The Therapeutic Contract: How treatment arrangements determine the effectiveness of therapy

Description

What is a therapeutic contract?

The therapeutic contract is a tactic that ensures the effectiveness of the entire treatment.This is the first step toward consistent and successful psychotherapy, which cannot begin without establishing clear treatment parameters.

The therapeutic contract is not just about “time, place, and fee.” It is about creating an environment in which an effective psychotherapeutic process can unfold. The therapeutic contract establishes the treatment frame, delineates the responsibility of each participant, and prepares the foundation for observing, studying, and modifying the patient’s psychic dynamics within the therapeutic space.

The therapeutic contract defines the reality of the therapeutic relationship. Guided by these agreements, the therapist can recognize the patient’s distortions of the therapeutic relationship, which opens the “royal road” to the patient’s unconscious – any deviations from the contract by the patient become objects of exploration and understanding in therapy. Without clear agreements about contact, these deviations can be elusive, leading to confusion in transference and countertransference and, in turn, to therapeutic impasse.

Why is it important to establish a therapeutic contract?

With a therapeutic contract, psychotherapists can:
– Establish a mutual understanding of the issues with the patient
– Define the reality of the therapeutic relationship
– Set the central focus on treatment goals
– Specify the responsibilities of both the patient and the therapist
– Protect the patient, the therapist, and the therapy itself
– Safeguard the therapist’s ability to think clearly
– Create a safe space for the unfolding of the patient’s dynamics and affects
– Lay the foundation for interventions regarding deviations from the contract (which provide a direct path to understanding the patient’s unconscious material)
– Establish the basis for forming the therapeutic alliance

The primary function of the contract is to bring conflicting object relations into the therapeutic process—in other words, to transform chronic acting-out behaviors into identifiable and examinable component object relations.

Which issue does the therapeutic contract address?

Individuals with borderline and other personality disorders tend to act out their conflicts in potentially dangerous ways that can create serious difficulties in psychotherapy, where the therapist may feel that their primary role is to “rescue” the patient from self-destructive behavior rather than conduct psychotherapy.

The more severe the patient’s disorder and the more distorted their interpersonal interactions in the therapeutic relationship, the more powerful the primitive object relations in the transference. These evoke an intense countertransference. The therapeutic position is vulnerable to the threat of potential acting out of transference feelings by the patient and, at times, to the therapist’s temptation to act out their own countertransference. Without a well-thought-out and mutually discussed therapeutic frame and contract, the mutual enactment of transference and countertransference obscures the therapist’s clear understanding of the psychodynamics of what is taking place.

With higher-functioning patients, different challenges emerge. The dynamics of higher-functioning patients are more difficult to track because their reactions in therapy appear almost normal. It is not easy to notice subtle deviations, and this is where the therapeutic frame and contract also helps – minor deviations from the agreed frame open the way to exploring deeper dynamics.

Who benefits from attending the webinar?

This webinar will be particularly valuable for:
– Psychodynamically (including psychoanalytic) oriented therapists
– Humanistically oriented therapists
– TFP-certified therapists seeking to refine their application of the TFP model
– TFP-oriented therapists who are on the path to certification

What does the webinar consist of?

The webinar is divided into three consecutive blocks:
– Block I – Didactic Lecture
– Block II – Didactic Session 1, Clinical Segment (Video Analysis), Q&A
– Block III – Didactic Session 2, Clinical Segment (Video Analysis), Q&A

Languages

We provide a comprehensive bilingual environment at our workshops, webinars, trainings so that participants fluent in both English and Ukrainian feel equally comfortable.

If the instructor uses slides, we ensure that bilingual slides are prepared, and if he/she uses videos, we subtitle them so that each participant feels equally comfortable learning. Audio broadcasting is done through separate audio channels, particularly in English and Ukrainian. Furthermore, participants in both languages find it equally convenient to ask questions and engage in discussions.

Join the training as this program is essential for all psychodynamic therapists, teaching you to understand personality disorders at the deepest level, which is the basis for appropriate therapeutic interventions.

Promotional webpage

Modalities

April 27, 2025

New York time: 8:40 a.m. – 3:00 p.m.
London time: 1:40 p.m. – 8:00 p.m.
Kyiv time: 3:40 p.m. – 10:00 p.m.
There will be two 30-minute breaks

Tuition fee: 175.00 USD 

Faculty

Monica Carsky, PhD

Contact

If you have any questions contact the curriculum organizer Oleksii Lemeshchuk: [email protected] 

Registration

Follow the link to register

REGISTRATION