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First sessions and initial assessments are different and in some ways more difficult than regular sessions within an established process. In a first session we do not yet have a shared understanding nor an agreed therapeutic frame. It is one of the main tasks of a first session to develop such a frame, but not just routinely or as an arbitrary or standard given, but in service of the specific work required and therefore appropriate and maybe adjusted to each individual client.
A first session, especially if it includes an assessment, therefore comprises some quite contradictory modalities of engagement (all of which have matter-of-fact, practical implications as well as therapeutic and relational ones): some quasi-medical interactions, a business negotiation, a meeting of two humans / strangers, as well as therapeutic considerations throughout, plus the tensions between the four, manifesting to some extent as contradictory pulls between the therapist's presence as a person and their presence within the role. Hopefully at the end of the hour all of that will culminate in a sufficiently solid and mutually understood and negotiated working alliance (another relational modality).
The special dilemmas of such initial sessions arise because, after all, these are quite contradictory relational modes, and thus reveal more clearly just what a confusing mix of relational modalities the therapeutic relationship consists of.
So that means that a workshop on this topic is of interest and has benefits for a wide range of therapists, including specifically beginners as well as experienced practitioners.
What will you get out of this workshop?
As a beginner trying to build up your practice, the topic is immediately relevant to how you approach initial meetings with clients and whether or not these lead to ongoing work. The way most of us handle this to begin with relies mainly on imitating and copying our own therapists and tutors. However, that may not suit you and your style. Being clear about the conflicts and dilemmas that are inherent in first sessions is helpful in you working out your way of conducting these.
These questions are not only relevant for beginners, obviously, but we can all continue learning and reflecting on the habits we have developed in our practice. We can all usefully spend some time investigating what happened with clients who did not choose to continue after initial meetings, and what was the dynamic that got in the way of a working alliance.
For experienced practitioners focusing on the complexities of first sessions helps us sharpen our awareness of the tensions between the various relational modalities that are inherent in the therapeutic relationship all the time. Based on an integration of contributions by Lavinia Gomez, Martha Stark and Petruska Clarkson, Michael has developed some formulations that bring out the inherent tensions more clearly than each of these models by itself.
Format of the day:
So in order to provide a foundation and framework, Michael will give some background teaching and briefly touch upon his ‘diamond model’. But apart from that more general and abstract input, we will stick closely to the topic of the day and its practical applications.
In preparation, it will be useful for you to remember difficult first sessions and bring these as examples for us to work on experientially.
You can find some background reading to the topic, which Michael has put together on the basis of running this kind of workshop before, here.
Date & Time: June 11th 2017 10.00 - 17.00
Venue: OTS-Witney Therapy Centre
Lunch: As usual we will arrange a bring and share lunch in the week before the event.
As this training is part of a series, a training package has been compiled and is available on booking. The material is in numbered order to support any limitations on study time you may have prior to June 11th, but please note that they are essential study prior to coming to another event in this series.
The training package includes:
A revised and worked through transcription of the first half of the May 7th training day.
A 2hr40m YouTube video of the 7th May 2017 training day.
To secure your place, please transfer the relevant fee to the OTS Account:
Account Name: EJ Smith
Account Number: 31434683
Sort Code: 40-47-39
OTS Members - £40
OTS Affiliates - £50
OTS Applicants - £60
Non-members - £75
If you live in the area and want to join, contact the director of OTS, Justin Smith via the website.
Michael is a TRS (The Relational School) member and has drawn from Martha Stark’s seminal 1999 book 'Modes of Therapeutic Action’, Lavinia Gomez’s work on object relations and the tension between humanistic and psychoanalytic traditions as well as Petruska Clarkson’s 5 modalities of therapeutic relating to develop a broad-spectrum integration of therapeutic traditions as part of the relational project. For this study day Michael will present and explore with us his particular journey since his own experience of a ‘relational turn’ in the mid-1990’s.
What do we mean by ‘relational’?
Over the last 15 years or so, relational perspectives have had a significant impact across the fields of psychotherapy. However, the wider its increasing influence has spread, the less clear it has become what we actually mean by ‘relational’. The default common denominator would be the recognition that in therapy it's the relationship between client and therapist that matters, and that the quality of that relationship is a significant indicator of outcome.
However, whilst there is quite a lot of agreement that the therapeutic relationship matters, this apparent consensus breaks down at the first hurdle: there is no such level of agreement as to what actually constitutes quality of relationship. On the contrary: there is a tendency for the traditional approaches to define ‘therapeutic relating’ predominantly within their own frame of reference, taking their own paradigm of relating for granted. It is, therefore, not generally accepted that 100 years of psychotherapy have given us a diversity of distinct notions of what kind of relating is to be considered ‘therapeutic’. The common ground of ‘relationality’ is a negative distinction from classical one-person psychology and ‘medical model’ non-relationality, but beyond that it is unclear whether relating means in Gomez’s terms being ‘alongside’ as an ally or ‘opposite’ as a relational other. And then what kind of other: positive, nurturing and reparative or authentic/dialogical or transferential other? And in amongst all that, what happens with the ‘bad’ object, and who relates to it how?
A multiplicity of diverse, contradictory and complementary relational spaces.
Unless we take into account these different and contradictory notions of relatedness - or in the terms of Petruska Clarkson’s seminal contribution from the early 1990's: the different relational modalities we now find in existence across the field - what we mean by ‘relational’ will remain confused and confusing. It clearly means very different things to different therapists, without - however - these differences being sufficiently acknowledged or investigated.
Michael’s starting point will be the polarisation between object-relating and inter(subject)-relating: when we validate both and recognise the tension between them as essential to the therapeutic endeavor (a tension not to be reduced, resolved or short-circuited ideologically, but to be entered into in each unique client-therapist relationship), a multiplicity of relational spaces – contradictory and complementary, forming a complex dynamic whole – can be seen to arise from it. Michael proposes his ‘diamond model’ as a map that can help therapists process their conflicted (countertransference) experience when involved in layers of multiple enactment.