Despite the fact that we know psychotherapy is effective across a wide range of mental health disorders, the mechanism of change is unknown. Each model of psychotherapy has a different theory about how change occurs, yet these theories do not explain why different therapies usually end up with similar outcomes. In this webinar, Dr Nick Bendit will outline a hypothesis that is central to all models, whether they recognise it or not, as a mechanism of change, mediated through the therapeutic relationship, which helps the client to experience emotions and thoughts that were unmanageable previously, and therefore avoided in a wide variety of ways. Different models address this with different techniques, implicit and explicit, but at the core is the safety and human contact of the therapeutic relationship. This, combined with the therapist modelling that emotions are important, tolerable and make sense, allows the client to explore their internal emotional world in a new way. A new relationship to their internal emotional and cognitive world is gradually built, allowing the client to live their life with more control, freedom and comfort.
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PPT Slides: Mechanisms of Change in Psychotherapy
Video Lecture: Mechanisms of Change in Therapy
Assessment Component
Dr Nick Bendit is a staff specialist psychiatrist working at the Centre for Psychotherapy (Newcastle), an outpatient public psychotherapy unit offering long-term psychotherapy for patients with borderline personality disorder (BPD) and eating disorders. He treats patients with BPD using the Conversational Model and DBT, as well as supervising mental health clinicians in the management of patients with BPD. He is the current Director of Training of the Australian and New Zealand Association of Psychotherapists (ANZAP). He has published articles on mechanisms of change in psychotherapy, reviewing the effectiveness of DBT in borderline personality disorder, and mechanisms of chronic suicidal thoughts in patients with borderline personality disorder. He has been a co-author on the most recent Australian Clinical Practice Guidelines on deliberate self harm in borderline personality disorder (RANZCP, 2016). He is the co-author of the second-largest randomised clinical trial of the effectiveness of psychotherapy in BPD, comparing DBT and the Conversational Model (Walton et al., 2020).
