Promoting Psychological Flexibility by Practicing Flexibly: The Therapist as Model


  • Jill Bresler



psychoanalysis, acceptance and commitment therapy (ACT), psychotherapy integration, attachment, mentalization, homework, termination, case study, clinical case study


In this discussion of Dr. Robert Cohen’s (2016) case study of his client Daniel, several integrative shifts over the course of the long-term, psychoanalytic treatment are noted. Initially, a shift from a traditional psychoanalytic model to a relational model was initiated in order to respond to Daniel's lack of responsiveness to a therapy focused on transference interpretation; and later a shift to employing strategies from Acceptance and Commitment Therapy (ACT;  Hayes, Strosahl, & Wilson, 2012) was implemented in order to address ruminative thought patterns and accompanying social inhibition. The therapist describes his own process of exploring options flexibly, allowing the reader a rare view into this clinical decision-making process. The treatment as a whole is conceptualized as fostering both mentalization and mindfulness skills in the context of the secure attachment that an intensive treatment tends to  foster. The possibility that a shift to ACT provided a bridge to a termination process is discussed.

Author Biography

Jill Bresler

Jill Bresler




How to Cite

Bresler, J. (2016). Promoting Psychological Flexibility by Practicing Flexibly: The Therapist as Model. Pragmatic Case Studies in Psychotherapy, 12(1), 31–38.