32150 - Clinical Methodology I

Learning outcomes

At the end of the course the student will be able to: use psychological consultation fundamentals;  recognise emotional, cognitive and communicative aspects of clinical relationship;   assess the patient in a bio-psycho-social perspective; assess context of couple, family and social relationships considering psychoanalysis, systemic theories and attachment theories.

Course contents

(Clinical Methodology I e II as integrated course for a total of 8 credits)

1. THEORY AND TECHNIQUE OF PSYCHOLOGICAL CONSULTATION

• Main concepts (definition of clinical consultation;  theoretical models; validity and reliability; diagnosis, clinical evaluation and therapy)
• Consultation elements (context; setting; verbal and non-verbal communication; emotional and cognitive aspects; clinical consultation in infancy and adolescence)
• The development of the consultation (preliminaries; beginning; central phase; conclusion)

2. THE PSYCHODYNAMIC PERSPECTIVE

• Clinical relationship as knowledge field
• Defence and resistance mechanisms
• Transfer and countertransfer
• Analysis of dreams
• Assessment of personality structure
• Diagnostic formulation in a psychodynamic perspective: the Psychodynamic Diagnostic Manual (PDM)
• Symptoms as symbolic expression of an unconscious conflict
• Interpretation
• The work of the clinical psychologist: the interpretation- psychological help continuum.

3. THE ATTACHMENT PERSPECTIVE

• Concept of attachment and its theoretical assumptions
• The influence of cognitivism
• Attachment relationships characteristics (proximity seeking, separation protest, secure base effect)
• Maternal deprivation, separation, loss and mourning
• Inner Working Models and attachment styles
• Attachment in infancy and adult age: Mary Ainsworth and Mary Main
• Dynamic Maturational Model (DMM) by Patricia M. Crittenden
• Assessment of attachment in life span (Strange Situation, CARE-Index, assessment of attachment in infancy and adolescence, Adult Attachment Interview, self-report questionnaires)
• The clinical assessment of trauma and loss experiences

4. MENTALIZATION AND CLINICAL RELATIONSHIP

• The concepts of mentalization and reflective function
• Mentalization, attachment and affective elaboration
• Mentalization and reflective function assessment
• Lack of mentalization and emotion elaboration difficulties (False Self; Pensée Opératoire, Alexithymia)
• The significance of aggressive behaviours and of addict disorders taking account of attachment and mentalization concepts
• The influence of attachment and mentalization on clinical relationship
• The treatment of the patient with lack of mentalization: countertransfer aspects and therapeutic strategies
• Attachment and mentalization based therapies

5. THE SYSTEMIC PERSPECTIVE

• General System Theory
• Linear and circular causality
• Cybernetics and feedback
• Gregory Bateson  and Double Bind Theory
• Palo Alto School and Mental Research Institute
• Relational and pragmatic aspects of human communication (axioms of communication, meta-communication and context, punctuation of sequences of communication, analogical and digital communication, symmetric and complementary interaction, reactions to communication, pathological communication)
• The biopsychosocial model
• Diagnostic formulation in a biopsychosocial perspective

6. FAMILY RELATIOSHIPS

• The relevance of family relationships in Clinical Psychology
• Family life cycle
• Couple relationship and parental functions in life span
• Attachment, secure base and reflective function in the family
• Assessment of Dyadic and tryadic relationships
• Assessment of reflective function in couple and family: the Reflective Function in the Family
• Psychosomatic families
• The family therapy setting
• Different significance of questions (linear, circular, strategic, reflective)
• Systemic perspective in family therapy (Paul Watzlawick and the strategic-systemic model, Don D. Jackson and the restrictive families. Mara Selvini Palazzoli and the Milanese model, Salvador Minuchin and the structural model)

Readings/Bibliography

Course bibliography (Clinical Methodology I e II as integrated course for a total of  8 credits)

Books:

• Baldoni F. (2010): La prospettiva psicosomatica. Dalla teoria alla pratica clinica. Il Mulino, Bologna (from chapter 6 to10 in particular).
• Gabbard G.O. (2005): Psichiatria psicodinamica (Quarta edizione). Raffaello Cortina, Milano, 2007 (to p. 177).

Articles and books' chapters (download from Web course site):

• Baldoni F., Baldaro B. e Ravasini C. (1994): Il colloquio clinico. In: Trombini G. (a cura di): Introduzione alla clinica psicologica. Zanichelli, Bologna, pp.103-126.

Optional readings for depth

• AA.VV. (2006): PDM. Manuale Diagnostico Psicodinamico. Raffaello Cortina, Milano, 2008.
• Allen J.G., Fonagy P. (eds.) (2006): La mentalizzazione. Psicopatologia e trattamento, Bologna, Il Mulino, 2008.
• Allen J.G., Fonagy P., Bateman A.W. (2008): La mentalizzazione nella pratica clinica. Raffaello Cortina, Milano, 2010.
• Baldoni F. (2007): Modelli operativi interni e relazioni di attaccamento in  preadolescenza. In: Crocetti G., Agosta R. (a cura di): Preadolescenza. Il bambino caduto dalle fiabe. Teoria della clinica e prassi psicoterapeutica.  Pendragon, Bologna, pp. 54-77.
• Bertrando P., Toffanetti D. (2000): Storia della terapia familiare. Raffaello Cortina, Milano.
• Cena L., Imbasciati A., Baldoni F. (a cura di) (2010): La relazione genitore-bambino. Dalla psicoanalisi infantile alle nuove prospettive evoluzionistiche dell'attaccamento. Springer-Verlag, Milano.
• Fava G.A., Grandi S., Rafanelli C. (eds.) (2010): Terapia psicologica. Centro Scientifico Editore, Torino.
• Gabbard G.O. (2010): Introduzione alla psicoterapia psicodinamica (Second edition). Raffaello Cortina, Milano, 2011.
• Holmes, J. (1993): La teoria dell'attaccamento. John Bowlby e la sua scuola. Raffaello Cortina, Milano, 1994.
• Jurist E.L., Slade A., Bergner S. (eds.) (2010): Da mente a mente: infant research, neuroscienze e psicoanalisi. Raffaello Cortina, Milano.
• Lingiardi V., Madeddu F. (2002): I meccanismi di difesa. Teoria, valutazione e clinica. Raffaello Cortina, Milano.
• McWilliams N. (1999): Il caso clinico. Dal colloquio alla diagnosi. Raffaello Cortina, 2002.
• McWilliams N. (2004): Psicoterapia psicoanalitica. Raffaello Cortina, Milano, 2006.
• Renik O. (2006): Psicoanalisi pratica per terapeuti e pazienti. Raffaello Cortina, Milano, 2007.
• Wallin D.J. (2007): Psicoterapia e teoria dell'attaccamento. Il Mulino, Bologna, 2009.
• Watzlawick, P., Beavin, J. H. e Jackson, D. (1967): Pragmatica della comunicazione umana. Studio dei modelli interattivi, delle patologie e dei paradossi. Astrolabio, Roma, 1971.

Teaching methods

Teaching will be done in a historical framework with references to daily life and clinical practice.

Use will be made of role playing methods, slides, videotapes and further reading suggested.

The teaching material (schedules, figures, articles and bibliographies) will be available on Internet at the course end.

Assessment methods

(Clinical Methodology I e II in a single examination for a total of  8 credits)

The final examination involves a written test based on three open questions in 60 minutes.

Teaching tools

Overhead projector, PC, Power Point, videotapes.

Office hours

See the website of Franco Baldoni