The Facilitating Partnership

A young mother suspected of abusing her toddler, a severely behavior-disordered teenager who faces expulsion from his community residence, a depressed and illiterate homeless man who fears psychiatric evaluation. These clients populate the caseloads of most mental health professionals, who often view them as too crisis-ridden, deprived, and overwhelmed with concrete needs to benefit from an in-depth approach to their problems. However, without this kind of treatment, such people continually reappear at social service agencies, their core psychological issues left unaddressed and their life situations unraveling. What can psychoanalytic theory offer practitioners working with these challenging clients? Although the helping professions have enjoyed a long and fruitful association with psychoanalysis, often the application of this theory has focused on treating motivated, articulate, financially secure clients in private practice. In The Facilitating Partnership, Jeffrey Applegate and Jennifer Bonovitz show how D. W. Winnicott's therapeutic ideas and technique are particularly relevant to a agency-based psychodynamic treatment of clients whose histories of deprivation and trauma historically have made them unlikely—and reluctant—candidates for in-depth clinical services. Winnicott's concepts are especially powerful in capturing the 'silent,' supportive, sustaining, relationship-based dimensions of clinical work and the authors provide an accessible language for explicating these invaluable activities. Through extensive case vignettes, Applegate and Bonovitz demonstrate that interventions emerging from Winnicott's key concepts—the good enough mother, the holding environment—can bolster clients' ego strengths and coping capacities while promoting their psychosocial development in ways that help them profoundly alter maladaptive life patterns. A Jason Aronson Book