The Wedging or Strengthening Technique has been modified in Germany and is called the Absorption Technique to create resources to deal with what the client is concerned about in the future, or having stress about working with eye movement desensitization and reprocessing (EMDR) in the future, a present trigger or even an intrusive memory. Having clients imagine a strength or skill that would help them during the problem often helps them to reduce their anxiety. Focusing on a specific strength or coping skill may create a wedge of safety or control that will assist clients with the difficult situation in the future. During the Future Phase of the Inverted Protocol for Unstable complex post-traumatic stress disorder (C-PTSD) use the Absorption or Wedging Technique to develop as many different resources for the different issues about which the client might be concerned.
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The Absorption Technique for Children is a protocol that was derived from the work of Arne Hofmann who based his work on an adaptation of “The Wedging Technique”. The absorption technique for children is a resource technique that supports children in creating resources for present issues and future challenges such as dealing with a difficult teacher or handling a disagreement with a classmate and so forth. This chapter uses resource installation for stressful situations. It includes summary sheets to facilitate gathering information, client documentation, and quick retrieval of salient information while formulating a treatment plan. The absorption technique, and the constant installation of present orientation and safety (CIPOS) technique, are excellent ways to encourage children to work with eye movement desensitization and reprocessing (EMDR) step-by-step even if they are not prepared to work with the worst issue in the beginning.
This chapter describes maneuvers to access the internal system of the patient as well as means to accelerate or decelerate the work in that process of accessing the self-system. Eye movement desensitization and reprocessing (EMDR), ego state therapy, and somatic therapy fit together like hand and glove. An extended preparation phase is often necessary before trauma processing in complex traumatic stress presentations and attachment-related syndromes, particularly when dealing with the sequelae of chronic early trauma. Clinical practice suggests that the adjunctive use of body therapy and ego state interventions can be useful, during stabilization and later on in increasing the treatment response to EMDR. Traditional treatment of complex posttraumatic stress disorder (PTSD) and dissociative disorders has usually included hypnoanalytic interventions, during which abreaction is considered an important part of treatment.
Acceptance and commitment therapy (ACT) is a behavioral intervention designed to increase and improve psychological flexibility. Psychological flexibility, from the ACT perspective, is defined as contacting the present moment fully, as a conscious human being, experiencing what is there to be experienced and working to change behavior such that it is in the service of chosen values. The therapeutic work explored in ACT counters the problem solving approach. Clients are taught to be aware of their thoughts and emotional experiences. An important feature of the therapy is that the therapist approaches these issues with humility and compassion for the client’s experience. Many clients who have experienced military sexual trauma (
MST) have limited their lives in a number of ways in an effort to control or prevent fear or fear-related experiences such as anxiety or difficult memories.Source:
- Go to chapter: ACT-AS-IF and ARCHITECTS Approaches to EMDR Treatment of Dissociative Identity Disorder (DID)
This chapter describes key steps, with scripts, for the phases of therapy with a dissociative identity disorder (DID) client, and for an eye movement desensitization and reprocessing (EMDR) session with a DID client. In brief, the method employs the artful use of EMDR and ego state therapy for association and acceleration, and of hypnosis, imagery, and ego state therapy for distancing and deceleration within the context of a trusting therapeutic relationship. It is also endeavoring to stay close to the treatment guidelines as promulgated by the International Society for the Study of Trauma and Dissociation. The acronym ACT-AS-IF describes the phases of therapy; the acronym ARCHITECTS describes the steps in an EMDR intervention. Dual attention awareness is key in part because it keeps the ventral vagal nervous system engaged sufficiently to empower the client to sustain the painful processing of dorsal vagal states and sympathetic arousal states.
This chapter explains the process of solution focused narrative therapy (SFNT) and offers suggestions for the therapist’s use of conversational questioning. SFNT therapy comprises six steps: best hopes, mapping the effects of the problem, constructing the preferred story, exception gathering, preparing the presentation of the preferred future and moving up the scale, and summarizing and inviting clients to watch for success. The most important step is beginning therapy. The therapist begins the session by introducing himself, learning the names of those attending, and asking the same question of all present. The chapter also presents an exercise, which may help to identify traits, values, and actions that help readers present their best self to their clients, particularly clients that are challenging.
This chapter introduces readers to the Active Client Engagement (ACE) model, which includes acquiring information, creating a context for collaboration, and evocation of clients’ strengths and resources. As with the strengths-based principles, each facet of ACE works in concert with and is dependent on the others. Together the three components assist with creating a focus in therapy and strengthening the therapeutic alliance. Additionally, the three aspects of ACE are interventive. The chapter introduces methods for gathering client information and using routine outcome monitoring (ROM). An additional part of this chapter involves ways to match clients’ communication styles. The chapter examines two different processes for gathering information: (a) routine outcome monitoring (ROM) in practice (including feedback-informed treatment [FIT]) and (b) interviewing for strengths. The processes are meant to make early contacts and what follows treatment-wise seamless.
Serving in the military presents many challenges, opportunities, and risks. Recently, the suicide rates among military service members and veterans have trended upward and reached unprecedented levels. Research has found that the primary motive for suicide attempts among military personnel is a desire to reduce or alleviate emotional distress, similar to motives reported by those in nonmilitary samples. This chapter highlights the individuals who are currently serving or have served in the military as they are specific populations due to their importance and distinct vulnerability. It explores the statistics, epidemiology, and trends in active military personnel and veteran suicide. In addition, the chapter draws specific risk factors (psychiatric, sociodemographic, interpersonal, and other associated factors) for military personnel and veterans from evidence-based research. The chapter also presents protective factors identified in literature for military service members and veterans. Finally, it explores treatment considerations and interventions for active military personnel and veterans.
This chapter discusses that brief therapy usually calls for an active, directive therapeutic stance. One of the biggest myths pervading a good deal of the literature on psychological treatment is that therapists should not give advice. In direct contrast to Karasu’s position, London a true visionary, pointed out that “action therapy” often calls for arguments, exhortations, and suggestions from therapists who are willing to assume responsibility for treatment outcomes. Karasu, like many theorists, overlooks the fact that a good deal of emotional suffering does not stem solely from conflicts but is the result of deficits and missing information. When hiatuses and lacunae result in maladaptive psychological patterns, no amount of insight will remedy the situation it demands a system of training whereby the therapist serves as a coach, model, and teacher. The major issue is to decide when certain methods are likely to be helpful or harmful.
- Go to chapter: Adaptations for the Implementation of EMDR Therapy With Infants, Toddlers, and Preschoolers
This chapter explores the unfolding of the phases of EMDR therapy as children go through developmental stages. Infants, toddlers, and preschoolers may express significant variation simply because of developmental processes and achievements. The chapter summarizes adaptations that may be helpful to consider through each phase of child development as the client and therapist simultaneously move through the phases of EMDR therapy. Mentalizing in parent-child relationships is a co-occurring theoretical and clinical intervention that is included through all the phases of EMDR therapy. With infants, toddlers, and preschoolers, the history taking, case conceptualization, and treatment planning are integrated with the goals of the preparation phase. Young children are often brought to therapy by parents who are concerned about clinical, emotional, behavioral, regulatory, and situational issues. Therapists and parents are active participants in the child’s therapy. Alternating bilateral stimulation can be taught in many ways using toys.