Clarification-oriented psychotherapy

Domain III · Humanistic, existential & experiential · Rainer Sachse · Bochum

What it is

KOP is an individual, verbal psychotherapy that grew out of Sachse's goal-oriented client-centred therapy (Zielorientierte Gesprächspsychotherapie). It keeps the client-centred basic conditions (empathy, acceptance, genuineness) but is explicitly directive about process: the therapist steers how…

Format

• Three working levels (used throughout, in every phase): content level (what is talked about: problems, goals, self-concepts, motives), processing level (how the client deals with the problem: internal vs external perspective, avoidance, whether feelings are used as information), relationship level…
• Game level and tests: deal with interactional games and relationship tests in the session; make them transparent and costly-to-keep.

Who practises it, and how they are trained or regulated

• Format. Individual outpatient talk therapy; therapist acts as process expert. Group formats exist in training (role-play practice) but not as a described treatment format. Typical session count: not given in the sources; Sachse stresses the process is recursive and cannot be planned in advance, and that schemas may be in different phases at the same time.
• Version followed: Rainer Sachse's Klärungsorientierte Psychotherapie (KOP; English: clarification-oriented psychotherapy, COP), developed at the Institut für Psychologische Psychotherapie (IPP), Bochum. The guide follows the "Therapeutic rules" chapter (Sachse, Fasbender & Sachse) with its four-phase model, the IPP/Klaus-Grawe-Institut training slides, and for personality disorders the five-phase model and dual…
• How change happens. Problems are produced by dysfunctional schemas (self-schemas, relationship schemas, norms, compensatory schemas) that activate automatically and steer perception, affect and action, and by alienation: the person has lost access to their own motives and follows norms or schemas instead. A schema can only be changed after it has been validly represented: made explicit in words, checked with the…

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 involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• 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?
• 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

• Clearer, more concrete second account.
• Distinguish from a real limit (see C12).
• Affect rises when you are on a hot trace.
• Correction is good data; never argue with it.
• Client hears confrontation as help, not attack.

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.