The Practice Of Therapy General comments

As in work with any client group, there are a number of issues that are common to work in therapy and a number of issues that are specific to the client group in particular. The most general issue for any therapy is, of course, the development of a collaborative therapeutic relationship; without such a relationship, effective therapeutic work is well-nigh impossible (e.g., Frank, 1982). In fact, the establishment of a good relationship is typically easier than with some other client groups, especially with those clients with strong dependency needs. As for the "autonomous" depressed individuals mentioned above, who normally aim to be self-sufficient, when they enter therapy, it is often because their attempts at self-sufficiency have broken down under the pressure of a significant life crisis. They may experience their need for help from the therapist as shameful or humiliating; nevertheless, one of the functions of depression may be to force individuals to question interpersonal and other goal-related issues which they have attempted to deny. It is more likely to be on recovery from depression that the autonomous individual becomes difficult to work with in therapy. Of course, the issue of the therapeutic relationship remains throughout therapy and is particularly relevant in short-term work for depression where termination issues are always just around the corner, a problem that we will return to later.

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