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Cognitive-Behaviorism Comes of Age

Grounding symptomatic treatment in an existential approach

January/February 2002
Helping her make a connection between her emotions and the traumatic event was an important milestone for Celeste, because it enabled her to viscerally experience her human vulnerability. This emotional work prepared the way for examining Celeste's schemas, a major intellectual component of contemporary cognitive therapy. Schemas are templates--learned ways of filtering and structuring incoming experience.

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Deep from the Start

Profound Change in Brief Therapy Is a Real Possibility

January/February 2002
In much long-term therapy, breakthrough experiences seem to come almost randomly, and then only after months or years. In briefer therapies, on the other hand, deeply rooted emotional realities are often ignored altogether in favor of "reframes" and other forms of cognitive or behavioral change.

Magazine Article

The Art of Commitment

Dissolving Power Struggles in Couples Therapy

September/October 2001
In working with approximately 3,000 couples during the past 20 years, we have made several discoveries about commitment that made I profound difference in how we view the whole therapeutic enterprise. Here's what we found.

Magazine Article

Psychotherapy's Soothsayer

Nick Cummings Foretells Your Future

July/August 2001
Suddenly, sometime in the mid-1980s, as the managed care revolution raged around them, therapists emerged as if from a dream to find that terms like "heath care delivery systems," "covered lives" and "capitated health plans" had gone from being mind-numbing policyspeak to urgent pocketbook issues.

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The Future of Psychotherapy

Beware the Siren Call of Integrated Care

July/August 2001
The age of integrated care is upon us, and psychotherapy may soon be incorporated in a way that will profoundly affect how and where it is practiced. But what will this new system really look like? How will therapists—and the therapeutic process—fit into it? What values will lie at its core?

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Revolution on the Horizon

DBT Challenges the Borderline Diagnosis

May/June 2001
Ever since it was coined 60 years ago, the term "borderline" has referred to a category of seemingly intractable clients whom many therapists consider the bane of their existence. Now, psychologist Marsha Linehan has developed a treatment approach, Dialectical Behavior Therapy, that is transforming treatment for them.

Magazine Article

The Anxious Client Reconsidered

Getting Beyond the Symptoms to Deeper Change

May/June 2001
To the ordinary observer, people who are rude in a restaurant, obnoxious at their child's soccer game or overly exacting of their employees might seem simply self-centered. But often, these individuals are dealing with a wide variety of inner phantoms.

Magazine Article

New Rules for Working with Adolescents

Getting Through

May/June 2001
Adolescence has changed dramatically over the last two decades, and therapists will have to revise the way they work if they want to break through the wall that separates adults from teens. While the fundamental therapeutic skills--joining and motivating clients, listening actively and intuitively, clarifying issues and relationship patterns--are as relevant to successful therapy as ever, there are new applications for those skills that can make therapy more effective with today's crop of adolescents.

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The Wall of Silence

Reinventing Therapy to Reach the New Teens

May/June 2001
Lauren's mother, Margaret, loathed her 14-year-old daughter's weird new look--hair dyed bright orange, pierced eyebrow, Dracula makeup. But though Lauren looked bizarre and tended to stay out too late, she hadn't ever gotten into any real trouble. She was doing fine in school and seemed pleasant enough at home. Remembering the awful screaming fights with her own parents as a teen during the '60s, Margaret tried hard not to antagonize Lauren and to be understanding.

Magazine Article

Creating the Good Divorce

Tools of the Trade

March/April 2001
The fundamental goal of a good divorce is simple yet challenging: children must experience their parents as a working partnership that reliably nurtures and protects them, regardless of how estranged the parents may be from each other. In this sense, the family as a parenting system continues.

Magazine Article

Judith Wallerstein and the Great Divorce Debate

Are the Unions the Answer to Managed Care?

March/April 2001
Judith Wallerstein, now 78, is the grand dame of divorce researchers; she's been studying the impact of divorce on children for 30 years, since the modern American divorce boom was launched in California in the early 1970s. She's troubled by what she's seen, but she insists the Times headline, which pegged her as a "Resolute Adversary of Divorce," is a serious distortion of her actual views.

Magazine Article

Beauty Resurrected

Awakening Wonder in the Consulting Room

January/February 2001
Many walk into the therapist's consulting room exactly at the moment, and because of the moment, that they have been stripped to the core of their being. While not at the physical meeting-point of life and death, they are often at its emotional and spiritual equivalent. One element they seek and are desperate for, one element they usually feel they've lost, is beauty; they present a situation that's cut them off from experiencing beauty. They may not articulate it that way, but that's what's going on.

Magazine Article

How Involved Is Too Involved?

Twenty-two Years and Still Wondering

November/December 2000
After 22 years, I can still see Amy sitting there, cross-legged, with her arms folded across her chest and her dirty blond hair falling down over her face. She was perched on the hood of my car. It was 9:00 p.m., and I was just leaving my office. Amy glared at me as I approached. Our therapy session had ended five hours earlier.

Magazine Article

A Matter of Life and Death

When the Therapist Becomes the Survivor

November/December 2000
I've been in full-time private practice for almost 30 years. I've seen maybe 10,000 families. In that time, three patients in my practice killed themselves. Strangely enough, the three suicides were eerily similar. Each suicide has left me shell-shocked and questioning my therapeutic attitudes and methods.

Magazine Article

Small Winnings

Learning from a Therapist's Nightmare

November/December 2000
Perhaps it isn't surprising that the challenging case that ambles through the thickets of my mind is Brian Stanley, a furious and terrified 11-year-old boy I've known well for six years and am still wrangling with every couple of weeks. Befitting my more deliberate gait, ours is a story of incremental healing and occasions for small hope.

Magazine Article

The Godfather Strategy

Finding the Offer a Client Can't Refuse

November/December 2000
After 20 years of teaching therapy, but not doing it myself, I decided I needed a lesson in humility. What better way to experience humility than to be a therapist? So I started a small practice that basically consisted of taking on the cases that, for a variety of reasons, other therapists couldn't handle: sexual violence, heartbreaking drama, money problems, celebrities. And I was quite successful, to the point that the lesson in humility was escaping me. Until I met Bob.

Magazine Article

Therapist, Colleague, or Friend

Stretching the Boundaries of the Therapeutic Relationship

November/December 2000
The agency transferred him to work with me as an AIDS educator, seemingly unconcerned that we were now simultaneously therapist and client, supervisor and volunteer and, increasingly, work partners. Nothing in my prior training or experience had prepared me for this tangle of relationships.

Magazine Article

Everyday Courage

Helping Anxious Clients Open the Door to Uncertainty

September/October 2000
After two decades of working with people suffering from phobias and other expressions of disabling fear, I still remember clearly two clients whom I met more than 15 years ago.

Magazine Article

How to Prevent Relapse

Treatment Strategies for Long-Term Change

September/October 2000
I notice that many of my couples clients do well in therapy, only to return with the same or similar problems in a few months. What can I do to make the effects of treatment last?

Magazine Article

The Four Most Common Mistakes in Treating Teeens

And What You Can Do About It

July/August 2000
Any therapist treating domestic violence takes one look at a husband who is dominating and abusing his wife and recognizes that he exercises power over her. Yet, when a teenager threatens, dominates by shouting and imposing guilt and controls her parents by threatening to run away, too many therapists fail to realize that abuse is going on.

Magazine Article

The Breakthrough

Waking Up to Life in a Mind-Body-Spirit Group

May/June 2000
On the day I understood that something had to change, I was sitting in a newspaper editorial meeting, feeling the slight, probing pressure behind my right eye that signaled the onset of a migraine headache. Stay cool, I firmly told myself. You can handle this. "Handling this" meant doing what I had been doing for the past 18 years or so of persistent migraines--dosing myself with drugs and resolutely pretending to be fine.

Magazine Article

Exposing the Mythmakers

How Soft Sell Has Replaced Hard Science

March/April 2000
Emotional suffering, according to a new view, is a genetic glitch, successfully treatable by drugs. Depression is no longer thought to be shaped by such diverse forces as a sedentary, lonely or impoverished life;

the loss of love, health or community; "learned helplessness" or feelings of powerlessness arising from unsatisfying work or an abusive relationship. Its resolution no longer requires anyone to get meaningful support from others, to establish a collaborative relationship with a good psychotherapist, to draw on community resources, or for communities to address conditions that breed depression.


Magazine Article

Getting Real

Candor and Connection with Adolescents

September/October 1999
Carl was a 17-year-old client of mine whom I always hoped would stand me up. Ten or twelve minutes into a scheduled therapy session, when it seemed clear that he had given me the slip, I could actually feel the knot in my stomach begin to uncoil, my shoulders soften, my jaw unclench. Ahhhh, I'd sigh inwardly. Safe for another week.

Magazine Article

Discovering Our Children

The Connection Between Anonymity and Rage in Today's Kids

September/October 1999
Over the last 10 years, as these exchanges are becoming increasingly part of everyday family interaction, it has become apparent to me that a tectonic shift about acceptable behavior is taking place in parent-child relationships throughout the country.

Magazine Article

Been There, Done That

When Clients Resist Your Advice, Hang in There

May/June 1999
What should I do when the response to anything I suggest to a client is, "I've already tried that and it doesn't work"?

Magazine Article
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