Previous research suggests one in five United States (U.S.) adults will engage in consensual nonmonogamy (CNM) in their lifetime (Haupert et al., 2017). Despite a significant number of adults engaging in CNM relationships, there is considerable stigma regarding CNM status. Clients that identify as CNM are marginalized in the process of psychotherapy (Henrich & Trawinski, 2016; Kisler & Lock, 2019; Schechinger et al., 2018). One previous study found that one-third of clients who identify as consensually nonmonogamous reported experiencing inappropriate therapy practices (Schechinger et al., 2018). Inappropriate therapy practices included their therapist pathologizing their relationship structure or expressing judgmental attitudes around their CNM relationship. Clients who experienced inappropriate practices were significantly more likely to terminate therapy prematurely. The present study measures relational therapists’ (n = 775) attitudes, monogamism sensitivity, and knowledge regarding consensual nonmonogamy. Treatment practices when working with clients who identify as CNM were also explored through open-ended questions. A simple linear regression revealed that knowledge of CNM predicted favorable attitudes toward CNM. Furthermore, monogamism sensitivity strengthened the relationship between knowledge and attitudes. Specialized training was not significant in predicting knowledge of CNM or attitudes toward CNM. Thematic analysis revealed four categories related to working with CNM clients in therapy. These categories were general treatment, helpful practices, unhelpful practices, and perpetuating stigma. Results of both the qualitative and quantitative data analyses suggest relational therapy training programs should better prepare clinicians in working with clients who identify as consensually nonmonogamous. Specifically, in addressing how monogamism influences therapists ’clinical judgement.

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A pesquisa e a clínica investigativa, no âmbito das psicoses precoces e do autismo, levantam questões concernentes às interfaces da Medicina e da Psicologia. A mudança de modelos e hipóteses de uma nosografia classificatória e diagnóstica, tal qual conhecemos tradicionalmente nos manuais especializados, para uma dimensão temporal dos processos psicopatológicos se torna essencial, acarretando uma inevitável redefinição das funções do médico e do psicólogo. Esta dissertação apresenta a obra de Nielle Puig-Vergès e o seu método de epistemologia clínica comparativa na prática diagnóstica e terapêutica de crianças autistas e psicóticas, junto com suas famílias. A autora tem suas principais referências teóricas na tradição filosófica da fenomenologia de Husserl e na vertente psicanalítica definida por Freud, Ferenczi e Bion. No desenvolvimento deste trabalho, serão discutidas as profundas modificações teóricas e metodológicas para efetivar a passagem de um modelo de atendimento fundado na preocupação classificatória das moléstias a um outro modelo em que os profissionais implicados deverão tornar-se capazes de, no limite, criar uma linguagem terapêutica particular com cada um dos seus pacientes. O trabalho de Puig-Vergès dá o arcabouço da constituição e organização de equipes pluridisciplinares no âmbito desse novo foco na saúde, e não na doença. / The research and the investigative clinic, in the context of early psychosis, raise questions concerning the interfaces of Medicine and Psychology. The change in a nosography worried with classification and diagnosis, as traditionally shown by specialized compendiums, becomes essential, in order to include a temporal dimension of psychopathological processes, bringing an unavoidable redefinition of the functions of both the physician and the psychologist. This dissertation presents the work of Nielle Puig-Vergès and her method of comparative clinic epistemology in the therapeutic and diagnostic activities concerning autistic and psychotic children, together with their families. The author has as main theoretical references the philosophical tradition of Husserl \'s phenomenology and the psychoanalytical path defined by Freud, Ferenczi and Bion. In this dissertation, it will be discussed the deep theoretical and methodological changes needed_to put into effect the change from a model of attendance based on the preoccupation with classifying diseases to a model in which the professionals engaged should be able of, in the limit, creating a specific therapeutic language with each one of their patients. The work of Puig-Vergès gives the framework for the constitution and organization of multidisciplinary teams in the context of this new focus on the health, and not on the disease.

A pesquisa e a clínica investigativa, no âmbito das psicoses precoces e do autismo, levantam questões concernentes às interfaces da Medicina e da Psicologia. A mudança de modelos e hipóteses de uma nosografia classificatória e diagnóstica, tal qual conhecemos tradicionalmente nos manuais especializados, para uma dimensão temporal dos processos psicopatológicos se torna essencial, acarretando uma inevitável redefinição das funções do médico e do psicólogo. Esta dissertação apresenta a obra de Nielle Puig-Vergès e o seu método de epistemologia clínica comparativa na prática diagnóstica e terapêutica de crianças autistas e psicóticas, junto com suas famílias. A autora tem suas principais referências teóricas na tradição filosófica da fenomenologia de Husserl e na vertente psicanalítica definida por Freud, Ferenczi e Bion. No desenvolvimento deste trabalho, serão discutidas as profundas modificações teóricas e metodológicas para efetivar a passagem de um modelo de atendimento fundado na preocupação classificatória das moléstias a um outro modelo em que os profissionais implicados deverão tornar-se capazes de, no limite, criar uma linguagem terapêutica particular com cada um dos seus pacientes. O trabalho de Puig-Vergès dá o arcabouço da constituição e organização de equipes pluridisciplinares no âmbito desse novo foco na saúde, e não na doença. / The research and the investigative clinic, in the context of early psychosis, raise questions concerning the interfaces of Medicine and Psychology. The change in a nosography worried with classification and diagnosis, as traditionally shown by specialized compendiums, becomes essential, in order to include a temporal dimension of psychopathological processes, bringing an unavoidable redefinition of the functions of both the physician and the psychologist. This dissertation presents the work of Nielle Puig-Vergès and her method of comparative clinic epistemology in the therapeutic and diagnostic activities concerning autistic and psychotic children, together with their families. The author has as main theoretical references the philosophical tradition of Husserl \'s phenomenology and the psychoanalytical path defined by Freud, Ferenczi and Bion. In this dissertation, it will be discussed the deep theoretical and methodological changes needed_to put into effect the change from a model of attendance based on the preoccupation with classifying diseases to a model in which the professionals engaged should be able of, in the limit, creating a specific therapeutic language with each one of their patients. The work of Puig-Vergès gives the framework for the constitution and organization of multidisciplinary teams in the context of this new focus on the health, and not on the disease.

Die Beendigung von Psychotherapien ist ein historisch vernachlässigtes Thema, das weitgehend ausgeblendet wurde aus der theoretischen und pragmatischen Konzeptualisierung von Psychotherapie und deren Erforschung. Begriffe wie Abschluss, Ende und Abschied, die mit dem Ende von Therapien verbunden sind, verweisen in unserer Kultur auf Un-Themen. Sie bedrohen mit ihrer assoziativen Verbindung zu Tod eine wesentliche Grundlage unserer normalen Wirklichkeit: die Verleugnung unserer Endlichkeit. Unter Berücksichtigung von Regeln und Normen der Alltagskommunikation für die Beendigung sozialer Situationen beinhaltet die Abschlussphase ein belastendes Potential für Therapeuten und Klienten. Die Beendigung von Psychotherapien wird in Therapiemanualen und Lehrbüchern entweder gar nicht erwähnt oder erstaunlich marginal behandelt. Dabei zeigen sich teilweise einseitige Konzeptualisierungen. So thematisieren tiefenpsychologische Ansätze vor allem Aspekte der Trennung des Therapeuten und des Verlustes der therapeutischen Beziehung, während verhaltenstherapeutische Ansätze fast ausschließlich Fragen des Transfers von Therapieergebnissen in den Alltag nachgehen. Elemente der Abschlussphase werden auf der Grundlage einer Befragung von Psychotherapeuten und Klienten empirisch erkundet. Dabei werden erstens Abschlüsse konkreter Therapien (formale Charakteristika, Veränderungen der Kommunikation in der Abschlussphase, Perspektiven von Therapeuten und Klienten, Katamnese, Supervision) dokumentiert und zweitens allgemeine Aspekte der Therapiebeendigung (Themen der Beendigung, Unterbrechungen im Laufe von Therapien, Grundsätze von Therapeuten) beschrieben. Empirisch zeigt sich die Abschlussphase als eine Zeit am Ende von Therapien, die in der Regel beginnt, wenn deutliche Verbesserungen von therapierelevanter Symptomatik eingetreten sind, die 10 bis 20 % der Gesamtstundenzahl umfasst und die durch spezifische Veränderungen formaler und inhaltlicher Gestaltung der Therapie gekennzeichnet ist. Auf der Grundlage von Ergebnissen einer metaphernanalytischen Auswertung von Sprachbildern der Therapeuten zur Therapiebeendigung wird abschließend ein Konzept von Therapiebeendigung als Übergangsphase entwickelt. In dieses Konzept sind die vielfältigen Aspekte der Therapiebeendigung wie z. B. Zwischenzeit, Verlust, Wachstum, Prüfung und Aufbruch integrierbar. Mit einer Sicht von Therapiebeendigung als Übergangsphase wird eine differenzierte Bearbeitung diagnostischer und handlungsrelevanter Aspekte der Abschlussphase für Praxis und Forschung möglich.

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