Abstract Therapists often struggle to determine the most important things to focus on during termination. Reviewing the treatment, identifying plans for the future, summarizing positive gains, and saying goodbye receive the most attention. Despite our best intentions, termination can end up becoming intellectualized. Attachment theory and recent developments in neuroscience offer us a road map […]
Evidence-based practice in psychology has been defined as the integration of the best available research, clinical expertise, and the individual client’s characteristics, values, and preferences (APA, 2006). This definition suggests that psychotherapists should be able, and willing, to integrate techniques from different theoretical orientations based on the context. Although integration is important, it is also […]
It is ironic that while most therapists champion the role of the therapeutic relationship in the success of therapy, there has been little research on how the transfer process and prior therapy relationships may have an impact on the therapeutic relationship. Clients are often transferred from one therapist to another in clinics when therapists-in-training leave […]
Psychological resistance refers to patients’ conscious or unconscious opposition to aspects of the therapy process. When not skillfully addressed, resistance can lead to therapeutic alliance ruptures, “deteriorations in the relationship [indicated by] patient behaviors or communications that are interpersonal markers indicating critical points in therapy for exploration” (Safran & Muran, 1996, p. 447). While ruptures […]
The therapeutic alliance had been found to be one of the most robust predictors of treatment retention and therapeutic outcome (Horvath, Del Re, Flückiger, & Symonds, 2011). In his seminal transtheoretical formulation, Bordin (1979) emphasized purposeful collaboration and the affective bond between patient and therapist as essential. This laid the foundation for its consideration as […]
An area of diversity often overlooked is socioeconomic status. Homeless clients are at an extreme end of the socioeconomic status continuum and present with concerns and stressors related to poverty. People often start psychotherapy due to a major stressor in their lives. Finally, after some apprehension, they make the initial leap to get help and […]
Background Research has demonstrated significant between-therapist variability in both process (e.g., working alliance) and outcome (e.g., symptom reduction), pointing to the so-called therapist effect (Baldwin & Imel, 2013). Although still in its infancy with regard to empirical scrutiny, thinking in this area has largely assumed that more effective therapists possess specific characteristics that foster consistently […]
My first session with a real, live psychotherapy patient[1] was at a university counseling center in New England. I was in my second year of graduate school. My only previous experience that even resembled doing therapy was limited to interviewing my classmates as pretend patients. In those role-plays, everyone was agreeable and talkative. They gave […]
If you are a psychotherapist of a certain age you no doubt remember the 1982 New York Times Magazine article on Short-Term Dynamic Psychotherapy (STDP; Davanloo, 1980) by journalist Dava Sobel. In contrasting STDP (“the most aggressive form of psychic medicine to rest on the principles of Sigmund Freud”) to traditional psychoanalytic psychotherapy, Sobel noted, […]
Currently, there is a paradigm clash between different visions of the nature of psychotherapy. The clash is not merely about what psychotherapy is, how it helps, and how it should be practiced. It is also about the nature of scientific evidence and what the evidence shows about effective practice. In the forward to this book […]