Re: Construing Psychotherapy Outcomes and the Role of Persuasion
Fri, 19 Apr 1996 23:11:58 -0400

In a message dated 96-04-18 04:24:17 EDT, you write:

>Do you
>consider useful what you attain with these people? It is diffcult for me
>to understand if you doubt the values you offer as alternative of
>construing, ie the goals you feel being imposed with? How would it be
>these alternatives? Try to picture their perspectives.
>What do you thik we try to convey to our own children? I should say: look
>here are
>the requirements one has to respect (not comply, please) in order to to
>have the liberty to look for some own ways. Find the way you want to deal
>with them - but be sure you can cope with all consequences created by it. Be

>sure you anticipate the result of your choise. It takes us years as
>parents to do this, you have only moths perhaps. Is the principles the same?

Dear Ana and Others,

Thank you for your reply to my posting. I do want some feedback from people
involved in PCP regarding the role of persuasion and manipulation in the
clinical role. I particularly want to hear from some people whom are strict
Kellians philosophically. You have somewhat misunderstood my question as I
did not give enough background regarding myself. I have read Kelly
extensively but in the absence of receiving any direct feedback from other
Kellian clinicians. I now want to have that direct feedback. In that
absence, I have developed my own interpretations and compromises and live in
a "real world of managed care" as Tim points out.

I do a great deal of interventions that work and I feel good about. I
believe it benefits the client and they generally feel good about the
intervention I have made eventually although it is often uncomfortable as I
do the intervention.

I heartily agree with all of your assertions in the above excerpt from your
reply and do not personally object to any of the answers to which you imply
in the above questions.

My questions I am asking about surround the role of the therapist or parent
as the expert in teaching and pushing a client or child towards a particular
pro-social goal. I am wondering how the strict PCP decides it is okay to
push a client towards a particular goal as correct when Kelly spends so much
time spoofing the role of "expert" and "one correct solution." Also
regarding the parent whom modifies the environment to achieve a particular
pro-social goal, who is to say this is the correct choice and is it ethical
in PCP to steer a person that way. In some way, this is an extension of the
discussion of the culturally based questions of truth.

Whom says it is better to stay outside the hospital when living inside a
hospital is a valid choice? Adopting the role of the expert and making the
choice to make life uncomfortable for the "hospital home bound" client, I
pride myself on my ability to create dissonance, rewards, alternative
constructions, reframing, and support throughout the difficult transition
from hospital to "real home in the community." This is a miserable
experience for the client during the transition. I help to cause them to be
dissatisfied with their former "home and earlier peer group" by creating new
expectations and values about the future. I dislodge them and move them into
a cold and cruel world filled prejudiced people about their past whom will
treat them badly. I develop coping skills and social armor to weather this
transition. These are skills they did not need in the safety of the
hospital. I remove for them the possibility of suicide from their scope
through repeated value judgements about the future and the development of
core constructs. "Life is harder now but so much fuller. Look how far you
have come...."

With this they have changed. They are new people and I and society have
decided this is better. I do allow the client to know my manipulations and
my goals. My clients generally come to me by choice although often their
alternatives suggest only one true choice. I was confident of my success and
will stay with the client throughout all of this process.

Did I, from a strict PCP vantage point have that right to disrupt their
earlier life and why? What are my limits and obligations regarding this
change. This is philosophical question for which I want to hear how this
question is resolved by others.

Feedback is much appreciated.