The Therapeutic Alliance as Active Inference: The Role of Trust and Self-Efficacy

Krupnik, Valery

doi:10.1007/s10879-022-09576-1

Cited by 5 publications

(2 citation statements)

References 46 publications

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“…The putative mechanism of confidence regulation is by adjusting the model’s precision through neuromodulation of the synaptic gain ( Feldman and Friston, 2010 ). SE can be conceived of as a nested hierarchy ( Krupnik, 2020a , 2021 , 2022 ) that comprises domain and task-general and specific levels, e.g., “I can do well in life”—“I can do well at physical fitness”—“I can run well”—“I can catch that bus.” It has to be noted that here we extend the original construct of SE as a person’s conscious subjective confidence that a chosen action will achieve the desired outcome ( Bandura, 1977 ) to a more general concept. It includes model confidence at any level and considers it a probability function as in Friston et al (2013) .…”

Section: The Brain Integrative Generative Model Of Stress and Homeost...mentioning

confidence: 99%

“…However, SE has not been specifically and explicitly targeted in therapy of depression or in psychotherapy in general. It has recently been identified as a possible target for development of the therapeutic alliance ( Krupnik, 2022 ), but the above formulation of depression suggests that interventions targeting SE could be a valuable addition to the anti-depressant toolkit.…”

Section: The Brain Integrative Generative Model Of Stress and Homeost...mentioning

confidence: 99%

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I like therefore I can, and I can therefore I like: the role of self-efficacy and affect in active inference of allostasis

Krupnik

2024

Front. Neural Circuits

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Active inference (AIF) is a theory of the behavior of information-processing open dynamic systems. It describes them as generative models (GM) generating inferences on the causes of sensory input they receive from their environment. Based on these inferences, GMs generate predictions about sensory input. The discrepancy between a prediction and the actual input results in prediction error. GMs then execute action policies predicted to minimize the prediction error. The free-energy principle provides a rationale for AIF by stipulating that information-processing open systems must constantly minimize their free energy (through suppressing the cumulative prediction error) to avoid decay. The theory of homeostasis and allostasis has a similar logic. Homeostatic set points are expectations of living organisms. Discrepancies between set points and actual states generate stress. For optimal functioning, organisms avoid stress by preserving homeostasis. Theories of AIF and homeostasis have recently converged, with AIF providing a formal account for homeo- and allostasis. In this paper, we present bacterial chemotaxis as molecular AIF, where mutual constraints by extero- and interoception play an essential role in controlling bacterial behavior supporting homeostasis. Extending this insight to the brain, we propose a conceptual model of the brain homeostatic GM, in which we suggest partition of the brain GM into cognitive and physiological homeostatic GMs. We outline their mutual regulation as well as their integration based on the free-energy principle. From this analysis, affect and self-efficacy emerge as the main regulators of the cognitive homeostatic GM. We suggest fatigue and depression as target neurocognitive phenomena for studying the neural mechanisms of such regulation.

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Section: The Brain Integrative Generative Model Of Stress and Homeost...mentioning

confidence: 99%

Section: The Brain Integrative Generative Model Of Stress and Homeost...mentioning

confidence: 99%

I like therefore I can, and I can therefore I like: the role of self-efficacy and affect in active inference of allostasis

Krupnik

2024

Front. Neural Circuits

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Pitfalls and Opportunities of the Therapist’s Metacommunication: A Self-determination Perspective

Holmström,

Kykyri,

Martela

2023

J Contemp Psychother

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Psychotherapy research identifies alliance ruptures and their resolutions as significant events in psychotherapy, influencing outcome. However, we know little about the process how such events influence outcomes, only assuming if clients stay in therapy that the rupture was resolved, and the outcome will be positive. The purpose of this paper is to problematize this assumption against the backdrop of self-determination theory, introducing motivation and relational positioning as relevant theoretical concepts for understanding rupture resolution and the effect on outcome. A therapeutic transcript demonstrating best practice for alliance rupture resolution in a brief integrative therapy is critically examined, calling the attention of both clinicians and researchers to the risk of prescribing and blindly following techniques during therapeutic impasses. Our analysis of metacommunication demonstrates how the therapist’s use of a certain technique for resolving threats to the therapeutic alliance can lead to the client’s external motivation and compliance, negatively influencing therapeutic outcome. Focusing on the therapist’s relational positioning we present two alternative courses of therapeutic action, ‘mindfulness in action’ and ‘embracing the patient’s ambivalence’, for supporting the client’s autonomous motivation for the therapy process.

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An Integrative Model of Psychotherapeutic Interventions Based on a Predictive Processing Framework

Villiger

2024

J Contemp Psychother

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There are numerous approaches to psychotherapy with distinct underlying theories. Yet, it is unlikely that any of these is conclusive because they broadly yield similar therapeutic effects. A different approach attempts to derive the common factors from the specific treatments and proposes that these common factors primarily promote therapeutic effects. But although generally promising, these common factors have not been integrated into a more fundamental explanatory framework that also considers the effectiveness of specific factors. Therefore, an integrative model of psychotherapeutic interventions is still missing. The aim of this paper is to help fill that gap by applying the theory of predictive processing to interventions from various psychotherapeutic approaches, including cognitive behavioural therapy, client-centred therapy, and psychoanalysis. The analysis results in the predictive processing model of psychotherapeutic interventions (3PI model for short). The new model reveals that psychotherapy comprises two main functions: to provide a safe and positive environment to which the patient can adapt, and to facilitate the process of updating a dysfunctional generative model. Further, it shows that common factors primarily promote the first function, while specific factors mainly support the second function, offering a new perspective to the debate on common and the specific factors.

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The Therapeutic Alliance as Active Inference: The Role of Trust and Self-Efficacy

Cited by 5 publications

References 46 publications

I like therefore I can, and I can therefore I like: the role of self-efficacy and affect in active inference of allostasis

I like therefore I can, and I can therefore I like: the role of self-efficacy and affect in active inference of allostasis

Pitfalls and Opportunities of the Therapist’s Metacommunication: A Self-determination Perspective

An Integrative Model of Psychotherapeutic Interventions Based on a Predictive Processing Framework

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