Therapeutic relationship

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Marina
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Therapeutic relationship

Postby Marina » Sun Mar 19, 2006 9:54 am

Therapeutic Relationship

Paradoxes in the Therapeutic Relationship
http://www.gestalt.org/magda.htm

1. The relationship is defined as compulsory in a voluntary framework, as in private practice. That is, the patient is told that he seeks help of his own free will and success depends on his cooperation despite difficulties. Within this voluntary frame the conditions are compulsory whereby the patient must pay, must not miss his appointments, and must not arbitrarily end treatment which he is advised ahead of time would constitute resistance, The reverse is true in compulsory settings as with forcefully hospitalized psychotics where within the compulsory frame the therapist tends to insist that the patient really wants treatment, only he does not know it. In other words, "whichever way the framework of the relationship is initially defined, within that framework it is defined as the opposite"

3. Haley's third paradox concerns the issue of blame. The patient is simultaneously told that he cannot help who he is while the very premise of psychotherapy is based on the notion that indeed he can help who he is. The same applies to significant figures in the patient's life. "His parents are at fault by their mistreatment of him, and yet they are not at fault because they could not help themselves"

4. The therapist presents himself as the expert, but within that framework, he disengages from offering expert advice and puts the responsibility for the proceedings on the patient. In Haley's words, "This formal pattern of directing while denying direction is typical of psychotherapy. The patient cannot follow direction or refuse to follow it when he is faced with both messages simultaneously. Therefore, the methods he has used to provoke direction or oppose it become impotent."

5. The patient is told that the treatment circumstance and the relationship are special and he can be self-expressive as in no other setting because ordinary rules do not apply. As soon as he believes this, he is reproached for not reacting to the therapist as one human being to another.

And finally,

6. The basic framework of psychotherapy is benevolence. Within that framework, the patient is placed through a punishing ordeal which varies with the type of therapy. In other words, the patient gets consistently disapproved of until he spontaneously "changes."

Although the time element does not fit, my fantasy is that Haley read Searles on how to drive somebody crazy and then proceeded to delineate the curative paradoxes in the psychotherapeutic relationship.
- - - - - - - -
One more point on this: The shift from interpretation to confrontation radically altered the therapeutic relationship. Traditionally interpretation has been a rationalistic exposition offered by the analyst to the patient based on the analyst's understanding and conceptualization of the patient's resistances and of the reason, usually instinctual conflict, for these resistances...

Confrontation also entails greater risk for the analyst because his immediate reactive mode is revealed. In other words, a confrontation always says as much about the confronter as it does about the confrontee. The same is not true of interpretation. Then too, since confrontation entails a dialogic relatedness in the here and now, there is no way to assert that the patient is reacting in terms of the past, to someone imagined, who is other than the analyst...

I am aware that it is possible to smile when one is hurt, instead of to cry. In which case we would term the reaction inappropriate. My point, however, is still that the style of the reaction is inappropriate, in this case defensive, but the reaction itself is embedded in the real interaction with the real analyst...

Marina
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Article: What to expect in therapeutic relationship

Postby Marina » Sun Mar 19, 2006 10:27 am

Article: What to expect in a therapeutic relationship

If I quoted it, I would have to quote all of it.

http://www.fmsfonline.org/SingerLalich.html

Marina
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CPS therapeutic relationsip

Postby Marina » Sun Mar 19, 2006 10:51 am

CPS Therapeutic relationship

page 17, Virginia CPS policy manual
http://www.dss.virginia.gov/files/divis ... policy.pdf

"Child protective services intervention needs to be therapeutic and each contact should support the family."

Marina
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Therap. relationship/ social workers

Postby Marina » Sun Mar 19, 2006 11:04 am

Therapeutic relationship/ social workers

Essential boundaries in clinical social work practice (North Carolina)
http://www.nccbsw.org/news2000-essentia ... actice.asp

Would have to quote the whole thing.

Take this one to court.

Marina
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Code of Ethics, Natl. Assoc. Social Workers

Postby Marina » Sun Mar 19, 2006 11:11 am

Code of Ethics, National Association Social Workers

http://www.naswdc.org/pubs/code/code.asp

There are a lot of links to this search.
Try your state and see what you find.

Code of Ethics, Michigan
http://www.ssc.msu.edu/~sw/ethics/nasweth.html

Code of Ethics, mention in regulations, Virginia
http://legis.state.va.us/codecomm/regis ... v14020.doc

Marina
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Code of ethics, addiction professionals

Postby Marina » Sun Mar 19, 2006 11:33 am

Code of ethics, addiction professionals

http://naadac.org/documents/index.php?CategoryID=23

Marina
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Disciplinary actions -- social workers

Postby Marina » Sun Mar 19, 2006 12:37 pm

Disciplinary actions -- social workers

From book, Prudent Practice
http://www.naswpress.org/publications/b ... apter.html


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