Home

Tvp20 07omslag kijk verder

Tijdschrift voor Psychiatrie 26 (1984) 8, 574 - 591

Korte bijdrage

Non...contracten en probleemoplossende sancties

M. Kouwenhoven

'No'-contracts, like no-suicide, no-alcohol and no-violence contracts are means by which the relationship between therapists and clients can be structured and protected. This is especially usefull for clients who have a lot of destructive tendencies like using alcohol, drugs, running away, being agressive, committing suicide etc.
From the beginning of the therapeutic relationship it is established what kind of destructive behavior a client uses when in a stressfull situation.
Besides the commitment to stop these destructive behaviors it is also formulated:
—what the unresolved problem is behind this behavior,
—what the client will do to solve this problem especially when he/she feels the urge to act in a destructive way,
—what the problemsolving sanction will be when the client violated the contract by being destructive and/or not solving the problem when he feels the urge to be destructive.
In this way the client will solve his problem or directly and will not feel the urge to be destructive or he/she does not solve the problem directly and sooner or later will feel the urge to be destructive or violates the contract. He/she than has to do what is formulated as the problemsolving sanction. In this way a lot of escalations and impasses are prevented; clients always have a choise between solving the problem or stopping the treatment on their own initiative. It is no longer necessary for therapists to send clients away.
It is described what the effects are in a therapeutic community, based on contracts, confrontations and Transactional Analysis.