This article gives a good checklist for persons trying to assess a psychotherapist or the behavior of a spiritual leader who has appropriated theories and techniques based on psychotherapy. The original article has diagrams that cannot transfer to message board posts--the URL is
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[b:126763f113]Undue Therapist Influence: A Paradigm[/b:126763f113]
Steve K. D. Eichel, Ph.D.
[i:126763f113]Medical ethics[/i:126763f113]
All things being equal (or all things considered), always favor the less intrusive approach. ([i:126763f113]Moderator note: the Prime Directive in health care is 'Above all, do no harm'[/i:126763f113])
The more [i:126763f113]intrusive [/i:126763f113]the treatment, the more the need for:
([i:126763f113]Moderator note: In other words, as intrusiveness increases, therapist accountability must increase--not decrease!)[/i:126763f113]
*External controls.
*External validation of the treatment's effectiveness.
*Therapist compliance with scientifically-validated treatment guidelines.
[b:126763f113]General rule[/b:126763f113]
*The more intensive and intrusive the therapy, the stronger the likelihood of abuse.
*The more intensive and intrusive the therapy, the more we need external controls.
*Conscious and unconscious motivations that might contribute to abuse
Material gain
Sexual conquest
Desire to validate one's own memories of abuse
Desire for professional fame and power
[i:126763f113]Modalities of abuse[/i:126763f113]
*Con-artist tactics (the therapist has strong sociopathic tendencies and is not primarily concerned with client wellbeing).
*Well-intended abuses of power: Therapeutic Techniques that can become exploitive.
Transference intensification methods.
*Prolonged sessions. (that exceed the 50 minute hour)
*Intensive therapy (e.g., analysis).
*Encouragement of dependence.
*Covert and overt sexualization.
*Hypnosis and hypnoidal methods: A new hypnosis model suggested by Theodore X. Barber may account for the ease with which some clients have trance experiences even without formal hypnosis.
*Hypnotherapy, especially by relatively untrained or poorly trained therapists.
*Guided imagery.
*Regression therapy.
[i:126763f113]Social Demand methods[/i:126763f113]
*Group therapy
*Role-playing
*Milieu therapy
[i:126763f113]Dimensions[/i:126763f113]
Treatment Permissiveness
Highly permissive
Decreased pervasiveness
Target is specific behavior, not underlying personality, change.
Focus is on current life, not childhood.
Minimal attempts by therapist to direct client's behaviors outside therapy hour.
Minimal interpretation of client's world by therapist.
[i:126763f113]Decreased influence[/i:126763f113]
*Highly client-centered ([i:126763f113]Focus is on client, therapist doesnt draw attention to him/herself, therapist keeps self-disclosure to a minimum--moderator[/i:126763f113] As one therapist puts it 'This hour belongs to YOU.')
*Permissive techniques only (See list above)
*Minimal use of overt or covert pressure.
*Minimal interpretation of client's world by therapist.
[i:126763f113]Decreased Intrusiveness[/i:126763f113]
*Minimal confrontation; "soft" confrontation.
*Minimal direction of affect experience and expression.
*Minimal attempts by therapist to direct people within client's sphere of social interaction.
*Minimal attempts by therapist to influence client's decision-making process.
*Decreased regression and dependency.
*Minimal attempts to initiate client regression.
*Minimal attempts to facilitate dependency.
[i:126763f113]Highly coercive[/i:126763f113]
*Increased pervasiveness
*Target is underlying personality change.
*Focus is on childhood, especially "forgotten" experiences; high degree of interpretation.
*Attempts by therapist to direct client's behaviors outside therapy hour.
[i:126763f113]Increased influence[/i:126763f113]
*Therapist directs treatment agenda.
*Therapist relies on directive techniques.
*Therapist incorporates overt or covert pressure.
*Therapist routinely interprets client's world; may encourage radical redefinitions of personal history (at risk for so-called "false memories")
[i:126763f113]Increased intrusiveness[/i:126763f113]
*Targeted "hard" confrontation.
*Therapist directs client's affect experience and expression.
*Therapist attempts to direct people within client's sphere of social interaction.
*Therapist attempts to direct client's decision-making process.
[i:126763f113]Increased regression and dependency.[/i:126763f113]
*Therapist deliberately and/or routinely regresses client.
*Therapist attempts to "reparent" client.
[i:126763f113]Suggestions for therapist working at various points along the continuums (Permissiveness vs. Coercion; Minimal vs. Maximum External Control).[/i:126763f113]
[u:126763f113]Therapy is highly permissive. [/u:126763f113]
Supervision/consultation can be informal and on as-needed basis.
[u:126763f113]Therapy involves moderate degree of influence and directiveness.[/u:126763f113]
Ongoing, regular supervision/consultation.
Therapist makes certain to keep abreast of research, including research critical of therapy approach.
Therapist engages in own therapy (focus on counter-transference) on as-needed basis.
[u:126763f113]Therapy is highly coercive.[/u:126763f113]
Ongoing, regular supervision/consultation, preferably with a highly skilled, mature therapist [i:126763f113]not [/i:126763f113]connected with agency or practice.
Therapist is engaged in own therapy with a highly skilled, [i:126763f113]mature [/i:126763f113]therapist [i:126763f113]not [/i:126763f113]connected with agency or practice.
Agency or program is routinely evaluated by outside credentialing body.
Therapist routinely and continuously exposes him/herself to research, including research critical of therapy approach.
([i:126763f113]Moderator note: It is important to see that Eichler insists any therapist using high risk methods must get regular consultation/supervision from someone who is 'mature'--that -which I take to mean someone who is [u:126763f113]not [/u:126763f113]a member of that therapist's 'fan club.'
It is noteworthy how most cultic therapists practice high risk methods and yet avoid the accountablity structures in Eichler's list: they much prefer to associate with other therapists who are disciples or admirers--which means they do not consult or socialize with persons who are mature. And the cultic therapists usually avoid getting input from persons who are independant of them--
everything is kept 'in house' as much as possible.
Finally, cultic therapists are likely to avoid peer review by audiences outside their cozy circle. They prefer to market their material to adoring, uncritical audiences[/i:126763f113])
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[i:126763f113]The following is based on a series of presentations and workshops by Dr. Steve Dubrow-Eichel, Dr. Linda Dubrow and Roberta Eisenberg to: The Fourth International Conference on Sexual Misconduct by Psychotherapists, Other Health Care Professionals & Clergy hosted by the Boston Psychoanalytic Society and Institute, Chestnut Hill, MA (1998, October); the annual meeting of the Pennsylvania Psychological Association, Pittsburgh, PA (1998, June); and the annual Renfrew Foundation conference, Philadelphia, PA (1997, November)].
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