Pengantar

 Psikoterapi  Individu  

Ahmad  Gimmy  Prathama  Siswadi  

gimmypsi@gmail.com  
Universitas  Padjadjaran  
 Harapan  
•  Psikoterapi  individu  lebih  de>l  
•  Cara  mengaplikasikan  ke  pasien  
•  Apa  saja  jenis  psikoterapi  dan  wewenang  sbg  
perawat  jiwa  
•  Lahan  psikoterapi  mana  yang  jadi  bagian  perawat  
jiwa,  psikiater,  dan  psikolog  
•  Aplikasi  diri  dan  pasien  
•  Tahapan  psikoterapi,  kelebihan,  sehingga  ber-­‐
efek  posi>f  pada  pasien  
•  Bgmn  supaya  mampu  dalam  psikoterapi  
Siapakah  Orang  Sehat  itu  ?    
Siapakah  Orang  Sakit    
Quick  overview  of  the  Clinical  Nosology  
(Mental)    Itu  ?    
DIAGNOSTIC SEVERITY INTERPERSONAL REALITY TESTING
CATEGORY RELATION
Disorder-Free State Mature, reciprocal, satisfying, Intact. Cause and effect logic is
flexible sound
0
Adjustment Disorders Disrupted, influenced by Intact. Cause and effect logic is
depression and anxiety for sound
1
duration of disorder
Anxiety Disorders Conflicted, vacillates between Intact. Use of defense
love and hate mechanisms that mildly distort in
(“Neuroses”) 2
self protective ways
Personality Egocentric, disrupted, Generally intact. Isolated “blinds
manipulative, immature spots” about self and others
Disorders 3
Borderline States Manipulative, occasionally Episodic failures. Delusions and
bizarre, frequently explosive, hallucinations possible. Episode
4
of depersonalization
fantastic, changeable
Psychoses and the Bizarre, fantastic, or Defective. Delusions,
Major Mood Disorders 5 completely disrupted. Possible hallucinations and
complete detachment or depersonalization possible
separation from others
 Definisi  Psikoterapi    
 
•  Psychotherapy is a formal process of interaction between
two parties, each party usually consisting of one person
but with the possibility that there may be two or more
people in each party, for the purpose of amelioration of
distress in one of the two parties relative to any of the
following areas of disability or malfunction: cognitive
functions (disorders of thinking), affective functions
(suffering or emotional discomforts), or behavioral
functions (inadequacy of behavior), with the therapist
having some theory of personality’s origins, development,
maintenance and change along with some method of
treatment logically related to the theory and professional
and legal approval to act as a therapist. (Corsini,  1989  :1)  
Poin  pen<ng  dalam  definisi  
Psikoterapi  
•  2  pihak  :  Terapis  dan  Klien  
•  Ada  masalah  yang  perlu  diatasi/
ditanggulangi  à  psikis  (kogni>f,  afek>f/
emosi,  perilaku)  
•  Kompetensi  Psikoterapis  :  kepribadian  
dan  perkembangannya,  psikopatologis,  
modifikasi  perilaku,  profesional,  legal  
à  S2;  di  negara  lain  bisa  Psy.D.    
 Estimation of Percent of Time Spent by “Counselors” and “Psychotherapists” in
Professional Activities

Process Counseling Psychotherapy

Listening 20 60
Questioning 15 10
Evaluating 5 5
Interpreting 1 3
Supporting 5 10
Explaining 15 5
Informing 20 3
Advising 10 3
Ordering 9 1

*Based on “Counseling and Psychotherapy” in E.F. Bogerts and W.W. Lambert (Eds.), Handbook of Personality Theory
and Research (Chicago, Rand Mc. Nally, 1968)
 Therapy
 Services
 
1.  Private
 prac<<oners.
 
 
2.  Community
 mental
 health
 centers.
 
3.  Hospitals.
 
 
4.  Human
 Service
 Agencies
 
5.  School
 and
 Workplace
 
Box 1.1 HEALTHY PEOPLE 2010 MENTAL HEALTH OBJECTIVES
• Reduce suicides to no more than 6 per 100,000 people
• Reduce the incidence of injurious suicide attempts by
1% in 12 months for adolescents aged 14 to 17
• Reduce the proportion of homeless adults who have seri-
ous mental illness to 19%
• Increase the proportion of persons with serious mental
illnesses who are employed to 51%
• Reduce the relapse rate for persons with eating disor-
ders, including anorexia nervosa and bulimia nervosa
• Increase the number of persons seen in primary health
care who receive mental health treatment screening and
assessment
• Increase the proportion of children with mental health
problems who receive treatment
• Increase the proportion of juvenile justice facilities that
screen new admissions for mental health problems
• Increase the proportion of adults with mental disorders
who receive treatment by 17%
• Adults 18 to 54 with serious mental illness to 55%
U.S. Department of Health and Human Services. (2000). Healthy people 2010: National health promotion and disease prevention objectives.
Washington, DC: DHHS.
• Adults 18 and older with recognized depression to 50%
• Adults 18 and older with schizophrenia to 75%
• Adults 18 and older with anxiety disorders to 50%
• Increase the population of persons with concurrent sub-
stance abuse problems and mental disorders who receive
treatment for both disorders
• Increase the proportion of local governments with
community-based jail diversion programs for adults with
serious mental illness
• Increase the number of states that track consumers’ sat-
isfaction with the mental health services they receive to
30 states
• Increase the number of states with an operational men-
tal health plan that addresses cultural competence
• Increase the number of states with an operational men-
tal health plan that addresses mental health crisis inter-
vention, ongoing screening, and treatment services for
elderly persons
Box 1.2 PSYCHIATRIC–MENTAL HEALTH NURSING PHENOMENA OF CONCERN

Phenomena of concern for psychiatric–mental health nurses • Self-concept and body image changes, developmental
include: issues, life process changes, and end-of-life issues
• Physical symptoms that occur along with altered
• Promotion of optimal mental and physical health and
psychological status
well-being and prevention of mental illness
• Psychological symptoms that occur along with altered
• Impaired ability to function related to psychiatric, emo-
physiological status
tional, and physiological distress
• Interpersonal, organizational, sociocultural, spiritual, or
• Alterations in thinking, perceiving, and communicating
environmental circumstances or events that have an
due to psychiatric disorders or mental health problems
effect on the mental and emotional well-being of the
• Behaviors and mental states that indicate potential
individual and family or community
danger to self or others
• Elements of recovery, including the ability to maintain
• Emotional stress related to illness, pain, disability, and loss
housing, employment, and social support, that helps
• Symptom management, side effects, or toxicities associ-
individuals re-engage in seeking meaningful lives
ated with self-administered drugs, psychopharmacologi-
• Societal factors such as violence, poverty, and substance
cal intervention, and other treatment modalities
abuse
• The barriers to treatment efficacy and recovery posed by
alcohol and substance abuse and dependence
 Helping  Rela>onship  

Attitudes Attitudes
Needs Needs
Values Values
Beliefs Beliefs
Skills Concerns

Helper
  Helpee
 
Adaptasi:
 Barbara
 Okun
 (1987)
 
Berbagai
 Pendekatan
 dlm
 Memahami
 
Manusia
 dan
 Permasalahannya
 
•  Psychodynamic/Psychoanalysis
 
(FREUD)
 
•  Humanis>k
 (ROGERS)
 
•  Cogni>ve
 (BECK,
 ELLIS)
 
•  Behavior
 (SKINNER,
 BANDURA)
 
•  Biomedical
 
 
 Perbandingan
 Pendekatan
 dalam
 
Psikoterapi
 
Psikoterapi
  Tokoh
  Sumber
 Gangguan
  Tujuan
 Terapi
  Teknik
 Terapi
 
Psikodinamika Freud,
  Konflik
 a
 sadar,
 fiksasi,
  Insight,
  Asosiasi
 bebas,
 
/Psikoanalisis
  Adler,
  trauma
 proses
  rekonstruksi
  analisis
 mimpi,
 
Kohut,
  perkembangan
 semasa
  kepribadian
  interpretasi
 
 
dll.
  kecil
 
Humanis>k/ Rogers
  Inkongruens;
  Kongruensi;
  Empathy;
 
Client
  Everdependent
 vs
 free
  ‘Masagi’,
  uncondi>onal
 
Centered
  will/independent
  Personal
  PR;
 Refleksi
 
growth
 
Cogni>ve
  Beck,
 
  Asumsi/keyakinan
  Subs>tusi
  ‘thought
 
Ellis
  irasional;
 penilaian
 diri
  pemikiran
  stopping’;
 
dan
 situasi
 nega>f
  nega>f
 menjadi
  reatribusi;
 
posi>f
  penugasan,
 
Homework
 
Behavior
  Bandura Pola
 belajar/ Recondi>oning,
 
  Relearning;
 
,
 Skinner
  pembelajaran
  desensi>sasi;
 
maladap>f
  token
 economy
 
Biomedical Psychological Elimination of Antipsychotic,
therapies malfunction, symptoms, antianxiety,and
primarily prevention of antidepressant
abnormal relapse drugs,lithium,
neurotransmiter electroconvulsive
activity therapy (ECT)
* Satoko
 Kimpara
 –
 Beutler
 
1.  Intake
 :
 Func>onal
 Impairment;
 
 
Chronicity;
 Social
 Support;
 Resistance
 
Trait;
 Coping
 Style;
 Readiness
 For
 
Change
 
2.  Func>onal
 Impairment
 Principle
 :
 1
 
3.  Rela>onship
 Principles
 :
 2,3,4
 
4.  Resistance
 Principle
 :
 5
 
5.  Coping
 Style
 Principle
 :
 6,7
 
6.  Readiness
 for
 change
 principle
 :
 8
 
Dimensi
 E<k
 
•  Kerahasiaan
 
•  Inform
 Consent
 
•  Perluasan
 akses
 
•  Dampak
 bagi
 kesejahteraan
 klien
 
•  Kesejahteraan
 lingkungan
 
•  Kompetensi
 :
 profesional,
 legal,
 norma
 
•  Pendidikan
 Berkelanjutan
 
à
 Kode
 e<k
 Himpsi
 
 Approach Summary
Psychodynamic Personality is characterized by
unconscious processes. Child-
hood experiences are of great
importance to adult personality.
Humanistic Personality evolves out of the
person’s innate, organismic
motives to grow and actualize the
self. These healthy tendencies can
be undermined by social pressure.
Trait Personality is characterized by
five general traits that are repre-
sented in the natural language
that people use to describe them-
selves and others.
Personological To understand personality, we
and Life Story must understand the whole
person. We all have unique life
experiences, and the stories we
tell about those experiences make
up our identities.
Social Cognitive Personality is the pattern of coher-
ence that characterizes a person’s
interactions with the situations he
or she encounters in life. The
individual‘s beliefs and expecta-
tions, rather than global traits, are
the central variables of interest.
Biological Personality characteristics reflect
underlying biological processes
such as those carried out by the
brain, neurotransmitters, and
genes. Differences in behaviors,
thoughts, and feelings depend on
these processes.
FIGURE 12.10 Approaches to Personality Psychology This figure summarizes the broad approaches to personality described in this
chapter. Many researchers in personality do not stick with just one approach but apply the various theories and methods that are most relevant to their
research questions.
Assumptions
The most important aspects of
personality are unconscious.
Human nature is basically
good. By getting in touch
with who we are and what
we really want, we can lead
happier, healthier lives.
Traits are relatively stable
over time. Traits predict
behavior.
The life story provides a
unique opportunity to
examine the personality
processes associated with
behavior, development, and
well-being.
Behavior is best understood
as changing across situa-
tions. To understand person-
ality, we must understand
what each situation means
for a given person.
Biological differences
among individuals can
explain differences in their
personalities.
Typical Methods Sample Research Question
Case studies, projective How do unconscious
techniques. conflicts lead to
dysfunctional behavior?
Questionnaires, Can situations be changed
interviews, to support individuals’
observation. organismic values and
enhance their well-being?
Questionnaires, Are the five factors
observer reports. universal across cultures?
Written narratives, TAT How do narrative accounts
stories, autobio- of life experiences relate
graphical memories, to happiness?
interviews, and
psychobiography.
Multiple observations When and why do
over different situa- individuals respond to
tions; video-recorded challenging tasks with fear
behaviors rated by versus excitement?
coders; questionnaires.
Brain imaging, twin Do genes explain
studies, molecular individual differences
genetic studies. in extraversion?