Beyond the One-Way Mirror - Page 4


Is There a Future for Public Sector Psychotherapy?

In the face of such obstacles, how can we transport effective models of therapeutic practice to frontline clinicians? How can we convince administrators and key government agencies to support and fund these efforts? What can we do to make sure that public agencies don't continue to devolve into institutions of dubious therapeutic quality?

In the evidence-based world of today's psychotherapy, the first step is demonstrating that what you do actually works. About 10 years ago, I began to develop a model from the ground up for treating teenagers diagnosed with either oppositional defiant or conduct disorder.

In developing the model, I used process research to identify the essential techniques and strategies in structural and strategic family therapy that led to positive changes in out-of-control adolescents aged 10 to 18. This type of research is so labor intensive that it isn't often conducted in our field. I had to watch hundreds of hours of videotapes to locate and analyze precise moments of change.

I spent an entire summer in the basement of Charles Fishman, one of the founders of structural family therapy, watching tape after tape of his and Salvador Minuchin's work with angry, aggressive adolescents and children. The next year, I approached Jay Haley, the founder of strategic family therapy, and his colleague Neil Schiff. They let me spend hundreds more hours with their tapes. (To better understand how the model was developed, please go to www.gopll.com and click on the link "research effectiveness.")

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