Psychotherapy Process & Goals

Psychotherapy Process and Goals:
Problems, Perspectives, Practice, Process, and Progress

1. Presenting problems bring complex compounding of issues that require recognizing, sorting, and identifying best approaches.

In identifying problems, we especially address issues of resilience and vulnerability:
What supports and brings strength?
What undermines and uncovers wounds?
What promotes healing and renewal?
What builds actualization of potentials?

In addressing problems, we have opportunity to consider:
Where are the obstacles?
Internal & conflictual, inter-relational & inter-subjective, systemic & contextual blocks.
Where is the locus of control?
Persistence & perseverance, strategies & set-backs, recovery & endurance, focus & goals.
What are the expectations?
Perceived outcomes, intervening variables, investment & contextual relevance.
What are the goals?
Realization of connection, restoration of meaning & sense of purpose.
Who knew?
Complexity & unintended consequences, lifespan transitions & challenges.

2. Perspectives bring together major foundational theories & approaches that inform therapy & counseling:

Depth psychologies focus the intrapsychic landscape, psychosocial & relational dynamics.
Behavioral & social learning psychologies focus conditioning & contextual dynamics.
Humanistic & systemic psychologies focus individual potential & group dynamics.
Existential & phenomenological psychologies focus psychohistorical & ecological dynamics.
Developmental & attachment psychologies focus contextual & relational dynamics.
Sociocultural & diversity psychologies focus historical & cultural dynamics.
Transpersonal psychologies focus wisdom traditions & spiritual potentials.
Biopsychosocial psychologies focus the mind/body interface in social context.
Neuropsychology & health psychologies focus somatic & environmental dimensions.

I have taught graduate coursework in all of these approaches. With clients I have found that a cohesive integration of perspectives provides a broad foundation in theory & research from which we can approach problems with a holistic view.

3. Practice describes methods & applications useful in developing a therapeutic plan to integrate skills from multiple perspectives in individual, dyad & group settings.
My practice and teaching specialties provide essential skills in

Depth Analytic: Jungian, Psychoanalytic & Psychodynamic Therapy
Existential-Humanistic Therapy
Cognitive-Behavioral Therapy
Mindfulness-Based Therapy
Partner, Parent-Child & Family Relational Therapy
Expressive Arts, Sandplay & Dreamwork
Creativity, Visualization & Guided Imagery
Gestalt & Emotion Focus
Attachment Styles & Interpersonal Focus
Self-Regulation & Core-Self Focus
Developmental & Special Needs Focus
Somatic & Mind/Body Focus
Cultural & Diversity Focus

Therapeutic and counseling methods best match the goals, issues, and context of the client. Sometimes therapeutic ambition may get in the way of identifying contributing issues: Too wide a focus may not meet the immediacy of the presenting issues, but too narrow a focus may constrict and delay the resolution possible from a more holistic approach. Each stage of therapy requires integration of skills and understanding of problem complexity. Short-term or partial solutions can create next-level additional problems. Rather than approaching the problem at a surface level of expression, problem resolution seeks to identify and meet the problem at its source.

4. Process describes the therapeutic & counseling relationship and client experience in the session. Attention to process especially requires

Developing the Therapeutic Alliance :
Mutuality and reciprocity describe essential ingredients in interpersonal and intergenerational connection.
Listening to the Symptom :
Symptoms develop language & seek to communicate what needs protection & sanctuary.
Listening to the Affect :
We miss essential information if we treat emotions as artifacts rather than core elements of expression.
Balancing Power and Responsibility :
Locus of control requires existential dynamics acting in accord together.
Recognizing Phases of Therapy :
Our task within the natural phases of therapy may be described in 4 stages:
In-Touch phase : The recognition of issues.
Downward phase : The discovery of issues at their source.
Upward phase : The working through .
Translation or Termination phase : The resolution.
These phases provide levels of focus both within the session and over the course of therapy.
Phase-specific skills are important to midwife these phases and carry the therapeutic process to completion.

5. Progress describes the outcomes that give the therapy connection and sense of purpose to the goals and experience of the client.
Outcomes are both direct and indirect: Presenting problems have multifaceted dimensions across life challenges.

Examples of direct areas for focus include
Vicarious, Ambient, and Direct Trauma
Situational and Generalized Anxiety and Panic Responses
Reactive and Chronic Depression
Adjustment, Life Circumstance, and Life Phase Transitions
Adaptation, Acculturation, Assimilation, and Intergenerational Challenges
Bereavement, Complicated, and Complex Grief
Gender Dysphoria and Sexual Identity
Cultural and Diversity Identity
Parenting and Elder Care
Health and Integrative Care

Examples of indirect areas for focus include
Core Self Identity and Self Recognition
Coping Skills and Resilience
Potentials and Actualization
Relational Connections and Resolutions
Sense of Purpose and Self Definition
Shame, Guilt, Regret, Remorse and Reconciliation
Healing and Renewal

A holistic approach integrates these 5 levels of therapy and counseling:
Problems, Perspectives, Practice, Process, and Progress 
We can approach problems at their source to discover what sets them in motion, what holds them in place, what vulnerabilities they express, what resilience they require for resolution, and what possibilities and potentials they reveal.

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