ABSTRACT
Treatment reassembles the working hypothesis. “Good therapy” is reconceptualized as developmental preparation of the client for second-order change. Client assessment, case conceptualization and treatment planning according to the DCT metamodel, and within the governing dialectic between goals and process, combine to confer intentionality and to predict client preparedness to benefit from specific interventions. The schema of intentional intervention, using the goals–process dialectic as an indicator for clinical decision-making, is thereby clarified as the vehicle for clinician adroitness. Effects on outcome are examined in relation to the case vignettes previously introduced. Client pathology and trajectory of treatment toward developmental optimization are contextualized within two further conceptual frames: transition theory, with its construct of the environmental call to “let go,” and the client’s dilemma as key focus for treatment. The working hypothesis recognizes that the enormous responsibility and environmental challenge of being a clinician call for a set of attributes in the Therapist-Self that is particular and extraordinary.
