Core Processes in Brief Psychodynamic Psychotherapy: Advancing Effective Practice

Core Processes in Brief Psychodynamic Psychotherapy: Advancing Effective Practice

Core Processes in Brief Psychodynamic Psychotherapy: Advancing Effective Practice

Core Processes in Brief Psychodynamic Psychotherapy: Advancing Effective Practice

Synopsis

Many students enter graduate programs with little or no experience of psychodynamic psychotherapy. Efforts to impart clinical skills have often been less than systematic and beginning psychotherapists have not always been encouraged to think about what they are doing and why they are doing it from a scientific standpoint. Thoughtfully building on current debates over efficacy and effectiveness, this book outlines a promising approach to training in which the work of therapy is divided into tasks patterned after Luborsky's influential delineation of "curative factors"-significant developments in the course of the therapy that are crucial for effective change. Each task step for the therapist-cognitive, behavioral, affective, or a combination-is analyzed, taught separately, and then put in sequence with the other task steps. Curative factors have been extensively studied in recent years and the approach rests on a solid empirical base. The authors are all leading practitioner-researcher-teachers identified with relational models of therapy. They share the assumption that psychological problems arise in the context of interpersonal relationships as the result of conflicting wishes vis a vis others, not necessarily of conflicting intrinsic instinctual drives, such as sex or aggression. Vignettes from their rich clinical experience illuminate the text throughout and an appendix presenting a case that includes an extended session transcript provides some common clinical ground for authors and readers alike. In a climate of increased accountability, clinicians must demonstrate that they are responding to providers' requests to conduct evidence-based practices. Core Processes in Brief Psychodynamic Psychotherapy is an invaluable resource not only for students and trainees, but for established therapists who find themselves asked to justify their work.

Excerpt

All psychotherapy educators aspire to teach evidence-based psychotherapy. They encounter problems, not the least of which is reaching agreement about the meaning of the phrase “evidence based” (Slade & Priebe, 2001). Other problems result from the fact that to advocate one particular evidenced-based treatment over others is to ignore the reality that treatments need to be tailored to the population one is treating. The university where I teach is located in a socially and economically deprived outer metropolitan area. Our clinic patients are mainly from lower socioeconomic circumstances, often from chaotic, disorganized families and with histories of abuse and deprivation. Our clinical trainees rarely get the option of working on prescribed homogeneous disorders or with circumscribed problem behaviors.

This patient group is similar to the one that I worked with in the field prior to becoming an academic. Early in my career I had been known as a neurpsychologist and even as a behavioral psychologist. However, when I accepted a position as a child and family clinical psychologist in a community health service, I quickly found that the skills I had acquired were not sufficient and sought a theoretical framework that could adequately encompass the intergenerational and systemic issues within which I could describe the maladaptive patterns in relating that I observed in many of my patients. To improve my effectiveness, I sought further training in psychodynamic psychotherapy and family therapy, both of which provide systemic and developmental perspectives and means for conceptualizing the complex in a wide range of patients and presenting problems.

When I joined the Department of Psychology at Victoria University, the then Head of Department, Associate Professor Ross Williams, seemingly moving against the tide promoting only evidenced-based cognitive-behavioral therapies, had a vision of instruction in psychodynamic psychotherapy. I was given the task of teaching it, among other things, and was determined to do so from an evidence base. I found that this task was difficult because although the evidence appeared to be there, it was not easily accessible to staff or students. The books that were readily available included ones devoted to specific treatments for specific disorders requiring students to purchase too many texts; conceptual bases for psychotherapies too far removed from actual practice skills; manuals for practitioners written by practitioners with little evidence that their clinical wisdom . . .

Search by... Author
Show... All Results Primary Sources Peer-reviewed

Oops!

An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.