Plan Analysis and the Motive-Oriented Therapeutic Relationship

Caspar, Franz (2019). Plan Analysis and the Motive-Oriented Therapeutic Relationship. In: Kramer, Ueli (ed.) Case formulation for personality disorders: Tailoring Psychotherapy to the Individual Client (pp. 265-290). London: Academic Press 10.1016/B978-0-12-813521-1.00014-X

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Plan analysis is a case formulation approach that is independent of any particular school of therapy, and the concept of Motive-Oriented Therapeutic relationship is a prescriptive approach for how to manage constraints and possibilities related to the therapeutic relationship. The therapeutic relationship is of particular importance in the treatment of patients with a personality disorder, as even in the absence of a patient wish to treat it, the therapist has to get along with its consequences for the therapeutic relationship, and he or she has the task of preventing personality disorder related issues from coming in the way of the treatment of the problems for which the patient seeks treatment. An introduction to these two approaches is given, describing what sources of information are used, how this information is selected, interpreted and utilized to infer hierarchical structures, which give an overview of a patient's functioning from an instrumental (means–ends) perspective. It is also explained how non-instrumental elements such as emotions are related to Plan structures. A case of a patient with social phobia and narcissistic personality disorders illustrates Plan analysis including the analysis of emotions, and the Motive-Oriented Therapeutic relationships. Information on the state of research related to the approaches is also given: The effects of Motive-Oriented Therapeutic relationships have been demonstrated in one of the rare RCTs on therapeutic relationships.

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