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Passivity and Activity in Psychotherapy

Arch Gen Psychiatry. 1961;5(4):411-417. doi:10.1001/archpsyc.1961.01710160091011.
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Skills needed by the therapist were recently summarized by Fleming and Hamburg1 as follows: (1) recognition and understanding of verbal and nonverbal cues; (2) understanding of one's own responses to patient behavior; (3) recognition of distortion in the patient's communications; (4) estimation of resistance to insight; (5) selection of therapeutic interventions apropriate to the level of insight and resistance manifested by the patient; (6) awareness and understanding of the effects of therapeutic interventions. It might be desirable to add under number 5 that interventions may vary considerably with the goals of therapy and may not be related to insight or resistance, but may be directed at accomplishing a more limited therapeutic effect. The skills as summarized are readily divided into passive and active elements in therapy. Items 1, 2, 3, 4, and 6 should be a part of every psychotherapeutic endeavor.


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