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The patient's adherence to rules and guidelines in psychological therapy

Updated: Jun 20, 2023


The patient's adherence to rules and guidelines in psychological therapy, used in the Habituation protocol.

The patient's adherence to rules and guidelines in psychological therapy is crucial for several reasons. Here are some key reasons why patients must follow the rules during treatment:


Safety and Well-being: Therapy rules are designed to prioritize the safety and well-being of the patient. They often include guidelines on confidentiality, boundaries, and professional conduct. By following these rules, patients can feel secure and protected in the therapeutic environment, fostering trust and openness in the therapeutic relationship.


Respect for Boundaries: Therapy rules help establish and maintain appropriate boundaries between the therapist and the patient. Respecting these boundaries ensures that the therapeutic relationship remains professional and focused on the patient's needs. It helps prevent potential harm or exploitation and maintains the integrity of the therapeutic process.


Treatment Effectiveness: Therapy rules are often based on evidence-based practices and therapeutic approaches that have been proven effective in treating various mental health concerns. By following these rules, patients can optimize the effectiveness of their treatment. This may include engaging in recommended activities, practicing new skills or coping strategies, and actively participating in therapy sessions.


Consistency and Progress: Consistency is critical in psychological therapy. Following therapy rules, such as attending sessions regularly, being punctual, and actively participating, contributes to a consistent therapeutic process. It allows for a steady progression in the therapy goals and ensures that essential insights and breakthroughs are not missed.


Personal Responsibility and Empowerment: Following therapy rules empowers patients to participate in their healing process actively. It promotes personal responsibility for one's well-being and encourages patients to self-care, practice self-reflection, and apply therapeutic techniques outside therapy sessions. This active participation can enhance personal growth and facilitate positive changes.


Trust and Collaboration: Adhering to therapy rules helps build trust and collaboration between the patient and the therapist. It demonstrates the patient's commitment to the therapeutic process and fosters collaboration and shared responsibility. This partnership between the patient and therapist is essential for effective therapy outcomes.


It's important to note that therapy rules should be discussed, explained, and agreed upon between the therapist and the patient at the beginning of therapy. Therapists should ensure that patients clearly understand the rules and their rationale. Additionally, therapists should create a safe and non-judgmental space where patients feel comfortable discussing any challenges or concerns related to following the rules. Open communication and collaboration between the therapist and the patient are crucial to navigating the therapeutic journey successfully.


Here are a few notable psychologists who have written about the importance of patients' adherence to rules and guidelines in psychological therapy:


Irvin D. Yalom: Yalom is a renowned psychiatrist and author who has written extensively on group therapy and the therapeutic relationship. His books, such as "The Theory and Practice of Group Psychotherapy" and "The Gift of Therapy: An Open Letter to a New Generation of Therapists and Their Patients," touch upon patients' active participation and adherence to therapy rules.


Judith S. Beck: Beck is a psychologist and the daughter of Aaron T. Beck, the founder of Cognitive Behavioral Therapy (CBT). She has written several books on CBT, including "Cognitive Therapy Basics and Beyond" and "Cognitive Therapy for Challenging Problems: What to Do When the Basics Don't Work." Her works emphasize the collaborative nature of therapy and the importance of patients' engagement and adherence to therapeutic techniques and homework assignments.


Marsha M. Linehan: Linehan is a psychologist known for developing Dialectical Behavior Therapy (DBT), a widely-used treatment for borderline personality disorder. In her book "Skills Training Manual for Treating Borderline Personality Disorder," she highlights the significance of a patient's commitment to therapy, including following structured protocols and practicing the skills taught in DBT.


Arnold Lazarus: Lazarus was a prominent psychologist who contributed to behavior therapy. His book "Multimodal Therapy" emphasizes the importance of patient collaboration, compliance with treatment plans, and active engagement in therapy tasks and homework.


Aaron T. Beck: As mentioned earlier, Aaron T. Beck pioneered Cognitive Behavioral Therapy. His numerous publications, including "Cognitive Therapy and the Emotional Disorders" and "Prisoners of Hate: The Cognitive Basis of Anger, Hostility, and Violence," emphasize the role of patients' active participation and adherence to therapy rules in achieving positive therapeutic outcomes.


It is important to note that many psychologists and therapists have written about the importance of patients' adherence to therapy rules and guidelines, and the list above is just a tiny sample. Exploring the works of these psychologists can provide further insights into the topic.


The protocol sets strict rules to be followed by the patient during the application of the protocol and participation in the support group offered to all involved in implementing the protocol. The rules, at first, appear authoritarian and are presented in an imperative form, but the format follows specific therapeutic technics as explained above.


Edvaldo de Oliveira Leme, RNC, ADON/LTC, BPSY

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