ABSTRACT
Evidence examines the manifestation of the goals–process dialectic in the two sources of available data informing clinical decision-making and treatment planning: the literature (goals) and the clinician’s countertransference (process). A composed case vignette of a suicidal client allows a deconstruction of cognitions involved in evidence-based practice and the associated concept of “clinical expertise.” The therapeutic prerequisites of empathy, congruence, unconditional positive regard and nondefensiveness are incorporated into the working hypothesis as manifestations in countertransference and operationalizations of the Therapist-Self. The concepts of clinician extension of self and the physiological basis of empathy are introduced, along with the key developmental intervention of Mirroring. The relationship between the goals–process dialectic, client pathology and clinician development is previewed: clients with more personality symptoms require more of the clinician in terms of process. The specific clinician developmental attainments needed for adroit implementation of process-based methods are identifiable within the DCT schema.
