Popular Topic - Challenging Clients & Treatment Populations

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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.

The Good, the Bad, and the Ugly

Turning Ambivalence into Possibility

January/February 2003
At the most basic level, we must discover how to perform the balancing act of simultaneously giving up the need to see clients change while holding open the possibility of change.

The Pragmatics of Hope

What to Do When All Seems Lost

January/February 2003
We frequently assume that all clients must feel hopeful and believe that life is meaningful before they'll make much progress in therapy or in life. But in the wake of catastrophe, it's often impossible to summon up the least glimmer of hope or faith or sense of life's meaning. To clients who have suffered profound trauma, it's ludicrous to suggest that they can be coaxed into feeling hopeful about the future. But sometimes, the simplest act can have profound power.

My Most Spectacular Failure

Voluntary Simplicity Meets Shop Til You Drop

November/December 2000
I will never forget the Correys, who were referred to me by their family doctor in western Nebraska. Every other week for a year, I saw them, during which time I tried pretty much every trick in my therapeutic arsenal. I spent hours discussing their case with trusted colleagues and read up on their particular problems. I don't know how many nights' sleep I lost worrying about how to get these folks on the right track. And in spite of all my efforts, the Correys were one of my most spectacular failures.

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.

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.

In Consultation

Breaking the Chain of Resentment: How to Help Clients Move Past Old Wounds

November/December 2015
How do you strike a balance between validation and empowerment in helping those afflicted with chronic resentment?

Moments of Meaning

Unexpected Lessons from Practice

September/October 2015
Three clinicians share stories of challenging cases that show how the most surprising outcomes often have nothing to do with therapeutic brilliance or technical wizardry.

In Consultation

Don’t Hit Your Sister! Understanding the complexities of moral development

September/October 2015
How to help the concerned parents of aggressive kids understand the complexities of moral development.

Point of View

Smart Growth: Developing a mindset for life

September/October 2015
A conversation with motivation expert Carol Dweck on the importance of the “growth mindset” and how to enhance people’s ability to tackle adversity and persevere.
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