Integrative Problem-Centered Metaframeworks Approach (Ipcm)

Front 1

What is IPCM?

Back 1

• Broader and more comprehensive than a specific therapeutic approach
  
• Integrative therapy (not eclectic)
• Multi systematic approach
  
• Empirically supported--use empirical data from clients throughout therapy to inform decision making.
  

Front 2

5 Pillars of IPCM's conceptual foundation

Back 2

1. Partial and Progressive Knowing

--There is an objective reality, but it is inaccessible to humans. Our knowledge is partial because it is limited by our perspectives.

--each couple has its own unique reality and our understanding of the reality will always be incomplete.

--Knowledge is progressive: as time passes in therapy, the therapist gains more knowledge of the couple. Does not know the couple in first session.

--Assessment is ongoing in IPCM. The therapist continuously formulates hypotheses about the couple's problems and the constraints that prevent the resolution.

2. Systems Theory

--A couple is a system, comprised of individual subsystems, that exists within a set of family systems.

--Each partner in relationship brings issues from their families into the relationship

3. Theory of Constraints

--The couple's problems are products of set of constraints within the couple system that prevent the couple from resolving their problems.

--What prevents the couple from solving the problem?

--The constraints interconnect and become a web.

4. Differential Causality

There are different types of constraints that may prevent couple from resolving their problem:

--Biological constraints (e.g., affect regulation problem lined to a biological disorder)

--Learned conflict and communication constraints

5. Sequential Organization

--Maladaptive sequences in the relationship may be organized by hierarchy, periodicity (short-term/long-term).

--This involves feelings, thoughts and behaviors ; can be intrapersonal and interpersonal.

--Typical couple sequences: emerging closeness, anxiety about disappointment or emotional injury, provocation of conflict, emotional withdrawal/disengagement.

--Couples need to change maladaptive sequence to adaptive sequences to create positive change in the relationship.

Front 3

The direct and indirect Client Systems

Back 3

• Direct system: the members of the client system attending sessions
  
• Indirect System: members not directly involved in therapy sessions
• The direct-indirect system boundary is permeable.
  
• The direct-indirect boundary distinction ensures that the therapist will inquire and not forget about people beyond the couple who play an important role in maintaining and/or resolving its problems.
  

Front 4

How IPCM identifies problems in the relationship and organize sequences

Back 4

• IPCM therapist translates the couple problem into workable problem sequences with 3 components: the antecedent conditions that trigger, precipitate, or precede the emergence of the presenting problem.
  
• IPCM couple therapy is sequence transformation--helping couples identify their specific problem sequences and then replace them with mutually agreed-upon alternative adaptive sequences.
  

Front 5

The "blueprint" for therapy

Back 5

1. Hypothesizing = diagnosing; ideas about what is wrong in the relationship.
   
2. Planning = intervention strategies used to implement adaptive solution and/or exploration of constraints.
   
3. Conversing: therapy is between the client and therapist; what is discussed is improvised during session and based on the individual's needs
4. Reading feedback: evaluating the impact of interventions used. Did the interventions work? If not, how did they fail? What can be learned?
   

Front 6

7 metaframeworks that contribute to the web of constraints in a relationship

Back 6

1. Biology

2. mind

3. organization

4. culture

5. development

6. gender

7. spirituality

Front 7

Systemic Therapy Inventory of Change (STIC)

Back 7

STIC's 3 major components:

1. Have clients fill out system questionnaires or scales

First session: give the STIC Initial (INI) asks questions about the 7 metaframeworks in client's life

Before every session: STIC Intercession (INT)

6 scales:

• Individual Problems and Strengths Scale (IPS)
• Family of Origin Scale (FOO)
• Relationship with Partner Scale (RWP)
• Family/Household Scale (FH)
• Child Problems and Strengths Scale (CPS)
• Relationship with Child Scale (RWC)
  

2. Integrative Psychotherapy Alliance Scales--3 scales designed to measure the alliance in family, couple, and individual therapy.

3. STIC feedback system: have clients fill out the STIC online; results sent to therapist. Therapist can read results (how client has changed since last session) before each session.

Front 8

Empirically Informed Problem Narrative

Back 8

The therapist combines the presenting problem with data gathered from STIC tests to create an empirically informed problem narrative.