Structurally informed psychodynamic theory case conceptualization: Expanding the conceptualization map

Area of Science:

• Psychology
• Social Psychology
• Clinical Psychology

Background:

• Psychological movements increasingly emphasize client collaboration to resist oppression.
• Professional guidelines highlight the role of social and environmental factors in client conceptualization.
• There's a growing need to consider power, privilege, and institutional disparities in psychological practice.

Purpose of the Study:

• To explore the integration of sociocultural identities within systems of power and oppression in case conceptualization.
• To advocate for improved socioenvironmental contexts and challenge structural oppression.
• To demonstrate how foundational contributions from Black psychology, intersectionality, liberation psychology, Indigenous, and radical healing can inform case conceptualization.

Main Methods:

• Review of foundational contributions from various psychological movements.
• Presentation of a composite case example illustrating client distress interwoven with structural forces.
• Demonstration of psychodynamic case conceptualization infused with attention to structural forces.

Main Results:

• Structural forces significantly shape and perpetuate client distress.
• Integrating structural competency requires addressing how these forces develop and are maintained.
• Advocacy beyond the therapy session is necessitated.

Conclusions:

• Case conceptualization must move beyond individual assessments to engage with clients' sociocultural identities within systems of power.
• Psychotherapy training needs to incorporate structural competency to address systemic influences on client distress.
• Integrating structural forces into case conceptualization guides impactful treatment and advocacy.