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Treatment Plans

Object Relations Treatment Plan #1

Early Phase

Goals Interventions
Provide a safe holding environment Establish and model boundaries
Establish a therapeutic alliance Use empathic/attentive listening/statements
Establish boundaries Listen with “evenly suspended” attention
Explore presenting problem to establish client goals Take a psychosocial history
Symptom identification and reduction Assessment
Identify early conflicts that are recapitulated in the current family situation Clarify and amplify issues
Begin to put language to feelings
Provide psychoeducation and normalization to promote symptom reduction
Use of referrals to reduce symptoms
Reframe role of identified patient

Middle Phase

GOALS INTERVENTIONS
Promote insight (e.g. into split-off or disowned parts of self) Clarification and amplification
Uncover unconscious wishes and desires Interpretations (e.g. linking past to the present, reframing)
Discover resistance / defense mechanisms Identify and educate about defences
Develop ability to distinguish past relational dynamics from present relational dynamics Explore intention of resistance / defences
Increase individuation and separation (reduction of pathological attachments) Interrupt and explore the projection process and acting out behaviors
Promote reintegration of split-off parts of self Identify and increase tolerance for split-off parts and feelings
Promote development of a cohesive, true self Continue psychoeducation when relevant
Reparent Provide corrective emotional experience
Use of objective countertransference
Interpret and explore transference

Late Phase

GOALS INTERVENTIONS
Resolve idealized transference Review and consolidate self-soothing and other coping mechanisms
Work through termination issues: Interpret and work through abandonment / loss issues
– loss of therapy Interpret and work through regression
– loss of therapist and therapeutic relationship Provide corrective emotional experiences
– attending to regression
– reparenting

Object Relations Treatment Plan #2

Early Phase

GOALS INTERVENTIONS
Establish a holding environment Making empathic statements
Utilizing active listening
Giving uninterrupted attention
Modulating feelings
Showing interest in responses
Structuring sessions
Setting limits
Improving communication Confronting and intervening
Modeling how to speak from “I” position
Pointing out that blaming is projecting
Role playing

Middle Phase

GOALS INTERVENTIONS
Promote insight and growth Providing a holding environment to provide an experience of re-parenting
Clarifying client statements
Seeing and understanding the client’s experience and providing interpretations
Confronting and exploring any resistance
Help client recognize and integrate split off parts of personality Encouraging expression of feelings
Confronting acting out behaviors
Identifying and empathizing with all good/all bad feeling states
Utilizing transference/countertransference/projective identifications to work through splits
Empathically confronting issues
Uncovering and interrupting projective identification process Observing interactions and identifying projections that are present
Reframing to provide meaning and understanding of the projective identifications present in interactions with
others
Confronting dysfunctional relational patterns and suggesting changes

Late Phase

GOALS INTERVENTIONS
Increase individuation Clarifying self and other boundaries
Clarifying individual needs of family members
Supporting self-esteem while confronting grandiosity
Work through termination issues Confronting and working through feelings
Interpret and work through abandonment issues