Abstract
La Mappa del Terapeuta (The Therapist’s Map) is a psychotherapy manual; it is a guide to the construction of therapy and of the therapeutic path as it provides guidance in making hypotheses, defining goals, and collecting results.
In this chapter I present the manual, point by point. It is divided into three parts: psychotherapy, child growth, and therapeutic work with individuals, couples, and families.
The first section focuses on working with psychopathological processes, on their management and planning interventions while dedicating special attention to the treatment of personality disorders.
The second section addresses the transformation of the family system, the central role held by the couple, new parenting functions, and the growth of children and the consequent therapeutic implications.
The third section is dedicated to the systemic assessment and setting of therapeutic work with families. This section is the core of the manual. It presents a map of family situations through a series of tables regarding the main life transitions, in which phases of the life cycle, the specificities of the situations being addressed, and the subjective emergencies expressed by patients are combined. There is also a moment-by-moment summary of which systems the therapists should intervene on how to do it, who is involved in the sessions, and which interventions are made.
Subsequently the application of this intervention model is exemplified through the description of some clinical cases.
In the final part, the manual addresses the topic of psychotherapy effectiveness by referring to research data in this area and recommending that clinicians always reflect on and initiate studies of the quality of their performance and the outcomes of their interventions.
Director of the Istituto Dedalus, post-graduate training school of specialization in psychotherapy recognized in Italy by the Ministry of Education, University and Research; and teacher within the Centro Studi di Terapia Familiare e Relazionale di Roma
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Notes
- 1.
The young adult in the organization phase, with neurotic area disorders, can be treated individually or in pairs, if his ability to build bonds outside the family allows him to carry out a job that looks forward instead of a job aimed backwards, towards the family of origin. The situation is different when the disorder occurs in other phases of the family life cycle, when the symptoms are at the service of family homeostasis. In all these cases, the first choice intervention is with the family (Cancrini L. & La Rosa C. 1991, Il vaso di pandora, pp. 132–133, Carocci editore, Roma).
- 2.
The delimitation of the system to be treated is particularly difficult with multiproblematic families. In these situations, the therapist is immediately confronted with the difficulty of summoning the whole family, for his tendency to come or not to come to therapy for instrumental and functional reasons with internal logic. Hence the inopportunity is to often convene the entire family and to choose to see individual members individually (Cancrini L. 1994, W Palermo viva. Storia di un progetto per la prevenzione delle tossicodipendenze, pp. 112–113, la Nuova Italia Scientifica, Roma).
- 3.
This diagram is a new and useful technique which can help the systemic-relational therapist on many levels: it enables the patient to narrate his or her personal, marital, or family history, highlighting the dysfunctional aspects, while using an alternative channel to that of the spoken word, with all the pros that can be derived from using an analogue technique. This allows patients to activate new learning processes, become aware of new questions and emotions which they experience in other contexts or which could be highlighted if freed from the rigidity of their scripts, rigidity which does not belong to a “linear” dimension but rather to a dimension which is “relational and circular.”
- 4.
The first version of the form was conceived and tested in 2004 at the Unità Operativa Dipartimentale di Psicoterapia of the “La Sapienza” University in Rome.
- 5.
In his book Psicoterapia, grammatica e sintassi, Luigi Cancrini analyzes the basic common rules of different therapy approaches and develops a two-level analysis: syntax – which concerns intervention guidelines and objectives – and grammar, which instead concerns the practical ways in which sessions are managed. Drawing on this analogy between therapy and language, Cancrini proposes a verbal scheme of therapy construction shared by all psychotherapists, identifying two possible outcomes of the therapy process: after having understood and expressed the significance of the symptoms, the reasons of all parties involved and having sympathized with the (designated) patient, the therapist can then choose to push the patient (or family) to change or to respect the deep motivations of the symptom (either because they are important or because they are too strong). Assuming this second position (syntax of the second type), the therapist applies a new logic and assumes a new position (no longer pushing the patient to change as is usually expected in treatment), implementing indirect and counter-paradoxical interventions (Cancrini L. 1987).
- 6.
The usefulness and effectiveness of psychotherapeutic interventions with the observed patients emerge from the follow-up forms. The results recorded by the data collection form were submitted to the institutes’ administration for the assessment and planning of services for the local territory.
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Acknowledgements
There are many people I would like to thank for the work which has led to the creation and implementation of this data collection form, first and foremost my students and colleagues (Fulvia Adragna, Gabriella Maria Bianco, Federico Bussoletti, Serena Cesi, Claudia Colamedici, Patrizia Costante, Silvia Curiale, Tania Di Giuseppe, Angela Falvo, Giusy Granata, Dora Monaco, Teresa Pomponi, Anna Rosa Prete, Adriana Romano, Sandra Stefanelli, Alessia Supino, and Claudio Tramentozzi, Rosangela Vaglio). Special thanks go to Francesca Martini, who worked by my side in both developing the form and coordinating the entire research project.
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Colacicco, F. (2021). Systemic Approaches to Therapy Manuals: Family Situation Mapping and Systemic-Relational Assessment of Treatment for Families, Couples and Individuals. In: Mariotti, M., Saba, G., Stratton, P. (eds) Handbook of Systemic Approaches to Psychotherapy Manuals. European Family Therapy Association Series. Springer, Cham. https://doi.org/10.1007/978-3-030-73640-8_8
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