Monday, August 22, 2011

Theory, Adaptations and Recommendations

The workbook is organized in a way that could be used alone or in a therapeutic setting. If you look carefully, you see the standard therapeutic structures within the assignments. Stage 1, for example, reflects the data collection often completed in early therapy. In the clinic I supervise, for example, we use an interview process where a therapist and client complete a bio-psych social. The relevant topics in the workbook for data collection are:

• Developing Rapport (talking about sex)
• Short-term treatment plan (what brought you to treatment)
• Data Collection (sex history, timeline, logs, acting out cycle, cross compulsivity, be-havioral analysis).

After the data is collected, a client will collaborate with the clinician to complete a treat-ment plan. The treatment plan is where the client tells the clinician what are the most im-portant issues. In the workbook, this corresponds to the summary and prioritization of topics at the end of stage 1 (see page 73).
After the completion of the treatment plan, the client starts the work corresponding to the client-defined priorities. The topics in stage 2 reflect an introduction to the major issues that I believe are most important. If additional material on a topic is needed, the client is encouraged to go beyond this workbook. All of the assignments in the workbook reflect an attempt to integrate a cognitive behavioral model with a health promotion model.

In the therapy process, there comes a time when both the clinician and client recognize the process is nearing the end. Assignments in stage three reflects the termination process by helping the client clarify the major issues to be addressed after treatment (continuing care plan), and provide opportunities for the client to demonstrate the progress that oc-curred in the treatment process (personal definition of sexual health). These two assign-ments are done within a context of motivational interviewing and stages of change model (Spirituality Values, and Sexual Health). In other words, a client’s values shapes what the client thinks is most important in his or her life, and confirms what the client is willing to commit to in the future within the client’s cultural context (e.g., the first topic in Stage 2).

The reason for the extended discussion is to help either the client or professional to make changes, or adaptations to the structure. You are encouraged to use the workbook in a way that makes sense to you. The implicit structure is what makes sense to me. But in the end, a personal definition of sexual health requires each of us to define what is right with-in our world. My hope is that you found the workbook helpful.

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