In this chapter, I will attempt to reconstruct the clinical thinking that has informed the work of a colleague, Dorota Jagielska-Hall, who is a qualified and experienced clinical psychologist. I have taken the first two sessions from a 16-session therapy which she conducted under my supervision in a National Health Service specialist psychotherapy outpatient department in which I work. In writing the account of the two sessions, I have relied on Dorota’s process notes of the sessions described. All the sessions were taped (apart from the first one) and Dorota wrote her notes after listening to the tape of that session. I have read Dorota’s notes from all of the sessions and listened to tapes from three of the sessions (although not of the two sessions described in this chapter). On the basis of this comparison between tapes and notes, I considered the process notes to be a reasonably reliable account of the sessions described, in the sense that they give an account of much of what was actually said between Dorota and her patient (certainly a much more reliable rendition than one dependent solely on memory and retrospective notes). Furthermore, the notes are written in a particularly open and transparent way, which leaves many traces and clues for a reconstruction of Dorota’s clinical thinking.
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