The Therapeutic Frame
Introduction to the Therapeutic Frame
The therapeutic frame refers to the fundamental guidelines within which psychotherapy is conducted. Psychodynamic therapists are especially concerned with formulating the therapeutic frame to create a predictable and safe psychological and physical space for conducting therapy (Howard, 2009). It is imperative to have this space in counselling as it has been proven to optimise the conditions for the client to come to touch with his/her internal world, thus, enabling emergence of the transference relationship (Corsini, Wedding & Dumont, 2008). By establishing the frame with clients, psychotherapists essentially set out a therapeutic contract so that when they or their clients deviate from the so formed contract, they can remain open in thinking out and understanding the deviation.
To construct the therapeutic frame, psychodynamic therapists utilise conventions that are not only very discipliners but also entirely incompatible with social relationships. This makes the rame act as a demarcation to set the scene for therapy by delineating the therapeutic relationship from all other associations in the life of the client (Mathison, 2009). As such, the client is able to express their thoughts, fantasies and feelings, some of which would not be acceptable in many other types of relationships, and are actually discouraged and shunned in some therapeutic models. In the end, the client is facilitated to access unconscious materials through a framework comprised of clinical techniques that include transference and counter-transference exploration (Zunker, 2011).
The analytic frame in psychotherapy is made up of two components: the analytic attitude and the analytic setting. The analytic attitude refers to the stance adopted by the therapist towards the client, and this has four core features that have been established through many years of consistency in clinical practice – neutrality, reliability, abstinence and anonymity (Lemma cited in Howard, 2009). On the other hand, the analytic setting is the physical aspect of the therapy such as the management of place and time. Should the client feel safe enough within the established therapeutic frame, they are more able to utilise the presence of the therapist in facing their deprivations, hurts and anxieties that have made them seek the therapy. They also feel safe in working with the therapist in a transference relationship. The ability to deploy the five features proposed by Lemma depends largely on the work completed in each therapy session and is further supported by supervision, reading and observation. Ethics and Ethical Dilemmas in Counselling
In the course of their practice, psychotherapists are often faced by challenging circumstances in which it is virtually impossible to reconcile all the relevant principles of psychology and choose between the available options all of which have their benefits and shortcomings. Nevertheless, ethical decisions in psychotherapy have to be strongly supported by valid ethical principles as provided by the Psychotherapy and Counselling Foundation of Australia (PACFA) and be free from any contradiction from others. However, it is imperative to note that a decision or course of action cannot be necessarily regarded as unethical just because it is contentious or because other practitioners would have arrived at different conclusions and decisions in the same situations (Akhtar, 2009).
The Psychotherapy and Counselling Federation of Australia (PACFA) states fidelity, autonomy, beneficence, non-maleficence, justice and self-respect as the ethical principles that direct the attention of psychotherapists to concentrate on their practice with appropriate responsibility and accountability for their actions (PACFA, 2011). Fidelity entails the trust bestowed in the practitioner by regarding confidentiality as an obligation that arises from the trust of the client (Corsini, Wedding &...
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