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When Three Threatens Two

Must Parenthood Bring Down the Curtain on Romance?

Esther Perel

By Esther Perel - Sex makes babies. So it is ironic that the child, the embodiment of the couple's love, so often threatens the very romance that brought that child into being. But the brave and determined couple who maintains an erotic connection is, above all, the couple who values it. They know that it's not children who extinguish the flame of desire: it's adults who fail to keep the spark alive.

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The Young and the Anxious

When Worried Clients Swing Back, What's Your Role?

Lynn Lyons

By Lynn Lyons - Lately, I’ve become aware of just how much of my practice is made up of young adults who return to therapy after leaving the nest. This pattern is also indicative of a generation of young people stuck in the transition between childhood and adulthood. Here's what I do with "long-term" clients who swing back.

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Treating Self-Harm

Here's a Behavioral Contract That Clients Can Stick To

Lisa Ferentz

By Lisa Ferentz - I used to think that repetitive self-injury could only be seen as pathological, and through contracts and other means tried to convince my clients that this behavior would only cause more problems. Now, I know that my job isn't to browbeat clients into change, but introduce them to healthier behaviors that bring the relief cutting often provides. Here's a little bit about the behavioral contract I use.

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Coping and Learning After a Client's Suicide

A Therapist Reflects on What He Might Have Done Differently

Frank Pittman

By Frank Pittman - I've been in full-time private practice for almost 30 years. In that time, three patients in my practice killed themselves. Each suicide has left me shell-shocked and questioning my therapeutic attitudes and methods. I did not expect Adam to be one of my casualties.

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Two Guidelines for Keeping Your Therapy Business Afloat

Strategies for Making Sure Therapy Clients Stick to Payments

Lynne Stevens

Money is an underdiscussed topic in graduate programs, supervision and peer groups, yet every therapist I know has felt the awkwardness of seeming mercenary when insisting to a client who has fallen behind that he or she needs to pay. Unfortunately, most therapists were never coached about how to reconcile the closeness of the therapeutic encounter with the fact that therapy is also a business. These days, I run into the problem of clients who don't pay far less frequently than I used to. I attribute this to two changes I've made.

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When the Therapeutic Alliance Makes Clients Dependent

When Should We Stop Seeing Difficult Therapy Clients?

David Treadway

After 22 years, I can still see Amy sitting there, cross-legged, with her arms folded across her chest. This case had been emotionally devastating for me. Amy began calling me at home. Then she began making hang-up phone calls, started cutting her wrists again and threatened suicide. Years after terminating therapy with Amy, she called me again, begging for me to treat her. I agreed. She was caught in the vortex once more and, like a complete fool, so was I.

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Creating a Therapeutic Alliance with the Troubled Teen

Matthew Selekman on How to Make Teen Therapy Engaging

Matthew Selekman

Building rapport with provocative teens in therapy can be a challenging task for even the most experienced therapists. A teen client can be a master at putting up the invisible force field while pushing our buttons, or telling us what we want to hear and side-stepping responsibility. Through the years, I’ve developed several engagement strategies that I regularly use, singly or in combination, that have consistently helped me establish a therapeutic alliance with even the toughest teen client.

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Panning for Gold

Michael White is the Ultimate Prospector

Mary Sykes Wylie

Over the past decade, Michael White has developed a worldwide following of both senior therapists and neophytes on several continents who insist he has something vitally important to say that the field needs to hear. But watching him in session is a far cry from seeing one of the recognized lions of clinical performance sweep grandly into the middle of a dysfunctional family circle and in one session transform it into a little kingdom of love and harmony, while being wildly entertaining in the process. Far from it. His pace is measured, even monotonous. Some find it maddeningly slow, the therapeutic persona respectful, solicitous, inquisitive, slightly donnish, almost deferential, the circuitous language an eccentric mix of the folksy and the politically correct.

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Hungry for Connection

10 Ways to Improve Your Therapy with Adolescent Girls

Martha Straus

Working with girls in therapy is what I do with the greatest interest and passion. Like many female therapists who have this specialty, I had my own tough times as a teenager. I have wells of empathy to draw on, and can stay attuned with them more easily than with males, or females of other ages. Our bond is implicit, and by being as fully authentic, connected, and present as I know how, I help them make it explicit. Thus the thoughts that follow are largely informed by my 20-odd years of experience treating adolescent girls and their families. They synthesize what's helped me forge alliances with them quickly and inspire change.

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Mission Possible

The Art of Engaging Tough Teens

Matthew Selekman

Trying to get in the door with provocative, therapy-savvy adolescents can be a challenging task for even the most seasoned of therapists. Some adolescent clients are masters at putting up the invisible force field while pushing our buttons, or telling us what we want to hear and side-stepping responsibility. Through the years, I've developed several engagement strategies that I regularly use, singly or in combination, that have consistently helped me to establish a therapeutic alliance with even the toughest teen client.

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