Treatment Paradigms in Psychology

Abstract

This commentary describes my observations as the clinical supervisor of Dr. Hector Garcia’s  (2008) second, psychodynamic phase of therapy with “Bridget,” which followed a first phase of successful cognitive-behavioral treatment for specific, obsessive-compulsive symptoms with religious content. The second treatment phase focused on less structured issues such as, in Dr. Garcia’s words, “the qualities and patterns of past relationships with men, her current social network, and dynamics within her family of origin.” This case raises a number of complex and highly important, general issues. The ones I have chosen to discuss are: (a) the meaning of “compulsive” versus “healthy” prayer;  (b) the sequencing of the theoretical shift from cognitive-behavioral to psychodynamic therapy; (c) the utilization of countertransference phenomena and the “real” relationship in psychotherapy; and (d) the impact of eclecticism in the training of beginning therapists.