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Functional Analytic Psychotherapy (FAP):

New Frontiers in Awareness, Courage,

Love and Behaviorism

Handouts & Forms**

Denver, Colorado

December 4th – 5th, 2009

Mavis Tsai, Ph.D.

Robert J. Kohlenberg, Ph.D., ABPP

**Please reference

source when using.

Examples of questions from

Pre-Therapy Questionnaire

  1. What are your goals for therapy?
  1. List at least 10 strengths, assets, or things you are proud of about yourself:
  1. Life Events Summary: On a separate sheet of paper, reflect on your life from birth to present in terms of the highlights, challenges, celebrations, relationships, enduring circumstances, turning points, accomplishments, losses, adventures, and the peaks and valleys that have shaped who you are as a person. You can do this in chart form or narrative form. Summarizing the main aspects of your life history will save us time in therapy.
  1. Is there anything else that is important for me as your therapist to know about, and If yes, please tell me about it here or on another sheet of paper:

Statement to Clients

Mavis Tsai, Ph.D.

What You May Expect in Our Therapy Work Together

Clients come into therapy with complex life stories of joy and anguish, dreams and hopes, passions and vulnerabilities, unique gifts and abilities. Your therapy with me will be conducted in an atmosphere of caring, respect and commitment in which new ways of approaching life are learned. Our work will be a joint effort; your input is valued and will be used in the treatment plan and in weekly homework assignments. I will be investing a great deal of care and effort into our work together, and I expect you to do the same. I will be checking with you in an ongoing way about what is working well for you in our relationship, and what needs to be changed.

The type of therapy that I will be doing is called Functional Analytic Psychotherapy (FAP). It is a therapy developed at the University of Washington that is behaviorally based, but has the theoretical foundation to incorporate methods from other therapeutic modalities when appropriate. FAP emphasizes that the bond that will be formed between you and me will be a major vehicle in your healing and transformation.

The most fulfilled people are in touch with themselves and are able to be interpersonally effective. They are able to speak and act compassionately on their truths and gifts, and are able to fully give and receive love. FAP will focus on bringing forth your best self. In order to do that, you must first be in touch with yourself at a core level (e.g., needs, feelings, longings, fears, values, dreams, missions). You will have the opportunity to learn how to express yourself fully, to grieve losses, to develop mindfulness, and to create better relationships. All aspects of your experience will be addressed, including mind, body, feelings, and spirit. I will be challenging you to be more open, vulnerable, aware and present. There is an optimal level of risk-taking in any situation, however, and it’s important that you and I monitor how much outside your comfort zone to be is best for you at any given time.

It will be important for us to focus on our interaction if you have issues (positive or negative) or difficulties that come up with me which also come up with other people in your life. When one feels the power in expressing one's thoughts, feelings, and desires in an authentic, caring and assertive way, one has a greater sense of mastery in life. Our therapeutic relationship will be an ideal place for you to practice being powerful.

I consider the space that you enter with me in therapy to be sacred—I am privileged to be embarking on a journey of exploration and growth with you, and I will hold all that you share with reverence and with care. I will be a genuine person in the room with you, and my main guiding principle is to do that which is in your best interest.

**********

I accept the above statement, and have been given a copy for myself. I have had the opportunity to ask questions and to voice my reactions. I am committed to doing my best in this therapy.

Client’s Name & SignatureTherapist’s Name and Signature:

What You May Expect in Our Therapy Work Together

Robert J. Kohlenberg, Ph.D., ABPP

Clients come into therapy with complex life stories of joy and anguish, dreams and hopes, passions and vulnerabilities, unique gifts and abilities. Your therapy with me will be conducted in an atmosphere of caring, respect and commitment in which new ways of approaching life are learned. Our work will be a joint effort; your input is valued and will be used in the treatment plan and in homework assignments. I will be investing a great deal of care and effort into our work together, and I expect you to do the same. I will be checking with you in an ongoing way about what is working well for you in our relationship, and what needs to be changed.

The type of therapy that I will be doing is called Functional Analytic Psychotherapy (FAP). It is a therapy developed at the University of Washington that is behaviorally based but has the theoretical foundation to incorporate methods from other therapeutic modalities. For example, the therapy often includes the empirically supported Cognitive Behavior Therapy protocols for specific disorders. At the same time, FAP emphasizes that the therapist-client relationship is important for accomplishing significant life change.

Thus in addition to a specific symptom focus as needed, FAP also provides the opportunity to bring forth your best self, to learn how to express yourself fully, to grieve losses as needed, to develop mindfulness, and to create better relationships.

It will be important for us to focus on our interaction if you have issues (positive or negative) or difficulties that come up with me which also come up with other people in your life. Our therapeutic relationship will be an ideal place for you to practice being more effective in your relationships with others.

I consider the space that you enter with me in therapy to bededicated to the above, it will not be handled lightly. I consider it a privilege to participate in a process of exploration and growth with you, and I will hold all that you share with reverence and with care. I will be a genuine person in the room with you, and my main guiding principle is to do that which is in your best interest.

I accept the above statement, and have been given a copy for myself. I have had the opportunity to ask questions and to voice my reactions. I am committed to doing my best in this therapy.

Client’s Name:Therapist’s Name:

Client’s Signature:Therapist’s Signature:

Date:

Functional Analytic Psychotherapy Session Bridging Questions

Client Initials:Date:

Part A (to be completely shortly after therapy session):

On a 10 point scale, how would you rate the following items?

Not at allA little bitModerateSubstantialVery Substantial

12345678910

  1. To what extent were you looking forward to this session? _____
  2. What stands out to you about our last session, or what did you take away from our session? Thoughts, feelings, insights?
  1. How would you rate the helpfulness/effectiveness of our session? _____

4. What was helpful?

5. What was not helpful?

6. How connected did you feel to your therapist? _____

What can you do to feel more connected?

7. How engaged/involved did you feel with the topics being discussed? _____

8. How present you were in the session? _____

9. What would have made the session more helpful or a better experience? Anything you are reluctant to say or ask for?

10. How freely were you able to talk with your therapist? _____

11. How well do you feel like your therapist understood what you were feeling and what was really on your mind during this session? _____

Please briefly describe your experience:

12. What issues came up for you in the session/with your therapist that are similar to your daily life problems?

13.What risks did you take in the session/with your therapist or what progress did you make that can translate into your outside life?

Part B (to be completed just prior to next therapy session):

  1. What were the high and low points of your week?
  1. What items, issues, challenges or positive changes do you want to put on the agenda for our next session?
  1. How much are you looking forward to your next session? _____
  1. How open were you in answering the above questions (0-100%)? _____
  1. Anything else you’d like to add?

Prepared by Mavis Tsai, Ph.D.

Couples Questionnaire

  1. List 10 things that you appreciate and love about your partner:
  1. What are the 5 most cherished memories you have of your relationship?
  1. What are some key self-defining experiences you’ve had growing up?
  1. What did you learn from your parents’ marriage, both positive and negative, about relationships?
  1. Create a detailed vision of how you want your relationship to be, both in terms of day-to-day interaction and your dreams for the future.
  1. What can you do to bring out the best in yourself?
  1. What can you do to bring out the best in your partner?
  1. What are areas of difficulty in your relationship, and what can you do about them?
  1. What do you really want your partner to understand about you?
  1. What is hard for you to say to your partner?
  1. What behavior can you make a commitment to change that will impact your relationship positively? What will help you to keep this commitment?
  1. Is there anything else that you want to talk about?

Prepared by Mavis Tsai, Ph.D.

FAP-ECR (Experiences of Closeness in the Therapeutic Relationship)

Attachment measure modified for therapist–client relationship

Name:Date:

The following statements concern how you feel in your relationship with your therapist. Respond to each statement by indicating how much you agree or disagree with it. Write the number in the space provided, using the following rating scale:

1 / 2 / 3 / 4 / 5 / 6 / 7
Disagree
Strongly / Neutral/
Mixed / Agree
Strongly

___ 1. I prefer not to show my therapist how I feel deep down.

___ 2. I am very comfortable being close to my therapist.

___ 3. Just when my therapist starts to get close to me I find myselfpulling away.

___ 4. I get uncomfortable when my therapist wants to be very close.

___ 5. I don’t feel comfortable opening up to my therapist.

___ 6. I want to get close to my therapist, but I keep pulling back.

___ 7. I am nervous when my therapist gets too close to me.

___ 8. I feel comfortable sharing my private thoughts and feelings with my therapist.

___ 9. I try to avoid getting too close to my therapist.

___ 10. I find it relatively easy to get close to my therapist.

___ 11. Sometimes I feel that I force my therapist to show more feeling, more

commitment.

___ 12. I find it difficult to allow myself to depend on my therapist.

___ 13. I prefer not to be too close to my therapist.

___ 14. I tell my therapist just about everything.

___ 15. I usually discuss my problems and concerns with my therapist.

___ 16. I feel comfortable depending on my therapist.

___ 17. I don’t mind asking my therapist for comfort, advice, or help.

___ 18. It helps to turn to my therapist in times of need.

___ 19. I turn to my therapist for many things, including comfort and reassurance.

FAP-ECR for Therapists (Experiences of Closeness in the Therapeutic Relationship)

Name:Date:

1 / 2 / 3 / 4 / 5 / 6 / 7
Disagree
Strongly / Neutral/
Mixed / Agree
Strongly

The following statements concern how you feel in your relationship with your client . Respond to each statement by indicating how much you agree or disagree with it. Write the number in the space provided, using the above rating scale.

___ 1. I prefer not to show my clients how I feel deep down.

___ 2. I am very comfortable being close to my clients.

___ 3. Just when my clients start to get close to me I find myselfpulling away.

___ 4. I get uncomfortable when my clients want to be very close.

___ 5. I don’t feel comfortable opening up to my clients.

___ 6. I want to get close to my clients, but I keep pulling back.

___ 7. I am nervous when my clients get too close to me.

___ 8. I feel comfortable sharing my private thoughts and feelings with my clients.

___ 9. I try to avoid getting too close to my clients.

___ 10. I find it relatively easy to get close to my clients.

___ 11. I often evoke my clients to show more feelings, more commitment.

___ 12. I usually discuss problems and concerns about the therapy process with my clients.

___ 13. I feel comfortable with my clients depending on me.

___ 14. I don’t mind asking my clients me for comfort, advice, reassurance or help.

___15. I often think about my clients in between sessions.

___16. I avoid challenging my clients on their avoidance behaviors.

___17. I self-disclose thoughts, feelings and experiences when I feel it is relevant to my

clients’ growth.

___18. I feel sad when a therapeutic relationship ends.

Emotional Risk Log

Creating more of what we want in our lives usually takes courage. We will have to move beyond our comfort zones and do things that feel anxiety-provoking, scary or risky. Discuss with your therapist 1) the risks you’ve taken in the past that led to desired outcomes, and 2) what risks you can take now that will move you towards what you value in your life, and the benefits versus costs of these risks. Try to take one risk daily; they can be small risks (e.g., rating of 1-2), or larger ones. Examples include: expressing your true feelings to someone, taking an art class, trying a new recipe. Consider things you would really like to do, but normally wouldn’t.

Date / Description of Emotional Risk / Risk Rating 1-10
(10=highest)

Typical FAP Questions

Typical FAP questions are of two types: they bring the client’s attention to what s/he is thinking and feeling a) at the moment; b) about the therapy or therapeutic relationship, preferably in the moment, but thoughts or feelings outside of the session regarding the relationship are ok too.

What are you thinking or feeling right now?

What’s going through your mind right now?

What’s your reaction to what I just said? To the rationale I just gave? To being in a research study, to me as your therapist, to agenda setting, to structured therapy, to the homework assignment, to time-limited 20 session therapy?

What were you thinking/feeling on your way to therapy today?

What were you thinking/feeling while you were waiting for me out in the waiting room?

What are your hopes and concerns/fears as you start this therapy relationship with me?

What are your behaviors that tend to bring closeness in your relationships? What do you tend to do that decreases closeness in your relationships? How would you feel about us watching for your behaviors in here which increase or decrease closeness?

What were your reactions to our last session?

What stood out to you regarding our last session?

What stands out to you about today’s session?

What are your feelings/reactions to our session today?

What’s hard for you to say to me?

How are you feeling about our therapy relationship? What’s good about it? What needs to be improved?

What do you wish I would have done.

What do you think I’m thinking about you/ that/ what you did/ said?

How do you feel about your progress?

What do you think I’m feeling about your progress?

Are your reactions to me similar to your reactions to X? or Is that how you feel about me too?

Beginning the Therapy Relationship

  1. In general, when I begin a new relationship or activity, I*

__ jump in quickly, ignoring any reservations I have.

__ move cautiously, taking time before I vent myself.

__ trust slowly before I make any commitment.

__ try hard to make a good impression.

__ feel shy and keep to myself until I feel comfortable.

__ am very quick to be critical of what’s going on.

__ become involved and stay that way.

__ am concerned that I might get trapped.

__ start out with high hopes and then get disappointed.

__ am different depending on the situation.

__ other, describe.

  1. I notice these similarities and differences between my usual style of beginning and how I am beginning this relationship:
  1. I will increase the likelihood of having a good experience and getting what I want from therapy if:
  1. What I like about therapy so far is;
  1. Therapy would work better for me if:
  1. What else is important for my therapist to know that will be helpful in working with me?
  1. Any other feedback – thoughts feelings, requests?

*Adapted from Bruckner-Gordon F., Gangi, B. & Wallman, G.(1988) Making therapy work: Your guide to choosing, using and ending therapy. New York: HarperCollins.

Anticipated CRB’s Based on Core Beliefs

Core Issue / Anticipated CRB’s Based on Client’s Core Issues
(also see Therapeutic Opportunities Scale)
Alone / Feels this way, even with therapist.
Defective / As seen by therapist.
Different / As seen by therapist or in reactions to therapy.
Doesn’t Measure Up / As seen by therapist.
Failure / In therapy. With therapy tasks, homework.
Helpless / In relation to therapist, can’t influence therapist.
Inadequate / To understand the therapy, to get better with this treatment.
Incompetent / In therapy.
Ineffective / In therapy.
Inferior / To therapist, to other clients.
Loser / In relation to therapist, as seen by therapist, to be in therapy.
Loser (In Relationships) / In therapy relationship.
Needy / Too needy for therapist.
Not Good Enough / For therapist, to receive therapy.
Out Of Control / Feelings in therapy or about therapist.
Powerless / To influence the therapist.
Rejected / By therapist.
Trapped / Must do what I’m told, by the therapist or comply with conditions of therapy.
Unattractive / To therapist.
Uncared for / Not really cared about by the therapist.
Undesirable / As a client.
Unlovable / By therapist.
Unwanted / By therapist. Therapist doesn’t want to see client.
Vulnerable / Therapist is kind or considerate because the client is vulnerable.
Weak / Therapist is kind or considerate because the client is weak.
Worthless /

Seen as worthless by therapist.

Bad / Any problem therapist has in doing treatment is because client is bad.
Not Good Enough / To be valued or respected by therapist.
FAP Conceptualization and Working Plan for Client:
Therapist: Date:
Relevant History:
Daily Life Problems:
Problematic Beliefs:
Variables Maintaining Problems:
Assets and Strengths:
CRB1s (Clinically Relevant Behaviors—in-session problematic behaviors and thoughts:
CRB2s (Clinically Relevant Behaviors—in-session target behaviors and improvements):
Daily Life Goals:
Therapy Goals:
Planned Interventions:
T1s (Therapist in-session problems)T2s (Therapist in-session target behaviors):

Loss Inventory