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Making Your Therapy Practices Stick

Four Steps to Help Clients Master Exercises Used in Session

Donald Altman

By Donald Altman - Perhaps the most important aspect of engaging your clients with practices and handouts is to listen to their feedback. What are the challenges? What is most helpful? How clear are your instructions? Here's a four-step approach to help your clients master practices used in session.

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Is Therapy About Transformation, or Small Breakthroughs?

Learning to Separate Our Hopes for Our Clients from Their Goals for Themselves

William Doherty

By William Doherty - Are therapists more like shamans or family doctors? Explorers of human depths or more like Siri on your iPhone, just directing you from one place to another? I'm a skeptic about whether any clinical approach is good at getting clients consistently to the promised land of transformation. Maybe therapy is better understood as being about breakthroughs—small, medium, and large—rather than about transformation.

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What Do Transformative Therapy Moments Have in Common?

The Surprisingly Simple Way to Get Powerful Results Swiftly and Reliably

Bruce Ecker, Laurel Hulley

By Bruce Ecker and Laurel Hulley - There's a moment that we therapists savor above all. Before our eyes, a shift takes place and the client slips from the grip of a lifelong pattern. Three decades ago, we discovered that what distinguished the pivotal interactions was that we had completely stopped trying to counteract, override or prevent the client's debilitating difficulties.

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A Brain Science Strategy for Overwriting Traumatic Memories

Creating Juxtaposition Experiences to Relieve Trauma Symptoms

Bruce Ecker

What we clinicians have learned in recent years about the intricacies of the brain's implicit memory systems has certainly helped us better recognize the linkage between distressing or traumatic experiences and many of the previously puzzling symptoms clients bring to our offices. But now brain science is beginning ...

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Psychotherapy Enters the Assisted Suicide Debate

Untangling the Controversy Behind the Right-to-Die Movement

Jordan Magaziner, Jordan Magaziner

At a time when medical technology has become increasingly adept at keeping people alive, some people are voicing a feeling within a growing part of the population that the goal may not always be keeping a terminally ill person alive at all costs. But even though there's support for the idea that, under certain circumstances, it might be more humane to help people at the end of life bring about their own death peacefully and quickly, the right-to-die effort is plagued with controversy.

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Preventing Burnout with Micro Self-Care

Rejuvenating Practices for the Burned-Out Therapist

Ashley Davis-Bush

One day while in session, I felt not only overworked and undernourished, but potentially unhelpful, or even damaging, to the people I wanted to help. The dominant advice was simple: do more self-care. Unfortunately, the suggestions, which I’ve since come to call macro self-care, usually seem to require substantial commitments of time, effort, and often money. But micro self-care is available at all times, on demand. Here's an array of brief tools that are simple, free, and doable.

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The Many Reasons Why Therapy Clients Cry

A Clinician's Guide to the Biological Basis of Tears

Jay Efran and Mitchell Green

How can both joyful and tragic events elicit tears? This question puzzles many clinicians, including some who are considered experts in the field of emotional expression. The problem is that few of us have received explicit training in theories of emotion. Physiologically speaking, emotional tears are elicited when a person’s system shifts rapidly from sympathetic to parasympathetic activity---from a state of high tension to a period of recalibration and recovery. And sometimes, clinicians can feel an urge to rush in and “fix things” that aren’t broken.

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Giving Therapy Clients a Little Push for Big Change

Balancing Long-Term Therapy Goals with Instant Remedies

David Waters

What first made me fall in love with being a therapist was the idea that I could make a living by having conversations that cut through everyday pretenses, got directly to the heart of the matter, and helped people change their lives. That was then, and this is now. Today as a profession---and as a society---we're much more fearbound and rule conscious than we used to be. Yet the sacred space of the therapy room is the ideal place to really exercise your creativity. It's taken me more than 30 years to realize that it's the combination of two strange bedfellows---imagination and repetition---that holds the key to change.

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Assessing the State of Psychotherapy

Is Today's Therapy Losing Out to Science and Psychopharmacology?

Mary Sykes Wylie

The bad news was made official in 2010, though everybody in the head-shrink business had long suspected as much: psychotherapy was in decline, or even in freefall. You might think this trend represents people’s preferences for the quick fix of a pill, rather than a slog through talk therapy, but you’d be wrong: surveys have consistently shown that depressed and/or anxious people and their families would rather talk to a real, live, human therapist than fill a prescription. So in what appears to be the twilight of the psychopharm gods, why aren’t therapy practitioners rising up, throwing off their chains, and reconquering lost mental health territory?

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Embracing Creativity and Play in Therapy

Taking Risks in the Therapy Room to Create Change

David Waters

In these days of Managed Care and Therapeutic Minimalism, my biggest concern about therapy is that we don't ask enough of it. Too often, we don't push ourselves or our clients hard enough to make the changes that make a real difference in people's lives. It's taken me more than 30 years to realize that it's the combination of two strange bedfellows---imagination and repetition---that holds the key to change. To move clients out of their ruts, their numbness, and their stuck places, we need to get their attention and start their adrenaline going at a rate that wakes them up and helps them to experience the fullness of life again.

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