Becoming a Therapist: What Do I Say, and Why?

Foreword,Nhi-Ha Trinh

Introduction

I. The Consultation

1. First Contact 

2. The First Moments

3. Initiating an Alliance and Assessing Safety

4. Enhancing the Therapeutic Alliance and Eliciting History

5. Collecting a Psychosocial History and Screening for Common Psychological Disorders

6. Creating a Formulation and a Treatment Plan

II. Frame and Variations

7. The Frame

8. Setting the Fee and Billing

9. Telephone Calls and Emails: From Dependencies to Emergencies

10. No-Shows, Late Arrivals, and Late Departures

11. When the Therapist’s Life Affects the Frame: Vacations, Pregnancies, and Illness

12. Confidentiality and Its Limits

III. Chemistry

13. Substance Use Disorders

14. Integrating Psychopharmacology with Psychotherapy

IV. Therapeutic Dilemmas

15. Managing Impasses

16. Empathic Lapses

17. Transference and Countertransference

18. Termination

V. Being a Therapist

19. Professional Development

Glossary

Additional Readings

References

Index

Suzanne Bender, MD, is a Staff Psychiatrist in the Division of Child and Adolescent Psychiatry at Massachusetts General Hospital (MGH) and Assistant Professor in Psychiatry, part-time, at Harvard Medical School. Within the Department of Pediatric Gastroenterology (GI) and Nutrition Department at MGH for Children (MGHfC), she is the Co-Director of the MGHfC Pediatric GI Psychiatry program. Dr. Bender teaches a weekly year-long course on child and adolescent psychodynamic psychotherapy in the MGH/McLean Child and Adolescent Psychiatry Fellowship Program. She has received five departmental teaching awards and three departmental mentoring awards from the graduating classes of the Child Psychiatry Fellowship. Dr. Bender has a private practice in Newton, Massachusetts, specializing in psychotherapy and psychopharmacology with children, adolescents, and adults.

Edward Messner, MD, until his death in 2006, was a Senior Psychiatrist at Massachusetts General Hospital (MGH) and Associate Clinical Professor of Psychiatry at Harvard Medical School. Dr. Messner trained as a psychiatrist at the Boston VA Hospital, at Boston’s Thom Clinic, and at MGH. He also graduated from the Boston Psychoanalytic Institute as a certified psychoanalyst. Dr. Messner received the Teacher of the Year award from the MGH Department of Psychiatry eight times. To honor him and his qualities of “kindness, compassion, understanding, insightfulness, humility, and selflessness in his daily work with patients and as an untiring teacher and supervisor of residents,” the MGH/McLean Adult Psychiatry Residency created the Edward Messner Faculty and Resident Awards in 2008. These awards annually recognize outstanding and committed teaching in Adult Psychiatry by both a faculty member and a graduating resident.