a identifica abilitatile pe care subiectul le-a dobandit pentru a evita intoarcerea la gandurile si modelul comportamental care a instituit interventia terapeutica.

Sedinta a IX-a: Scopul sedintei este de a ajuta subiectul sa identifice conduite (de principiu) pentru a obtine autocontrolul dorit.

BILIOGRAFIE 1. POPESCU-NEVEANU, P. - Dictionar de psihologie, ed. Albatros, Bucuresti, 19793. IONESCU, C - Psihiatrie Clinica, ed. Univers enciclopedic, Bucuresti, 2000. 4. KAPLAN & SADOCK - Psihiatrie clinica, ed. Medicala, Bucuresti, 2001. 5. DAFINOIU, I. - Elemente de psihoterapie integrativa, ed. Polirom, Iasi, 2001. 6. DAFINOIU, I - Hipnoza clinica, ed. Polirom, Iasi, 2003. 7. HOLDEVICI, I, VASILESCU, I. P. - Psihoterapia. Tratament fara medicamente, ed. Ceres, Bucuresti, 1993. 8. HOLDEVICI, I - Ameliorarea performantelor individuale prin tehnici de psihoterapie, ed. Orizonturi, Bucuresti, 1993.9. HOLDEVICI, I. - Psihoterapie, ed. Ceres"Bucuresti 1993. 10. HOLDEVICI, I - Sugestie si psihoterapie sugestiva, ed. Victor, Bucuresti, 1995. 11. HOLDEVICI, I. - Autosugestie si relaxare. ed. ALL, Bucuresti 1995. 12. HOLDEVICI, I - Gandirea pozitiva, ed. Dual-tech, Bucuresti, 2000. 13. HOLDEVICI, I. - Hipnoza clinica. ed, Ceres, Bucuresti 2001. 14. HOLDEVICI, I - Noua hipnoza ericksoniana, ed. Dual-tech, Bucuresti, 2001. 15. HOLDEVICI, I - Psihoterapia cazurilor dificile, ed. Dual-tech, Bucuresti, 2003. 16. HOLDEVICI, I - Psihoterapia de scurta durata, ed. Dual-tech, Bucuresti, 2004. 17. HOLDEVICI, I - Psihoterapii scurte, ed. Ceres, 2004. 18. HUBER, W - Psihoterapiile, ed stiinta si Tehnica, Bucuresti,1997. 19. IAMANDESCU, I. B. - Dimensiunea psihosociala a practicii medicale, ed. Info - Medica, Bucuresti, 200320. IAMANDESCU, I. B. - Muzicoterapia receptiva, ed. Info - Medica, Bucuresti, 200421. MITROFAN, I.-Cuplul conjugal. Armonie si dizarmonie. Ed. stiintifica si enciclopedica, Bucuresti 1989. 22. MITROFAN, I MITROFAN, N. - Elemente de psihologie a cuplului. Ed. sansa S. R. L., Bucuresti, 1994. 23. MITROFAN, I - Psihoterapie experentiala, Ed. Info-Medica, Bucuresti 1997. 24. MITROFAN, I., CIUPERCa, C. - Psihologia relatiilor dintre sexe. Ed. Alternativa, Bucuresti, 1997. 25. VERZA, E - Psihologia varstelor, ed. Hyperion XXI, Bucuresti 1993. UNIVERSITY OF ORADEA MASTERs PROGRAMProfessor Howard Kassinove and Mr. Bruno Broll-BaroneASSIGNMENT FOR March 2012Anger is one of the basic emotions and is a very common experience. In this assignment, you are asked to interview three people about an anger experience they have had.

Please interview one child (age 6 to 10), one adolescent (age 13 to 18), and one adult (age 21 and over). Be careful about these ages. Do not to interview anyone who is age 11 or 12, or age 19 or 20.

Most important, is that you interview these three people in private. The child, adolescent, and adult who you interview is most likely to be honest if parents, friends, or other family members are not present during the interview.

Always begin by helping the person to be comfortable and feel secure. Pick a time when you have at least 20 minutes for each interview. Go slow and allow the person to think about the answers to each question. Again, slowly moving through the questions will increase honesty.

Begin each interview with this statement;

I am taking a course in which we are learning about personal anger experiences. So, I want to know about a time when you felt angry. First, I will ask you to think about a specific time when you felt angry. Then, I will ask some questions about whathappened. Think very carefully about my questions. We are not in a rush. I just want to learn whatever you remember about the anger.My plan is to hold everything you say in confidence, unless you really plan to hurt another person. I will not talk about your answers to your friends or family. However, I will hand in what you say to my own teacher at the University of Oradea. Your name will not be on the paper I hand in, so no one will know that it was you who gave the answers.Thanks for helping me. Do you have any questions? Okay, lets begin.CHILD INTERVIEW (AGE 6 TO 10)Your name:Ovanescu Ana Ioana

Date of interview: 18.05.2012

First name of child : Lucsan Claudia

This is a GIRL

Birthdate of child: 16.03.2003

Age of child : 9

1) Tell me what happened that made you angry.

M-a lovit colegul meu de banca2) When did it happen? De 1 saptamana

Was it in the morning, afternoon, evening, or at night? ziua

3) Where did it happen? (for example, in school or at home or at work or while in a store)La scoala4) Exactly, who were you angry at? Am fost furioasa pentru ca m-a lovit colegul meu

OK, thanks for telling me about this. Lets continue.5) Now, I am going to give you two sentences. Pick the one that sounds most like what you thought about what happened. The words in the sentences are similar. So, think carefully before you answer.

A1) What happened was really awful (or terrible).

A2) What happened was only bad or unpleasant. It was not terrible or horrible.

B1) When I think about it, I know I could have easily dealt with it. I could have just accepted it.

B2) I couldnt stand what happened. I could not take it.C1) The other person (s) should have acted better. He/she/they must know how to behave.

C2) I wanted the person (s) to act better. But, other people dont have to do what I want.

D1) The other person (s) does lots of things. I like some of them and I dont like other things.

D2) The other person (s) is a really and totally bad person.

Your name: Ovanescu Ana Ioana

First name of child:_Lucsan Claudia

OK, now, I want to learn about exactly what you felt. Lets continue.6) How angry were you? (read the four choices and circle one)NOT VERY ANGRY,A LITTLE ANGRY,VERY ANGRY,

EXTREMELY ANGRY7) For how long were you angry? (read the four choices and circle one)Was it A FEW MINUTES, A FEW HOURS, A FEW DAYS,

or MORE THAN A FEW DAYS

8) When you were angry, what did your body feel like? What happened in your body? (write exactly what the child said)

Am simtit ca vreau sa-l lovesc si euNow, I want to learn about exactly what you did.9) When you were angry, did you(read each item to the child, and check Yes or No YESNOa) yell or scream.

YESb) cry

YESc) make a bad face or stare at the other person

NONOd) throw something or break somethingWhat was it?

YESNOe) hit, kick, push, or shove the other person

NO f) just keep your anger inside and not tell anyone you were angry

NONOg) plan to get even later on. You held a grudge and wanted revenge

NONOh) just leave

YESi) do something to calm down.What did you do? Am vorbit cu colegii

YESi) try to make it better, or talk to the person about what you wanted.

NONOj) have something to eat or drink, to help you forget about your anger.

Your name Ovanescu Ana Ioana_First name of child_Lucsan Claudia

Now, I want to learn about what happened afterwards.10) How did you feel after you were not angry anymore? Did you feel? _happy _sadafraid _satisfied(Record exactly what was said) Am fost suparata, ma durea11) What was the best part about getting angry?

L-am spus doamnei invatatoare si a fost pedepsit12) What was the worst part about getting angry?Ma durut unde ma lovit13) How did your anger affect your relationship with the other person or persons?

This episode had a generally (check one) negative or positive effect. Or, no effect. This anger episode affected a:

School relationship FriendshipRelationship with Parents and Brothers or Sisters Relationship with other family members (like grandparent, aunts, uncles, etc.) Other

Explain Nu mai vorbesc cu colegul meu

Great, thanks for telling me all of this.Is there anything else, you want to tell me?

A fost urat din partea lui sa ma loveascaOk, thanks again.ADOLESCENT INTERVIEW (AGE 13 TO 18)Your name Ovanescu Ana IoanaFirst name of adolescent : Ivan Cristian

This is a BOY

Birthdate of adolescent : 29.07.1995

Age of adolescent :161) Tell me what happened that led you to become angry.

Am luat nota mica in teza la matematica2) When did it happen? De 2 saptamani Was it in the morning, afternoon, evening, or at night? Ziua

3) Where did it happen? (for example, in school or at home or at work or while in a storeLa scoala4) Exactly, who were you angry at? Profesoara mi-a dat nota prea mica

OK, thanks for telling me about this. Lets continue.5) Now, I am going to give you two sentences. Pick the one that sounds most like what you thought about what happened. The words in the sentences are similar. So, think carefully before you answer.A1) What happened was really awful and terrible.

A2) What happened was only bad. It was not terrible or horrible.

B1) When I think about it, I know I could have easily dealt with it. I could have just accepted it.

B2) I couldnt stand what happened. I could not take it.

C1) The other person (s) should have acted better. He/she/they must know how to behave.

C2) I wanted the person (s) to act better. But, other people dont have to do what I want.

D1) The other person (s) does lots of things. I like some of them and I dont like other things.

D2) The other person (s) is a really and totally bad person.

Your name Ovanescu Ana Ioana

First name of adolescent Ivan Cristian

OK, now, I want to learn about exactly what you felt. Lets continue.6) How angry were you? (read the four choices and circle one)NOT VERY ANGRY,A LITTLE ANGRY,VERY ANGRY,EXTREMELY ANGRY

7) For how long were you angry? (read the four choices and circle oneWas itA FEW MINUTES, A FEW HOURS, A FEW DAYS, or MORE THAN A FEW DAYS

8) When you were angry, what did your body feel like? What happened in your body? (write exactly what the adolescent said)

Am inceput sa fiu nervos si sa tremurNow, I want to learn about exactly what you did.9) When you were angry, did you (read each item to the adolescent, and check Yes or No) _NO _YESNO NO

NO a) yell or scream or argue. b) cry

c) cross your arms, stare at the other person, or frown, or give a nasty look ;d) throw something or break something.What was it?

_YES

_YES

_NO NO

e) hit, kick, push, or shove the other person

f) just keep your anger inside, boil inside, and not tell anyone you were angry. g) plan to get even later on. You held a grudge and wanted revenge

h) just leave, or do something else to calm down. What did you do?

_YES

_YESi) do something to calm down.What did you do? Am mers in parci) try to make it better, or talk to the person about what you wanted.

j) have something to eat or drink, to help you forget about your anger.

Your name Ovanescu Ana Ioana

First name of adolescent Ivan Cristian

Now, I want to learn about what happened afterwards.10) How did you feel after you were not angry anymore? Did you feel? happy _sad _afraid _satisfied(Record exactly what was said) Am luat in teza la romana o nota foarte buna

11) What was the best part about getting angry?

Nu stiu12) What was the worst part about getting angry?Am tremurat de nervos ce eram, m-am consumat13) How did your anger affect your relationship with the other person or persons?This episode had a generally (check one) negative or positive effect. Or, no effect. This anger episode affected a: School relationship Friendship Relationship with Parents and Brothers or SistersRelationship with other family members (like grandparent, aunts, uncles, etc.) Other

Explain Sunt suparat pe doamna profesoaraGreat, thanks for telling me all of this.Is there anything else, you want to tell me?Profesorii trebuie sa dea notele corectOk, thanks again.Adult Interview (age 21 and above)Your name: Ovanescu Ana IoanaFirst name of adult Daraban Camelia

This is a WOMAN

Birthdate of adult 13.09.1985

Age of adult 261) Tell me what happened that led you to become angry.

Mi s-a marit rata la banca2) When did it happen? In urma cu 2 luni

Was it in the morning, afternoon, evening, or at night? Ziua

3) Where did it happen? (for example, in school or at home or at work or while in a store)acasa4) Exactly, who were you angry at? Pe banca de unde am luat creditul

OK, thanks for telling me about this. Lets continue.5) Now, I am going to give you two sentences. Pick the one that sounds most like what you thought about what happened. The words in the sentences are similar. So, think carefully before you answer.

A1) What happened was really awful and terrible.

A2) What happened was only bad. It was not terrible or horrible.B1) When I think about it, I know I could have easily dealt with it. I could have just accepted it.

B2) I couldnt stand what happened. I could not take it.

C1) The other person (s) should have acted better. He/she/they must know how to behave.

C2) I wanted the person (s) to act better. But, other people dont have to do what I want.

D1) The other person (s) does lots of things. I like some of them and I dont like other things.

D2) The other person (s) is a really and totally bad person.

Your name Ovanescu Ana Ioana

First name of adult Daraban Camelia

OK, now, I want to learn about exactly what you felt. Lets continue.6) How angry were you? (read the four choices and circle one)NOT VERY ANGRY,A LITTLE ANGRY,VERY ANGRY,EXTREMELY ANGRY

7) For how long were you angry? (read the four choices and circle one)Was it A FEW MINUTES, A FEW HOURS, A FEW DAYS, or MORE THAN A FEW DAYS

8) When you were angry, what did your body feel like? What happened in your body? (write exactly what the adult said)

Am fost foarte furioasa, am simtit ca explodez cand am vazut ce se intamplaNow, I want to learn about exactly what you did.9) When you were angry, did you(read each item to the adult, and check Yes or No) NO

NONO

NO

NOa) yell or scream or argue. b) cry

c) cross your arms, stare at the other person, or frown, or give a nasty look d) throw something or break something.What was it?

NONO NO

NO

NOe) hit, kick, push, or shove the other personf) just keep your anger inside, boil inside, and not tell anyone you were angry.NO g) plan to get even later on. You held a grudge and wanted revenge

h) just leave, or do something else to calm down. What did you do?

NO

_YES YES i) do something to calm down.What did you do? M-am uitat la televizori) try to make it better, or talk to the person about what you wanted.

j) have something to eat or drink, to help you forget about your anger.

Now, I want to learn about what happened afterwards.10) How did you feel after you were not angry anymore? Did you feel? _happy _sad _afraid _satisfied(Record exactly what was said) Mi-este foarte frica sa nu creasca si mai mult

11) What was the best part about getting angry?

Nici o part e buna12) What was the worst part about getting angry?Faptul ca ma enervez degeaba, deoarece nu pot face nimic pentru a rezolva problema13) How did your anger affect your relationship with the other person or persons?

This episode had a generally (check one) negative or positive effect. Or, no effect. This anger episode affected a:

School relationship Friendship\ Relationship with Parents and Brothers or SistersRelationship with other family members (like grandparent, aunts, uncles, etc.) Other

Explain Nu-mi afecteaza relatiile socialeGreat, thanks for telling me all of this.Is there anything else, you want to tell me? Ok, thanks again

1