The clinical outcome. Implications for training and research

The end of the therapy and the clinical stance

The psychodynamic approach enables us to understand that human relationships are complex, and that there is rarely a neat ending to a problem, particularly where people have experienced trauma and challenges in their early lives. This implies that children, parents and young people may return for therapeutic help at a later stage, since some of these problems may not be fully resolved. As mentioned earlier, this is always a sign that the earlier therapy has been a success, and never that it has been a failure. In fact, the speed, with which people pick up the therapeutic process when they return, is in itself evidence of success and resonates with the earlier foundational work that has taken place.

This foundational work is underpinned by what may be described as the clinical stance of the therapist. In the context of our fast-paced environment, the clinical stance avers that there are no simple answers to the complexity of human experience and suffering. In seeking to find meaning and understanding, the clinical stance asserts that reflection is a legitimate part of this process and must always precede action. Maintaining the clinical stance is reassuring for clients and patients. It provides a containing framework for them, as opposed to one which seeks after facile solutions, and is not dependent on the nurturing of relationships.

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