Thursday, February 13, 2014

Multimodel Therapy




Overview :

The above video is an excellent way to start knowing what is multimodel therapy. More than a therapy, it is an approach to psychotherapy.  Multimodal therapy is the approach to psychotherapy founded by Arnold Lazarus. Arnold Allan Lazarus was a South African psychologist who is known for his contributions to behavior therapy. Concurrently with the pioneering contributions of Albert Ellis and Aaron Beck, starting in the late 1950s and continuing through the 1970s, Lazarus developed what was arguably the first form of "broad-spectrum" cognitive behavioral therapy. Indeed, in 1958, Arnold Lazarus was the first person to introduce the terms "behavior therapy" and "behavior therapist" into the professional literature He later broadened the focus of behavioral treatment to incorporate cognitive aspects .When it became clear that optimizing therapy's effectiveness and effecting durable treatment outcomes often required transcending more narrowly focused cognitive and behavioral methods, Arnold Lazarus expanded the scope of CBT to include physical sensations (as distinct from emotional states), visual images (as distinct from language-based thinking), interpersonal relationships, and biological factors. The final product of Arnold Lazarus' approach to psychotherapy is called multimodal therapy and shares many of its assumptions and theorizing with Ellis' rational emotive behavior therapy. His scholarly output is prolific: more than 250 articles and chapters and 18 books, including his classic "The Principles of Multimodal Therapy". His interpersonal charisma, inculcated in his early South African/English upbringing, and his feisty temperament, forged in his early boxing experiences, coalesce into a powerful voice for technical eclecticism.

 Multimodal therapy also considers the patient’s personality or temperament a significant factor in forming a treatment that the patient will be most open to. Patients may have the same structural profile from their question, but their personalities will differ, and so will their receptiveness to the treatment. One of the advantages of multimodal therapy is that psychologists and therapists do not have to submit to just one psychological ideology, but rather, they are more open to using different strategies from different ideologies. This form of flexibility is called “technical eclecticism.” It is based on the idea that humans are biological beings that think, feel, act, sense, imagine, and interact; and that each of these "modalities" should be addressed in psychological treatment.

 Principle Multimodal therapy (MMT) is the approach to psychotherapy based on the idea that there are multiple modalities of each individual that should be addressed when both identifying and treating a psychological disorder. To say in simple terms MMT is customizing treatments for each individual. According to MMT, each individual is affected in different ways and in different amounts by each dimension of his or her personality, and should be treated accordingly in order for treatment to be successful. We are products of interplay among our genetic endowment, our physical environment, and out social learning history. To state that learning plays a central role in the development and resolution of our emotional problems is to communicate very little. For a connection to be made between events, they need to occur simultaneously or in close succession. An association may be said to exist when responses evoked by one stimulus are predictably and reliably similar to those provoked by another stimulus. In this regard, classical and operant conditionings are two central concepts. 

BASIC ID A very vital component to Lazarus’ MMT, BASIC ID refers to the seven dimensions of personality. In order to create a successful treatment for a specific individual, each dimension must be considered along with the individual’s deficits in each. “B” represents behavior, which can be manifested through the use of inappropriate acts, habits, gestures, or the lack of appropriate behaviors. “A” stands for affect, which can be seen as the level of negative feelings or emotions one experiences. “S” is sensation, or the negative bodily sensations or physiological symptoms such as pain, tension, sweat, nausea, quick heartbeat, etc. “I” stands for imagery, which is the existence of negative cognitive images or mental pictures. “C” represents cognition or the degree of negative thoughts, attitudes, or beliefs. The second “I” stands for interpersonal relationships, and refers to one’s ability to form successful relationships with others. It is based on social skills and support systems. Finally, “D” is for drugs and biological functions, and examines the individual’s physical health, drug use, and other lifestyle choices. MMT addresses the fact that different people depend on or are more influenced by some personality dimensions more than others. Some people are prone to deal with their problems on their own, cognitively, while others are more likely to draw support from others, and others yet are likely to use physical aspects to deal with problems, such as exercise or drugs. All reactions are a combination of how the 7 dimensions work together in an individual. Once the source of the problem is found, treatment can be used to focus on that specific dimension more than the others. 

CBT 
Multimodal therapy originated with cognitive behavioral therapy (CBT), which is a fusion of cognitive therapy and behavioral therapy. While purely cognitive therapy focused on mental aspects and internal processes, behavioral therapy contributed the consideration of external behaviors, making it possible to utilize both internal and external factors of treatment simultaneously. Further description of CBT: CBT merges the disciplines of cognitive therapy with behavioral therapy; while behavioral therapy focuses on external behaviors on their own, cognitive therapy contributes the cognitive, or mental aspects, focusing on internal thought processes. Put together, cognitive behavioral therapists can utilize both internal and external factors of treatment simultaneously. What Lazarus added to this is the idea that since personality is multi-dimensional, treatment must also be considered in this way in order to be effective. His idea of MMT involves examining symptoms on each dimension of personality in order to find the right combination of therapy to address them all.

The picture below shows an example of Multimodal Therapy for ADHD


 Assessment Multimodal assessment and treatment which follows BASIC I.D.: (i.e., seven interactive and reciprocally influential dimensions of personality/psychology or "modalities" which are Behavior, Affect, Sensation, Imagery, Cognition, Interpersonal relationships, and Drugs/biology, respectively). 

Client therapist relationship …in MMT is according to the choice of the client, either directive or reflective. The therapist asks client what they want at the beginning of the therapy session and how they want their therapist to act Lazarus’ Contributions MMT is a brief but comprehensive psychotherapy retained the basic premises of CBT, but believed that more of the individual’s specific needs and personality traits needed to be considered. He reasoned that since personality is multidimensional, treatment must also be considered in this way in order to be effective. His idea of MMT involves examining symptoms on each dimension of personality in order to find the right combination of therapies to address them all.

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