10) Contracting for Success – The most helpful aspect of a ‘written contract’ is that it is a physical document the client can hold. This acts as a reminder that other people are in his life. It also reminds him of what is expected if he is to be responsible in fulfilling the contract. In a sense the contract reinforces that someone is ‘looking over his shoulder’ and is a ‘witness’ to him and his behavior. It serves as physical proof that he exists in relation to the therapist (and others). As such, the ‘contract’ has an excellent potential to reinforce the ‘therapeutic alliance’.
Having stated this, it is important to note that the prevailing and conventional use of written contracts is to focus on ‘changing behavior’ rather than improving the alliance. For this reason contracts often are a destructive force, since they tend to set the client up for failure. Particularly the treatment-resistant client often has no motivation to participate in the contract. Since the focus of the contract is on behavior, such conventional contracts tend to downplay or negate the relevance of the ‘therapeutic alliance’.
Conventional contracts play into the clinician’s desire “to do something helpful”. This often leads to identifying a “to do list” the client is expected to complete. Even though this ‘list’ seems easy (at least easy enough for the therapist to do) – for the client who is unmotivated or minimally motivated for change, such goals are out of reach. Rather than promoting a sense of ‘joining’, such contracts further a sense of isolation and aloneness when he inevitably does not reach and maintain the ‘expected behavior’.
Of course, when the client does not reach ‘the goal’, it is plain to all that he himself is to blame for his lack of effort. In addition, for the client who is familiar with a ‘lose-lose lifestyle’, this added failure is yet another reminder of the ongoing and previous ‘failures’ he has already experienced.
So now for the ‘paradox contract’! In contrast to the conventional contract, the focus of this intervention is to highlight the positive aspect of a written document as a ‘witness’ to behavior. The twist of a ‘paradox contract’ is that rather than coming up with a ‘to do list’ of new behaviors, we outline the details of everything he must do to maintain the status-quo. In essence we ask for the client to do nothing new; along with the usual and expected consequences and loss of privileges. As such the contract places no external pressure for the client to be different.
In this way the nature of the contract places the client in a position that the therapeutic alliance becomes the primary aspect of the intervention. If the client ‘keeps to the contract’ the clinician is able to enhance the alliance by praising him for his cooperation. If the client chooses to ‘break the contract’ by making the effort to undo problematic behavior, he is then met with the consequence of gaining in privileges. Therefore the nature of a ‘paradox contract’ is therefore to corner the client in a ‘win-win’ scenario.
So for example, if the client has been on Level Red (lowest level) with the least privileges for the last 3 weeks, the contract would list in detail all the behaviors he needs to do to keep himself at that level. As part of the ‘contract’ the clinician’s responsibilities would also be noted regarding maintaining the ongoing ‘status-quo’ of limited privileges!
The nice part of this ‘contract’ is that the client is ‘guaranteed to be successful’ if he does nothing. Further, it now puts the client in a position where he is more able to recognize and take responsibility for behavior that maintains the status quo. In an ‘upside down’ manner, the intervention raises the client’s awareness to the degree that previous habitual behavior will need to be done in a conscious manner for him to ‘keep the contract’.
The ‘paradox contract’ takes pressure off the client to ‘change and be somebody he is not’. In classic paradoxical style the intervention places the client in a ‘win-win double bind’. If he does his usual behavior, the clinician can praise him (join with him) for ‘keeping to the contract’. However if the client ‘breaks the contract’ this means that the clinician will have to reinstate privileges (which is also an act of joining). In this way, as with other paradoxical interventions, the client is put in a position that the ‘therapeutic alliance’ will be strengthened – no matter which way he turns!
11) Bribery and Payoffs – This intervention highlights how contrary the nature of paradoxical interventions is in relation to ‘conventional wisdom’ as to what is expected. Without the support of the ‘orbits-gravity model’, these interventions would seem totally absurd and beyond the pale of consideration. ‘Bribery and payoffs’ demonstrate the degree and extent that the counter-intuitive nature of such interventions can unfold. Again, the aspects of ‘joining and the therapeutic bond’ are central to treatment.
In ‘bribing and payoffs’ the clinician actually pays money ($5, $10, $20) for the client to continue and promote symptomatic non-crimineogenic behavior. On the surface this seems crazy! – as it appears that the clinician is actively promoting and rewarding destructive behavior. At first glance, this seems antithetical to the goals of treatment. However, this is the intrigue of the paradoxical method.
Since the clinician is not asking the client to make any changes in his behavior, the client is easily enticed to accept ‘bribe’ money (to ensure ongoing symptomatic behavior in the future) or accept ‘payoff’ money (for a status-quo destructive behavior he just did). As the intervention plays out, the client’s ‘greed’ entraps him to accept the money and make an easy buck!
While a ‘bribe’ is paid ahead of time to elicit the client’s cooperation around completing future status-quo behavior, and a ‘payoff’ is paid after-the-fact for a “job-well-done”, the exchange of money means there is now an implicit alliance between clinician and client! Once the client accepts the offer of money, there is no doubt that a connection between them exists. And it is this alliance that now sets the stage for an ‘unsolvable quandary’.
Through incorporating ‘bribery and payoffs’ as with other paradoxical techniques, the focus is purely on strengthening the ‘therapeutic alliance’.
In ‘bribery and payoff’ interventions the aspect of ‘joining’ leads the client into an unsolvable quandary; was he The intervention eludes to the fact that the central purpose of PdxI is to create ‘quandaries’ from which the client can not escape. . As strange as it may sound, it is ‘the quandary’ –and not the solution to the quandary - is the core aspect of treatment. It is therefore ‘the quandary’ in-and-of-itself that makes treatment relevant. Contrary to linear logic, the solution to the quandary is irrelevant. In other words, it is the paradoxical nature of quandary that is central to ‘how and why’ treatment works.
‘The quandary’ represents a ‘laser beam’ to the unconscious mind. Since the intervention hones into the unconscious mind the client is unable to ‘defend against it’. It is through this aspect that treatment reminds the client’s unconscious mind of his unique human nature and dignity. The reason for this is that it is only the human mind that has the ability to recognize and process dilemmas that have no solution. This is in contrast to the lower nature of the animal mind that has no way of recognizing when a paradox is being presented.
It is therefore by addressing the human mind specifically within a paradoxical context that treatment is able to access and raise client self-esteem. It is the paradoxical quandary that specifically negates and dissolves the client’s assumed sense of isolation and abandonment. It is therefore the human mind’s capacity to intuitively recognize that it has been ‘cornered by a paradox’ that the individual simultaneously finds comfort and relief in knowing that his plight and internal struggle has been acknowledged.
In addition it is the absurd nature of the quandary that allows the client to feel understood in a way that words alone are insufficient to convey the message of being seen and witnessed.
So for example: Let’s say Dan is an angry teen who has been suspended from school. Although assigned for home-schooling, he refuses to get out of bed until 11AM. His mother constantly struggles with him to be down for breakfast by 10AM. In Dan’s mind he is ‘making a choice’ not to come down until 11AM.
However, by instigating the ‘bribe’ a doubt is raised as to whether Dan’s decision remains independent. Is he independent or complying with his end of the ‘bribe’? –fostered together with the clinician! The bottom line is that by accepting the ‘bribe’, the clinician ‘has the key to the bedroom’. In this way the ‘bribe’ negates Dan’s isolation and aloneness whether he complies with the ‘bribe’ or not. The intervention sets up a ‘win-win double bind’ that whether Dan comes down before 11AM or after 11AM, he no longer is alone and isolated either way. The intervention creates a scenario that he will be either compliant with the clinician or his mother.