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Therapeutic Alliance, Focus, and Formulation: Thinking Beyond the Traditional Therapy Orientations

Therapeutic Alliance, Focus, and Formulation: Thinking Beyond the Traditional Therapy Orientations

by Robert-Jay Green

The main elements of successful therapy include a positive therapeutic alliance, a clear focus, a coherent problem formulation, and improvised techniques—not a particular theoretical orientation.
I recently attended the 40th annual retreat conference sponsored by the Association of Family Therapists of Northern California (AFTNC), and this year's renowned speaker, Monica McGoldrick, showed many videotapes of her own work. Throughout the two-day conference, I was continually impressed by her ability to relate so very closely and easily with such a racially and culturally diverse group of clients. I also kept noticing how much of the connecting seemed to take place through nonverbal behaviors and tone of voice (conveying warmth, comfort, directness, engagement, confidence, being collaborative, and indicating genuine interest in the details of people's life histories). As president of AFTNC, I also received lots of spontaneous comments afterwards about Monica McGoldrick being such a "lovely person," a "great human being," so "down-to-earth," "easy to relate to," "willing to show her mistakes," and so on. At the same time, I heard many therapists in the audience make comments about how they work so very differently from McGoldrick in terms of not using extended family genograms as a main vehicle for connecting nor using traditional Bowen coaching methods with one family member. I also heard a few complaints that McGoldrick's presentation did not allow for easy note-taking in that it was not structured with specific teaching points or generalizable techniques one could use with almost every case.
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Copyright © 2004 Robert-Jay Green. All rights reserved.
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Robert-Jay GreenRobert-Jay Green is Professor and Associate Director of the Clinical Psychology Ph.D. Program, California School of Professional Psychology at Alliant International University, San Francisco campus. He has a private practice in San Francisco specializing in couples therapy, and is currently President of the Association of Family Therapists of Northern California (AFTNC). He is author of more than sixty publications about couples/family interaction and therapy. You may contact him at 415-749-0100 or by email: rjgreen415@cs.com. His personal website is at: www.robertjaygreen.com.
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CE credits: 1
Learning objectives:

• Explore the core elements for effective psychotherapy.
• Understand factors that contribute to a positive therapeutic alliance.
• Recognize the significance of direct observation of training therapists' work.
• Recognize the significance of direct observation of training therapists' work.
• Understand the importance of maintaining focus throughout the course of therapy. 
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