Section L Theory and Practice: Clinical
Cycles of Psychotherapy
Gordon Hewitt
Abstract
This article proposes a system for classify-
ing psychotherapy, counseling, and supervi-
sion in terms of a cycle of four phases. The
author describes each phase and the bound-
ary condition that indicates the client is
ready to move to the next phase, as well as
the tasks of therapist and client at each
phase. The effects of premature passage to
the next phase of treatment or termination
at an inappropriately early phase are also
discussed. The phases, with their boundary
conditions in brackets, are: contact (con-
tract), content (decision or redecision), con-
solidation (integration), and conclusion
(termination or reengagement).
This article presents a system for classifying
the phases of psychotherapy which can also be
applied to counseling, supervision, and many
activities in business and education. This system
owes a great deal to previous descriptions of
treatment in the TA literature, to recent research
by Steenbarger (1992), and to the idea of treat-
ment as cyclical as developed by Prochaska and
DiClemente (1982) and modified by Miller and
Rollnick (1991). Gobes (1993) also implicitly
suggested a sequence in her checklist for consul-
tants. This article further develops the view of
treatment as cyclical, or more properly, spiral-
like.
Therapy as a Cycle of Phases
In a metastudy ofthe outcomes of brief coun-
seling and therapy, Steenbarger (1992, p. 426)
suggested that successful treatment can be
divided into three phases: engagement, in which
client and therapist form a working alliance and
develop a plan; discrepancy, in which therapist
The author wishesto thank the manyworkshoppartici-
pantsand the TAl reviewerswho provided constructive criti-
cismof the model presented in this articleand his wife, Pam
Hyde,for her help in preparing the paperfor publication.
200
and client work to achieve symptom relief,
enhance client experience, and challenge previ-
ous client patterns; and consolidation, in which
gainsare supported and extended. These phases
seem to fit just as well when describing longer-
term therapy. The phases described in this
article essentiallyfollow Steenbarger's, although
the terms used for the first two have been
changed to contact and content (terminology
more consistent with the TA literature) and the
definitions have been extended somewhat. In
addition, a fourth phase, conclusion, has been
added; while this phase is more prominent in
longer-term therapy, it is also important in
short-term work.
Also added in this article is the concept of
boundary conditions. This refers to events, usu-
ally of short duration, that indicate that a phase
of therapy is complete and therapist and client
may safelymove to the next phase. For example,
making a clear Adult/Adult contract marks the
successful completion of the contact phase; a
decision or redecision marks the end of the
content phase; successful integration of new
thinking, feeling, or behavior marks the end of
the consolidationphase; and successful termina-
tion or reengagement marks the end of the
conclusion phase.
These phases are presented as a cycle (Figure
1) rather than as a sequence. This removes the
temptation of seeing therapy as linear, when in
filet clients often need to move on and then back
to complete a previous task more fully. For each
phase we need to consider:
1) the tasks of the therapist and the c1 ient
2) problems that arise if the client leaves
therapy without completing the phase
3) difficulties that arise when therapy moves
too soon to the next phase or the client
moves prematurely to reengage with the
therapist in a new cycle
4) boundary conditions that indicate that a
phase has been successfully completed
and that it is safe to move on
Transactional Analysis Journal
 CYCLES OF PSYCHOTHERAPY

INTEGRATION 14----++---+----'H----.
Figure 1
Cycles of Psychotherapy
This article concentrates on the first and final
phases oftherapy because, in my view, previous
TA literature has tended to emphasize the mid-
dle phases. The following sections describe in
more detail the four phases of treatment, and
Table 1 provides a summary of them.
Contact Phase
The need for therapist and client to form a
working alliance has been recognized by authors
from many theoretical perspectives. For exam-
ple, therapists who use the object relations
framework talk of forming a "holding environ-
ment" (e.g., Hamilton, 1989, p. 1554), and
Steenbarger (1992, p. 427) refers to "engage-
ment." Berne (1962) described the first part of
this contact phase when he wrote that the patient
is " 'really' in treatment ... when his Child
CONTRACT
accepts the Adult of the therapist as a substitute
for his own Parenf' (p. 10). Boyd (1978, p. 180)
referred to this as reparenting and indicated that
the client's major task (which he called decon-
tamination) was to separate himself or herself
from his or her neurosis rather than identifying
with it. WooIIams and Brown (1978, pp. 261-
262) put the emphasis at this phase of treatment
on increasingthe client's motivation and aware-
ness of what he or she wants to change. Clark
(1991, p. 93) stressed the place of empathy in
this process to the extent of defining "empathic
transactions" as those in which the therapist
expresses understanding of the client's experi-
ence and the client confirms that he or she has
been understood. After selecting the term I use
for this phase, I discovered that Erskine (1993a)
had chosen the same term for what seems to be
a similar stage of the psychotherapy treatment
process.

Table 1
Phases of Treatment

Phase Activity Completion Result of Result of Treat-

Marked By Premature Move ment Termlna-
to Next Phase tlon at this Point

Contact Building empathy, Contract made Client becomes Client feels rejected
trust, and safety "resistant"

Content Impasse clarification Decision or Client fails to Client leaves with

redecision implement change heightened
discomfort

Consolidation Practica of new Integration of change Client is reluctant Client relapses

behavior, feeling, to leave treatment
thinking

Conclusion Summarizing, ver- Mutually agreed Client feels rushed Client feels
balizing, apprecia- terminattion or abandoned
tions, good-byes reengagement

Vol. 25. No.3, July 1995 201

GORDON HEWITT
We can also view this phase of treatment as
working through the stages of discounting
(Schiff et al., 1975, pp. 14-16), in which the
client moves from lack of awareness ofa stimu-
lus or its significance as a problem to an aware-
ness that there is a problem, the problem can be
solved, and he or she can solve it.
In summary, in the contact phase clients come
to:
1. trust that they can change
2. trust the therapist to help and not abandon
or abuse them (McCormick & Pulley-
blank, 1985, p. 52), a task greatly facili-
tated if therapist and client form a clear
administrative contract
3. see their problem as separate from them-
selves (i.e., realize that they can change
and still retain their fundamental sense of
identity)
4. develop the motivation to change
5. make sufficient Adult available to allow
themselves to form a working alliance
with the therapist. (Here working alliance
refers to a relationship in which both client
and therapist agree to work together to
achieve the realistic goals ofthe client.)
Much of the therapist's work in this phase
involves stroking the congruent, effective parts
ofthe client and reflecting enough ofthe content
and fueling of the client's experience so that the
client feels understood. Techniques that are
especially effective in this phase include using
verbal and nonverbal attending signals, summa-
rizing, paraphrasing, asking open-ended ques-
tions, appropriate self-disclosure, accessing the
client's previous experience, and giving appro-
priate positive feedback. Erskine (1993a) sug-
gests similar interventions in the contact phase.
In addition, the therapist must set clear and
appropriate boundaries to the therapeutic rela-
tionship so that both therapist and client can feel
safe.
Another wayoflooking at this phase is that as
therapists we need to deal with the non-useful
aspects oftransference (both positive and nega-
tive) so that the therapeutic relationship is safe
for both therapist and client. Such non-useful
aspects may include the beliefthat the therapist
can solve all the client's problems or that the
therapist will abandon the client ifhe or she gets
202
angry. This means that destructive aspects of
transference (Clarkson, 1991, p.105) must be
identified and worked through. Doing so may
include integrating the mother figure from the
good and bad "objects" (P,+and P,") in individ-
uals who did not successfully achieve this inte-
gration in childhood (see, for example, Black-
stone, 1993). People who have not achieved this
integration see the therapist as alternately all
good ("Gee, You're Wonderful Mr. Murga-
troyd") or all bad ("Now See What You Made
Me Do") (Berne, 1964); they need enough
experience ofthe authentic, competent, and yet
fallible therapist to realize that both of these
games are based on false assumptions. Moiso
(1985, pp.198-200) gave examples of some of
the ways in which these extremes of positive and
negative transference can be treated. Useful or
facilitative transference (e.g., the therapist re-
minds the client of a protective older brother)
may be retained and can be useful in the thera-
peutic process, although sometimes it may need
to be resolved before a successful conclusion
phase can be completed.
For some clients, the bulk of therapy may
occur in this contact phase during which the
therapist accepts and works with the transfer-
ence. This is especially true of clients with
disorders that make authentic contact with the
therapist difficult, including those with schizo-
phrenia or personality disorders and those who
have little available Adult and positive Parental
introjects. With such individuals--who tend to
form strong transference relationships with the
therapist and who tend to regress and cathect
Child---the therapist must decide whether he or
she has:
1. adequate training in working with transfer-
ence issues
2. an appropriate backup process for when
he or she is on holiday or otherwise un-
available
3. the possibility of providing a restraining
environment (e.g., through a local psychi-
atric ward) if it should be required
Without these safeguards there is a danger that
either:
1. the therapist will provide too little Con-
trolling or Nurturing Parent and the client
will feel unsupported or too strongly
Transactional AnalysisJournal

confronted and leave therapy. Sometimes
to avoid this the therapist must play along
withtheclient'sgametemporarily (Dusay,
1966, p. 136).
2. thetherapist will take over the client's life
as a Rescuer, using the excuse that they
needto form a strong positive transference
for the work to continue, thereby putting
the client at risk of increasing his or her
game and racket behavior.
Sometimesthe line between these two alterna-
tivesis quitefineand can only be maintained by
the use of good supervision. In addition,thera-
pists accepting clients for work at this depth
must realize that the client will be introjecting
themas a powerful Parentfigure. Good supervi-
sion can help to ensure that the introject pro-
vided by the therapist is as healthy as possible.
When clients develop (or have available from
the beginning) a reasonable amount of Adult,
therapists and clients may decide to minimize
transference bygivingclients as much responsi-
bility for themselves as possible. This may be
done, for example, by confronting evidence of
discounting, which is seen in this contextas an
attempt by the client to establish or further
develop a transferential relationship with the
therapist. Whenclients are ready to change from
Adapted Child phrases such as "try" and "want
to" to an Adult "I will," they are then likely
ready to makeclearcontractsand to move to the
next phase oftherapy.
For some clients who have psychotic epi-
sodes, forming a working alliance may in itself
involve learning new social skills that have
practical value. Learning how to be with another
person in the here and now in an appropriate
way may constitutethe major part of the treat-
ment Some research suggeststhat sound work
ofthis kind, especiallyif the family is involved,
may be a major factor in preventing relapse in
peoplewho have had a psychoticepisode (Leff,
Kuipers, Berkowitz, Eberlein-Vries, & Stur-
geon, 1982). Parts of this work will be done
contractually and may occur during various
phases inthecycle, but the main work will be in
the contact phase.
An important factor in developing a safe
therapeutic relationship at this stage may in-
volve closing escape hatches by getting a clear
Vol. 25. No.3. July 1995
CYCLES OF PSYCHOTHERAPY
contract with the client that he or she will not
"go crazy," "kill myself," or "kill others" (Hol-
loway, 1973, p. 16). Sometimeswhen making
such a contract, the client also redecides; in
othercasesthecontract is time-limited (until the
nexttreatment session, for six months, etc.) and
the actual redecision work may come much later
in therapy.
Any client is at risk ofleaving therapywith a
feeling of rejection if treatment is terminated
before the successful completionof this phase.
This part of the process may fail if the client is
not readyforthe change process or the therapist
fails to engage the client. If the client is not
ready, it is important for the therapistto help the
client to minimize his or her sense offailure by
stroking the client for the positive aspects of
their work together (being careful not to stroke
anygamesinvolved) and by encouraging him or
her to return when the time is right
Boundary Condition: The Contract. If the
contact phaseis successful,the boundarycondi-
tion that will indicatea readinessto move on is
an agreement for change-s-acontract The clear
contract is presented here as a boundarycondi-
tion rather than as a phase of therapy (as it was
by Berne, 1961; Boyd, 1976; McCormick &
Pulleyblank, 1985; Woollams & Brown, 1978;
and others) because it is more of an outcome
thana process, and as such it is a useful indica-
tion that this phase of treatment is complete.
Such contracts are Adult-to-Adult, and they
specify the change(s) the client will make that
will indicate that treatment (or more properly
the contact phase of treatment) is satisfactorily
completed. For example, during the contact
phase, social control contracts may be useful,
butthese and other less precise contracts(often
made from Adapted Child) do not indicate
readinessto move on.
Content Phase
In the content phase of treatment, therapist
andclientwork to produce change. Steenbarger
(1992, p. 426) referred to thisphase as "discrep-
ancy," whereas BobandMaryGouldingreferred
to it in their New Zealand workshops as "height-
ening ofthe impasse." During this phase, some
therapists (e.g., the Gouldings)have worked to
minimize the development oftransference, while
203
GORDON HEWITI
others (e.g., Jacqui Schiff) seek to maximize the
facilitative aspects of transference while con-
fronting passivity. In general, the more the
therapist works with the transference, the more
work will be needed in the conclusion phase of
treatment.
Many techniques are useful in the content
phase, includingredecision (Goulding & Gould-
ing, 1979), reparenting (Childs-Gowell, 1979),
rechilding (Clarkson & Fish, 1988), and self-
reparenting (James, 1981). The therapist's role
is to assist clients in confronting internal im-
passes and/or in reintegrating parts of them-
selves (structural ego states) from which they
have become dissociated. This may involve
helping the client to recognize impasses, rack-
ets, games, scripts, passive behaviors, discounts,
and crossed transactions and to change these to
achieve the contracted aim. (See Erskine, 1993a
for further discussion of the causes and treat-
ment of dissociation.) Although the goal of
treatment in this phase is for clients to assume as
much responsibility for themselves and their
therapy as possible, therapists may contract to
take a parent role and to use helpful (usually
positive) aspects of transference to support
clients in facing internal conflicts.
If clients leave at this point, they will have
heightened awareness of their discomfort but no
resolution of it. If sufficient contact was not
established before moving to this phase, clients
will not feel safe enough to do the work and will
move into their usual defensive pattern (racke-
teering, dissociating, etc.). If this is defined as
avoidance and confronted, contact is further
damaged and the defense is either strengthened
or abandoned in favor of overadaptation to the
therapist. In the latter case, therapy will feel
unauthentic and false. The best approach to
defensiveness at this phase is to return to the
contact phase to seek an empathetic understand-
ing of the client's fears, both to inform treatment
and to engage the client more deeply. Once the
client (and therapist) has established a safe
relationship based on "I'm OK, You're OK"
and the contract has been reexamined to see if it
is still appropriate, then progress through the
content phase should be possible.
Boundary Condition: Decision or Redeci-
sion. The boundary condition for this phase is
204
reaching a decision or a redecision. However,
this is only valid if it comes from Free Child.
Adapted Child decisions made to please the
therapist will not be effective. Decisions and
redecisions are considered to be a boundary
condition rather than a phase of treatment
(Boyd, 1976, p. 181) because, as with contracts,
they are viewed here as an event, not a process.
Consolidation Phase
This phase was referred to by Bob and Mary
Goulding in their New Zealand workshops as
"relearning," by Steenbarger (1992, p. 427) as
"consolidation," and by McCormick and Pulley-
blank (1985, p. 59) as "integrating the re-
decision." The client's task is to practice the
new behavior, thinking, or feeling until it be-
comes automatic. The therapist's task is again to
use empathetic transactions and stroking to
encourage the client in using his or her new
freedom, and, if necessary, to deal with relapse.
For example, if the new decision is made from
an adapted position rather than from Free Child
and Adult, the client will be unable to sustain
the change. Even if the decision is made from
Free Child, if the client leaves therapy before the
task of consolidation is complete (i.e., integra-
tion has not been achieved), there is a strong
probability of relapse. Such unplanned relapses
ditrer in their effects from planned relapses. The
term "planned relapse," used extensively in the
addiction field, denotes situations in which the
possibility of relapse is foreseen, positively
reframed as a natural part of the learning pro-
cess, and responded to with a previously con-
tracted response by both client and therapist. In
contrast, unplanned relapses are experienced as
defeat (Miller & Rollnick, 1991, p. 15).
Boundary Condition: Integration. The
boundary condition at this phase is the integra-
tion of the decision or redecision into the per-
son's everyday life. When this is achieved,
clients realize that they are responding automati-
cally according to their decision or redecision,
rather than having to make a conscious choice.
In my experience, some decisions and redeci-
sions are made so forcefully that integration
occurs quickly. In other cases, integration comes
only after the client has consciously practiced
his or her new strategy on many occasions.
Transactional AnalysisJournal

Conclusion Phase
The aim of this phase is to terminate the
relationship in such a way that the client is not
left feeling abandoned. The therapist and client
usuallyneed to talk about what happened during
their work together, including what each did that
was helpful or unhelpful, and to express appre-
ciation fur each other's work. The length of time
this takes is a function ofthree factors:
I. the length ofthe therapy relationship
2. the intensity of the therapy relationship
3. the extent to which the client has unre-
solved abandonment issues
The extent of the work that needs to be done at
this phase must be determined by the needs of
the client. Therapists should remember that the
client may have experienced the relationship as
much more intense than did the therapist. Less
commonly, the therapist may have experienced
the relationshipas having been more meaningful
than did the client. However, therapists have
clinical supervisors who can help them work
through their feelings about the situation, where-
as clients who have terminated prematurely may
be reluctant to call their therapist.
Boundary Condition: Termination or Reen-
gagement. If the conclusion phase is handled
well, both client and therapist will feel that the
process is complete. The client will express this
either by terminating the therapy or indicating a
readiness to continue at a deeper level (i.e.,
reengage).Reengagementusually involves mov-
ing into areas that engender more anxiety for the
client, and it is necessary to go through a pro-
cess of making contact again to establish the
kind of relationship needed for the new work.
However, this may occur rapidly, as the follow-
ing example illustrates: "OK, now I'm ready to
move on." "Good. What do you want to change
next?" On the other hand, this process may be
quite slow as the client tests the therapist by, for
example, being obnoxious, vague, or angry to
see if the therapist can be trusted to stay engaged
when the relationship is more challenging.
In this article we have been considering
therapy as a cycle of phases. However, often,
after tennination ofone cycle a client is ready to
move to deeper levels. In his work, Perls
(1973/1976) described therapy in terms of the
layers of an onion (p. 74). Combining these
Vol. 25, No.3, July 1995
CYCLES OF PSYCHOTHERAPY
analogies, one can imagine completing the four
phases and then unhinging at termination and
moving down to thenext layer so that we end up
with a spiral that goes deeper until treatment
reaches a final tennination. For example, a client
maymake a provisional decision that it is OK to
be successful in relationships. After fmding
waysto be closer to others (e.g., by changing his
or her strokingpattern), the client may choose to
revisit the decision more fully later so that he or
she can move further along what Woollams and
Brown (1978, p. 208) call "the decisional
scale." Another client might decide it is OK to
be close, use that decision to form a closer
relationshipwith the therapist, and thus feel safe
enough to confront and redecide scarier injunc-
tions having to do with craziness or suicide.
Types of Cycles of Psychotherapy
It is also possible to think of the cycles of
psychotherapyin terms of Berne's classification
of contracts (Berne, 1966, pp. 15-17). In my
view, Berne focused in Principles of Group
Treatment only on the boundary condition (the
contract) when what he was actually writing
about was a series of processes. Thus we can
usefully think of what Berne (1966) called the
administrative contract as the administrative
cycle, which involves:
1. a contact phase (do we have times that fit,
is the fee OK, what kind of relationship do
we have and what are its boundaries, what
do we expect from each other, how long
shall we go on meeting, etc.) that ends in
a contract that involves agreement on
these issues
2. a content phase (settling of any discrepan-
cies) that ends in a decision to pursue this
particular therapy
3. a consolidation phase characterized by the
regularity of relationship
4. a conclusion phase during which arrange-
ments are made to cover termination and
post-termination relationships (is it OK to
phone occasionally or to have a refresher
appointment, etc.?)
Likewise, we can think of Berne's profes-
sional contract as the professional cycle, which
is essentiallythe one first outlined in this article.
Finally, we can think of Berne's psychological
205
GORDON HEWITI
contract as the psychological cycle. All phases
in the psychological cycle are enacted outside
awareness unless the work of client, therapist,
and supervisor bring them into awareness. The
phases relate to whether the therapist is commit-
ted to the client becoming autonomous or de-
pendent and whether the client is genuinely
committed to change or is more committed to
engaging the therapist in his or her script. With
some clients, especially the more difficult ones
(such as those with borderline personality disor-
der), the psychological cycle is by far the most
important and is often played out during the
contact phase of the professional cycle. For
individuals with borderline personality disorder,
furminga relationship with the therapist may in
itselfbe sufficient to enable the client to develop
the positive sense of self that is missing (Stev-
enson & Meares, 1992). This may well come
about, in part, by the client introjecting the
therapist as a positiveControlling and Nurturing
Parent. However, it should be noted that such
therapeutic relationships are difficult, and a
clear understanding of the transference phe-
nomena involved is important (Moiso, 1985).
Treatment with this group is often facilitated by
identifying the psychological cycle and making
it overt so that it becomes part of the profes-
sional cycle. In many cases, failure to recognize
an important aspect of the psychological cycle
results in ineffective treatment.
Summary
The process of psychotherapy can be de-
scribed in terms of four phases, each of which
presents the client and therapist with particular
tasks. The client's readiness to terminate each
stage can be recognized by an event described
here as a boundary condition. The stages and
their boundaryconditions (in brackets) are: con-
tact phase (contract), content phase (decision or
redecision), consolidation phase (integration),
and conclusion phase (termination or reen-
gagement). Workshop participants who have
been taught this model report that it greatly
assists in treatment planning.
Gordon Hewitt, Ph.D., is a Teaching and
SupervisingTransactional Analyst (clinical) in
private practice. He divides his time between
206
seeing clients, providing supervision, and
running training events. Please send reprint
requests to Gordon Hewitt, 30 Totara Street,
Eastboume, Wellington, New Zealand; phone/
fax 64 (4) 562 7101; e-mail gordon.hewitt
@vuw.ac.nz.
REFERENCES
Berne, E. (1961). Transactionalanalysis in psychother-
apy: A systematic individual and social psychiatry.
New York: Grove Press.
Berne, E. (1%2). "In treatment." TransactionalAnalysis
Bulletin, 1(2), 10.
Berne, E. (1964). Games people play: Thepsychology of
human relationships. New York: Grove Press.
Berne, E. (1966). Principles of group treatment. New
York:Grove Press.
Blackstone, P. (1993). The dynamic child: Integration of
seoond-ooJer structure,object relations,and self psychol-
ogy. TransactionalAnalysis Journal, 23,216-234.
Boyd, H. S. (1976). The structure and sequenceof psycho-
therapy. TransactionalAnalysis Journal, 6, 180-183.
Childs-Gowell, E. (1979). Reparenting schizophrenics:
The cathexis experience. North Quincy, MA: The
ChristopherPublishingHouse.
Clark, B. D. (1991). Empathic transactions in the decon-
fusion of child ego states. Transactional Analysis
Journal, 21,92-98.
Clarkson, P. (1991). Through the looking glass: Explora-
tions in transferenceand countertransference. Transac-
tional AnalysisJournal, 21, 99-107.
Clarkson, P.,& Fish, S. (1988). Rechilding: Creating a new
past in the present as a support for the future. Transac-
tional Analysis Journal, 18,51-59.
Dusay, J. M. (1966). Response. Transactional Analysis
Bulletin, 5(18), 136-137.
Erskine, R. G. (1993a). Inquiry, attunement,and involve-
mentinthepsychotherapy of dissociation. Transactional
Analysts Joumal, 23,184-190.
Erskine, R. G. (l993b). The processof integrative psycho-
therapy. In B. R. Loria (Ed.), The boardwalkpapers:
Seteaionsfrom the 1993 eastern regional transactional
analysis association cOliference (pp. 1-26). Madison,
WI: Omnipress.
Gobes,L. (1993).C4P4:A consultationchecklist. Transac-
tional Analysis Journal. 23,42-44.
Goulding, M. M., & Goulding, R. L. (1979). Changing
lives through redecision therapy. New York: Brun-
nerlMazel.
Harnihon, N. G. (1989).A critical reviewof object relations
theory. American Journal of Psychiatry, 146, 1552-
1560.
Holloway, W.H.(1973).Shut the escape hatch.Monograph
IV. In M. M. Holloway & W. H. Holloway(Eds.), The
monograph series (pp. 15-18). Medina, OH: Midwest
Institutefor Human Understanding.
James, M. (1981). Breakingfree: Self-reparentingfor a
new life. Reading, MA: Addison-Wesley.
Left; 1., Kuipers, L., Berkowitz, R., Eberlein-Vries, R., &
Sturgeon, D. (1982).A controlledtrial of social interven-
tion in the families of schizophrenic patients. British
Journal ofPsychiatry, 141,121-134.
Transactional AnalysisJournal

McConnick, P., & Pulleyblank, E. (1985). The stages of
redecision therapy. In L. B. Kadis (Ed.), Redecision
therapy: Expanded perspectives (pp. 51-59). Watson-
ville, CA: Western Institute for Group and Family
Therapy.
Miller, W. R., & Rollnick, S. (1991). Motivational inter-
viewing: Preparing people to change addictive behav-
ior. New York: Guilford.
Moiso, C. (1985). Ego states and transference. Transac-
tional Analysis Joumal, /5,194-201.
Perls, F. (1976). The gestalt approach & eye witness to
therapy. New York: Bantam Books. (Original work
publishedin 1973)
Prochaska, J. 0., & DiClemente, C. C. (1982). Trans-
theoretictherapy:Toward a more integrative model of
Vol. 25. No.3. July 1995
CYCLES OF PSYCHOTHERAPY
change. Psychotherapy: Theory, Research and Practice,
/9,276-288.
Schiff; J., with Schiff, A. W., Mellor,K., Schiff;E., Schiff;
S., Richman, D., Fishman, J., Wolz, L., Fishman,C., &
Momb, D. (1975). Cathexis reader: Transactional
analysis treatment ofpsychosis. New York: Harper &
Row.
Steenbarger, B.N. (1992). Toward science-practiceintegra-
tion in brief counseling and therapy. The Counseling
Psychologist. 20,403-450.
Stevenson, J., & Meares, R. (1992). An outcome study of
psychotherapy for patients with borderline personality
disorder. American Journal 0/ Psychiatry, /49, 358-
362.
Woollams, S., & Brown, M. (1978). Transactional Analy-
sis. Dexter, MI: Huron Valley Institute Press.
207