Endings in Clinical Practice


Book Description

Effective endings ensure that intervention gains continue after the therapeutic relationship ends. Joseph Walsh relates this critical topic to all practitioners through his use of diverse settings, detailed coverage of clinical endings, and extensive case illustrations that make the content concrete, practical, and accessible. Walsh takes a multi-setting and multi-theoretical approach to the often-overlooked topic of endings in clinical practice. Endings in Clinical Practice is organised into three parts. The first part covers types of endings in clinical practice, both planned and unplanned; the importance of closure; and common endings tasks across fields of practice. Part Two outlines theoretical perspectives on endings especially pertinent to advanced practitioners. The final section considers a variety of specific clinical ending situations and the ways in which clients and practitioners may react to them. New to the Second Edition: 10 new case studies. Revised and expanded chapter on endings with families. An exploration of client suicide. Discussion on how children and adolescents experience clinical endings. More material on the role of agency administrators in maximizing chances to experience positive endings with clients.




Endings and Beginnings


Book Description

What sets off the termination of analysis and psychodynamic therapy from the variety of endings that enter into all human relationships? So asks Herbert J. Schlesinger in Endings and Beginnings: On Terminating Psychotherapy and Psychoanalysis, a work of remarkable clarity, conceptual rigor, and ingratiating readability. Schlesinger situates termination - which he understands, variously, as a phase of treatment, a treatment process, and a state of mind - within the family of "beginnings and endings" that permeate one another throughout the course of therapy. For Schlesinger, therapeutic endings cannot be aligned with the final phase of treatment; ending-phase phenomena are ongoing accompaniments of therapeutic work. They occur whenever patients achieve some portion of their treatment goals and supervene when therapy stagnates. Small wonder that an assessment of the patient's relationship to time and capacity to end therapy are key aspects of diagnostic evaluation. By linking beginning and ending phases not to the chronology of treatment but to the patient’s experience of it, Schlesinger brings revivifying insight to a host of psychodynamic concepts. Nor does he shy away from a trenchant critique of the instrumental “medical model” of psychiatric and psychotherapeutic training, which militates against the therapeutic exploration of treatment endings. Schlesinger's exemplification of how to begin treatment from the point of view of ending; his sensitive delineation of the mid-treatment "ending" crises characteristic of "vulnerable patients"; his richly woven case vignettes illustrating various "ending" contingencies and permutations - these inquiries are gems of pragmatic clinical wisdom. Endings and Beginnings distills lessons learned over the course of a half century of practicing, teaching, and supervising psychotherapy and psychoanalysis and is a gift to the profession.




Ending Medical Reversal


Book Description

Medications such as Vioxx and procedures such as vertebroplasty for back pain are among the medical "advances" that turned out to be dangerous or useless. What Dr. Vinayak K. Prasad and Dr. Adam S. Cifu call medical reversal happens when doctors start using a medication, procedure, or diagnostic tool without a robust evidence base—and then stop using it when it is found not to help, or even to harm, patients. In Ending Medical Reversal, Drs. Prasad and Cifu narrate fascinating stories from every corner of medicine to explore why medical reversals occur, how they are harmful, and what can be done to avoid them. They explore the difference between medical innovations that improve care and those that only appear to be promising. They also outline a comprehensive plan to reform medical education, research funding and protocols, and the process for approving new drugs that will ensure that more of what gets done in doctors' offices and hospitals is truly effective. "Every doctor should read this book."—JAMA Internal Medicine "[A]n excellent and realistic discussion of some of the horror stories that occur in medical practice . . . Highly recommended."—Choice "Ending Medical Reversal goes far in teaching medical students and practicing physicians alike how to learn on our own."—The Lancet "This has to be on the reading list for medical and nursing students."—Nursing Times "Ending Medical Reversal presents persuasive evidence that many current standard-of-care treatments are probably ineffective or harmful, thoroughly explains how such treatments came to be accepted, and proposes a number of ways to address the general problem (only some of which involve avaricious companies and mercenary physicians) and minimize its impact on a specific patient."—Journal of Clinical Research Best Practices "Dr. Prasad and Dr. Cifu offer a five-step plan, including pointers for determining if a given treatment is really able to do what you want it to do, and advice on finding a like-minded doctor who won't object to a certain amount of back-seat driving."—The New York Times "When I describe Ending Medical Reversal as revolutionary, I don't use the term lightly. Go out and read it—right now."—Common Sense Family Doctor "Should be considered for undergraduate reading lists. Keep a copy in the pharmacy or your briefcase as a great icebreaker or discussion point with other local healthcare professionals."—The Pharmaceutical Journal




Forced Endings in Psychotherapy and Psychoanalysis


Book Description

Forced Endings in Psychotherapy and Psychoanalysis: Attachment and Loss in Retirement explores the ambivalence the therapist may feel about letting go of a professional role which has sustained them. Anne Power explores the process of closing a private practice, from the first ethical decision-making, through to the last day when the door of the therapy room shuts. She draws on the personal accounts of retired therapists and others who had to impose an ending on clients due to illness, in order to move house, to take maternity leave or a sabbatical. A forced ending is an intrusion of the clinician’s own needs into the therapeutic space. Anne Power shows how this might compromise the work but may also be an opportunity for deeper engagement. Drawing on attachment theory to understand how the therapeutic couple cope with an imposed separation, Power includes interviews with therapists who took a temporary break to demonstrate the commonality of challenges faced by those who need to impose an ending on clients. Forced Endings in Psychotherapy and Psychoanalysis opens up an area which has been considered taboo in the profession so that future cohorts can benefit from the reflections and insights of this earlier generation. It will support clinicians making this transition and aims to support ethical practice so that clients are not exposed to unnecessary risks of the sudden termination of a long treatment. This book will be essential reading for practicing psychotherapists and psychoanalysts, and to undergraduate and post-graduate students in clinical psychology, psychiatry and social work




Constructing Authentic Relationships in Clinical Practice


Book Description

This essential text explores the intersectionality of the self in therapeutic practice, bringing together theoretical foundations and practical implications to provide clear guidance for students and practitioners. Bringing together a collection of insightful and experienced clinicians, this book examines the ways in which intersectionality influences all phases of clinical and supervisory work, from outreach, assessment, and through to termination. Integrating research with clinical practice, chapters not only examine the theoretical, intersectional location of the self for the therapist, client, or supervisee, but they also consider how this social identity effects the therapeutic process and, crucially, work with clients. The book includes first-hand accounts, case studies, and reflections to demonstrate how interactions are influenced by gender, race, and sexuality, offering practical ideas about how to work intentionally and ethically with clients. Engaging, informative, and practical, this book is essential reading for students, supervisors, family, marriage, and couple therapists, and clinical social workers who want to work confidently with a range of clients, as well as clinical professionals interested in the role of intersectionality in their work.




Understanding Boundaries and Containment in Clinical Practice


Book Description

The authors propose to investigate the meaning and purpose of boundaries within and around the therapeutic experience. A boundary is more than a simple line delineating one space from another; it is an entity with properties that demand a response if they are to be negotiated. Boundaries circumscribe a space that can be viewed objectively, or experienced subjectively, as a 'container'. For the uninitiated, this therapeutic container can be difficult to penetrate. Even health professionals such as GPs and psychiatrists often do not know how to access psychotherapy organisations and their referral networks. Also, real constraints on the availability of counselling and psychotherapy within the National Health Service, and the cost of private sector services, may prohibit access to the help being sought. The book explores aspects such as the gradual evolution of therapeutic boundaries in psychodynamic work, boundary development in infancy and childhood, the role of the therapist's mind and the therapeutic setting, confidentiality and issues such as money and time.




Supervision in Clinical Practice


Book Description

Since the publication of the first edition of this book supervision has become of even greater significance in health, education and social care settings, with continuing pace in the trend towards mandatory registration, managed care and clinical governance. This fully updated and expanded edition includes new chapters on issues of diversity and the managerial role of the supervisor in context. Packed with practical examples in the key areas of personal and professional development, Joyce Scaife and her contributors draw on three decades of clinical experience to explore frequently encountered dilemmas including: how supervisors facilitate learning the ethical bases of supervision creating and maintaining a good working alliance how supervisors can balance management and supervision roles working equitably in an increasingly diverse and pluralistic world Supervision in Clinical Practice offers a range of suggestions for providing supervision that are stimulating, creative and fun, using methods that ensure safe and open practice. It is an indispensable text for supervisors and supervisees who practice clinically in a range of professions, including applied psychology, counselling, psychotherapy, psychiatry, nursing, and social work.




Good Goodbyes


Book Description

(Choral Score)"The Waters of Prayer" for Female Chorus, a cappellaText by Vassar MillerMusic by Kentaro Sato (1981-)Voicing: SSAADuration: 12minLyrics: English1. Heritage2. Renewal3. Prayer upon Waking4. InvitationVisit: www.wisemanproject.com for more information.




Learning from Mistakes in Clinical Practice


Book Description

TABLE OF CONTENTS: 1. Becoming a professional 2. Early successes and derailments 3. Engaging with clients and getting started 4. Professional relationships: steps and missteps 5. Assessment and contracting 6. The middle phase of work 7. When the work doesn't work 8. Common mistakes in ending -- Epilogue.




Myths of Termination


Book Description

Psychoanalysis can make a huge difference in the lives of patients, their families and others they encounter. Myths have developed, however, about how psychoanalysis should end – what patients experience and what analysts do. These expectations come primarily from accounts by analysts in the analytic literature which are often perpetuated in an oversimplified form in teaching. Patients' perspectives are rarely presented. I her book, Judy Leopold Kantrowitz seeks to address this omission. Exploring the accounts of 82 former analysands, she illustrates the rich diversity of psychoanalytic endings and ways of maintaining analytic benefits after ending; in presenting patients' experiences Kantrowitz provides correctives for some myths about termination. Myths of termination: What patients can teach psychoanalysts about endings is not a book that seeks to refute or support any specific idea about a best way of ending analysis, but rather to show that there are countless ways of having a satisfactory conclusion to the process. Nor is the author espousing any particular analytic theory. Kantrowitz sets out to show that an oversimplified view of psychoanalytic endings not only diminishes an appreciation of the diversity of psychoanalytic outcomes but may also interfere with the creativity of individual psychoanalysts. In this book, former analysands describe and illustrate how their analyses ended. They reflect on the effect of non-mutual endings due to external factors (moving, retirement, illness or death) or psychological factors (wishing to avoid facing some issue); the impact of post-analytic contact; and the ways in which they have held on to their analytic benefits after ending their analyses. Myths of termination confronts and refutes the myths about the termination phase of psychoanalysis that are passed from generation to generation. It is a refreshing and insightful study that will be welcomed by psychoanalysts, psychodynamic therapists, such as clinical psychologists, social workers, and others trained or in training to do clinical work.