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Paradox in psychotherapy: a cybernetic perspective.

J S Efran, G C Caputo

    Journal of Behavior Therapy and Experimental Psychiatry
    |September 1, 1984
    PubMed
    Summary

    Psychotherapy, including behavior therapy, is inherently paradoxical due to self-evaluation. Effective therapy hinges on the therapist-client relationship and negotiated social contracts, not just techniques.

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    Area of Science:

    • Psychology
    • Psychotherapy Research
    • Behavioral Science

    Background:

    • The term "paradox" in psychotherapy often narrows focus.
    • Self-evaluation's recursive nature implies all therapy is paradoxical.
    • Agoraphobia is characterized by a demand for environmental control.

    Purpose of the Study:

    • To explore the broader implications of paradox in psychotherapy.
    • To reframe behavior therapy within a relational and contractual framework.
    • To highlight the significance of the therapist-client dyad.

    Main Methods:

    • Conceptual analysis of "paradox" in psychotherapy.
    • Illustrative case example using agoraphobia.
    • Examination of the therapist-client relationship as a "bonding of two observers".

    Main Results:

    • Therapy's effectiveness relies on the negotiated social contract between therapist and client.
    • Even seemingly automatic behavioral techniques are embedded within this contract.
    • The client-as-observer and therapist-as-observer relationship is crucial.

    Conclusions:

    • All psychotherapy, including behavior therapy, is fundamentally paradoxical.
    • The therapeutic relationship and negotiated agreements are paramount to successful outcomes.
    • Behavior therapy is defined by its context within a social contract.

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