Conversational Model
Encyclopedia
The Conversational Model of psychotherapy
was devised by the English
psychiatrist Robert Hobson
, and developed by the Australia
n psychiatrist
Russell Meares. Hobson listened to recordings of his own psychotherapeutic practice with more disturbed clients, and became aware of the ways in which a patient's self - their unique sense of personal being - can come alive and develop, or be destroyed, in the flux of the conversation in the consulting room.
The Conversational Model views the aim of therapy as allowing the growth of the patient's self through encouraging a form of conversational relating called 'aloneness-togetherness'. This phrase is reminiscent of Winnicott's idea of the importance of being able to be 'alone in the presence of another'. The client comes to eventually feel recognised, accepted and understood as who they are; their sense of personal being, or self, is fostered; and they can start to drop the destructive defenses which disrupt their sense of personal being.
The development of the self implies a capacity to embody and span the dialectic of 'aloneness-togetherness' - rather than being disposed toward either schizoid isolation (aloneness) or merging identification with the other (togetherness). Although the therapy is described as psychodynamic, and is accordingly concerned to identify activity and personal meaning in the midst of apparent passivity, it relies more on careful empathic listening and the development of a common 'feeling language' than it does on psychoanalytic interpretation.
Psychodynamic Interpersonal Therapy - PIT
In its manualised form ('PIT'), the conversational model is presented as having seven interconnected components. These are:
Together with the patient generate an understanding which links emotional or somatic symptoms with interpersonal difficulties
In developing a shared understanding, the therapist uses statements rather than questions, uses mutual ('I' and 'We') language, deploys conditional rather than absolute statements of understanding, allows metaphorical elaborations of the patient's experience to unfold, and makes tentative interpretations or 'hypotheses' about the meaning of the patient's experience.
Feelings that are present in the room are encouraged; abstract talk about feelings by the therapist is discouraged.
Gently commenting on the presence of hidden feelings or the absence of expected feelings.
Interpretations are provided which link the dynamics of the current therapeutic interaction with problematic present and past interactions in the patient's life.
The therapist does not jump in with explanatory interpretations before laying the groundwork of the therapeutic relationship and jointly understanding the emotions present in the room.
Emotional changes that are made by the patient during therapy are offered positive reinforcement.
Research
Web Resources
The Australia and New Zealand Association of Psychotherapy (ANZAP) has a website: http://www.anzapweb.com which contains several http://www.anzapweb.com/html/downloads/journal-article.html resources on the Conversational Model.
Video recording (requires subscription) of lectures about the Conversational Model is available from http://www.psychevisual.com/lecture_summary.html?lecture_summary=1.
A brief introductory week long course on the model is run in Manchester UK twice a year in April and October. http://www.medicine.manchester.ac.uk/postgraduate/cpd/pit/
Psychotherapy
Psychotherapy is a general term referring to any form of therapeutic interaction or treatment contracted between a trained professional and a client or patient; family, couple or group...
was devised by the English
England
England is a country that is part of the United Kingdom. It shares land borders with Scotland to the north and Wales to the west; the Irish Sea is to the north west, the Celtic Sea to the south west, with the North Sea to the east and the English Channel to the south separating it from continental...
psychiatrist Robert Hobson
Robert Hobson
Robert George E. Hobson was a professional footballer, who played for Bishop Auckland, Huddersfield Town, Bradford City and Dulwich Hamlet. He was born in Leeds.-References:*99 Years & Counting - Stats & Stories - Huddersfield Town History...
, and developed by the Australia
Australia
Australia , officially the Commonwealth of Australia, is a country in the Southern Hemisphere comprising the mainland of the Australian continent, the island of Tasmania, and numerous smaller islands in the Indian and Pacific Oceans. It is the world's sixth-largest country by total area...
n psychiatrist
Psychiatrist
A psychiatrist is a physician who specializes in the diagnosis and treatment of mental disorders. All psychiatrists are trained in diagnostic evaluation and in psychotherapy...
Russell Meares. Hobson listened to recordings of his own psychotherapeutic practice with more disturbed clients, and became aware of the ways in which a patient's self - their unique sense of personal being - can come alive and develop, or be destroyed, in the flux of the conversation in the consulting room.
The Conversational Model views the aim of therapy as allowing the growth of the patient's self through encouraging a form of conversational relating called 'aloneness-togetherness'. This phrase is reminiscent of Winnicott's idea of the importance of being able to be 'alone in the presence of another'. The client comes to eventually feel recognised, accepted and understood as who they are; their sense of personal being, or self, is fostered; and they can start to drop the destructive defenses which disrupt their sense of personal being.
The development of the self implies a capacity to embody and span the dialectic of 'aloneness-togetherness' - rather than being disposed toward either schizoid isolation (aloneness) or merging identification with the other (togetherness). Although the therapy is described as psychodynamic, and is accordingly concerned to identify activity and personal meaning in the midst of apparent passivity, it relies more on careful empathic listening and the development of a common 'feeling language' than it does on psychoanalytic interpretation.
Psychodynamic Interpersonal Therapy - PIT
In its manualised form ('PIT'), the conversational model is presented as having seven interconnected components. These are:
- Developing an exploratory rationale
Together with the patient generate an understanding which links emotional or somatic symptoms with interpersonal difficulties
- Shared understanding
In developing a shared understanding, the therapist uses statements rather than questions, uses mutual ('I' and 'We') language, deploys conditional rather than absolute statements of understanding, allows metaphorical elaborations of the patient's experience to unfold, and makes tentative interpretations or 'hypotheses' about the meaning of the patient's experience.
- Focus on the 'here and now'
Feelings that are present in the room are encouraged; abstract talk about feelings by the therapist is discouraged.
- Focus on difficult feelings
Gently commenting on the presence of hidden feelings or the absence of expected feelings.
- Gaining insight
Interpretations are provided which link the dynamics of the current therapeutic interaction with problematic present and past interactions in the patient's life.
- Sequencing interpretations
The therapist does not jump in with explanatory interpretations before laying the groundwork of the therapeutic relationship and jointly understanding the emotions present in the room.
- Acknowledging change
Emotional changes that are made by the patient during therapy are offered positive reinforcement.
Research
The Conversational Model, which has been manualised as Psychodynamic-Interpersonal Therapy, has been subject to outcome research, and has demonstrated effectiveness in the treatment of depression, psychosomatic disorders, self-harm, and borderline personality disorderBorderline personality disorderBorderline personality disorder is a personality disorder described as a prolonged disturbance of personality function in a person , characterized by depth and variability of moods.The disorder typically involves unusual levels of instability in mood; black and white thinking, or splitting; the...
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Web ResourcesThe Australia and New Zealand Association of Psychotherapy (ANZAP) has a website: http://www.anzapweb.com which contains several http://www.anzapweb.com/html/downloads/journal-article.html resources on the Conversational Model.
Video recording (requires subscription) of lectures about the Conversational Model is available from http://www.psychevisual.com/lecture_summary.html?lecture_summary=1.
A brief introductory week long course on the model is run in Manchester UK twice a year in April and October. http://www.medicine.manchester.ac.uk/postgraduate/cpd/pit/