Chapter 6.Therapeutic Action and the Multiple Functions of Play Therapy

Therapeutic action refers to those aspects of treatment that are hypothesized to foster psychological change and ultimately improve people’s lives. Psychoanalysts’ views of these mutative agents are diverse, inextricably linked to their theories about the goals of treatment and the relative weight they assign to various intrapsychic and interpersonal processes. Verbal interpretations, the clinician’s consistent availability and empathic attunement, and various conscious and more implicit aspects of patient–therapist interactions are variously privileged as contributing to the individual’s personal growth. Within psychodynamic theory, desirable changes include increased insight and self-reflection, affect tolerance, softening of rigid relational and defensive patterns, expanded capacities for intersubjective sharing and communication, and a more coherent sense of self (Ablon 2005; Friedman 2007; Michels 2007). Most contemporary writers conceive of the therapeutic process as multifaceted rather than unidimensional, highly reflective of both patients’ and therapists’ unique individual qualities and powerfully shaped by the dyad’s collaborative style. Inevitably, any discussion of therapeutic action includes the complex interplay of the clinician’s theories, a repertoire of techniques and less consciously derived interventions, the evolving patient–therapist relationship, their verbal and nonverbal here-and-now interactions, and the structure and consistency of the treatment.