Self-Esteem Research, Theory, and Practice Toward a Positive ...

140 SELF-ESTEEM RESEARCH, THEORY, AND PRACTICEwhich aims at determining “the client’s capacity for a candid and realisticconversation about the meaning and significance of personal problemswith a nonpunitive, reasonably astute professional person” (1989,p. 188). Because the therapist is looking for limits as well as ability, he orshe is active in this assessment. For instance, the therapist makes it clearthat it may be necessary to actually push the client toward sensitive orpainful material. In such work, the focus is on what makes this particularperson defensive, the degree to which the patterns of avoidance areingrained, and how well the individual can tolerate looking honestly athimself or herself. Process evaluation, which assesses how well the clientis able to take advantage of the therapeutic process, is done throughoutthe program. It is especially important to pay attention to this dimensionof the work at its beginning, lest the program moves too fast or too slowfor an individual. The other form of assessment focuses on what theauthors refer to as an evaluation of “content and substance.” This typeof evaluation focuses more on understanding the specific patterns ofcoping and avoiding that a person characteristically uses. For instance, itincludes assessing what specific issues trigger these responses in an individual’sunique personality and life and which behaviors he or she uses toavoid facing the conflicts involved in his or her responses.Finally, Bednar and colleagues unequivocally indicate that the role ofthe therapist and the abilities of the person in that role are vital to thisself-esteem enhancement program. In fact, it may be said that the entireprocess hinges on the ability of the therapist because he or she activelyseeks to “make things happen” in the therapeutic encounter. Such an orientationalso means that the responsibility of making sure that things donot happen too quickly or too intensely also falls to the therapist, becauseeither of these two possibilities could be harmful to the client. For it towork, this approach to enhancing self-esteem depends on an intense personalencounter right in the office and on client risk-taking both in andout of the session. Obviously, such an orientation is not a “soft” path toself-esteem. Indeed, the authors say that, “Psychological anguish inducedin treatment is the first sign of personal change in the direction of coping”(1989, p. 134). Experiencing the full effect of one’s own negative selfevaluations,then, is a necessary but tricky part of treatment. Accordingly,Bednar and colleagues clearly emphasize the need for the program to beoffered by a highly skilled, experienced therapist.SummaryPerhaps the most important and distinguishing feature of this approach isthat it is an explicitly clinical program. This highly individualized approachrequires professional assessment and intervention by a well-trained