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Reaching the "Externalizers"-A Three-Phase Approach
EDNA OBERMAN; MARGOT WOOD; ANNE CLIFTON
Am J Psychiatry 1969;125:1404-1411.
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Social workers with the mental health unit, Tufts-New England Medical Center, 171 Harrison Ave., Boston, Mass. 02111

1968-69, American Psychiatric Association

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Abstract

Patients who are initially preoccupied with external problems rather than internal conflict are often considered unsuitable candidates for insight psychotherapy. Many economically deprived patients are so viewed for reasons of both psychopathology and cultural factors. In contrast, this paper suggests that such patients can in fact benefit from a flexible psychotherapeutic approach in which motivating and engaging the patient in treatment, through work on his presenting external problem, is the first therapeutic step. Social casework can provide a model for this approach, and two clinical illustrations are offered.

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