Conversational Model

The Conversational Model of psychotherapy was devised by the English psychiatrist Robert Hobson, and developed by the Australian psychiatrist Russell Meares. Hobson listened to recordings of his own psychotherapeutic practice with more disturbed clients, and became aware of the ways in which a patient's self - their unique sense of personal being - can come alive and develop, or be destroyed, in the flux of the conversation in the consulting room. The Conversational Model views the aim of therapy as allowing the growth of the patient's self through encouraging a form of conversational relating called 'aloneness-togetherness'. This phrase is reminiscent of Winnicott's idea of the importance of being able to be 'alone in the presence of another', and of Rogers' notion of 'unconditional positive regard'. The client comes to eventually feel recognised, accepted and understood as who they are; their sense of personal being, or self, is fostered; and they can start to drop the destructive defenses which disrupt their sense of personal being. The development of the self implies a capacity to embody and span the dialectic of 'aloneness-togetherness' - rather than being disposed toward either schizoid isolation (aloneness) or merging identification with the other (togetherness). Although the therapy is described as psychodynamic, it relies more on careful empathic listening and the development of a common 'feeling language' than it does on psychoanalytic interpretation.

Research

The Conversational Model, which has been manualised as Psychodynamic-Interpersonal Therapy [Shapiro, D. A. & Firth, J. A. (1985). "Exploratory Therapy Manual for the Sheffield Psychotherapy Project." (Memo 733) Psyschological Therapies Research Centre, University of Leeds, England.] [Guthrie, E. (1999) "Psychodynamic interpersonal therapy", Advances in Psychiatric Treatment, 5: 135-145.] , has been subject to outcome research, and has demonstrated effectiveness in the treatment of depression [Shapiro, D. A., Barkham, M., Rees, A., Hardy, G. E., Reynolds, S., Startup, M. (1996). Effects of treatment duration and severity of depression on the effectiveness of cognitive-behavioral and psychodynamic-interpersonal psychotherapy. "Journal of Consulting and Clinical Psychology, 64," 1079-85.] , psychosomatic disorders [Guthrie, E., Creed, F., Dawson, D. & Tomenson, B. (1991). A controlled trial of psychological treatment for the irritable bowel syndrome, "Gastroenterology, 100," 450-457.] , self-harm, and borderline personality disorder [Korner, A., Gerull, F., Meares, R., & Stevenson, J. (2006). Borderline personality disorder treated with the conversational model: a replication study. "Comprehensive Psychiatry, 47", 406-411] [Stevenson, J. & Meares, R. (1992). An outcome study of psychotherapy for patients with borderline personality disorder. "American Journal of Psychiatry, 149", 358-62] ..

Notes and references

Further reading

* cite book
last = Hobson
first = Robert
authorlink = Robert Hobson
title = Forms of Feeling: The Heart of Psychotherapy
publisher =
date =
location =
id = ISBN
* cite book
last = Meares
first = Russell
authorlink = Russell Meares
title = The Metaphor of Play: Origin and Breakdown of Personal Being
publisher = Brunner-Routledge
date = 2005
location =
id = ISBN 1583919678
* cite book
last = Meares
first = Russell
authorlink = Russell Meares
title = Intimacy and Alienation: Memory, Trauma, and Personal Being
publisher = Brunner-Routledge
date = 2001
location =
id = ISBN

Web Resources

The Australia and New Zealand Association of Psychotherapy (ANZAP) has a website: http://www.anzapweb.com/home.php which contains several resources on the Conversational Model.