08704 - Clinical Methodology

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 context of couple, family and social relationships;

- assess the patient in a biopsychosocial perspective.

The student will be encouraged to take an aware and critical attitude towards the subject.

Course contents

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; emotive, cognitive and relational 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
• Transference and countertransference
• Analysis of dreams
• Assessment of personality structure
• Diagnostic formulation in a psychodynamic perspective: the Psychodynamic Diagnostic Manual: PDM-2 (Second edition)
• Symptoms as symbolic expression of an unconscious conflict
• Interpretation
• The work of the clinical psychologist: the interpretation- psychological help continuum.
• The therapeutic alliance
• Efficacy of psychotherapy (Efficacy, Effectiveness, Efficiency)

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
• Internal 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 concept of psychological trauma
• Resolution and psychopathology of trauma and loss
• The clinical assessment and treatment of trauma and loss experiences

4. ASSESSING THE TRAUMA

• Danger and adaptation.
• The concept of psychological trauma.
• Adaptive meaning of despair.
• Resolution and psychopathology of trauma and loss: dissociation and Post-Traumatic Stress Disorder (PTSD).
• Clinical evaluation and treatment of trauma and loss

4. MENTALIZATION AND CLINICAL RELATIONSHIP

• The concepts of mentalization and reflective function
• Mentalization, attachment and emotive regulation
• Mentalization and reflective function assessment
• Lack of mentalization and emotion disregulation (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 treatments

5. THE SYSTEMIC PERSPECTIVE

• General System Theory
• Linear and circular causality
• Cybernetics and feedback
• Gregory Bateson and the 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 limits of the reductionist paradigm and of the biomedical model
• The biopsychosocial model
• The analogical assessment of suffering: the PRISM method
• 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 triadic relationships
• Assessment of mentalization in psychotherapy: the Reflective Function in the Family (RFF) and Mentalization Assessment in Psychotherapy (MAP)
• Psychosomatic families
• The family therapy setting
• Different significance of questions (linear, circular, strategic, reflective)
• The genogram
• 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

Books:

• Baldoni F. (2010): La prospettiva psicosomatica. Dalla teoria alla pratica clinica. Il Mulino, Bologna (chapters 1 and from 5 to 10, in particular).
• Gabbard G.O. (2013): Psichiatria psicodinamica (Quinta edizione basata sul DSM-5). Raffaello Cortina, Milano, 2015 (to p. 182).

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

• Baldoni F., Baldaro B., Ravasini C. (1994): Il colloquio clinico. In: Trombini G. (Ed.): Introduzione alla clinica psicologica. Zanichelli, Bologna, pp.103-126.
• Baldoni, F. (2013). La funzione adattiva della disperazione nel fallimento delle strategie di attaccamento: una prospettiva Dinamico-Maturativa. In V. Caretti, G. Craparo, A. Schimmenti (Eds.) Memorie traumatiche e mentalizzazione. Teoria, ricerca e clinica. Astrolabio, Roma, pp. 215-236.
• Baldoni, F. (2014) La regolazione psicosomatica delle emozioni. Mentalizzazione e utilizzo di regolatori esterni. Pneireview, 2, pp. 4-22.
• Baldoni, F. (2015). L'efficacia della psicoterapia nel trattamento dei disturbi psichici. La mente che cura, 1, pp. 17-20.

Optional readings for depth

• Allen J.G., Fonagy P. (Eds.) (2006). La mentalizzazione. Psicopatologia e trattamento. Il Mulino, Bologna, 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.
• Baldoni F. (2013). Psicoterapia e attaccamento. Il paradigma dell'attaccamento nella pratica clinica. In: Lazzari D. (a cura di). Psicoterapia: effetti integrati, efficacia e costi-benefici. Tecniche Nuove, Milano, pp. 106-140.
• Baldoni, F. (2015) Aggressività, attaccamento e mentalizzazione. Contrappunto, 51-52, pp. 9-44.
• Baldoni F. (2016). I disturbi affettivi perinatali nei padri. In P. Grossu e A. Bramante (Eds.), Manuale di Psicologia Perinatale. Milano: Erickson, pp. 443-485.
• Baldoni F., Campailla A. (2017). Attaccamento, Working Alliance e relazione terapeutica: cosa rende efficace una psicoterapia? Giornale Italiano di Psicologia, XLIV (4), 823-846.
• Bertrando P., Toffanetti D. (2000). Storia della terapia familiare. Raffaello Cortina, Milano.
• Caretti V., Craparo G., Schimmenti A. (a cura di) (2013): Memorie traumatiche e mentalizzazione. Teoria, ricerca e clinica. Astrolabio, Roma.
• Caretti V., Ragonese N., Crisafi C. (Eds.) (2013). La depressione perinatale. Aspetti clinici e di ricerca sulla genitorialità a rischio. Fioriti, Roma.
• Cena L., Imbasciati A., Baldoni F. (Eds.) (2010). La relazione genitore-bambino. Dalla psicoanalisi infantile alle nuove prospettive evoluzionistiche dell'attaccamento. Springer-Verlag, Milano.
• Cena L., Imbasciati A., Baldoni F. (Eds.) (2012): Prendersi cura dei bambini e dei loro genitori. La ricerca clinica per l'intervento. Springer-Verlag, Milano.
• Fava G.A., Grandi S., Rafanelli C. (Eds.) (2010). Terapia psicologica. Centro Scientifico Editore, Torino.
• Gabbard G.O. (2017). Introduzione alla psicoterapia psicodinamica (Terza edizione). Milano: Raffaello Cortina, 2018.
• 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.
• Levy, R.A., Ablon, J.S., & Kächele, H (2012). La psicoterapia psicodinamica basata sulla ricerca. Raffaello Cortina, Milano, 2015.
• Lingiardi V. McWilliams N. (Eds.) (2017). Manuale Diagnostico Psicodinamico: PDM-2 (Seconda Edizione). Milano: Raffaello Cortina 2018.
• 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, Milano, 2002.
• McWilliams N. (2004): Psicoterapia psicoanalitica. Raffaello Cortina, Milano, 2006.
• Renik O. (2006): Psicoanalisi pratica per terapeuti e pazienti. Raffaello Cortina, Milano, 2007.
• van der Horst F.C.P. (2011): John Bowlby. Dalla psicoanalisi all'etologia.Raffaello Cortina, Milano, 2012.
• Wallin D.J. (2007): Psicoterapia e teoria dell'attaccamento. Il Mulino, Bologna, 2009.
• Watzlawick, P., Beavin, J. H., 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.

Attendance in class, while not compulsory, is very important to be able to fully acquire from the teacher notions related to the modalities of relationship with the patient through clinical examples and references to personal experiences.

Use will be made of role playing methods, slides, videos and further reading suggested. During the course there will be seminars with professionals and experts.

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

To obtain the teaching material, consult: http://campus.unibo.it/

Access to teaching material is reserved for students enrolled at the University of Bologna.

Assessment methods

The final exam consists of a written test based on three open questions in 60 minutes.

All questions must be answered sufficiently to pass the exam with at least the minimum grade (18/30). Some topics will be treated exclusively in class and demonstrate their knowledge will positively influence the exam grade. The highest marks (30/30 and the possible Praise) will be assigned to the tests that will highlight an excellent knowledge of the topics of the program, as well as a good capacity for synthesis, original reflection and integration of the topics taught. The correctness and clarity of the written text and the ability to provide meaningful examples will be considered as evaluation criteria influencing the vote. Possible omissions, inaccuracies or errors, as well as off-topic answers, attempts to mask one's own unpreparedness or copied answers will progressively penalize the exam, leading, in the most serious cases, to insufficiency.

During the exam, books, vocabularies, notes, photocopies, phones, smartphones, tablets, notebooks and tools for calculation aids are not allowed (exceptions are possible through agreements with the teacher). In case of comparison with other students during the exam, the task will be cancelled.

To take the exam, it is necessary to register on the ALMAESAMI site through an electronic bulletin board, in compliance with the deadlines provided for. Those who fail to register for technical problems by the scheduled date, are required to promptly communicate the problem to the teaching secretariat (in any case before the official closing of the registration list). The teacher will have the right to admit them to take the test.

 

Teaching tools

Overhead projector, video camera, PC, Power Point, videos.

Office hours

See the website of Franco Baldoni