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How Therapy Enhances Psychopharmacology

Frank Anderson On The Process That Gets A Client’s Body On Board

NP0038: Who’s Afraid of Couples Therapy?

Welcome to our “Who’s Afraid of Couples Therapy?” This exciting series, back by popular demand, is based on our November/December 2011 issue on this topic and will explore the challenges of couples work. What are the most effective strategies in working with couples? How can therapists structure therapy—particularly in the early sessions—so that couples leave with a sense of hope, rather than frustration? Can working with individuals who have serious issues in their relationships actually be detrimental to them? Find out the answers to these questions and much more. In this first session with expert couples therapists Ellyn Bader and Peter Pearson, the creators of the Developmental Model of Couples Therapy, you’ll find out why clinicians often avoid working with couples and how you can better prepare yourself for couples therapy work. How can therapists most effectively work with emotion in the consulting room—particularly when it comes to couples therapy? Learn with internationally known couples therapist Hedy Schleifer how to help create a nourishing connection between partners, define a role as therapist-as-guide, and much more. Schleifer, who’s pioneered the training of Imago Relationship therapists internationally, will go into how to use this theory in practice and how to best work with emotions. What happens when partners in couples therapy have two different agendas in mind? Hear from expert William Doherty on this little spoken about topic. Learn how Discernment Counseling, an approach that helps couples clarify their feelings about the next step in their relationship, can help both clients and therapists. Is it possible to rebuild trust and intimacy in a couple’s relationship after a partner has had an affair? How can therapists help? Hear from Esther Perel, author of the international bestseller Mating in Captivity: Unlocking Erotic Intelligence, on how to help couples after an infidelity and the role that cultural perspectives have in this emotional situation. Explore this classic dynamic of couples therapy—an angry woman and a withdrawn man—that’s often confusing for therapists, with couples therapist Jette Simon. Learn more about what’s behind the feelings of anger and the behavior of withdrawing, and how clinicians can more effectively work with shame and fear of disconnection. Hear an unconventional perspective on couples therapy from David Schnarch, who believes that the best way to help couples is to challenge partners to change their individual behaviors and attitudes. Schnarch’s direct, upfront approach to helping clients will illustrate a different viewpoint on effective couples therapy. Join Marty Klein, a marriage and family therapist and certified sex therapist, us for a candid discussion about the assumptions that both clients and therapists often share that can get in the way of improving couples’ sexual relationships. Discover with Kathryn Rheem how to respond effectively when clients express strong feelings in session. Based on Emotionally Focused Therapy, you’ll explore attunement and how to use your own emotions to help clients move beyond attachment injuries. After the session, please let us know what you think. If you ever have any technical questions or issues, please feel free to email support@psychotherapynetworker.org.

Whole Psychiatry: Alternatives to Conventional Psychopharmacology with Robert Hedaya

Meds: Myths and Realities: NP0035 – Session 4

Is psychopharmacology is a 'go-to' in your practice? Join Robert Hedaya as he discusses how to treat the bodily systems that underlay many mental health issues while avoiding medication. After the session, please let us know what you think. If you ever have any technical questions or issues, please feel free to email support@psychotherapynetworker.org.

Treating the Mixed-Agenda Couple

Bill Doherty On An Approach For Unaligned Relationships

Tough Customers: Is It Them or Us?

Tough CustomersBy Rich Simon As therapists, many of us practice in two different worlds. In the first, we see polite, well-behaved, articulate clients with solid values. They engage fully in therapy, talk cogently about their problems, listen attentively to our responses, make reasonably good-faith efforts to follow our suggestions, and sooner or later get better. No wonder we genuinely like these people!
Clinicians Digest Jan/Feb 2008 - Page 3


Zuckoff and colleague Holly Swartz were especially distressed about the high numbers of depressed African American women who came to their clinic for intake sessions but never showed up for their first therapy appointment. They suspected that the therapists' assumptions about what the clients needed and thought interfered with their ability to listen deeply to the women and draw out their commitment to treatment.

They then became interested in ethnographic interviewing (EI), a technique used by sociologists to interview people of other cultures that helps interviewers keep their own cultural biases from distorting the conversations. They wondered whether they could combine principles of EI and MI to develop an intake session that would help enhance depressed African American women's intrinsic motivation to change.

Zuckoff and Swartz developed a single-session intake session that helps therapists open their ears and clients fully express their ambivalence about therapy. In their small study of the intake model at a community clinic, 23 of 24 depressed African American women who received the session kept their first therapy appointment, while only 7 of 33 who didn't receive the intake session did.

They describe the session in the August Professional Psychology: Research and Practice. Therapists first elicit the client's story, using reflective listening and empathic questioning, and making sure to ask both about feelings--"You're stuck with all these bills and busy all the time. How's that affecting you?"--and the situation--"You've been feeling hopeless lately. What's been going on in your life that might be causing this?" They invite clients to fully air their ambivalence, talking about both their hopes and fears about treatment, and any external barriers, such as transportation problems, lack of child care, or unsupportive spouses. They tie feedback and information to what the client has said, never using it to push or persuade. Finally, summarizing both the situation and anything the clients have said that indicates their readiness to change, they ask whether they'd like to give therapy a try.

The paradox of the MI approach is that clients who fully express ambivalence are more likely to locate their intrinsic motivation to change. "MI is really about therapeutic humility," says Zuckoff. "It helps therapists stay out of their own way."

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