The document discusses psychodynamic formulation as a crucial tool for managing therapeutic alliances, highlighting various defenses such as mature and borderline defenses, and the importance of differential diagnosis and ego function assessment. It also emphasizes attachment patterns, including Ainsworth's categories, and the roles of transference and countertransference in therapy. Lastly, it outlines therapeutic strategies and prognosis factors that influence treatment outcomes.

1. Psychodynamic Formulation
A Critical Tool For Managing The
Therapeutic Alliance

2. Defenses
 Mature Defenses  Borderline Defenses
 Suppression  Splitting
 Sublimation  Projective
 Reaction Formation Identification
 Idealization
 Devaluation
 Projection

3. Defenses
 Mature Defenses  Borderline Defenses
 Suppression  Splitting
 Sublimation  Projective
 Reaction Formation Identification
 Idealization
 Devaluation
 Projection

4. Defenses
 Denial
 Repression
 Projection
 Undoing
 Intellectualization
 Rationalization
 Externalization

5. Components of the
Psychodynamic Formulation
 1. Differential Diagnosis on Axis I
 2. Differential Diagnosis on Axis II
 3. Ego Function Assessment
 4. Adult Attachment Pattern
 5.Transference Predictions
 6. Counter-transference
 7. Transference Resistance
 8. Therapeutic Strategies and Tactics
 9. Prognostic Predictions

7. Attachment Patterns
 Ainsworth Attachment Patterns
 1. Secure
 2.Insecure
 3. Ambivalent
 4. Disorganized
 Adult Attachment Styles
 1.Secure
 2.Preoccupied
 3.Fearful Avoidant
 4.Dismissing

8. Ego Function Assessment
 1. Object Relations 8. Adaptive Regression in
 2. Affect Regulation the Service of the Ego
 9. Reality Testing
 3. Frustration Tolerance
 10. Sense of Reality
 4. Impulse Control  11. Stimulus Barrier
 5. Judgment  12. Synthetic Integrative
 6 Thinking Functions
 7. Defenses  13 Ego Autonomous
Functions ( Hard Wired)

9. Transference
 Positive  Negative
 Maternal or Paternal  Maternal or Paternal

10. Countertranference
 Positive  Negative
 Maternal  Maternal
 Paternal  Paternal
 Emerging from ones  Emerging from ones
own conflict own conflicts
 Emerging from  Emerging from
patient’s projections patient’s projections

11. Transference Resistance
 Focus on extra-transferential situations
and relationships in the here and now
 Focus on relationships in the there and
then

12. Therapeutic Strategy and
Tactics
Supportive Psychotherapy
Expressive-Insight Oriented Psychotherapy
Interpersonal Psychotherapy
Cognitive Behavioral Therapy
Dialectical Behavioral Therapy
Pharmacotherapy
Psycho-education Patient and Family Centered

13. Prognosis
 Outcome is determined by a GAS score
that seeks the highest level of
functioning in love work and play.
Factors complicating this goal involves
adherence, motivation, supports, pre-
morbid level of functioning etc. All
factor allow for a prognostic prediction