TAILIEUCHUNG - Handbook of Psychotherapy Integration, Second Edition Part 5

Tham khảo tài liệu 'handbook of psychotherapy integration, second edition part 5', kỹ năng mềm, tâm lý - nghệ thuật sống phục vụ nhu cầu học tập, nghiên cứu và làm việc hiệu quả | Cognitive Analytic Therapy 209 overactivity in therapists and passive resistance in patients. Maintenance and Relapse Prevention The maintenance and continuation of change after a 16- or 24-week therapy depend on the internalization of the therapist as a corrective voice and on the continuing use of the tools developed in the therapy. Follow-up at 3 months usually shows that more has been retained than appeared likely during the ambivalent phase of termination. This experience of coping alone is a positive one for most patients. Nonetheless a proportion of patients especially those with personality disorders may need further help. This may take the form of further spaced follow-up sessions or a short spell of top up sessions designed to reinforce what was learned. In other cases long-term dilute supportive therapy informed by the understanding of the reciprocal role patterns may be appropriate. Patients needing a continuation of active therapy may be referred to group therapy therapeutic community or day hospital programs preferably to receive various inputs such as other group activities psychodrama or art therapy coordinated by CAT-informed management. There may be a place for a second CAT after a gap of a year or more for example with patients who building on a first therapy risk greater involvement with others and encounter new forms of difficulty. CASE EXAMPLE Kate aged 33 consulted with the aim of obtaining psychiatric support for her request to be allowed more access to her 3-year-old daughter who was in the custody of her husband from whom she had separated shortly after the birth of the child. She did not want psychotherapy but agreed to attend for four assessment sessions. At the end of this time she accepted a further 20 sessions. Kate was an intelligent and attractive woman who told her story histrionically and incoher ently. She described her father as very stern and cried when describing how critical he was but added It was for my own good. Later she

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