Working across the Clinical Spectrum with Enactments, Ruptures, and Repairs (on demand - student)

Title of Workshop:
Working across the Clinical Spectrum with Enactments, Ruptures, and Repairs

Format: On Demand
Credit: 4 Ethics CEUs approved for Psychologists, Social Workers, LPCs/LMFTs and LADCs

Cost:
$125 for Non-Members
$100 for Members - Log into the Member Area to purchase
$25 for *Students - Click here to request a student discount
*(Full-Time Undergraduate, Graduate, Doctoral students, and LMFT, LADC, LPC, Social Work, Psychology, and Psychoanalytic licensure/certification candidates

Speakers: Nancy McWilliams, PhD, ABPP, and Michael Garrett, MD

Title of First Talk:

Repairing (and Sometimes Failing to Repair) the Therapeutic Alliance in Psychotherapy with Nonpsychotic Patients

Description:

Dr. McWilliams will review empirical data supporting the critical importance of the therapeutic alliance to therapy outcome. Although almost all research on the alliance has been done with nonpsychotic patients, and such patients will comprise the main group about which she talks, she will attempt to infer general principles of therapy process relevant to the rupture-repair cycle in all psychotherapy patients. She will give examples from her own experience of enactments and efforts at repair of ruptures of the therapeutic alliance.

Title of Second Talk:

Transference, and Rupture and Repair of the Therapeutic Alliance in Psychotherapy for Psychosis

Description:

Dr. Garrett will note research evidence that chronic psychosis diagnosed as “schizophrenia” would be better considered a bio-psycho-social stress-related disorder that requires psychotherapy than as a genetically determined brain disease treatable primarily with medication. Given the high incidence of childhood adversity (abuse and neglect) in people who develop psychotic disorders, he will describe how in abused children, insecure attachments to primary caregivers lead to implicit relational models of others that are internalized as dissociated, split-off, unintegrated mental representations of the self in relation to grandiose and persecutory psychological objects which, when projected into the individual’s interpersonal world, become manifest as delusions. He will outline how at times, in the psychotherapy of psychotic adults, early self- and object representations emerge in a psychotic transference. He will describe the treatment of three patients with varying intensities of psychotic transference amendable to varying degrees of repair in psychotherapy and offer suggestions for how to avoid and repair disturbances in the therapeutic alliance with patients suffering from psychosis.

Learning Objectives:

After this workshop, participants will be able to:

1. Apply research findings on the role of the therapeutic alliance to their clinical work;
2. Name two factors that account for most of the variance in psychotherapy outcome;
3. Describe three ways of repairing ruptures of the alliance that apply to all patients;
4. Describe research evidence that what is conventionally diagnosed as “schizophrenia” is better regarded as a complex bio-psycho-social stress-related disorder.
5. State how insecure attachments can lead to dissociated internal objects
6. List two aspects of technique in psychotherapy for psychosis that may help minimize therapeutic ruptures.

Speakers' bios:

Nancy McWilliams, PhD, ABPP. is Visiting Professor Emerita of clinical psychology at Rutgers University’s Graduate School of Applied & Professional Psychology and practices in Lambertville, New Jersey. She is author of Psychoanalytic Diagnosis (1994, rev. ed. 2011), Psychoanalytic Case Formulation (1999), Psychoanalytic Psychotherapy (2004) and Psychoanalytic Supervision (2021) and is associate editor of both editions of the Psychodynamic Diagnostic Manual (2006, 2017). A former president of Division 39 (Psychoanalysis) of the American Psychological Association, she has been featured in three APA videos of master clinicians. She is on the Board of Trustees of the Austen Riggs Center in Stockbridge, MA. Her books are available in 20 languages, and she has taught in 30 countries. License: New Jersey Psychologist: 35SI001260000

Michael Garrett, MD is Professor Emeritus of Clinical Psychiatry at SUNY Downstate Medical Center in Brooklyn, New York. He is also on the faculty of the Psychoanalytic Association of New York (PANY), affiliated with NYU Medical Center in New York City. He residency training in Psychiatry was at Bronx Municipal Hospital Center. He currently teaches and supervises clinicians doing psychotherapy for psychosis and consults regularly to several first-episode-for-psychosis teams in the United States and abroad. He has a particular interest in the integration of cognitive behavioral and psychodynamic treatment in the psychotherapy of psychosis, as detailed in his recent book: Garrett, M. (2019) Psychotherapy for Psychosis: Integrating Cognitive Behavioral and Psychodynamic Treatments. Guilford Press/New York.

Licenses:

New York medical license #121229

New Jersey medical license # 25MA11080500

Relevant references:

Eubanks, C. F., Muran, J. C., & Safran, J. D. (2018). Alliance rupture repair: A meta-analysis. Psychotherapy, 55 (4), 508–519. https://doi.org/10.1037/pst0000185

Eubanks, C. F., Sergi, J., & Muran, J. C. (2021). Responsiveness to ruptures and repairs in psychotherapy. In J. C. Watson & H. Wiseman (Eds.), The responsive psychotherapist: Attuning to clients in the moment (pp. 83–103). American Psychological Association. https://doi.org/10.1037/0000240-005

Friedlander, M. L. (2015). Use of relational strategies to repair alliance ruptures: How responsive supervisors train responsive psychotherapists. Psychotherapy, 52 (2), 174–179. https://doi.org/10.1037/a0037044

Garrett, M. (2019) Psychotherapy for Psychosis: Integrating Cognitive Behavioral and Psychodynamic Treatment. New York: Guilford Press.

Muller, T. (2004). "On psychotic transference and countertransference." Psychoanalytic Quarterly, 73 (2), 415-452.

Muran, J. C., Eubanks, C. F., & Samstag, L. W. (2021). One more time with less jargon: An introduction to “Rupture Repair in Practice.” Journal of Clinical Psychology, 77 (2), 361–368. https://doi.org/10.1002/jclp.23105

Tasca, G. A., & Marmarosh, C. (2023). Alliance rupture and repair in group psychotherapy. In C. F. Eubanks, L. W. Samstag, & J. C. Muran (Eds.), Rupture and repair in psychotherapy: A critical process for change (pp. 53–71). American Psychological Association. https://doi.org/10.1037/0000306-003

Yeo, E., & Torres-Harding, S. R. (2021). Rupture resolution strategies and the impact of rupture on the working alliance after racial microaggressions in therapy. Psychotherapy, 58 (4), 460–471. https://doi.org/10.1037/pst0000372