Clinical Social Work Journal

, Volume 37, Issue 2, pp 104–111 | Cite as

The Complexities of Change in the Psychotherapy of Serious Mental Illness: A Practitioner’s Reflections

  • Richard Horowitz
Original Paper


The sweeping revisions in the understanding of major mental illness brought about by the biological revolution in psychiatry moved the spotlight away from the treatment relationship. In recent years, however, a resurgence of interest in subjectivity underscored the fact that despite dramatic scientific breakthroughs the existential realities of illness were largely unaltered. Even with this shift in inquiry, however, little attention was shown to the inner experience of practitioners engaged in long-term therapeutic relationships where movement of any kind was barely detectable. Clinicians and clients alike frequently travel a long and difficult road in search of pathways to recovery. Tracing their shared journey through a detailed case presentation illuminates the interior worlds of both travelers and illustrates that neither is left untouched by the complexities of change.


Mental illness Psychotherapy Change Countertransference Recovery 


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Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  1. 1.ChicagoUSA

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