Collaborative therapy
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Collaborative therapy is a therapy developed by
Harlene Anderson Harlene Anderson (born 1942) is an American psychologist and a cofounder of the Postmodern Collaborative Approach to therapy. In the 1980s, Anderson and her colleague Harold A. Goolishian pioneered a new technique that is used to relate to patients ...
, along with Harold A. Goolishian (1924–1991), in the US. It is intended for clients who are well educated in any field, or for those that have distrust of psychotherapists due to past negative experiences with one or more.


Overview

Collaborative therapy gives the client the option to have a "non-authoritarian" counsellor, for clients who are not
heteronormative Heteronormativity is the concept that heterosexuality is the preferred or normal mode of sexual orientation. It assumes the gender binary (i.e., that there are only two distinct, opposite genders) and that sexual and marital relations are most ...
, who have gender dysphoria or are
transgender A transgender (often abbreviated as trans) person is someone whose gender identity or gender expression does not correspond with their sex assigned at birth. Many transgender people experience dysphoria, which they seek to alleviate through ...
, or who choose to live an alternative lifestyle. Anderson used collaborative therapy in family therapy and marriage therapy with success, and believed it could help families and partners to understand the client better, should the client find that they cannot adhere to social norms any more, such as coming out as transgender or homosexual. Collaborative therapy is intended primarily for adults, and for those with
dual diagnosis Dual diagnosis (also called co-occurring disorders (COD) or dual pathology) is the condition of having a mental illness and a comorbid substance use disorder. There is considerable debate surrounding the appropriateness of using a single categ ...
, (i.e. more than one mental health issue usually due to substance abuse such as alcohol and non- prescription drugs);
bipolar disorder Bipolar disorder, previously known as manic depression, is a mental disorder characterized by periods of depression and periods of abnormally elevated mood that last from days to weeks each. If the elevated mood is severe or associated with ...
, chronic
schizophrenia Schizophrenia is a mental disorder characterized by continuous or relapsing episodes of psychosis. Major symptoms include hallucinations (typically hearing voices), delusions, and disorganized thinking. Other symptoms include social wit ...
and parents with
psychosis Psychosis is a condition of the mind that results in difficulties determining what is real and what is not real. Symptoms may include delusions and hallucinations, among other features. Additional symptoms are incoherent speech and behavior ...
,
body dysmorphic disorder Body dysmorphic disorder (BDD), occasionally still called dysmorphophobia, is a mental disorder characterized by the obsessive idea that some aspect of one's own body part or appearance is severely flawed and therefore warrants exceptional meas ...
. The model is a
postmodernist Postmodernism is an intellectual stance or mode of discourseNuyen, A.T., 1992. The Role of Rhetorical Devices in Postmodernist Discourse. Philosophy & Rhetoric, pp.183–194. characterized by skepticism toward the " grand narratives" of modern ...
approach that maintains that human reality is created through
social construction Social constructionism is a theory in sociology, social ontology, and communication theory which proposes that certain ideas about physical reality arise from collaborative consensus, instead of pure observation of said reality. The theory ...
and dialogue, and aims to avoid "the traditional Diagnostic and Statistical Manual of Mental Disorders (
DSM-IV The ''Diagnostic and Statistical Manual of Mental Disorders'' (DSM; latest edition: DSM-5-TR, published in March 2022) is a publication by the American Psychiatric Association (APA) for the classification of mental disorders using a common langu ...
) used to diagnose individuals". It uses the idea that the clients become subject to mental pain when they have tried to apply "oppressive tories which dominate the person's life. It posits that problems occur when the way in which peoples' lives are storied by themselves and others does not significantly fit with their lived experience. It also assumes that significant aspects of their lived experience may contradict the dominant narrative in their lives. It states that the client internalizes what they regard as unreasonable societal standards, and in doing so are aspiring to ideals of fulfillment and excellence, leading to, for example, self-starvation and
anorexia Anorexia nervosa, often referred to simply as anorexia, is an eating disorder characterized by low weight, food restriction, body image disturbance, fear of gaining weight, and an overpowering desire to be thin. ''Anorexia'' is a term of Gre ...
, extreme self-criticism in
clinical depression Major depressive disorder (MDD), also known as clinical depression, is a mental disorder characterized by at least two weeks of pervasive low mood, low self-esteem, and loss of interest or pleasure in normally enjoyable activities. Intro ...
, or a sense of powerlessness in the face of threat and
anxiety Anxiety is an emotion which is characterized by an unpleasant state of inner turmoil and includes feelings of dread over anticipated events. Anxiety is different than fear in that the former is defined as the anticipation of a future threat wh ...
"; obsessive compulsive disorder (OCD), and
trichotillomania Trichotillomania (TTM), also known as hair-pulling disorder or compulsive hair pulling, is a mental disorder characterized by a long-term urge that results in the pulling out of one's own hair. A brief positive feeling may occur as hair is remov ...
(hair pulling). These last two mental health issues as well as anorexia can often symptoms of body dysmorphic disorder (BDD). Cognitive behavioral therapy (CBT) can also be useful to treat this last condition.) (page 2)


Process

Using the principle of 'not-knowing', Goolishian and Anderson's term for the recommended approach that therapists should have towards their clients. In this approach therapists avoid taking dogmatic postures and try to remain flexible to have their perspectives altered by their clients. In her book, Conversation Language and Possibilities: A Postmodern Approach to Therapy, Anderson says, "The meaning that emerges n therapyis influenced by what a therapist bring into conversation and their interactions with each other about it. The issue of new meaning relies on the novelty (not-knowing). Fred Newman and Lois Holzman talk about something quite similar when they speak about the "end of knowing." Fred Newman discusses the concept of non-knowing in his book, ''The End of Knowing; A New Developmental Way of Learning''. The therapist stance according to Collaborative Theory is summarized in the following list: * Mutually Inquiring Conversational Partnership – Therapy as a partnership * Relational Expertise – Client and therapist bring their expertise together * Not-Knowing – Humility before the client * Being Public – Therapist is open with their invisible thoughts * Living with Uncertainty – Enjoy the spontaneity of a conversation * Mutually Transforming – Hermeneutic circle, reciprocal effect on client and therapist * Orienting towards Everyday Ordinary Life – Tap into natural resilience of clients.


Criticisms

When there is a serious lack of and need for
community-based rehabilitation The aim of community-based rehabilitation (CBR) is to help people with disabilities, by establishing community-based medical integration, equalization of opportunities, and Physical therapy (Physiotherapy) rehabilitation programs for disabled peopl ...
programmes, including
behavioural Behavior (American English) or behaviour (British English) is the range of actions and mannerisms made by individuals, organisms, systems or artificial entities in some environment. These systems can include other systems or organisms as wel ...
and
psychosocial The psychosocial approach looks at individuals in the context of the combined influence that psychological factors and the surrounding social environment have on their physical and mental wellness and their ability to function. This approach is ...
treatment programmes, (page 5) it is difficult for the client to get medical back-up for the therapy which can makes the treatment less effective. In the case of more serious mental issues such as
schizophrenia Schizophrenia is a mental disorder characterized by continuous or relapsing episodes of psychosis. Major symptoms include hallucinations (typically hearing voices), delusions, and disorganized thinking. Other symptoms include social wit ...
, there is a likelihood that 30% of clients will have a poor long term prognosis, as stated by Linzen in 2003. (page 6) Two out of three people with schizophrenia recover significantly.


Bibliography

* ''"Collaborative Therapy: Relationships and Conversations that make a Difference"'', (2007) Anderson, Harlene; Gehart, Diane. ''Collaborative Therapy: Relationships and Conversations that make a Difference'' (Softcover) {{ISBN, 978-0-415-95326-9 (Hardcover). 2007. Routledge. New York. Oxon.


References


External links


Social Construction Therapies Network
Psychotherapies Treatment of bipolar disorder