Therapists’ competencies are crucial to ethical delivery of short term dynamic therapy – knowledge of psychodynamic principles and of psychopathology, in order to assess for suitability, and to help the patient reach his/her expected goals through an active stage-process model in a maximum of 25 weekly sessions. Length of therapy will depend on the severity of the presenting problems and the collaborative therapist/patient’s capacity to work together in a safe therapeutic relationship. It is neither an abbreviated model nor a substitute for long term therapy. Training, supervision and peer support is recommended to those who embark on STIPP.
Attachment theory is a robust biopsychosocial model that is developmental and evolutionary based, proposing that human beings develop in relationship. It speaks to both the development of self and self-regulation and the mal/adaptations and disruptions due to stress or trauma that often underlie health presentations as well as the ongoing power of relationships to promote resilience and to heal. It powerfully predicts the stress responses and the coping strategies that arise if a person is not safely and comfortably supported, including both the conscious strategies and unconscious strategies. It then offers a guide to different recovery pathways and strategies and is a model that can apply to systems and cultures as well as the individual and is conducive to integrated care. An overview of a body of collaborative biopsychosocial research (including work by McLean, Kozlowska and Proctor) will be presented, using the unifying model of Attachment theory for research and integrated care.
This paper will give an overview of the research efforts conducted by the Westmead Psychotherapy Research Program over the last 25 years. Examples are given of research that relates to outcome, phenomenology and process in the treatment of Borderline Personality Disorder. The basis of research in psychotherapy is also discussed with reference to the need to continue questioning our philosophical assumptions.
Severe trauma in both children and adults leads to a disintegration of the core aspects of self-organisation and experience. In treating clients who are survivors of loss, trauma and torture, we need to optimize their assessment, case formulation and treatment plan to promote biopsychosocial recovery.
When we think about “ethics” or “ethical practice” our minds can move in two main directions: that this relates to serious transgressions (which does not involve us) or that this is something to do with our professional codes (which we will read if and when required). In fact, our need to respond ethically occurs in a myriad of small ways that make up the moment to moment relational transactions through which we deliver our services. This should mean that discussions about ethics are commonplace with colleagues, and yet they are often not.