Being Frank about therapy

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We are off to San Diego for The Brief Therapy Conference next Wednesday. I’m tweaking my presentation and thinking about what other workshops I want to go to.

And here’s the dilemma again. Lots of presentations are about technique when technique is not what is responsible for effectiveness. But how do we talk about what we do without talking about the technical aspects?

And so I came back to Frank and Frank 1991, Persuasion and Healing: A comparative study of psychotherapy.

They think the biggest thing therapy does is tackle what they call the client’s demoralisation about the problem, rather than the problem itself. In our world we call that resignation, and create expectancy as it’s antidote.

They think all therapies have commonalities:

A healing relationship
A healing setting
An explanation, true or mythical, to make sense of the client’s symptoms, that the client accepts as real for them.
A ritual treatment that the client believes, or comes to believe will work, and that both client and therapist participate in.

They also think there are commonalities between all rituals (therapies)

A therapeutic relationship that survives the client sharing their demoralisation thereby combating alienation
The therapist maintains expectancy by linking hope to the process of therapy
The therapist provides new learning experiences
The client’s emotions are aroused
The therapist enhances the client’s sense of mastery or self-efficacy
The therapist provides opportunities for practice

But here’s the thing, and it’s a bit like what happened to me when I first read a theory that dogs domesticated humans, not the other way around. My whole world was tipped on its head, and of course I liked it, because that’s who I am. But the best thing was that it changed the way I am with our dogs. Our communication is more expansive. I am more likely to wonder… “How did they get me to do that”

I think an important part of successful therapy is that the therapist does not get demoralised. So I wonder if we apply the commonalities of the rituals or therapies to the therapist, not the client.

The therapist must first believe that their particular ritual can help the client. But what if the client helps that happen.

So if we turn those 6 points on their head:

The client generates expectancy in the therapist by sharing their demoralisation and letting them think they can help.
The client engages in the therapy that the therapist believes in so that the therapist feels hopeful.
Hope in the therapist is increased by the client sharing that they are learning new things.
The therapists emotions are aroused, as they are connected to their passion for their work.
The Client shares their mastery and self efficacy So the therapist feels validated in what they are doing, thereby improving their own sense of mastery and self efficacy.
The client returns with more scenarios for the therapist to practice their therapy.

What do you think?

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2 thoughts on “Being Frank about therapy

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