Dialogical psychotherapy

Domain III · Humanistic, existential & experiential · Maurice Friedman, Richard Hycner · 1984 · San Diego

What it is

Dialogical psychotherapy is an attitude and an approach, not a school with its own techniques. Its founders present it as applicable whatever the therapist's orientation or technique, grounded in the conviction that human existence is centred on the "interhuman" dimension (relation between…

Format

• No formal phase model. None of the sources sets out a staged protocol, session count or explicit criteria for moving between phases. Friedman and Hycner present dialogue as an attitude that should run through the whole of therapy, not a start-up phase (Vavassori 2017 makes the same point for…
• Goal: the client carries the regained capacity for dialogue into relationships outside therapy. Progress is judged by more frequent moments of authentic meeting, in and out of session.

Who practises it, and how they are trained or regulated

• Format. Individual adult psychotherapy, open-ended. Session frequency and length follow the host orientation (usually weekly, 50 minutes). Friedman also extended the approach to families and communities and drew on Boszormenyi-Nagy's contextual family therapy, but no family-therapy procedure is described in the sources. The Institute's training was a two-year programme (Wikipedia, Friedman).

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• How do you and the practitioner understand what is happening, in spiritual or cultural terms? Is that a source of comfort, worry, or both?
• 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

• experiments used to bypass the relationship.
• overly rigid neutrality (no meeting) or overly loose mutuality (role confusion).
• turning real guilt into a symptom to be removed, or harsh self-punishment replacing repair.
• bracketing becoming detachment. Working sign: the client says more than you would have predicted.
• pushing too early (see Newman's warning against shortcuts). Working signs: the client's world widens.

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.