Decision Making Process in Uncertainty
without knowledge of Apriory Conditions
Ofer: From the beginning of the research process, Anat observed how I formed therapeutic alliances and maintained the relationship with uncooperative adolescents, and considered if she could learn from my approach. This caused me to examine if my therapy techniques, were independent of my personality or personal talents, and were an entity transferable to other practitioners. The fact that Anat utilises the practical knowledge which I transferred to her, in her work, is evidence that my ReachingOut approach is an entity independent of my personality. After reaching this conclusion during the research process, I could then progress with the conceptualisation of my ReachingOut approach through academic grounding.
The discussions between Anat and I, in the latter part of the research process, were intense and dealt with the composition of our practical ReachingOut model of psychotherapy.
This model illustrates the main features of the professional techniques we use to collect information about our patients, their family and environment. One of the major components of the model is the decision-making process under uncertainty of the prior conditions. It also includes examples of management techniques which illustrate my individual approach to therapy, which other practitioners may consider in their work.
The ReachingOut model is a continuous process of gathering information, analysis of the understandings, directing interventions and reality testing. Identification of anomalies in the result of the intervention will uncover mistakes in my preliminary understanding of the circumstances of the case. This leads to revised understandings and directs a new course of action.
This chapter includes a series of diagrams illustrating this cyclic process described above and the stages of the therapy process from the telephone intake onwards. The diagrams are interrelated through automatic links and are therefore best represented and understood on our website artefact.
During the research, I underwent a process of immense personal and professional development, which in my experience greatly improved the efficiency of my professional practice techniques. I derived several practical professional products from my long research process and our ReachingOut model of Psychotherapy. I developed a training course for Therapeutic Mentors, which I began teaching this year, and together with Anat, I developed another training programme in Psychotherapy which we teach together. Anat and I also established a charitable organisation for the treatment and support of children suffering from rare syndromes, and their families, who struggle to attain individualised treatment, recognition and to receive financial aid from the official authorities in Israel.
Another significant application of both stages of my research is the practical knowledge framework artefact which I developed in collaboration with Anat and Dr Anna Cristal-Lilov (see below) and am presenting here. The three of us are developing a generic website for conducting and presenting research. The website application utilises revolutionary organisational procedures and up to date web developing skills. I developed these skills during the research process while I sought for a suitable method of presentation for our research.
The investigation of our practical work, led to the understanding, that we did not limit ourselves to a single theoretical approach to the human psyche, but used some aspects of each when it was required by our professional understanding to help the specific patient. We had the patient in front of us as our main guiding principle, and not the theory. Working with many patients showed us on a daily basis, that each person is unique and there is no one way to work with many unique individuals, if we want to be helpful for different personalities, we have to use different outlooks on each and not categorise the personalities into groups.
Reaching out constructed as a practical model to approach a therapeutic case. Basic principles were conceptualised, the decision-making process was emphasised, while ethical considerations applied, and by definition, a therapist could use this model integrating within it, his personal theoretical inclination. The model teaches how to look at a patient or the family, how to gather information and to interpret it, taking into consideration transference and countertransference issues, the cultural differences and working with errors, in our conceptualization of each patient's difficulty and its epistemological roots. The model constructed in a way which will enable each trainee in the future to construct his personal model and approach the therapy according to his personality and level of depth he acquires, in a way that will preserve both his personal and professional identity and prevent from a "typical" therapist creation.