Chapter
Being a bit more practical about concerns
What do these illustrations show about reasons and concerns?
Concerns about the therapeutic relationship
Evidence-based approach to concerns
Whose concern is it anyway?
Is the client always right?
Concerns as we tell them to others
Consensus or conflict between therapist and client?
What is psychotherapy after all?
Truthfulness, honesty and effectiveness
The client’s treatment values
3 What life means. Emotional flavour
Why give emotions such importance? What about relationships?
How to act when plans fail
Maintaining the social bond
Making decisions, particularly ethical decisions
I in the interpersonal domain
Projection and emotional meaning
Strong emotional meanings
Strong emotors and the fear of extinction
Emotional meaning and choice
Identity and emotional meaning
Projective identification and strong emotors
4 Narrating the treatment: the formulation, reformulation and therapeutic contract
Exercise: how are your interviewing skills?
Constructing a therapeutic narrative
The struggle of narratives
Splitting and narrative coherence
The therapist’s responsibility for the narrative
Narrative types in psychotherapy
Formulation and reformulation
Issues in third-party contracts
Collecting information of relevance to the organization
The duration of treatment
Reporting on outcome to a third party
Issues about the treatment contract with the client
The relationship with the therapist
Assessment and treatment carried out by different psychotherapists
The duration of treatment
What the therapy is expected to bring about
Who is responsible for the treatment working, and who brings it up if it is failing?
What are the limits of treatment confidentiality?
The ethical framework under which the treatment is being carried out
Narrating a self that is convincing to others
The significance for psychotherapy
Boundaries, shame and disgust
The effacement of the ‘I’: catastrophic reactions
6 Procedures for gaining relief
Non-specific distress-relieving factors
Relaxation, breathing control and imagery
Relief of future symptoms
Common features in symptomatic treatments
Actions, beliefs and appraisals which exacerbate symptoms
Testing beliefs about treatment and self-treatment
The crucial role of meaning
7 Resolution: finding out what’s doing this to me
Interpersonal, exploratory, dynamic, analytic...
Supportive, expressive, person-centered problem solving
Personal constructivist, cognitive-analytic, applied relationship theory
Family, systems, networks
Relationship or couple therapy
8 Universal technique for resolving predicaments
Speaking, or thinking, aloud
The eyes of the therapist
9 Relinquishment and releasement: changing something about me
Changing values through addiction
The emotional meaning of Lucy’s anorexia
First steps in treating addiction: addressing the craving
Dissociation and deception
10 Re-narration: finding happiness
The unspoken and the unspeakable
Why is some therapy long-term?
Issues raised by transference
Which justifications are justified?
What should we make of resistance and transference?
An alternative account of resistance and transference
Interpreting the unconscious: trumping the ace
What is long-term therapy again?
Identity and value in long-term therapy
Shame and disgust: the other story
The short story about long-term therapy
11 Crises, and how to surmount them
General principles of managing crises
Attribute everything that happens to the effects of the therapy unless proven otherwise
Re-consider the focus of the treatment
Review the therapeutic relationship
Some specific crises considered
Falling in love with your client, and other kinds of acting out
Making demands on the therapist
Appendix: confidential record
Psychotherapy and Counselling in Practice
：A Narrative Framework
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