Crises in the Psychotherapy Session

What do you do when your client flies into a rage or has a severe panic attack during a therapy session? Author Julian D. Ford explains how to harness such crises for breakthroughs.

Crises that erupt in the midst of a psychotherapy session can be overwhelming not just for the client but also for the therapist. Yet every crisis also can be a therapeutic breakthrough. With this book, therapists learn how to transform such critical moments in psychotherapy into powerful and positive turning points.

Drawing from trauma and attachment theory and the essential principles of psychotherapy and crisis management, Ford explains how crises can be understood as episodes of extreme emotional dysregulation. With a series of in-depth case examples, Ford shows how therapists can utilize emotion regulation as a practical framework to deescalate crises.

Each case study is a transcript of a psychotherapy session, complete with dialogue and commentary, featuring real-life expert clinicians who use a crisis as an opportunity to help clients face and resolve a sense of being damaged, betrayed, or abandoned. With wisdom, compassion, and a deep understanding of human emotions, this book teaches essential skills that all therapists will need.

Introduction: Transforming Crises into Turning Points in Psychotherapy

I. Essential Principles and Practices for Resolving Crises in the Psychotherapy Session

1. A Phase-Based Crisis Model
2. Emotional Dysregulation and Adaptive Self-Regulation
3. Essential Elements of Crisis Intervention
4. Essential Psychotherapy Principles and Practices
5. An Integrative Approach to Resolving Crises in the Psychotherapy Session
6. Crises as a Challenge to Therapist Self-Regulation

II. Case Session Transcripts of In-Session Critical Moments

7. Supporting a Recently Traumatized Youth in a Crisis of Dissociation and Self-Harm
8. Engaging a Sexually Traumatized Youth in Therapy
9. Understanding and Working with Dissociative States
10. A Crisis of Trauma and Distress Across Generation
11. Helping a Family Cope with the Threat of Revictimization
12. Defusing Violence and Facilitating Recovery from Profound Dissociation

Epilogue

References

Julian D. Ford, PhD, ABPP, is a board-certified clinical psychologist and Professor of Psychiatry and Law at the University of Connecticut, where he directs two Treatment and Services Adaptation Centers in the National Child Traumatic Stress Network: the Center for Trauma Recovery and Juvenile Justice and the Center for the Treatment of Developmental Trauma Disorders.

Dr. Ford is the immediate past president of the International Society for Traumatic Stress Studies and a fellow of the American Psychological Association.

He has published more than 250 articles and book chapters and is the author or editor of 10 books.

Ford (Univ. of Connecticut) is truly a pioneer in the treatment of trauma…This volume is particularly valuable, as part 2 includes six transcripts of therapy sessions based on recorded sessions, as reenacted by graduate students…Highly recommended. Upper-division undergraduates. Graduate students, faculty, and professionals. General readers.
—CHOICE

This book is a very significant and timely contribution to the treatment of trauma from a developmental perspective. It is a unique and much-needed resource that presents highly salient themes contributing to the most challenging moments in this work, while also providing rich case material illustrating effective interventions with insightful discussions. Ford’s latest book should be required reading for every therapist working with trauma survivors.
—Cheryl Lanktree, PhD, Clinical Psychologist and Project Director, University of Southern California Adolescent Trauma Training Center, Keck School of Medicine, University of Southern California, Los Angeles

Renown researcher and clinician Julian Ford has done it again, offering a new book on treating psychotherapy clients in crisis. Filled with helpful examples and case reports, this book asks a critical question: Can crises, problematic behaviors, trauma reactions, and seeming emergencies be viewed not as “acting out” or evidence of inherent psychopathology, but, instead, actively taken advantage of during treatment to increase the client’s self-regulation, problem-solving skills, and emotional resilience? Drawing upon his work with the National Child Traumatic Stress Network, Ford offers a highly recommended, imminently practical, and ultimately hopeful approach to some of the most difficult moments in psychotherapy.
—John Briere, PhD, Professor of Psychiatry, University of Southern California; Director, USC Adolescent Trauma Training Center; author, Treating Risky and Compulsive Behavior in Trauma Survivors