“Any clinician can be successful working with someone motivated to change. The real challenge is being able to influence the treatment-resistant client who has no overt intent or desire to change . . .”
Eliot P Kaplan, PhD, LCSW, CAS
Dr. Eliot P Kaplan is the director of The Paradox Psychology Institute and is the author of this website.
The goals of this website are two-fold:
1) The Paradox Psychology Institute is dedicated to the theory and practice of paradoxical interventions, and its strategic use when working with the ‘treatment-resistant’ client.
2) To offer a scientific base that defines 'change' and theoretically unifies behavioral, cognitive, psychodynamic, and paradoxical orientations.
Goal 1) Paradoxical interventions are particularly important in working with the ‘treatment-resistant’ client. Independent research indicates that paradoxical interventions have a higher rate of success than traditional approaches - behavioral, cognitive, and psychodynamic methods - when working with ‘treatment resistant’ populations. These clients include:
Ø borderline personality,
Ø compulsive disorders,
Ø eating disorders,
Ø oppositional / defiant behaviors
This work will show that it is possible to extend the list to:
Ø addictive disorders,
Ø fire setters,
Ø problem sexual behavior and aggression,
Ø violent behavior and ideation, to name a few.
Goal 2) As will be discussed, it is through understanding the paradoxical method that we are able to define the meaning of 'change' offer the theoretical 'missing link' that unifies the seemingly separate natures of behavioral, cognitive, and psychodynamic orientations under a single conceptual umbrella.
Master Therapists
In this era of ‘evidence based treatment’, we hear little about the potential and historic importance of paradoxical interventions. However, it should be noted that numerous ‘master therapists’ have been associated with the implementation of the method. They include:
Alfred Adler Milton Erikson
Fritz Perls - Gestalt Therapy Salvador Minuchin
Victor Frankl - Logotherapy Virginia Satir
Research supporting paradoxical interventions:
Shoham-Salomon, Avner, & Neeman, (1989) You’re changed if you do and changed if you don’t; Mechanisms underlying paradoxical interventions, Journal of Consulting and Clinical Psychology, 57, 590-598
Horvath & Goheen, (1990) Factors mediating the success of defiance and compliance-based interventions. Journal of Counseling Psychology, 37, 363-371
Beuter, Moleiro, & Talebi (2002) Resistance in Psychotherapy: What conclusions are supported by research, Journal of Clinical Psychology, 58 (2), 207-217
A Peculiar Pre-condition
It should be recognized that almost any treatment method will be successful with the client who is motivated toward change. In terms of treatment-resistant clients, traditional approaches often express a peculiar ‘pre-condition’ before they endeavor to help such clients. That pre-condition is that the client must be willing to ‘participate, or make some minimal effort to cooperate’. In other words, these approaches ask that the resistant client should ‘agree to be less resistant’ so that treatment might be successful!
Paradoxical interventions do not rely on this pre-condition, and are therefore not invested in gaining the client’s overt agreement, or willful cooperation to ‘participate’. However, the process of treatment does impact the client’s underlying ‘free will’ and desire to take self-responsibility toward achieving personal changes. The question we will address is: What is the ‘active ingredient’ that makes the paradoxical method successful?!
Counter-intuitive
While the method is known for its ability to influence exponential and rapid change, many seasoned clinicians are wary of the approach. This is due to the fact that interventions are often counter intuitive and lack face validity. As a result, due to the ambiguity around the dynamics of this approach, little recent effort has been made to encourage a new generation of clinicians from embracing and learning about this significant and powerful approach.
Science Based Approach
Through the science of an ‘orbits-gravity model’, this work intends to clarify the mechanism of the paradoxical approach, and the unified relationship between behavioral, cognitive, and psycho-dynamic orientations.
Dr. Eliot P. Kaplan can be reached at:
email: ParadoxDoc@gmail.com
phone: 917-345-5750.
www.ParadoxPsychology.com EPK Revised: 8-30-2009
