Healthcare Training Institute - Quality Education since 1979
CE for Psychologist, Social Worker, Counselor, & MFT!!

Section 12
Using 'Client Insulation' to Increase Immunity from Insults

Question 12 | Test | Table of Contents

Read content below or listen to audio.
Left click audio track to Listen; Right click to "Save..." mp3

In the last section, we discussed affirming self worth. Our case study in this section involved Jacqueline. Over several sessions with Jacqueline, I found it productive to put self worth into different perspectives using four methods. These four methods for affirming self worth are eliminating the idea, unrestricting the idea, acknowledging personal worth, and the compassionate perspective.

In this section, we will discuss the danger of external disconfirmation. The focus of this section is on the cognitive behavior therapy client insulation technique, which is quite common with a teen or adult client who has experienced abuse. The basis of this technique is to devise measures to render a client more immune to external degradation through cognitive promotion.    

As a general rule, it is desirable to accredit clients in such a way that other people are either unlikely or unable to disconfirm the client’s new status as a confident and assertive person.  Regarding disconfirmation, let’s consider two questions.

♦ Two Questions Regarding Disconfirmation
1. First, will the new status assigned to the client be supported, or at least not disconfirmed, by others in his or her world?
2. Second, if external disconfirmation seems likely, what procedures may be employed to help insulate the client from such disconfirmation?

An example of such an attempt to insulate the client from external criticism occurred in the case of a young woman.  Julie, age 32, had long appraised herself as unlovable.  Julie’s self criticism was based primarily on her childhood.  Julie stated, "I was always scapegoated by both of my parents.  My mom was very narcissistic and basically rejected me.  It was like the worst kind of abuse."  Further, continued rejection and blame at the hands of her mother were currently serving to perpetuate Julie’s conviction of unlovability. 

♦ CBT Technique:  Client Insulation
To help Julie, I implemented the client insulation CBT technique. Aside from simply accepting Julie and putting her best interests first in the therapeutic relationship, I decided to work to devise measures to render her more immune to her mother’s continued degradations. Think of your Julie. How might you have insulated your client from such disconfirmation? I felt that a cognitive promotion could be productive. 

Therefore, I strongly and repeatedly promoted a picture of reality in which Julie was portrayed as a ‘placeholder’ in her family. I often repeated this idea to Julie by stating, "You are someone who, regardless of your own merits or value, occupy a certain position in your family. In this position you are scapegoated. It’s not you who is at fault.  No matter who occupies your position in your family, that person would become the new scapegoat." 

In addition to projecting the cause of Julie’s mother’s scapegoating, I also promoted an idea regarding Julie’s lovability. I stated to Julie, "The simple notion that your disturbed mother cannot love explains everything. Her failure to love you is not in any sense a comment on your lovability." This idea was promoted over and over again in various ways throughout therapy. In time, through these efforts to insulate Julie from her mother’s degradations, she became relatively immune to them. 

Ultimately, both through the establishment of an accrediting therapeutic relationship and through these efforts to disqualify her mother as a legitimate external critic, Julie was able to appraise herself as lovable and acceptable to others. Furthermore, she was able to act on this by entering into new relationships and a better relationship with her father.

QUESTION 12
What is the basis for the client insulation CBT technique? To select and enter your answer go to Test.

Test
Section 13
Table of Contents
Top