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Single session therapy (SST) is an increasingly popular approach to mental health treatment that aims to address clients' presenting difficulties in a single appointment. However, experiential approaches to SST are limited. In this paper I describe the theory and practice of "chairwork" – an integrative, action-focused method of intervention centred on the concept of self-multiplicity – and outline how these procedures can be coherently applied in a single-session format. A preliminary protocol for delivering single-session chairwork (SSC) or "brief dialogical psychotherapy" is presented, alongside a case illustration that demonstrates features of this approach. Finally, directions for future research and the continued development of chairwork as a psychotherapeutic modality are considered. [ABSTRACT FROM AUTHOR]

"Chairwork" is a collection of experiential methods that utilize movement between chairs and dialogue with parts of the self to bring about change. Because of their emotionally intense nature, therapists often assume that a robust therapeutic relationship is a prerequisite for these tasks. However, it could be said that chairwork also supports the development and strengthening of the alliance. This article presents a single‐session, chairwork‐centered treatment with an individual experiencing social anxiety. Verbatim extracts and post‐intervention feedback illustrate the reciprocal and reinforcing roles of client participation, therapist facilitation, and the therapeutic bond during chairwork. Moreover, the case demonstrates that relationship and technique are intimately bound when using experiential methods, suggesting that therapists do not always need to privilege the former to implement the latter. [ABSTRACT FROM AUTHOR]

A proportion of individuals given an eating disorder diagnosis describe the experience of an eating disorder 'voice' (EDV). However, methods for working with this experience are currently lacking. Voice Dialogue (Stone & Stone, 1989) involves direct communication between a facilitator and parts of the self to increase awareness, understanding, and separation from inner voices. Adapted forms of this method have shown promise in working with voices in psychosis. This study aimed to explore the experience and acceptability of Voice Dialogue amongst individuals with anorexia nervosa who experience an EDV. Nine women participated in a semistructured interview following a single Voice Dialogue session. Interview transcripts were analysed using interpretative phenomenological analysis (IPA). Three overarching themes were identified as follows: (i) "separating from the EDV"; (ii) "better understanding of the EDV"; and (iii) "hopeful, motivated, and afraid of recovery". The majority of participants found Voice Dialogue acceptable and helpful for exploring their EDV. Whilst preliminary, the results suggest that Voice Dialogue has potential in terms of helping individuals establish a more constructive relationship with their EDV and motivating change. Further research is needed to build upon these findings. Implications for addressing the EDV using voice‐focused interventions are explored. [ABSTRACT FROM AUTHOR]

Objective: Recent years have seen a significant and rapid increase in the provision of tele-therapies. Chairwork methods such as empty-chair dialogues and role-play represent a "common" category of therapeutic interventions which are utilized in many psychotherapeutic approaches. However, guidelines for facilitating chairwork in tele-therapy are currently lacking. The aim of this study was to survey expert providers regarding how chairwork is best provided in internet-delivered psychotherapy. Method: Forty one experts were recruited from a range of therapeutic backgrounds including cognitive behaviour therapy, compassion focused therapy, emotion focused therapy, psychodrama, schema therapy, and voice dialogue. Participants completed a brief questionnaire survey exploring the delivery of tele-chairwork. Responses were analysed using thematic analysis. Results: Five themes were identified: (i) divided opinion; (ii) convergence between therapy and home; (iii) disconnection and depth; (iv) practical impediments and benefits; and (v) revising and re-visioning chairwork. Overall, results indicate that chairwork can be successfully incorporated into tele-therapy, but requires adaption and special considerations. Discussion: Despite challenges, tele-chairwork appears to be a feasible method of psychotherapeutic intervention. Preliminary guidelines for initiating, facilitating, and concluding tele-chairwork are presented, alongside future directions for research. [ABSTRACT FROM AUTHOR]

Chairwork refers to a collection of experiential interventions which utilise chairs, their positioning, movement, and dialogue to facilitate therapeutic change. Chair-based methods are used in several models of psychotherapy, including cognitive behavioural therapy (CBT). However, little is known about cognitive behavioural therapists' use and attitudes towards chairwork. A mixed methods survey was conducted of 102 therapists who provided CBT. Overall, training in chairwork was weak amongst CBT therapists (35%). Quantitative results indicated that most therapists perceived chairwork to be clinically effective and consistent with the cognitive behavioural model, but did not feel competent using these methods. Perceived competence was highest amongst therapists who had been trained in chairwork and practised it frequently, but was unrelated to CBT accreditation or clinical experience. Qualitative feedback identified a number of factors that encouraged the use of chairwork (e.g. overcoming limitations associated with verbal restructuring methods), as well as inhibitors (e.g. therapist anxiety and limited access to training). These preliminary findings highlight a need for further research relating to cognitive behavioural chairwork and suggest that increased training in experiential interventions could go some way towards improving outcomes in CBT. Key learning aims: As a result of reading this paper, readers should: (1) Understand cognitive behavioural therapists' attitudes towards chairwork. (2) Appreciate therapists' anxiety and avoidance in relation to chairwork. (3) Identify the key factors that facilitate or inhibit the use of cognitive behavioural chairwork. [ABSTRACT FROM AUTHOR]

Action-based methods such as behavioural experiments, role-play and (by extension) 'chairwork' are powerful techniques recommended in core supervisory texts for cognitive behavioural therapy (CBT). Despite this, experiential methods are seldom used by supervisors, suggesting that supervision often drifts from a 'doing process' to a 'talking process'. A number of factors contribute to this divergence from best practice, including limited confidence and a lack of familiarity with experiential procedures amongst supervisors. To address this, the current paper presents a variety of action-based techniques for enhancing supervisees' technical, perceptual, interpersonal, reflective and personal competencies. Behavioural experiments, empty-chair, multi-chair and role-playing exercises for maintaining treatment fidelity, enhancing empathic attunement, repairing therapeutic ruptures, resolving impasses and working through negative countertransference are described, amongst others. Further research is needed to establish the nature and extent of supervisory drift, as well as the efficacy of action-based methods. Key learning aims: As a result of reading this paper, readers should: (1) Understand why supervision sometimes drifts from being a 'doing' process. (2) Appreciate the value of experiential, action-based supervisory methods. (3) Feel competent using action-based methods to enhance supervisees' clinical skills. [ABSTRACT FROM AUTHOR]

Reappraisal strategies such as 'thought challenging' and 'cost-benefits analysis' are a hallmark of cognitive therapy, but sometimes fail to bring about lasting changes in the cognitive-affective structures underlying psychopathology. Modern theories of information processing suggest that experiential, action-based interventions such as chairwork may be a more efficacious route to cognitive modification. Based upon this hypothesis, a 'dialogical' approach to cognitive therapy is presented, which aims to bring about change through evocative, here-and-now interactions with parts of the self (self-to-self dialogues) and other individuals (self-to-other dialogues). Implementation principles and facilitation skills which guide this approach are outlined. To illustrate how dialogical interventions are utilized in clinical practice, chair-based strategies for socializing clients to the cognitive behavioural model, restructuring cognitions, facilitating emotional processing, resolving ambivalence, addressing distressing memories, building character strengths, and overcoming therapeutic impasses are described. Key learning aims: As a result of reading this paper, the reader should: (1) Understand the limits of 'standard' cognitive techniques. (2) Appreciate some of the advantages of experiential methods of intervention, namely chairwork. (3) Learn how dialogical interventions are conceptualized, implemented, and facilitated in cognitive therapy. [ABSTRACT FROM AUTHOR]

AbstractAlthough prevalent among those given a diagnosis of anorexia nervosa (AN), the internal anorexic voice (AV) is little understood. This study aimed to explore the AV’s role in the development and maintenance of AN from a new perspective – that of the AV itself. Nine women with a diagnosis of AN participated. Data was collected via dialogical enquiry, which entailed direct, semi-structured interviews with participants’ AVs. Transcripts were analyzed using thematic analysis. Three themes build a picture of a symbiotic yet destructive relationship between AV and individual. Firstly, “Pragmatism” describes the AV’s supposedly invaluable, problem-solving persona. Secondly, “Relationship” depicts the valued yet fraught, unbalanced, and often unwanted bond between AV and individual. Thirdly, “Self-preservation” presents the AV’s drive to retain control for its own survival. In clinical practice, curiosity regarding relationships with AVs could highlight barriers to recovery and inform treatment. Future research should focus on diverse samples and consider ways of working with eating disorder voices to promote recovery. [ABSTRACT FROM AUTHOR]