THERAPEUTIC CONTRACTS IN MENTAL HEALTH

Contracts form a center piece of psychotherapy. They detail methods and specify goals.The agreement must make sense or the patient may not follow it. It evolves during a course of therapy and reflects the changing views patient and therapist hold of the problem as well as of each other.

Both parties bring a basic philosophy and a set of expectations into their relationship;they observe,select as relevant, and interpret events accordingly. A behaviourist would monitor chains of stimuli and responses, whereas an existentialist would relate to their meaning.  An analyst would interpret a disturbed relationship as a result of childhood memories. Meanwhile, a frightened patient might see signs   of mental illness and ask for reassurance. Reality is obviously multidimensional.  Cognitively oriented therapists consider the patient’s conceptions and explain to him the effects of his own    interpretative style and how it colours his views. They do not intervene right away with a prescribed procedure. An emphasis on subjective experiences at the expense of matter-of-fact observation is first confronted and shifted toward a more balanced view before an  otherwise alien technique is suggested. Cognitively oriented contracts  are designed to be compatible with the patient’s concept of reality.

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