Navigating Ruptures Repairs And Termination Within The Therapeutic Process

This book explores the importance of the therapeutic relationship, the tensions or disagreements that may emerge during a therapy session, and how they can be repaired. Dr. Koenigsberg introduces a two-part transtheoretical, psycholinguistic model which focuses on the connection between ruptures and the termination phase of therapy, emphasizing the verbal and nonverbal nuances of language, to understand what is happening in the therapeutic alliance. With a reliance on psycholinguistic elements, this model can guide therapists who wish to reduce the premature termination of patients from therapy. Written in an accessible format, it provides case examples, including the patient’s and therapist’s inner experiences, and defines and describes the phases of therapy so that difficult transitions in the therapeutic process can be navigated with skill and compassion. This text is essential for providing early career as well as more seasoned therapists with excellent strategies to repair their therapeutic relationships with clients.

Working Alliance Skills for Mental Health Professionals provides expert guidance to mental health providers who wish to develop and augment their skills and competence in this area of practice. Each chapter deconstructs a dimension of the working alliance in psychotherapy, defining and describing specific mechanisms and interventions that can help professionals establish an alliance with their clients. The book includes skills in nonverbal communication, ways to foster the working bond with diverse clients, goal and task setting strategies, and verbal and interpersonal therapeutic skills, as well as mechanisms for repairing ruptures and for fostering the working alliance through supervision. The authors provide "in session" examples of how each skill may be implemented, and highlight the use of interventions through clinical vignettes and masked clinical cases. Working Alliance Skills for Mental Health Professionals is ideal for use in training programs in counseling, clinical psychology, and social work. It may also be valuable to professional-level practitioners interested in honing their skills in optimizing the working alliance.

Ruptures in the therapeutic alliance are common clinical experiences. If left unresolved, they can lead patients to drop out and to other poor outcomes.

A half-century of psychotherapy research has shown that the quality of the therapeutic alliance is the most robust predictor of treatment success. This unique book provides a systematic framework for negotiating ruptures and strains in the therapeutic alliance and transforming them into therapeutic breakthroughs. Cutting-edge developments in psychoanalysis and other modalities are synthesized with original research and clinical wisdom gleaned from years of work in the field. The result is a practical and highly sophisticated guide that spells out clear principles of intervention while at the same time inspiring therapists toward greater creativity.

Attachment theory is influencing how we understand interpersonal relationships and how psychotherapy can help facilitate change for those struggling in relationships. More recently, researchers and clinicians have applied attachment theory to group treatment, one of the most effective forms of psychotherapy to address interpersonal difficulties. This book highlights some of the bridges between attachment theory and contemporary approaches to group treatment. In addition to applying attachment theory to innovative treatments, each chapter addresses a specific way in which attachment impacts the members’ capacity for empathy and perspective taking; the development of cohesion in the group; the automatic fight-flight response during group interactions; members’ ability to tolerate diversity; and the leaders’ capacity to foster safety within the group. This book will help group leaders gain a richer understanding of attachment theory and attachment based techniques that will ultimately benefit their groups. This book was originally published as a special issue of the International Journal of Group Psychotherapy.

"Understanding how and why group therapy works is the subject of The Process of Group Psychotherapy: Systems for Analyzing Change. This book describes nine current approaches to analyzing group process, then applies each system to a single group psychotherapy session. The theory, methodology, and empirical support associated with each system are summarized, tracing the evolution of this growing field to its current form. A comparison of the systems illuminates the clinically relevant insights provided by each approach and is designed to spur development of group therapy process research within the field of psychotherapy research. This provocative analysis has implications for theory building and research design, as well as applications in treatment and teaching."--BOOK JACKET.Title Summary field provided by Blackwell North America, Inc. All Rights Reserved

Outcome research has shown that the experience of a rupture-repair process in the therapeutic relationship can have a beneficial impact upon symptomology, interpersonal problems and social functioning. There is a lack of qualitative research on therapeutic ruptures and how they are repaired. This study explored parallel accounts of therapeutic ruptures produced by clients and therapists during long-term psychodynamic therapy. Interviews were conducted with four client-therapist dyads. The data were analysed using Interpretative Phenomenological Analysis. Five overarching themes and six sub-themes are presented. These included: clients' experience of the danger of emotional experience (Emotions as dangerous); accounts of the discovery during therapy being a difficult and gradual experience (Therapeutic discovery; gradual and hard work; to and fro); the experience of problems within the therapeutic relationship (The struggle; not knowing; control and power); followed by a connection within the relationship (The positive connection; emotional sensitivity; shining a light); and the experience of the end of the therapy (Leaving and being left). The findings are discussed in relation to the literature on the emotional experience of psychodynamic therapy. The results demonstrated the importance of attunement and reciprocity within the therapeutic relationship to help maintain a positive connection in the dyads.

Treating Complex Trauma and Dissociation is the ideal guide for the front-line clinician whose clients come in with histories of trauma, abuse, self-injury, flashbacks, suicidal behavior, and more. The second edition includes the latest research and developments in treatment for trauma and dissociative disorders. The book is written with the knowledge that survivors may read it, and the authors have consciously maintained the dignity of the survivors throughout. Clinicians will find that the chapters help them develop their own responses and practical solutions to common questions, including "How do I handle this?" "What do I say?" and "What can I do?" Treating Complex Trauma and Dissociation is the book clinicians will want to pick up when they're stuck and is a handy reference that provides the tools needed to deal with difficult issues in therapy. It is supportive and respectful of both therapist and client, and, most of all, useful in the office.

The topic of terminating therapy is not one that clinicians normally consider. However, the session limits placed on clinicians by managed care require that the end of therapy be built into the treatment plan from the onset. With a focus on the termination of psychotherapy, A Clinician’s Guide examines the pertinent additional training that will aid mental health professionals in providing the most financially sensible and clinically deep treatment for their clients. Specifically, the book provides information on how to identify and understand when and how to discontinue psychological treatment with clients who have achieved sub-par results, as well as with clients who have ulterior motives such as friendship or support. The volume examines how to identify the client’s motivations early in therapy in order to better plan the course of treatment and to effectively prepare for "unplanned" terminations. It supplies important additional training in its discussions on ethical dilemmas, financial and personal consequences, and troubleshooting when it comes to engaging in termination. Offering a comprehensive and practice-focused guide from distinguished contributors, the book covers a wide spectrum of therapy approaches, patient populations and termination strategies. The book provides an in-depth look at termination by discussing various patient models, types, backgrounds, and problems, noting that with clear goals and a set course of action, the therapist will be better equipped to design a treatment that will best serve the patient’s interest.