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Treatment Guidelines' Effect On Therapists' Willingness

Treatment Guideline's Effect
Abstract
Working with trauma survivors leads to intense countertransference reactions. These are counterproductive to the efficacious treatment environment of survivor empowerment. A theoretical orientation using medical analogies can further frustrate the survivor and clinician with the implicit assumptions of the clinician having a "cure" and the survivor having symptoms that should be treated and alleviated. Both of these assumptions lead to decreased survivor empowerment and a strain on the theraputic alliance with pressures for a quick cure and an assumption that generalized guidelines can be applied to specific relationships. The clinician may respond with a sense of being "deskilled" and rely more than usual upon outside sources including "expert" consultation and written guidelines based upon diagnosis. Unfortunately, experts have their own bias, based upon their own unresolved countertransferences and methodological orientation. These biases can then be passed on to the primary clinician. This study will attempt to determine how strongly this bias might affect the primary clinician by looking at willingness to use coercion on a "paper patient" with strongly differing treatment guidelines as the independent variable.

Treatment Guideline's Effect
Research Literature Review of
Treatment Guideline's Effect on Therapists' Willingness to Use Coercion with Trauma Clients

Impetus for conducting this study. As I have done volunteer peer-support service work over the Internet, I have noticed more and more therapy clients describing problems in the theraputic alliance. Many therapists have decided what goals they have for the client, and refuse to work with any clients that don't agree with the goals. Others seem to be fearful of a client's possibility of acting out, and act with pre-emptive haste to control, causing severe disruptions in the development of a trusting relationship. These techniques are in direct contradiction...