Marken Richard S, Carey Timothy A
Department of Psychology, Antioch University, Los Angeles, California, USA.
Centre for Remote Health, Alice Springs, NT, Australia.
Clin Psychol Psychother. 2015 Nov-Dec;22(6):580-90. doi: 10.1002/cpp.1919. Epub 2014 Sep 14.
A review of the literature on psychotherapy suggests that improvements in effectiveness, efficiency and accessibility have been hampered by a lack of understanding of how psychotherapy works. Central to gaining such understanding is an accurate description of the change process that occurs when someone solves a psychological problem. We describe the Perceptual Control Theory (PCT) model of human functioning, which can be used to understand the nature of psychological problems and how they are solved. PCT suggests that problems can be broadly grouped into two categories: those that can be solved using existing skills and those that require the generation of new skills. In general, psychological problems belong in the second category. PCT describes a fundamental form of learning in which existing structures and systems are reorganized to create new skills, perspective and insights. Psychotherapy based on PCT is aimed at directing reorganization to the source of the problem.
Understanding the phenomenon of control is central to understanding how psychotherapy works. Conflict could be considered a general formulation for psychological distress. Therapy will be efficient when the reorganization process is focused at the right level of the client's control hierarchy. Therapy will be effective only when the client's reorganization system-not the therapist-has managed to come up with a solution to the client's problem. What the client says about the nature and reason for their problem is less important than the point of view from which these problems are being discussed.
对心理治疗文献的综述表明，由于缺乏对心理治疗如何起作用的理解，其有效性、效率和可及性的提升受到了阻碍。获得这种理解的核心是准确描述当某人解决心理问题时发生的变化过程。我们描述了人类功能的感知控制理论（PCT）模型，该模型可用于理解心理问题的本质以及如何解决这些问题。PCT表明，问题大致可分为两类：一类可以通过现有技能解决，另一类则需要生成新技能。一般来说，心理问题属于第二类。PCT描述了一种基本的学习形式，即对现有结构和系统进行重组以创造新技能、新视角和新见解。基于PCT的心理治疗旨在将重组导向问题的根源。
理解控制现象是理解心理治疗如何起作用的核心。冲突可被视为心理困扰的一般表述。当重组过程聚焦于客户控制层次结构的正确层面时，治疗将是有效的。只有当客户的重组系统（而非治疗师）成功找到解决客户问题的方法时，治疗才会有效。客户对其问题的性质和原因的表述不如讨论这些问题所采用的视角重要。
