timing and pacing
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- Опубликовано: 6 сен 2024
- In this video we discuss the vital role of timing and pacing for conducting effective psychotherapy, especially ISTDP. The best therapists take charge of timing and pacing and don't simply follow wherever the patient may Rome. This is particularly important in the opening phase of treatment.
Thankyou for another important video. I think skipping over the enquiry in part comes from the fact that in trainings, ISTDP teachers tend to present the more dramatic videos where there is high levels of pressure towards an unlocking. This gives the trainee the false impression that this is how ISTDP works out of the gate. This is also why trainers showing the early stages of therapy is so important to counteract this trend.
I agree!
Dr Patricia. I saw one of your videos about the second session and i would love a more detailed explanation about how to conduct the second session onwards. Are you able to maybe do a video on that? I love your work. You are an inspiration to me. Thank you
Will do. Keep tuned!
Wonderful as always. Thank you, Patricia!
Thanks for letting me know!
I had a question Patricia. If ISTDP views the therapist as the expert, then why the need to get agreement from the patient about the problem, and how to go about solving it? Shouldn't the "expert" just engage in the therapeutic interventions/approaches that they (in their expert opinion) deem would best help the patient? Why the need for collaboration and consideration of patient's preferences for treatment if we are going in, a priori, with the stance and positionality of being the "expert"? (before even meeting the patient)
These concepts are not mutually exclusive. In fact, the patient's view of the therapist as skillful and competent (as opposed to simply supportive) is associated with high levels of alliance. We also know from research that establishing and maintaining a collaborative alliance is most highly associated with positive outcomes. It is possible to take charge by asking the questions you need answers to, while still working for consensus. If you think about surgery, for example, the surgeon is an expert and the patient needs to trust him or her but at the same time has the option to agree or disagree with the surgeon's recommendations. Does that help?
Thank you, Patricia for this helpful informative video. I was wondering if you have any videos that you might recommend on doing the restructuring work? I'm currently seeing a client that has severe pathology of narcissism and as a trainee therapist it's been quite difficult to conduct dynamic inquiry with this client. so, I guess working on restructuring first might help.
I will appreciate comments.
When resistance is high and interferes with iniquity, you must got to phase II and III - pressing for feelings in the transference and working to turn the patient on the defenses which will prevent therapy from being effective. Those with narcissistic defensive structures are among the most difficult to treat. I hope you are getting expert supervision.