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CHAPTER FOUR: Jointly agreed strategic focus: contract part I

Penny Rawson Karnac Books ePub


…In this chapter I return to importance of the focus in brief therapy and of holding the client to the focus. I also elaborate on the idea of the strategic focus.

Earlier in the book I have outlined ways to find the focus in the first session. In subsequent sessions it is important to allow the the client a little time to say where they are since the last meeting, to ‘arrive’ and to get off their chest anything that is impeding them from going straight into the work of the contract. This might simply be done by asking if they are ready to continue with the agreed contract or whether there is something more pressing on their minds. I usually allow a client up to ten minutes for this, if needed, and then would check whether we stay with the new topic or continue with the previously agreed work. They may be quite ready to go on straight away with the contract, and some do continue almost as if the previous session were five minutes ago. For others, the events of the week may be powerfully acting on their lives and distracting from the focus. By checking if these now

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CHAPTER SIX: What can I do to help the bereaved?

Penny Rawson Karnac Books ePub

Be aware of what can happen in bereavement

It can be a great help if you are aware of what a grieving person can go through, so you yourself may wish to read up about grief and bereavement, not just the earlier pages here, but other books also. In this way you may be able to be more understanding when, perhaps, someone seems to be irrationally angry for a while, as happens, or keeps dropping things. (You will recall from Chapter Two and the list of effects of grief that muscles are affected.)

Some of the ideas outlined in Chapter Five could also be suggested, and perhaps you could work along with the bereaved with some of the ideas. They may also spark off other ideas that are more suitable for your friend. My suggestions are just examples.

At a time of loss it is so hard for the one grieving to make the move, so don’t hesitate to make the offer, to issue the invitation. The last thing the bereaved need is to be ignored, abandoned, left to get on with it because we don’t know what to say or how to say it. Some cross the road rather than meet the person who has suffered a bereavement. In doing this they exacerbate the bereaved person s sense of loss. Often the bereaved person finds that they are having to reassure others about their own loss. How back to front this is, and yet it is so often the reality. We certainly need to be tactful, sensitive to what people want and need. We can but ask! Is it so difficult to say, What would help? , and I am so sorry , or to give a hug if that is appropriate? If the person simply does not know, can we not try to see if there is some way to help.

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CHAPTER TEN: Review and what next?

Penny Rawson Karnac Books ePub

What has been covered?

In these pages I have encompassed the material that would normally be presented in a three-day course to give practising therapists a working idea of the basics of brief psychodynamic psychotherapy. I have briefly covered all the points in the following summary, which is repeated in the quick reference notes at the end of the concluding chapter for the reader’s convenience as a final summary.

Brief psychodynamic psychotherapy

Experience required of the therapist Motivation on the part of the client

—  Understanding of psychodynamic principles.

—  Importance of the first session.

—  Therapy as short as client need allows.

—  Early establishment of the therapeutic alliance.

—  Therapist attitude.

—  Teaching.

—  Enabling clients to become their own therapists.

—  Activity.

—  Focus.

—  Flexibility and fusion.

—  Incisiveness.

12.  The sensitivity of the therapist in order to be in tune with the client.

Hope » Involvement » Intensity » Magic

—  Client is capable of being own therapist

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Penny Rawson Karnac Books ePub

To conclude, then, I have presented the reader with a basic guide as to the key concepts in the practice of brief psychodynamic psychotherapy. This is a brief psychody-namic method that deals with the past through the present, in order to improve the present and future. It is not a superficial, sticking plaster approach. I have not laboured aspects of transference or countertransference, nor other basic aspects of therapy in general, since these are part of the knowledge I would expect of the experienced therapist. Rather, I stress aspects such as activity, flexibility, and the fusion of skills, an agreed focus and time span for the work, and the importance of the first session, all of which can enable the work to move on more swiftly. These aspects were stressed in turn by the earlier proponents of the brief method. One recalls that most of the early proponents were analysts, so the stress on these aspects was really very innovative. In the above pages I have attempted to highlight the key issues and to demonstrate how these ideas can be incorporated into the brief work in practice.

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CHAPTER FOUR: Findings from the initial cycles of analysis

Penny Rawson Karnac Books ePub

This chapter reports the findings from the first phase of the analysis. It is organized as follows:

Section A. Summary of fieldwork

Section B. The empirical data

i) Key themes from the analysis of my selected cases

ii) Key themes from a combination of my own cases and those of colleagues

Section C. The data emerging from the literary sources

i) Key proponents

ii) The developmental context of brief psychodynamic therapy

iii) The key themes emerging from the literature

Section D: Empirical data: key themes from analysis of the cases against themes from literature

Section E. Reflections on the initial findings

Section F. A reflective process to select key themes for further analysis

Section A. Summary of fieldwork

The first stage was to undertake case work that would become the focus of detailed analysis. Eleven cases were examined in total, eight from my own college practice, two from a colleague within the same college and one case from another therapist (AM) in private practice. The rationale for the way that the case material has been used and presented has been discussed in the last chapter. In summary Case “I” is to be seen in full in Chapter 6 and extracts from the other cases are used in the detailed examination of the key themes. Three commentaries written by the clients also appear in full in Chapter 6, Clients M, C and “I”.

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