The Narrative/Collaborative Process in Couples Therapy:

A narrative approach to couples therapy provides a glance at the emerging postmodern dialogue. This article discusses changes in the therapeutic relationship, content, and process, emphasizing a feminist perspective. The client/therapist relationship is viewed as a collaborative process by which hierarchical distinctions are decreased. Externalization, deconstruction, and re-authoring are described and demonstrated through a clinical vignette. Our own evolving story as couples therapists is also presented.     

Beyond Theory and Practice: A Postmodern Perspective

The insights of chaos theory and postmodernism can be applied by therapists to resolve the apparent conflict between theory and practice. Using the example of the modern scientist, the argument is made that for therapy to have integrity the therapist needs a theoretical foundation. This theoretical orientation, however, is tempered by a postmodern perspective that recognizes the finite nature of all theories. The therapist is encouraged to have a theoretical orientation, but not to become that orientation.     

Ontological and epistemological reflexivity: A core skill for therapists

This paper argues that a core skill needed to be an effective therapist is to have developed an awareness of one's own ontological and epistemological positions in relation to one's work as a therapist. In the same way that researchers need to develop reflexive awareness of their assumptions about what there is to know (ontology) and how they can come to know about it (epistemology), therapists need to be aware of their fundamental assumptions about human beings and the world they live in (ontology), as well as their beliefs about how best to develop an understanding of their clients and the meaning(s) of their experiences (epistemology). Regardless of which therapeutic model is adopted, the language used to talk about (and in) therapy, the kinds of questions asked of clients and the comments/interpretations offered, all presuppose and reinforce particular versions of human being and experiencing, which are themselves not usually questioned or challenged during the course of therapy. It is essential that therapists are aware of their own fundamental assumptions about what it means to be human and that they recognise their ontological and epistemological positions as positions that they are taking (rather than perceiving them to be self‐evident truths). This is important for two reasons: (a) if clients do not share the therapist's assumptions, the therapeutic work cannot proceed and be effective; and (b) without such an awareness, therapists are at risk of unwittingly imposing their own model of the person upon the client which raises ethical issues.     

Navigating Critical Theory and Postmodernism: Social Justice and Therapist Power in Family Therapy

The family therapy field encourages commitment to diversity and social justice, but offers varying ideas about how to attentively consider these issues. Critical informed models advocate activism, whereas postmodern informed models encourage multiple perspectives. It is often not clear how activism and an emphasis on multiple perspectives connect, engendering the sense that critical and postmodern practices may be disparate. To understand how therapists negotiate these perspectives in practice, this qualitative grounded theory analysis drew on interviews with 11 therapists, each known for their work from both critical and postmodern perspectives. We found that these therapists generally engage in a set of shared constructionist practices while also demonstrating two distinct forms of activism: activism through countering and activism through collaborating. Ultimately, decisions made about how to navigate critical and postmodern influences were connected to how therapists viewed ethics and the ways they were comfortable using their therapeutic power. The findings illustrate practice strategies through which therapists apply each approach.     

Writing and Praying Collects as an Intervention in Narrative Therapy

The integration of spiritual practices in therapy is a valuable tool for supporting and reinforcing change. This paper explores the use of a written form of prayer called a collect as an intervention in narrative therapy. A collect is a form of prayer with a structure that can be easily co-constructed by clients and therapists. This spiritual intervention serves as a therapeutic document to help reinforce the externalization of a client’s problem or help thicken alternative narratives. Relevant aspects of narrative therapy and written prayer are summarized. A guide for implementation, examples of collects, and a worksheet for helping clients write collects is provided.

     

Walking in sacred spaces in the therapeutic bond: therapists' experiences of compassion satisfaction coupled with the potential for vicarious traumatization

The therapeutic bond is at the heart of effective therapy, yet few studies have examined therapists' experience of this bond. Using a qualitative study design, this exploratory study examines the experiences of couple and family therapists in relation to their perceptions of the satisfactions and risks involved in the therapeutic bond. The research was conducted using grounded theory methodology and eight in-depth interviews were conducted with therapists working in five counseling agencies in Sydney, Australia. Therapists described the importance of the 3 component parts of the therapeutic bond: the empathic connection between therapist and client; the role investment of the client; and the mutual affirmation experienced by both therapist and client in the therapeutic process. Walking in sacred spaces with the client was seen as both enriching and challenging for the therapist. The therapeutic bond gave therapists intense satisfaction and posed risks for them, especially when working with traumatic client experiences. However, the findings suggest that the experience of compassion satisfaction and the development of vicarious resilience counter-balanced the intense difficulty of bearing witness to clients' traumatic experiences and the potential for vicarious traumatization. The implications for sustaining couple and family therapists in their work are discussed.     

A Narrative Approach to Supporting Students Diagnosed With Learning Disabilities

Students diagnosed with learning disabilities experience many challenges that school counselors may address through narrative therapy. Narrative therapy is a postmodern, social constructionist approach based on the theoretical construct that individuals create their notions of truth and meaning of life through interpretive stories. This article identifies potential challenges students diagnosed with learning disabilities encounter, provides an orientation to narrative therapy, and offers a case example illustrating the application of narrative therapy with this client population.     

Existentialism in a Post-Modern World: Meaningful Lessons for the Counselor

This article advocates a humanities-philosophy model of therapeutic practice that emphasizes empowering and promoting understanding in a client by encouraging him or her to investigate and choose between alternative meaning structures in the context of a trusting human relationship. An integration of existential and postmodern attitudes is proposed as a template for understanding human experience that must underlie the application of all therapeutic procedures.     

Therapists' Use of DBT: A Survey Study of Clinical Practice

The purpose of this study was to examine how therapists conduct Dialectical Behavior Therapy (DBT) individual psychotherapy with clients, focusing on clinical factors that could account for decisions regarding modifications of DBT (e.g., client diagnosis, therapist theoretical orientation, and intensity of DBT training). Additionally, the study investigated how therapists integrate DBT into their primary approach to therapy. Greater adherence to the DBT protocol was reported by therapists who described using DBT with a client with a diagnosis of borderline personality disorder. More frequent use of DBT components (i.e., group skills training, consultation teams, and telephone consultation) was reported by therapists who viewed their therapy as being guided by an applied behavior analysis/radical behavioral theoretical orientation and by therapists who had received intensive DBT training. Most therapists reported using DBT skills in their non-DBT work, with non-cognitive-behavioral therapists more likely to introduce mindfulness skills.     

Keeping It Up

SUMMARY

Clients benefit from an eclectic approach. In the case of a presenting problem such as failure to maintain an erection, the assistance of body psychotherapy in the form of Core Energetics brings additional dimensions to couples work. In this case, only the male partner came to the office; but both benefited from the integration of bodywork into the therapeutic enterprise. The client needed access to his body to incorporate the insights and the skills of other therapeutic work. This article offers a sample of the work.     

Postmodernism in the Post-Confucian Context: Epistemological and Political Considerations

This paper reflects on the implications of postmodern political discourse for East-Asian politics. It argues that the postmodernist deconstruction of modern epistemology and politics provides an opportunity for the reappraisal and rehabilitation of Confucianism in East Asia. First, the paper begins with an account of Cartesian epistemology which undergirds the liberal conceptions of selfhood and politics. Second, it provides a brief history of the Neo-Confucian synthesis and the resulting epistemology based on an intersubjective and ethical understanding of being human. Third, it gives an account of how East Asian thinkers have until recently tried to overcome Confucianism as a way of achieving modernity. Fourth, it attempts to show how the Heideggerian deconstruction of Cartesian epistemology reveals the intersubjective and ethical nature of Dasein which allows for a reevaluation of Confucianism. In essence, this paper describes earlier attempts by East Asians to go beyond modernity and the way they have led to detrimental consequences. It concludes that the current debate should proceed with a more careful and balanced consideration of both modernity and Confucianism.     

A Behavior Analytic Interpretation of the Therapeutic Relationship

The paper examines, from a behavior analytic perspective, the mechanisms through which change occurs within the context of the therapeutic relationship in individual psychotherapy. The analysis focuses upon the therapist’s shaping of the client’s behavior through subtle nonverbal cues and explicit verbal analyses. In the relationship, therapists modify behavior that has created difficulties for the client in the natural environment, and clinical change is dependent upon the extent to which those in the natural environment will reinforce functionally similar response classes. Ferster’s distinction between natural and arbitrary reinforcement and Skinner’s distinction between contingency-shaped and rule-governed behavior are also used to describe the manner through which change occurs. The goal of the paper is to stimulate behavior therapists to look more closely at the therapeutic relationship as a mechanism of clinical change and to help those of other perspectives see how their effectiveness within the relationship can be understood using the principles of learning.

     

Vivid RET II: Disputing methods

Summary In this article, I have outlined a variety of ways in which therapists can make the disputing process more vivid and memorable for clients. I have underlined that tailoring interventions to fit clients' idiosyncracies is most important and have suggested ways of doing this. The point was made that what might work for one client may very well not work for another. In conclusion, I would encourage therapists to adopt an experimental attitude toward their interventions and to continually monitor the effect of them by requesting feedback from clients as Beck et. al. (1979) advocate. This would help therapists to construct, for each client, a profile of the types of disputing tactics that are effective and the types that prove ineffective.     

Honoring Protective Responses: Reframing Resistance in Therapy Using Polyvagal Theory

Therapists often conceptualize resistance as client behaviors that impede progress; this perspective threatens the therapeutic alliance, especially in couple and family therapy where increased resistance and multiple alliances are present. Polyvagal theory reframes and normalizes resistant behaviors as preconscious, protective responses emerging from our autonomic nervous system. The theory also explains how humans reciprocate safety cues to connect with each other; therapists can use concepts of polyvagal theory to manage their own emotional regulation and foster safety and connection in therapy. Polyvagal concepts deepen our understanding of protective behaviors presenting in couple and family therapy; therapists can help couple and family clients to recognize protective behaviors in their own relationships and facilitate safer connection and engagement. Clinical implications are presented: psychoeducation can help clients normalize and understand their protective processes; therapist presence and immediacy acknowledges and normalizes protective behaviors as they arise; therapist and client self-regulation skills support connection; therapist genuineness is a precondition to client safety; and understanding of polyvagal theory enhances assessment of conflict and enactments in couple and family therapy.

     

Methods for Connectedness

SUMMARY

There are prerequisites that must be achieved developmen-tally before individuals are capable of co-creating healthy intimacy in adult relationships. Thus, therapists often have to work to help client systems overcome failures of maturation. In these kinds of therapeutic encounters the therapist acts as a developmental partner. By designing compensatory experiences, the therapist can help partners fill gaps in early development and education that operate to sabotage loving relationships. This paper offers examples of how levels of moral development and social-perspective taking can be utilized within a transpersonal approach to help couples achieve more satisfying intimate connections.     

后现代心理学与现代心理学的对话

当现代心理学正身处众多困境时,后现代心理学者们从新的视角和观点对其展开了攻势,因此在这近十多年里,西方心理学界充满了激烈辩论的声音。文章总结了西方心理学界围绕着后现代心理学这个话题展开的各种对话,包括心理学的认识论、研究性质、研究方法以及后现代心理学的价值等各个方面的讨论。作者在梳理这些对话的同时,对二者的观点进行了论述,其目的是为了更加深入地了解后现代心理学和现代心理学的理论建构,从而推进心理学科的深入研究。     

A solution-focused approach to working with clients who are suicidal

Self-harm and suicide are amongst the most challenging and frightening problems that therapists and counsellors can encounter in the course of their work. The risk of clients harming themselves in the course of treatment can debilitate the therapists from acting creatively and collaboratively, and make their actions defensive, focused solely on risk assessment rather than therapeutic change.Yet it is precisely a creative and collaborative response, such as that engendered by solution-focused therapy and other models, that is the most likely to facilitate change and re-empower clients to take back charge of their lives. This article describes a solution-focused approach to working with suicidal clients that can be used in conjunction with traditional approaches and which focus on establishing safety as well as assessing risk.Working from this model the clinician shifts to identifying client strengths and coping skills, to collaborating with the client to establish meaningful goals and to helping the client envision a positive future. Arguably, such an approach can increase collaboration between therapist and client and lead to a more client-centred safety plan.     

A confusion of tongues between psychoanalysis and philosophy: Is the controversy over drive versus relational theory a philosophical one?

In recent years the controversy over Drive versus Relational models of the psyche has become entangled in a philosophical controversy over epistemology. Some have argued that the Drive model was a relic of an age of positivistic science, while Relational models are a product of a postmodern condition. This paper argues that the controversy need not be a philosophical one, and that Relational views are not, in fact, a product of postmodernism, nor are they necessarily dependent on a postmodern epistemology. Separating the epistemological from the psychological more carefully may help return the debate to its proper, psychoanalytic domain, and perhaps contribute to a more fruitful dialogue across what, at times, seems like an abyss between Relational views and Drive theory.     

The Non-Indian Therapist Working with American Indian Clients

Abstract

The lack of success non-Indian therapists have had in working with American Indian clients has perpetuated a repetitive cycle of poor mental health services with this population. Although we cannot change the historic distrust that exists, we can begin to understand cultural differences and how they can impact treatment to obtain positive results. Acknowledgment of these differences can promote trust, a core ingredient that must be established between the client and therapist. This paper offers guidelines to assist the non-Indian therapist in working with the American Indian client.     

Tales of a Therapist

ABSTRACT

Historically, theorists and clinicians from various schools of family therapy have discussed therapist self-disclosure in terms of either helping or inhibiting therapeutic progress. Although postmodern language-based theorists and therapists accept and encourage its use, few clinical examples of therapist self-disclosure exist in the family therapy literature. In this paper, a postmodern family therapist working within the language-based tradition describes the use of self-disclosures with a couple. The therapist then reviews the effects of those self-disclosures through the eyes of husband, wife, and therapist.