ABSTRACT
Therapists from most theoretical perspectives would agree that behavior destructive to the patient or to the therapeutic alliance must be stopped before other aspects of the therapy can proceed. Limit setting may even include the requirement that the person attend therapy. The word confrontation implies some mental forcefulness, and indeed forcefulness of purpose is required when one is working against forces that hold an entrenched character pattern in place. The difference between forcefulness that is therapeutic and forcefulness that becomes an inflammatory provocation is one of tone and motivation. In contrast, therapeutically forceful confrontation is planned and steady, maintains respect for the patient, maintains empathy for the need to balance self-reflection with self-esteem, and is motivated by the conviction that continued lack of awareness is harming the patient. Education is explaining to the patient the reasoning behind our interventions, working toward identifying the goals of the patient, and explaining how the therapy work help the patient achieve his goals.
