Conversational model

Domain I · Psychodynamic & depth psychology · Robert Hobson, Russell Meares · 1985

What it is

CM is a psychodynamic, relational therapy. Hobson devised it from recordings of his own sessions with severely disturbed patients, and Meares extended it in London and then Sydney (Westmead). It treats the patient's self (William James's reflective "I–me" consciousness, Meares's "personal being")…

Format

• Format and dose.
• Individual, face to face, in a stable frame: same room, same time, regular breaks announced in advance.

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it use a device, heat, cold, water or a physical procedure? Has a medical professional checked that it is safe for you?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• self-disclosure that serves your own relief. It is working when your observation re-opens contact.
• shame ("I'm cold"). It is working when the patient becomes curious about the absence or a feeling arrives.
• sudden 'flight into health' or crises near the end. It is working when the patient can feel and speak about the loss.
• splitting between services. It is working when there are fewer unplanned crises and a consistent response across services.
• the patient experiencing the inward turn as intrusive. It is working when brief reflective comments start appearing within the chronicle.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.