The therapeutic environment

1 The standard environment. 2 Some effects of altering the frame. 3 The patient's unconscious responses to deviations. 4 Deviations in a first session. 5 A shift from an insecure to a secure environment. 6 Establishing the therapeutic environment. 7 Some major alterations in the setting. 8 Some consequences of deviations for patient and therapist. 9 Medication and the frame. 10 Intervening in the face of deviations. 11 Motives for altering the ground rules. 12 Some unconscious implications of deviations. 13 Rectifying the frame. 14 Insurance coverage and the therapeutic environment. Appendix A - The standard therapeutic environment. Appendix B - Glossary

'...Fundamental to this work is the realization that the manner in which the therapist establishes and maintains the ground rules is filled with unconscious communications that critically influence the nature of every therapeutic transaction and every communication, whether from patient or therapist....'

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