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This book focuses on problematic situations in therapy mpasses, wounding, and ruptures. Based on the author's extensive clinical experience with therapists and patients in impasses, as well as her survey questionnaire of other therapists Elkind views impasses, wounding and ruptures as unavoidable pivotal events in therapeutic relationships. She offers numerous vignettes of consultations she has provided to patients and therapists grappling with a diverse range of problems. Elkind introduces uniquely humanizing theoretical concepts such as, primary vulnerability and problematic relational modes to provide a framework for understanding and working with relational knots between therapists and patients.
In this perceptive work, Dr. Robin Connors offers helpful guidelines to clinicians that will improve their capacity to respond in a direct, effective, and respectful way to people who self-injure. Key to this work is understanding the function of self-inflicted violence and its relationship to unresolved traumas and losses, including the role of trauma in disrupting the formation of the self-boundary. Dr. Connors identifies fundamental therapeutic tasks, gives clear examples of interventions, and offers concrete recommendations for interacting with patients about their self-injury.
This book examines therapeutic failures in psychotherapy. Despite the consistent positive outcome findings and psychotherapists’ best intentions in their efforts to help their clients, psychotherapy simply does not work in all cases. In fact, 5-10% of adult clients deteriorate during psychotherapy. Although not exclusively due to treatment failures per se, almost a fifth of clients terminate their therapy prematurely and findings suggest that that between 20 and 30% of clients do not return after the first session with half terminating after just two sessions. Therapeutic failures could include a range of negative therapy outcomes, such as harm, deterioration, client non-response, premature termination, or dropout, as well as process factors, such as negative therapy experiences, impasses, or alliance ruptures. Investigating therapeutic failures holds the key to improving the effectiveness of psychotherapy as well as understanding some of the fundamental conditions that need to be in place for the change mechanisms of psychotherapy to take effect. Although psychotherapy has made many strides over the last few decades to improve research rigour and to promote evidence-based practices, it is a profession that is still growing. By embracing the opportunity to learn from therapeutic failures the profession will continue to refine its practices to better serve clients and to strive toward developing ethical and effective practices. Both comprehensive and accessible, this book will be of great interest to psychotherapists in practice, therapists-in-training, as well as students and professionals in psychology and mental health in general. The chapters in this book were originally published in Counselling Psychology Quarterly.
Cognitive therapy, with its clear-cut measurable techniques, has been a welcome innovation in recent years. However, the very specificity that lends itself so well to research and training has minimized the role of the therapeutic relationship, making it difficult for therapists to respond flexibly to different clinical situations. What is needed is an approach that focuses on the underlying mechanisms of therapeutic change, not just on interventions. In this practical and original book, two highly respected clinician-researchers integrate findings from cognitive psychology, infant developmental research, emotion theory, and relational therapy to show how change takes place in the interpersonal context of the therapeutic relationship and involves experiencing the self in new ways, not just altering behavior or cognitions. Making use of extensive clinical transcripts accompanied by moment-to-moment analyses of the change process, the authors illustrate the subtle interaction of cognitive and interpersonal factors. They show how therapy unfolds at three different levels—in fluctuations in the patient's world, in the therapeutic relationship, and in the therapist's inner experience—and provide clear guidelines for when to focus on a particular level. The result is a superb integration of cognitive and interpersonal approaches that will have a major impact on theory and practice. A Jason Aronson Book
In this fascinating and robust volume, the editors have compiled a collection of articles that provides an account of their individual theoretical journeys as they trace the evolution of relational transactional analysis. They re-examine the term ‘relational’, offering the reader a multiplicity of ways in which to conceptualise the theory of transactional analysis from a truly pluralistic perspective. This collection of 14 stunning articles from the Transactional Analytic Journal, written over a period of nearly three decades, traces the evolutionary process of a way of thinking that incorporates both theoretical innovations and advanced methodological ideas. Central to the themes of this book is a theoretical understanding of the bidirectionality of the relational unconscious, alongside a methodology that not always, but most often, demands a two-person methodology in which the therapist’s subjectivity comes under scrutiny. Uniquely useful as a research tool for psychotherapists interested in the most up to date psychological theories, this book offers a perspective on relational theory that is both respectful and critical. It will be of enormously useful to the trainee, the researcher, the clinician and the supervisor and will help inform the development of a clinical dialectical mind.
Although the therapeutic relationship is a major contributor to therapeutic outcomes, the cognitive behavioral psychotherapies have not explored this aspect in any detail. This book addresses this shortfall and explores the therapeutic relationship from a range of different perspectives within cognitive behavioral and emotion focused therapy traditions. The Therapeutic Relationship in the Cognitive Behavioral Psychotherapies covers new research on basic models of the process of the therapeutic relationship, and explores key issues related to developing emotional sensitivity, empathic understanding, mindfulness, compassion and validation within the therapeutic relationship. The contributors draw on their extensive experience in different schools of cognitive behavioral therapy to address their understanding and use of the therapeutic relationship. Subjects covered include: · the process and changing nature of the therapeutic relationship over time · recognizing and resolving ruptures in the therapeutic alliance · the role of evolved social needs and compassion in the therapeutic relationship · the therapeutic relationship with difficult to engage clients · self and self-reflection in the therapeutic relationship. This book will be of great interest to all psychotherapists who want to deepen their understanding of the therapeutic relationship, especially those who wish to follow cognitive behavioral approaches.
This two-volume handbook offers a thorough treatment of the concepts and theoretical developments concerning how to apply cultural knowledge in theory and practice to various racial and cultural groups. Volume Two focuses on practice and training, and addresses such topics as: assessment testing group therapy occupational therapy supervision ethics couples and family therapy continuing education
In this collection of powerfully illuminating and often poignant essays, contributors candidly discuss the impact of central life crises and identity concerns on their work as therapists. With chapters focusing on identity concerns associated with the body-self (body size, ethnicity, sexual orientation, and age), urgent life crises, and defining life circumstances, The Therapist as a Person exemplifies the myriad ways in which the therapist's subjectivity shapes his or her interaction with patients. Included in the collection are life events rarely if ever dealt with in the literature: the death of family members, late pregnancy loss, divorce, the failure of the therapist's own therapy, infertility and childlessness, the decision to adopt a child, and the parenting of a profoundly deaf child.
Volume 15 of Progress in Self Psychology conveys the rich pluralism of contemporary self psychology with respect to a central theoretical and clinical issue: the nature of the self and the manner in which is can best be studied. This topic is initially addressed through a series of papers reassessing selfobject transferences and the selfobject function of interpretation. It is then approached via the theory of psychoanalytic technique, with papers that focus on boundaries and intimacy and on "Surface, Depth, and the Isolated Mind". And it culminates in two case studies that elicit animated discussion delineating different perspectives - intersubjective, motivational systems, and self-selfobject - on the self in relation to the therapeutic process. Two studies comparing Melanie Klein and Heinz Kohut; a discussion of how current cultural attitudes affect parenting; a relational view of the therapeutic partnership; and an integration of Silvan Tomkin's affect theory with self psychology add breadth to this timely and provocative collection. Volume 15 includes additional letters from the Kohut Archives and a moving account of Kohut's struggle with his own impending death.
Provides first-person, subjective accounts of the supervisory process from the viewpoint of both the supervisor and the supervisee.