Choice Point Analysis and Action Alternatives

  • Alan Eppel


This chapter describes how therapists decide which interventions to make at any point during a therapy session. Therapists’ choice of interventions is governed by both System 1 and System 2 decision-making processes. The range of interventions used in psychodynamic psychotherapy is described. Six of the main psychodynamic change factors are discussed: promoting the therapeutic alliance, the use of relational interventions, transference, rupture and repair, exploration and expression of emotion and the use of a relational focus.

Empirical evidence for the relationship between each of these variables and outcome is reviewed. There is some good evidence to support the use of these interventions with modest effect sizes.

Lewis Tauber’s ideas are expanded to include these key processes. Based on the current review, the interventions are grouped into three sets on a priority basis. These priorities will help guide therapists in the selection of the appropriate intervention at any moment in a therapy session.

An examination of the use of humour in psychotherapy is also included. Humour is one of the taken for granted dimensions in the exchange between therapist and patient. It is a complex interaction that impacts on the therapeutic alliance.


Systems 1 and 2 Process research Decision theory Therapeutic alliance Transference 


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Alan Eppel
    • 1
  1. 1.McMaster UniversityHamiltonCanada

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