ABSTRACT

How does the therapist begin psychotherapy? How, that is, does she conceptualize the needs of the patient while simultaneously enlisting him or her as an active partner in formulating an individualized working plan? And how should supervisors teach the skills needed to make the intake procedure truly the beginning of treatment? In Beginnings: The Art and Science of Planning Psychotherapy Mary Jo Peebles-Kleiger tackles these and other questions in an authoritative manner that draws on the cumulative experience of the outpatient department of the Menninger Psychiatric Clinic.

Peebles-Kleiger's elegant synoptic discussions of the major categories of psychological dysfunction and the different treatment strategies appropriate to them are carefully calibrated, with actual examples, to the limits and opportunities of the first sessions. Of particular value is her unusual capacity to articulate patients' various difficulties in forming and maintaining an alliance, and then to show how such difficulties feed back into the clinician's interventions in the first few sessions. In this manner, she illustrates how potential treatment obstacles-- difficulties in affect regulation, in reality testing, in conscience formation, among others--can be assessed and subjected to trial interventions from the very start.

Skilled in various psychodynamic and behavioral approaches, from psychoanalysis to hypnotherapy, Peebles-Kleiger consistently advances an integrative approach that cuts across specific modalities and combines sophisticated psychodynamic understanding with the fruits of empirical research. Both primer and sourcebook, Beginnings: The Art and Science of Planning Psychotherapy fills a niche in the literature so admirably that clinicians will find it indispensible in planning humanely responsive treatment in an increasingly complex therapeutic world.

chapter 1|13 pages

What Do We Mean by Diagnosis?

chapter 2|11 pages

Alliance

chapter 3|10 pages

Focus

chapter 5|16 pages

Patient Activity

chapter 6|15 pages

What Material Is Important?

chapter 7|14 pages

How Can We Be Sure?

chapter 8|15 pages

Trial Interventions and Feedback

chapter 9|7 pages

The Concept of Underlying Disturbance

chapter 10|11 pages

Deficit

chapter 11|8 pages

Characterological Dysfunction

chapter 12|9 pages

Conflict

chapter 13|18 pages

Trauma

chapter 15|21 pages

Reality Testing and Reasoning

chapter 16|14 pages

Emotional Regulation

chapter 17|18 pages

Relatedness

chapter 18|9 pages

Conscience

chapter 19|10 pages

The Psychological Costs of Change

chapter 20|11 pages

The Patient’s Learning Style

chapter 21|9 pages

Expectations

chapter 22|17 pages

Priorities and Modalities