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CHAPTER FOUR: Creating potential for repair and growth in the brief therapies

Wake, Lisa Karnac Books ePub

Creating potential for repair and
growth in the brief therapies

The recent advances in neuroscience have enabled an understanding of the potential for repair and growth of neural synapses in psychotherapy work. Yet, it is clear that we are only just beginning to scratch the surface of what can be done within the therapy context. Many of the brief therapies include elements of neuroscience, and certainly some of them are able to provide empirical evidence of their effectiveness in working with a range of psychological disorders.

In this chapter, I summarize the main brief therapies and review the potential of neurological growth and repair that exists within each of them.

The chapter concludes with a contribution from Betty Alice Erickson, Milton Erickson’s daughter. Betty Alice is a licensed Professional Counsellor, Marriage and Family Therapist, and works in private practice in Texas. She has authored numerous books and articles on Ericksonian therapy, and in this chapter, she summarizes Erickson’s work with children with anxiety disorders.

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CHAPTER TWO: The inner world of the client through the brief therapies

Wake, Lisa Karnac Books ePub

The inner world of the client
through the brief therapies

Introduction

This chapter integrates the current understanding within the brief therapies of core belief structures, sense of self, and internal processes, and links these to the theories of object relations and the later development of attachment disorder.

One of the challenges that the brief therapies face is the ability to demonstrate effectiveness of therapy in relation to outcomes, and, where brief therapies have evolved from the more traditional approaches, to gain recognition, respect, and credibility with the longer-term psychodynamic and analytic approaches.

In reviewing some of the underpinning theories of psychody-namic and analytic approaches, my intention is to present alternative and briefer therapeutic interventions to specifically respond to attachment-based problems.

Most brief therapies aim to affect the subjective relationship that a client has to their current reality. In considering the underlying principle of object relations theory that later informed the development of attachment theory, it is clear that Klein (1928) worked to alter the subjectivity of relationship to the internal object, viewing the client as a “subjective agent within a subjective world of relationship, conflict and change” (Gomez, 1997, p. 34). This resonance with the subjectivity of relationship, which is an inherent component of many of the brief therapies, is also found in the work of other, later object relations and attachment therapists, such as Winnicott, Fairbairn, and Bowlby.

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CHAPTER THREE: Attachment theory and recent developments in neuroscience

Wake, Lisa Karnac Books ePub

Attachment theory and recent
developments in neuroscience

As the previous chapter and research included within it have argued, the sample of brief outcome-orientated therapists interviewed were working with the attachment relationship. They were also describing some of the concepts that are present within attachment theory and its predecessor, object relations theory. Whether these concepts are common across all therapists is open to debate and feeds into the Dodo verdict (Stiles, Shapiro, & Elliott, 1986): that all therapies have equivalently positive outcomes. It may well be that as the understanding of neuro-science develops, it will be possible to measure the effect that empathy, alliance, and collaborative involvement (Stiles, Barkham, Twigg, Mellor-Clark, & Cooper, 2006) has on determining the outcome of therapy. However, as there is little known about the direct impact of the therapy process on repairing neurological deficit regarding attachment processes, my aim is to add to the debate from the perspective of the brief therapies.

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CHAPTER FIVE: Outcome orientation as a model of psychotherapy

Wake, Lisa Karnac Books ePub

Outcome orientation as a model
of psychotherapy

Goal orientation and outcome focus is a common component of each of the brief therapies described in this book. Each therapy approaches goals and outcomes differently, and some approaches will focus only on the outcome without referring to past related issues. This chapter reviews the outcome process of each brief therapy, and then considers stress and arousal responses in regulated and dysregulated individuals. The use of sensory motor stimuli and associated and dissociated states is discussed, leading to an understanding of motivational patterns and goal orientation.

Outcome processes in brief therapy

Cognitive analytic therapy acknowledges and works with past, present, and future states, with the aim being to create more effective ways of responding behaviourally and emotionally in the future.

Cognitive behavioural therapy operates in the here and now to gain insight into the relationship between thoughts, feelings, and behaviour. The approach includes clear strategies, goals, and timescales for developing psychological and/or behavioural skills. Goal orientation is in the immediate future.

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CHAPTER ONE: The purpose of the book

Wake, Lisa Karnac Books ePub

The purpose of the book

Within the brief therapy field, there is a plethora of books on the “how to” of each approach, most of which are effective at demonstrating the approach. Many of the therapists who are recognized within the brief therapy field originated from psychodynamic or systemic schools, having moved across to what they identify as briefer, more respectful, outcome-orientated approaches. Only a few of the publications in this arena are underpinned by theory, research, and evidence-based practice, yet the therapies appear to work.

With the increasing understanding of neuroscience and developmental theory, there is now the opportunity to make the links between these therapies and those that are grounded in a more psychodynamic approach, specifically for attachment disorder and related problems. By adding to the understanding that exists in the field, and supporting this through grounded research, brief therapy may then take its place as a therapy equal to those that have been long recognized in the psychodynamic world.

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