Clinician's Digest

Clinician's Digest

By Garry Cooper

September/October 2010

From the time of Sigmund Freud, a core belief in the therapy profession has been that clinicians should be trained rigorously in a specific technique and orientation to keep treatment on track. But two recent studies conducted half a world apart suggest that, irrespective of their specific training, most therapists pay more attention to making and maintaining a connection with their clients, especially when treatment doesn't seem to be working.

A study led by Christian Moltu of Helse Forde, a governmentally-run Norwegian psychiatric clinic, reported in the May Psychotherapy Research, finds that, when the going gets rough, clinicians focus far more on repairing the therapeutic bond than on diagnosis and technique. Moltu's team asked 12 highly experienced therapists from different orientations to select one extraordinarily difficult therapy impasse they'd encountered, and then had in-depth discussions with them about what they'd felt during the impasse and how they'd dealt with it. Every therapist in the study—cognitive-behavioral, psychodynamic, psychoanalytic, and body-oriented—reported they felt negative feelings toward their clients during impasses. But rather than thinking diagnostically about them or relying on specific treatment interventions, they'd worked through these difficulties by striving to find their way back into a supportive, empathic connection with their clients.

"If you have only technique to fall back on," a psychoanalytic…

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