Mentalizing in the psychotherapy of a disturbed adolescent girl

Intensive psychiatric treatment with emerging adults: Addressing the problem of establishing collaboration

The Compass Program at The Menninger Clinic was designed to assess and treat emerging adult psychiatric patients with severe disorders. Establishing a collaborative therapeutic relationship with these challenging patients is an essential step in facilitating effective assessment and treatment for them. The author presents a therapeutic model for engagement and collaboration. Three interrelated processes that are keys to promoting and creating collaborative behavior are described: (1) taking agency, the ability to accept responsibility for and believe in one's own contribution to solving problems; (2) mentalizing, the ability to reflect on, as opposed to react to, mental states in self and others, as well as to contemplate the issues in one's treatment process, and (3) the ability to examine one's problems from the standpoint of identifying core issues, those internal and external factors that have been impediments to one's progress. Case examples are used to illustrate these processes.

Finding and refinding the therapeutic alliance: on thinking and thirds

This article represents an attempt to clarify some of our thinking about the component aspects of the analytic relationship as they enter into and play their role in the analytic setting and process. The interaction between transference and alliance generates a dual mental perspective within which the patient experiences and thinks about the analysis and the analyst experiences and thinks about the patient. Concepts of an analytic third, by displacing aspects of the alliance component of this dual relational perspective into either a separate transitional mental space or subjective third, have arisen in the attempt to shed light on the multiplicity of interactional perspectives in analysis: these are discussed and evaluated. The argument concludes that resort to the concept of an analytic third effectively dilutes the direct interpersonal involvement and responsibility of both analyst and patient for transactions within the therapeutic alliance.