In this comprehensive training programme, therapists delve into the intricate realm of therapeutic complexities. They explore:

• The multifaceted nuances of psychological defences as relational strategies
• Tackling intricate decision-making processes surrounding therapeutic boundaries
• Navigating the terrain of idealized fantasies and complex transference within the context of developmental trauma
• Gaining insight into recognizing, addressing, and navigating diverse client dynamics, from idealized constructs impacting therapy to the multifaceted transference patterns arising from developmental trauma

With a deep understanding of countertransference, boundary calibration, and interventions to mitigate maladaptive affects; therapists emerge equipped to foster authentic connections, decipher intricate client behaviours, and cultivate adaptive attachment strategies. This holistic training programme empowers therapists to navigate the complexities of the therapeutic landscape, fostering compassionate and effective interventions for their clients’ profound healing and growth.

Advanced Therapeutic Skills Workshop 1:

Working with Disorganized Attachment and Developmental Trauma

Video recorded version of the 28^th March 2024 session

CPD hours: 3 / CE credits: 2.75

The manifestations of disorganized attachment present a labyrinthine array of contradictory emotions and behaviours, complicating therapeutic approaches. Clients display intense emotional reactions and difficulties in emotion regulation, stemming from unresolved trauma and a compromised sense of safety. The interplay between attachment needs and defence mechanisms further complicates the therapeutic landscape.

As therapists, we can struggle with the delicate balance of offering a secure therapeutic environment while respecting our clients’ defence mechanisms. Integrating diverse therapeutic modalities —attachment-based, trauma-focused, and relational psychotherapies — requires skill and finesse. Establishing a collaborative therapeutic alliance becomes pivotal, prioritizing safety, empathy, and attunement.

Negotiating healthy boundaries within the therapeutic relationship is imperative. At this session, we start with the approach that working with disorganized attachment necessitates a multifaceted approach steeped in attachment theory, trauma dynamics, and relational intricacies. Psychotherapists and psychologists confront the intricate task of deciphering complex behaviours, regulating emotions, and creating a secure therapeutic milieu while delicately addressing attachment needs and defence mechanisms. Integration of diverse therapeutic modalities alongside a steadfast focus on the therapeutic relationship offers a beacon of hope in aiding individuals with disorganized attachment toward forming more secure internal models of relationships.

At this session, we will start with the premise that disorganized attachment is the bedrock of developmental trauma and should be a central focus of our therapeutic endeavours. We will explore how it develops and manifests and discuss practical approaches to treatment using the therapeutic relationship and boundaries as a healthy structure.

Learning Objectives:

• Identify the manifestations of disorganized attachment
• Employ collaborative relational approaches that take into account both the need for attachment and the need for defence

Advanced Therapeutic Skills Workshop 2:

Psychological Defences as Relational Strategies

Date changed from 25^th April 2024 to 27^th of June 2024

CPD hours: 3 / CE credits: 2.75

Understanding psychological defences as relational strategies delves into the complex realm of how individuals safeguard themselves within interpersonal dynamics, particularly within therapy. Expanding upon psychoanalytic notions of defence mechanisms, rooted in the works of Anna Freud and later ego psychologists like Hartmann, highlights their role as shields against anxiety.

Clinical challenges arise as therapists navigate these defences within therapy. Our clients’ use of defences like intellectualization or denial, obstructs vulnerability, hindering authentic engagement. Recognizing these nuanced behavioural patterns requires a deep understanding of individual psychodynamics.

Moreover, these defences within therapy pose difficult challenges. For instance, a client’s projection might hinder perceiving the therapist accurately, creating barriers to trust and rapport. As therapists, we must delicately balance challenging these defences for growth while creating a safe space that encourages our clients to lower their guard gradually.

At this session, we evaluate how psychological defences as relational strategies present multifaceted challenges for therapists. Decoding and addressing these defences demands a keen understanding of psychoanalytic theory, individual dynamics, and the complexities of therapeutic relationships. Therapists face the nuanced task of navigating clients’ protective shields, fostering a balance between challenge and safety for authentic growth.

We are familiar with defences in general, such as avoidance of emotions, aggression, or projection. But often defences are employed to protect against vulnerability and authenticity in the therapeutic relationship. We will discuss several ways in which clients can engage with the therapist that block adaptive relationship and stall therapy, and practical interventions to reduce these defences.

Learning Objectives:

• Distinguish animal defences against threat from psychological defences
• Identify at least 5 psychological defences that impact the therapeutic relationship

Advanced Therapeutic Skills Workshop 3:

Decision Making about Boundaries

30^th May 2024

CPD hours: 3 / CE credits: 2.75

Deliberating therapeutic boundaries demands a subtle approach encompassing diverse communication modes and session adjustments. The intricate decision-making revolves around determining the appropriateness of extending therapy via emails, texts, or calls, and discerning the optimal timing for elongating or altering session frequency. This decision-making landscape demands astute judgment, distinguishing clients poised to benefit from flexible boundaries from those necessitating more stringent limits. The exploration extends beyond mere boundary setting, delving into the complexities of countertransference:

• Caretaking inclinations
• The allure of rescuing
• The weight of guilt
• The urgency that profoundly influences therapists’ boundary decisions

This session equips participants to discern clients amenable to flexible boundaries and grasp the fluidity of these limits. A deep understanding of countertransference becomes crucial, unraveling the complex interplay between therapists’ emotional responses and the calibration of boundaries.

The discourse extends beyond initial boundary establishment, delving into the delicate art of boundary reaffirmation amid treatment enactments. As therapists, we encounter the intricate task of reinstating limits once relaxed, necessitating finesse in maintaining therapeutic rapport while reinstating necessary boundaries.

In essence, the complex process of delineating therapeutic boundaries challenges therapists on multiple levels. Grasping our clients’ needs for adaptable boundaries, navigating the sway of countertransference, and deftly re-establishing boundaries demand keen discernment into client dynamics and therapists’ introspection. Negotiating these complexities is essential not only to maintain therapeutic efficacy but also to uphold the ethical and professional fabric of the therapeutic relationship.

• How do we decide whether to use email, texts or phone calls outside of therapy?
• When should we increase sessions in length or frequency?
• And when do these boundaries need to be limited?

Participants will learn which clients benefit from some flexibility and which do not. We will also explore countertransference issues of caretaking, rescue, guilt and urgency that may influence the decision -making process of the therapist regarding boundaries.

Learning Objectives:

• Identify which clients might benefit from boundary flexibility, and what types of boundaries can be altered, and how countertransference can affect their decisions about boundaries
• Discuss how to re-assert boundaries within therapeutic settings

Advanced Therapeutic Skills Workshop 4:

Working with Idealized Fantasies

03^rd October 2024

CPD hours: 3 / CE credits: 2.75

Clients often have specific idealized fantasies about the past, themselves, perpetrators, and the therapist that can be maladaptive. These may significantly interfere with therapy. Navigating clients’ idealized fantasies involves unravelling complex layers entwined with perceptions of the past, self, perpetrators, and even the therapist, often intertwined with maladaptive implications. These idealized constructs wield significant influence, potentially hindering therapeutic progress.

This session equips participants to decode the multifaceted functions of idealized fantasies in shaping self-perception and perceptions of others. It delves into the intricate realm of interventions designed to identify and attenuate the maladaptive positive affect interwoven within these fantasies.

In essence, comprehending and addressing clients’ idealized fantasies necessitates a deep dive into their underlying functions and the therapeutic means to mitigate their maladaptive influences. Unravelling these constructs empowers therapists to navigate through these complexities, fostering a more authentic and productive therapeutic journey for their clients.

At this session, we will examine various common idealized fantasies and how they protect the client, as well as interventions to decrease the maladaptive positive affect associated with these fantasies.

Learning Objectives:

• Identify the functions of idealized fantasies of self and others
• Apply interventions to identify and decrease the maladaptive positive affect associated with these fantasies

Advanced Therapeutic Skills Workshop 5:

Working with Complex Transference

05^th December 2024

CPD hours: 3 / CE credits: 2.75

Understanding complex transference within the context of developmental trauma unveils a multitude of adaptive strategies that clients adopt due to the absence of secure attachment. These strategies, although initially protective, often manifest as maladaptive and give rise to an array of conflicting transference patterns with the therapist. In developmental trauma, clients acquire many strategies that help them relate to others in the absence of secure attachment. These strategies are often maladaptive and lead to multiple and contradictory transference patterns with the therapist. Clients may be alternately passive, aggressive, competitive, seductive, seeking attachment, and avoiding it. Additionally, they might perceive themselves as victims while expecting the therapist to rescue them. This complex landscape necessitates therapist’s adeptness in recognizing these patterns and employing compassionate approaches to directly address them, fostering the cultivation of more adaptive and secure attachment strategies.

This session will train participants to discern prevalent relational strategies arising from complex trauma, serving as substitutes for secure attachment strategies. Also, we will delve into the nuanced realm of employing compassionate approaches in therapeutic interactions.

Learning Objectives:

• Identify common relational strategies in complex trauma that substitute for secure attachment strategies
• Employ ways to relate compassionately and collaboratively with clients to help them modify their relational approaches

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