Rafaeli Eshkol, Rafaeli Alexandra K
Department of Psychology and Gonda Center for Neuroscience, Bar-Ilan University, Ramat-Gan, Israel.
Unit for Psychological Services, Ben-Gurion University, Beer-Sheva, Israel.
Clin Psychol Eur. 2024 Apr 26;6(Spec Issue):e12753. doi: 10.32872/cpe.12753. eCollection 2024 Apr.
Advances in motivational science (Dweck, 2017), personality dynamics (Lazarus & Rafaeli, 2023), and process-based psychotherapy (Hofmann & Hayes, 2019) converge into a pragmatic, integrative, and transtheoretical model of practice and training.
The model comprises three elements: a formulation centered on clients' psychological needs which provides guidance regarding the goals and processes most profitable to pursue; a recognition that such pursuit frequently requires contending with a multiplicity of clients' internal self-states (i.e., modes); and an enumeration of pragmatic therapeutic stances likely to help address clients' need-related goals in light of their modes.
We distill these elements into three cardinal questions: What needs does this client have that are not currently met, and what are the most profitable ways of remedying that frustration? What mode or modes does this client manifest - both generally and at this very moment? and What stance should I adopt in response to the client's current mode? We suggest that clinicians should be trained to continually pose these questions and seek to answer them collaboratively with their clients.
This model - illustrated here using schema therapy terms - offers a process-based approach which serves as a theoretically integrative starting point but is general enough to provide an assimilative integration roadmap for therapists anchored in most primary orientations. Integrative or assimilative therapists trained to attend to needs, modes, and stances are likely to be (and be perceived as) particularly responsive, and thus, to enact "common factor" practices known to be conducive to therapeutic alliance and gains.
动机科学（德韦克，2017年）、人格动力学（拉扎勒斯和拉斐利，2023年）以及基于过程的心理治疗（霍夫曼和海斯，2019年）的进展汇聚成一种实用、综合且跨理论的实践与培训模式。
该模式包含三个要素：以客户心理需求为中心的构想，它为追求最有益的目标和过程提供指导；认识到这种追求常常需要应对客户多种内在自我状态（即模式）；以及列举可能有助于根据客户模式满足其与需求相关目标的实用治疗立场。
我们将这些要素提炼为三个基本问题：这位客户有哪些当前未得到满足的需求，补救这种挫折感的最有益方法是什么？这位客户通常以及此刻表现出何种模式？针对客户当前的模式我应采取何种立场？我们建议临床医生应接受培训，不断提出这些问题，并寻求与客户共同解答。
此模式——这里使用图式疗法术语进行说明——提供了一种基于过程的方法，它作为理论综合的起点，但具有足够的通用性，可为大多数主要取向的治疗师提供一个同化整合路线图。接受过关注需求、模式和立场培训的整合或同化治疗师可能会（并被视为）特别有反应能力，因此会践行已知有利于治疗联盟和治疗效果的“共同因素”实践。
