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This text provides an accessible, reader-friendly guide to conducting Cognitive Analytic Therapy (CAT) on a one-to-one basis, developed in partnership with service users who have lived experience of CAT.The book will cover the applications of CAT in clinical practice including: assessment; introducing CAT; the main concepts and how to build a therapeutic relationship; mapping; the middle phase and the integration of other models; monitoring; developing exits; the ending and saying goodbye. Grounded in CAT theory, the content will be ordered sequentially, as one would conduct the therapy, and will feature first-hand accounts from CAT-experienced service users including their own perspectives on the model and the impact it had on their wellbeing.A straightforward, beginner's introduction to practicing CAT, this book will be useful for trainee practitioners, assistant and trainee clinical/counselling psychologists, and those practising CAT-informed therapy in supervision.

Deliberate practice exercises provide trainees and students opportunities to develop a more multicultural, intersectional approach to psychotherapy and hone their own personal therapeutic style. These exercises present role-playing scenarios in which two trainees act as a client and a clinician, switching back and forth under the guidance of a supervisor. The clinician improvises appropriate and authentic responses to client statements organized into three difficulty levels—beginner, intermediate, and advanced—that reflect common client questions and concerns. Each of the first 12 exercises focuses on a single skill, such as developing cultural self-awareness and cultural humility, exploring cultural implications and explanations of clients'concerns, responding to resistance, and repairing culturally based ruptures in the working alliance. A comprehensive mock therapy exercise follows in which these essential skills are brought together into a single multicultural therapy session. Step-by-step instructions guide participants through the exercises, identify criteria for mastering each skill, and explain how to monitor and adjust difficulty. Guidelines to help trainers and trainees get the most out of training are also provided.

“A much needed and long-awaited book. An important read for all wishing to succeed in their training.” Professor John Nuttall, Regent's University London and Chair of West London Centre for Counselling, UK“This is an eminently useful and accessible book for anyone considering embarking on counselling and psychotherapy training. I can recommend it to anyone considering training, or at the beginning part of their journey.”Dr Biljana van Rijn, Metanoia Institute, UK“This beautifully structured manual serves as a companion to navigating the complex and multi-layered journey of a therapy training. It adds an invaluable contribution to any reading list for Counselling and Psychotherapy trainings.”Sue Healey BACP Accredited Counsellor, Counselling TutorHow to Succeed in Your Counselling and Psychotherapy Training is an accessible and friendly guide for new trainee counsellors and psychotherapists. It outlines the difficulties that a new trainee may encounter and provides guidance on the main aspects of the training journey, both in the classroom and in a clinical placement. As well as excerpts from trainees who have shared their experience of the training journey this book includes guidance on:• The full cycle of training – from choosing a training to the post qualifying year• The key components of clinical practice – starting work in a clinical placement and how to make the most of supervision• The essential aspects of training – from development of reflective practice to competency in assessment• How to develop a therapeutic presence, the ability to work with a client's feelings and how to communicate and work within the therapeutic relationshipThe book is structured so that readers can dip in and out of chapters depending on their current needs or interests. Additionally, there are self-reflection exercises throughout to help stimulate thinking and to prepare the reader for supervision.Cecilia Jarvis is a UKCP registered psychotherapist. Cecilia has over thirty years'experience of being a trainer and clinical supervisor in the field of counselling and psychotherapy. She was the co-founder of The Professional Diploma in Integrative Counselling at the Mary Ward Centre, London, UK.

Deliberate practice exercises allow students and trainees to rehearse foundational dialectical behavior therapy (DBT) skills and strategies to respond effectively and flexibly to diverse, complex clinical presentations and situations. Each book in the Essentials of Deliberate Practice series contains customized role-playing exercises in which two trainees act as a client and a therapist, switching back and forth under a supervisor's guidance. The trainee playing the therapist improvises appropriate and authentic responses to client statements organized into three difficulty levels—beginner, intermediate, and advanced—reflecting common issues encountered by DBT practitioners. The first 12 exercises each focus on a single skill, such as validating clients, encouraging commitment to therapeutic goals, teaching problem-solving skills, and working with clients in crisis or expressing suicidal ideation. Following these are two comprehensive exercises—an annotated transcript and free-form mock therapy sessions—in which trainees integrate essential skills into a single DBT session. Step-by-step instructions guide participants through the exercises, identify criteria for mastering each skill, and explain how to monitor and adjust difficulty. Guidelines to help trainers and trainees get the most out of training are also provided.

This book examines the training and supervision of psychotherapists, with a focus on psychotherapy efficacy and key issues facing psychotherapy training programs today. While some therapists are more effective than others, good training and supervision can provide all clinicians with the skills and tools to become effective practitioners. Considerable research has shown the broad efficacy of psychotherapy, but there are still many clients who do not fully benefit from therapy, some who don't benefit at all, and even some who get worse as a consequence of therapy. The overall goal of training and supervision, and efforts to study these practices, should be to enhance the current degree of effectiveness that has been reached in psychotherapy. This book offers innovative knowledge on how to better understand and improve training by relying on the reflections, research discoveries, and collaborative work of psychotherapy scholars who represent a diversity of theoretical orientations, methodological expertise, and levels of experience.

Deliberate practice exercises help trainees achieve competence in essential psychodynamic therapy skills and apply them in a range of clinical situations while honing their own personal style and language. These exercises present role-playing scenarios in which two trainees act as a patient and a therapist, switching back and forth under the guidance of a supervisor. The therapist improvises appropriate and authentic responses to patient statements organized into two difficulty levels—intermediate and advanced—that reflect common patient questions and concerns. Each of the first 12 exercises focuses on a single skill, such as engaging in a therapeutic inquiry, deepening emotional experience, pointing out defenses, making transference interpretations, and providing corrective emotional experiences. Two comprehensive exercises follow in which trainees integrate these essential skills into a single psychodynamic therapy session. Step-by-step instructions guide participants through the exercises, identify criteria for mastering each skill, and explain how to monitor and adjust difficulty. Guidelines to help trainers and trainees get the most out of training are also provided.

This book provides a clear and concise description of the multifaceted notion of psychotherapeutic competencies, building on years of research and training and informed by a systemic approach. Psychotherapeutic Competencies clearly describes methodological principles to guide both trainees and experienced therapists through the definition of four levels of systemic competencies and illustrates each principle with compelling clinical case material. The book emphasises the need for therapists to develop relational skills, which allow for the consolidation of a trusting relationship in which change can take place, as well as acquiring a set of methods and techniques. Psychotherapeutic Competencies encourages therapists of all levels of experience and therapeutic backgrounds to develop epistemological competency and to deepen their awareness of the extended contexts in which they operate and of the possible effects of their practice at a social and cultural level. This book will be essential reading for psychotherapists of all therapeutic backgrounds, in practice and in training, who wish to enhance their understanding of competency, context, and clinical skill. It will also be a key text for systemic and relational psychotherapists, trainers, trainees, clinical supervisors, and researchers.

www.richardraubolt.comAn intense account of the misuse of power in psychotherapeutic training that offers solutions to this urgent issue.Over the course of his own training in psychotherapy and psychoanalysis, Richard Raubolt came to see that advanced training is more often than not plagued by authoritarian practices, some subtle and many pronounced. It is the contention of Raubolt and his contributors that these practices instill fear and foster blind obedience to the favored proclivities of the leaders of the training institute. In turn, this subservience, which seeps into the therapeutic relationship, prevents both the training candidates and their prospective patients from developing creative, authentic, and meaningful experiences.This is a book written from the perspective of scholars and experienced clinicians who are acutely aware both on a personal and theoretical level of the disruptive role of power games in psychoanalytic institutes. The collection features a highly nuanced and comprehensively developed psychoanalytic understanding of the use and misuse of power, authority, status, and control operating in many traditional and nontraditional training experiences. Finally, new supervisory and training models based on empathy, respect for subjective experiences, and democratic principles are proposed as an alternative to the abusive practices so powerfully described in this book.

Innenansichten eines'unmöglichen'Berufs - Fernab üblicher Therapie-Manuale: Hier steht, was man sonst nicht in Büchern findet oder in der Ausbildung lernt - Auch interessant für: PatientInnen und Interessierte, die Einblicke in die Innenwelt von TherapeutInnen gewinnen möchten In diesen'Briefen'schreibt der erfahrene Gestalttherapeut Victor Chu seinem jungen Alter Ego, der vor 45 Jahren die ersten unsicheren Schritte ins therapeutische Metier machte: Welche Erkenntnisse und Einsichten hat er im Laufe seiner Laufbahn gewonnen? - Warum entscheide ich mich für solch einen'unmöglichen'Beruf? - Was macht einen guten Therapeuten, eine gute Therapeutin aus? - Für welche KlientInnen eigne ich mich, für welche nicht? - In welche Verwicklungen kann ich in der Beziehung zu ihnen geraten? - Wie gestalte ich die'professionelle Intimität'in der therapeutischen Beziehung? - Was tue ich, wenn ich zu viel für einen Klienten, eine Klientin empfinde? - Wie kann ich mich davor schützen, durch die Arbeit mit schwer traumatisierten KlientInnen selbst traumatisiert zu werden? - Wie vereinbare ich Privatleben und Beruf? Chu ermutigt den jungen Therapeuten, mehr auf sich zu hören und sich zu trauen, eigene Wege zu gehen. Besonders wichtig ist ihm dabei die Balance zwischen Privatleben und Beruf. Höhen und Tiefen im Privatleben erweisen sich als wichtige Lernschritte, um ein menschlicher Therapeut zu sein. Dieses Buch richtet sich an: Angehende und erfahrene PsychotherapeutInnen jeglicher Richtung; Laien; KlientInnen/PatientInnen

The Contemporary Relational Supervisor, 2nd edition, is an empirically based, academically sophisticated, and learner-friendly text on the cutting edge of couple and family therapy supervision.This extensively revised second edition provides emerging supervisors with the conceptual and pragmatic tools to engage a new wave of therapists, helping them move forward together into a world of highly systemic, empirically derived, relational, developmental, and integrative supervision and clinical practice. The authors discuss major supervision models and approaches, evaluation, ethical and legal issues, and therapist development. They present methods that help tailor and extend supervision practices to meet the clinical, institutional, economic, and cultural realities that CFT therapists navigate. Filled with discussions and exercises to engage readers throughout, as well as updates surrounding telehealth and social justice, this practical text helps emerging therapists feel more grounded in their knowledge and develop their own personal voice.The book is intended for developing and experienced clinicians and supervisors intent on acquiring up-to-date and forward-looking, systemic, CFT supervisory mastery.

In this 10th Anniversary text, Thomas M. Skovholt and Len Jennings paint an elaborate portrait of expert or'master'therapists. The book contains extensive qualitative research from three doctoral dissertations and an additional research study conducted over a seven-year period on the same ten master therapists. This intensive research project on master therapists, those considered the'best of the best'by their colleagues, is the most extensive research on high-level functioning of mental health professionals ever done. Therapists and counselors can use the insights gained from this book as potential guidelines for use in their own professional development. Furthermore, training programs may adopt it in an effort to develop desirable characteristics in their trainees. Featuring a brand new Preface and Epilogue, this 10th Anniversary Edition of Master Therapists revisits a landmark text in the field of counseling and therapy.

The PsycTHERAPY® Teaching Guide provides practical ideas on how to use APA's video database of streaming psychotherapy demonstrations in a variety of classes, in clinical supervision, and in other training contexts. This guide will be valuable to any psychology faculty seeking new ways to use video to teach concepts and skills in psychotherapy, psychopathology, personality, and psychotherapy research.

Many supervisors need help navigating the most challenging dilemmas and conflicts that arise in supervision of trainees, addressing skill deficits and competency concerns, working through role conflicts, and gender or ethnicity-related misunderstandings. Because these interpersonal conflicts can be so challenging, however, they often represent a golden opportunity for real progress. This book presents a process model with specific strategies—such as exploration of feelings, focus on self-efficacy, and attention to parallel processes—that together enable supervisors and trainees to successfully resolve the problem at hand and achieve lasting success in their careers.

Struggling to secure the right counselling or psychotherapy placement for you? Unsure of how to deal with complex challenges or how to make sure you get the most out of your placement? Then you have come to the right place! Packed full of hints and tips, advice, checklists and points for reflection, this practical guide will provide you with those all important answers, and more. Key content includes: - History and background of the placement - How to get the most out of the placement - Wider professional and ethical considerations - The placement search, completing the application and tips for the interview - Managing placement relationships - Planning for the Future This one stop shop will provide counselling and psychotherapy trainees with everything they need to know to secure and survive their practice placement.

Das Essential gliedert das komplexe Gebiet der psychotherapeutischen Kompetenzen (Wissen, Handlungskompetenz und Haltung) und zeigt, auf welche Weise und in welcher Reihenfolge diese Kompetenzen vermittelt und abgeprüft werden können. Die bisher praktizierte Ausbildung zum Psychotherapeuten bedarf dringend einer Reform. Stärker als zuvor sollte sie sich an der Frage orientieren, was einen guten Psychotherapeuten ausmacht und wie er seine Kompetenzen am besten erwerben kann. Ferner muss es möglich sein, die Qualität psychotherapeutischen Handelns rational zu beurteilen. Psychologische und ärztliche Psychotherapeuten wenden eine für den Einzelfall, den individuellen Patienten, höchst folgenreiche Handlungskompetenz an. Sie müssen ihr Handeln daher auch in ethischer Hinsicht begründen und verantworten können. Die Ausbildung zum Psychotherapeuten muss ihnen auch diese Fähigkeiten vermitteln.

This book, through the personal journey of a clinical psychologist, is shedding light on the obstacle course that students face, commonly with no one to guide, direct, and mentor them. Once they succeed in getting into universities, they commonly attend huge classrooms, are anonymous and feel disconnected. When their time comes to prepare for graduate school, it is then that they are particularly short of directing and empowering, and that is one of the main goals of this book – to empower young adults, and share with them the lessons and wisdom that were accumulated by a seasoned psychologist on his path from high school to graduate school, to the life of healing and helping others. The author shares his experiences and the lessons learned, from university, undergraduate and graduate schools, and what he learned on his journey to become a psychologist, university professor, a researcher, and an author.

Learning how to use critical self-reflection creatively when practising therapy is an important component of training. This level of self-awareness is, however, often neglected in research, despite the centrality of the researcher to their work. Doing Practice-based Research in Therapy: A Reflexive Approach makes the vital link between practical research skills and self-awareness, critical reflection and personal development in practice-based research. Starting with a clear introduction to the theory, practice and debates surrounding this type of research, the book then guides the reader step-by-step through the practicalities of the research process, encouraging them to reflect upon and evaluate their practice at each stage. The book: - incorporates case studies throughout to illustrate different methodological approaches - uses real life examples from students conducting practice-based psychotherapy research - includes exercises, chapter objectives, end-of-chapter questions and suggestions for further reading to help consolidate learning - encourages ongoing personal development by introducing personal development planning (PDP) and lifelong learning in the field of research. By demystifying the reflexive approach, this highly practical guide ensures that trainees and qualified therapists get the most, both professionally and personally, from their practice-based research.

Good communication between the doctor and patient is essential for the patient to establish a trusting relationship with their doctor and to make the best use of the appropriate treatment. Traditional methods for teaching communication skills have focused on simulated clinical situations in which students learn how to improve their communication, with actors playing the part of the patients, rather than from live experiences with patients. Psychodynamic psychotherapy, with its emphasis on learning to reflect on experiences, offers the student the possibility of learning from a real experience with a patient. Such opportunities allow students to learn directly about patients'emotions, as well as to appreciate their own emotional responses to illness and to communicate better with their patients. In this book, Peter Shoenberg, Jessica Yakeley, and their contributors who include students and teachers, discuss two different teaching approaches developed at University College London to help medical students understand the role of emotions in illness, communicate more effectively, and gain a deeper understanding of the doctor patient relationship. The benefits of Ball, Wolff and Tredgold's Student Psychotherapy Scheme are considered alongside Shoenberg and Suckling's short term student Balint discussion group scheme to provide clear guidance about how psychotherapeutic understanding can be used to inform medical education, with positive results. At a time when medicine is becoming increasingly technological and there is a growing demand by the public for more psychologically minded doctors, this book will be a key resource for physicians, general practitioners, psychologists, psychiatrists and psychotherapists who are involved in medical teaching and for medical students.

How Master Therapists Work engages the reader in experiencing what really happens in therapy with master therapists: who they are, what they do, and how they bring about significant change in clients. It examines one master therapist's actual six-session therapy (also available on DVD) that transformed a client's life, resulting in changes that have been sustained for more than seven years. Session transcriptions directly involve the reader in every aspect of the therapeutic change process. This is followed by the commentary of a master therapist-psychotherapy researcher who explains how these changes were effected from a psychotherapy research perspective. Next, the master therapist who effected these changes explains what he was thinking and why he did what he did at key points in the therapy process. Then, the client shares her thoughts on this life changing therapeutic experience. This is a must have, one-of-a-kind book that will greatly enhance the therapeutic understanding and skills of both practicing therapists and therapists-in-training.

This book provides a comprehensive overview of the professional development of counselors and therapists over the career lifespan. Drawing on their own extensive experience as psychotherapists, supervisors, teachers, and researchers, as well as from their own extensive study of the topic, previously published in their 1992 book The Evolving Professional Self, the authors aim to provide an update of their work that all counselors and psychotherapists will find valuable and useful. Readers are provided with empirically based conceptual knowledge that can increase their awareness of the central issues in professional development, allowing them to monitor their own development. The authors discuss the concept of development and review the research literature on practitioner development, and then provide detailed descriptions of its six phases. Aspects of each phase addressed include the developmental tasks unique to that phase; the sources of influence and the learning process which impacts therapeutic work and a sense of development; the perception of the professional role and working style; and therapists'measures of effectiveness and satisfaction. All of this is augmented with quotes and illustrative examples from participants in the authors'research studies. The book includes knowledge generated from research on master therapists and from the Society for Psychotherapy Research/Collaborative Research Network. The book also considers themes of professional development; struggles faced by novice practitioners; patterns of practitioner resiliency; and ways to improve training, supervision, and practice.

Clinical psychology is a quickly growing profession, yet it is a challenging one: the preparation is arduous, the training is highly selective, and the results – an established and financially successful practice – are not easy to achieve. This book explains how to prepare for and surmount all of the hurdles presented to those who hope to eventually develop a lucrative and rewarding practice in clinical psychology. It is the first of its kind to focus primarily on financial success, though it does also look at the personal stresses and rewards of the profession. The author provides tips from his own experience and from other financially successful private practice psychologists and offers business techniques and pointers that are not explained in training programs. Undergraduate students contemplating a career in psychology will find advice on preparing for the GRE, applying to graduate schools, and getting involved in research and clinical work. For graduate students, an overview of a graduate clinical psychology program, preparing and completing a dissertation, and gaining experience in psychological testing are provided. Chapters then focus on how to build and manage a private practice, the best ways to manage personal and business finances, and how to practice good self-care. Additionally, the book includes a chapter by an expert on student-loan repayment that examines how to best work through the process of paying back student loans while building a practice.

An increasing number of psychologists who were trained in clinical psychology, health psychology, or another specialty are gravitating toward rehabilitation psychology, but many of them have little or no experience with rehabilitation populations. With the explosion of interest in traumatic brain injury (TBI), many neuropsychologists are taking jobs in rehabilitation settings that treat people with TBI but also care for persons with the array of other disabling conditions such as spinal cord injury, stroke, MS, and amputation. In Specialty Competencies in Rehabilitation Psychology, Drs. Cox, Cox, and Caplan provide a guide to the knowledge and skills required by competent rehabilitation psychologists, with an emphasis on the evidence base of the specialty. The volume will be valuable to those preparing for the Board Certification Examination in Rehabilitation Psychology and will also be valuable to newcomers to the field and to clinicians working on an outpatient basis with individuals with a wide variety of chronic conditions. Series in Specialty Competencies in Professional Psychology Series Editors Arthur M. Nezu and Christine Maguth Nezu As the field of psychology continues to grow and new specialty areas emerge and achieve recognition, it has become increasingly important to define the standards of professional specialty practice. Developed and conceived in response to this need for practical guidelines, this series presents methods, strategies, and techniques for conducting day-to-day practice in any given psychology specialty. The topical volumes address best practices across the functional and foundational competencies that characterize the various psychology specialties, including clinical psychology, cognitive and behavioral psychology, school psychology, geropsychology, forensic psychology, clinical neuropsychology, couples and family psychology, and more. Functional competencies include common practice activities like assessment and intervention, while foundational competencies represent core knowledge areas such as ethical and legal issues, cultural diversity, and professional identification. In addition to describing these competencies, each volume provides a definition, description, and development timeline of a particular specialty, including its essential and characteristic pattern of activities, as well as its distinctive and unique features. Written by recognized experts in their respective fields, volumes are comprehensive, up-to-date, and accessible. These volumes offer invaluable guidance to not only practicing mental health professionals, but those training for specialty practice as well.

The Contemporary Relational Supervisor is an empirically based, academically sophisticated, and learner-friendly book on the cutting edge of couple and family therapy supervision. Appropriate for master's and doctoral level students, as well as experienced clinicians who wish to learn about supervision, it emphasizes system and relational thinking and intervention, while privileging the diversity of training system members, their realities, experiences, and interpretations of life.The authors are attuned throughout the text to how and where clinical training and services are provided, and to whom, and provide detailed literature reviews for readers. These factors assist their discussion of the socio-historic development of the AAMFT supervision designation, and the fundamentals, contexts, philosophy, relationships, and pragmatics of CFT supervision. They also discuss major models and approaches, evaluation, ethical and legal issues, and therapist development. Perhaps most important is their presentation of methods that help tailor and extend supervision practices to meet the clinical, institutional, and economic realities that CF therapists navigate.Readers are engaged by the discussions and exercises at the end of each chapter, which help them to feel more grounded in a topic, to have their own voices heard, and to be granted insight through experiencing multiple realities. This valuable reference prepares the next wave of cutting-edge CFT supervisors–those who are knowledgeable, skilled, and realistically confident.

Praise for Clinical Case Formulations Matching the Integrative Treatment Plan to the Client, Second Edition'[Barbara Ingram has put] a career into the development of this book and it is wonderful! My students love that it was written with them in mind and they love the statements designed to reduce anxiety and normalize the learning process. This is an excellent book!'—Amy M. Rees-Turyn, PhD Associate Professor of Counseling Psychology, Lewis & Clark College A step-by-step model for individualized case conceptualization Fully revised and updated, the second edition of Clinical Case Formulations provides step-by-step tools and insightful guidance for moving from first contact with a client to the development of an effective, personalized treatment plan. Addressing the essential question every therapist faces—How do I create a treatment plan that is the best match for my client?—this unique resource provides a systematic and thoughtful method for integrating ideas, skills, and techniques from different theoretical approaches. It combines empirical research and clinical experience to create a case formulation that is tailor-made for the client. This comprehensive resource offers two tools to guide case formulations: a problem-oriented framework, with a list of 28 standards for evaluating its application, and a set of 30 core clinical hypotheses derived from the knowledge bases of psychology, psychiatry, counseling, and social work professions. The new edition includes: Hypotheses on Emotional Focus, Trauma, and Metacognitive Perspective More detailed attention given to empirically supported therapies such as Dialectical Behavior Therapy (DBT) and Acceptance and Commitment Therapy (ACT) Discussion on the importance of bringing cultural competence to case formulation tasks with every client Skill-building activities throughout the text Offering a thorough framework to help clients experience effective clinical service, practitioners will learn to conceptualize clients'needs in ways that lead to strong and individualized treatment plans, as well as advice and guidance on what to do when selected interventions fail to produce the expected benefits.

Here, for the first time, is a book that submits the psychoanalytic training institute to deep anthropological scrutiny. It expertly uncovers the hidden institutional devices used to transform trainees into professionals. By attending closely to what trainees feel, do, and think as they struggle towards professional status, it exposes the often subtle but deeply penetrating effects psychoanalytic training has upon all who pass through it; effects that profoundly shape not only therapists (professionally and personally), but also the community itself. The author's fascinating and original data is culled from his extensive fieldwork, his case-studies of clinical work, and his interviews with teachers, senior practitioners and trainees. This book is written to be accessible to all those who have an interest in the therapeutic profession from the professional (whether psychotherapist or anthropologist) to the trainee and general reader.

This book is a selection of papers written over 25 years of practising psychoanalytic psychotherapy, of training and supervising psychotherapists, psychodynamic counsellors and supervisors. It reflects a preoccupation with the growth and diversification of counselling and psychotherapy, with the imperatives of training, supervision and regulation, and with the significant changes in the profession due to the invention of brief, time-limited, intermittent and recurrent psychotherapy. An overall theme is the conviction that what patients and therapists share is vulnerability, and that the therapist is a'wounded healer', whose reparative tendency informs his professional choice, his therapeutic empathy and his capacity to bear the rigours of therapeutic work. Thus an unconscious connection between the helper and the helped is the driving force of every therapeutic relationship, for better and for worse. Its responsible management requires thorough training, ongoing supervision and a firm frame in order to contain the powerful forces operating when two strangers meet for the purpose of therapy.