Core Processes in Psychodynamic Psychotherapy: Advancing Effective Practice

Many students enter graduate programmes with little or no experience of psychodynamic psychotherapy. Efforts to impart clinical skills have often been less than systematic and beginning psychotherapists have not always been encouraged to think about what they are doing and why they are doing it from a scientific standpoint.Building on debates over efficacy and effectiveness, this text outlines an approach to training in which the work of therapy is divided into tasks patterned after Luborsky's influential delineation of "curative factors" - significant developments in the course of the therapy that are crucial for effective change. Each task step for the therapist - cognitive, behavioural, affective, or a combination - is analysed, taught separately, and then put in sequence with the other task steps. Curative factors have been extensively studied in recent years and the approach rests on a solid empirical base.The authors are all leading practitioner-researcher-teachers identified with relational models of therapy. They share the assumption that psychological problems arise in the context of interpersonal relationships as the result of conflicting wishes vis a vis others, not necessarily of conflicting intrinsic instinctual drives, such as sex or aggression. Vignettes from their clinical experience illuminate the text throughout and an appendix presenting a case that includes an extended session transcript provides some common clinical ground for authors and readers alike. In a climate of increased accountability, clinicians must demonstrate that they are responding to providers' requests to conduct evidence-based practices. This work should be a useful resource not only for students and trainees, but for established therapists who find themselves asked to justify their work.