Mediation and Psychotherapy: Two Sides of the Same Coin? Stewart Gabel
Some mediators believe that mediation and psychotherapy are quite similar, and that when doing mediation, the mediator also is practicing an art form similar to psychotherapy. On face value, some forms of mediation (e.g., evaluative) and some forms of psychotherapy (e.g., psychoanalysis) are so far apart in theoretical conception and in actual practice that they cannot be compared meaningfully. However, the forms of mediation known as “facilitative” and “transformative” and the forms of brief or focused psychotherapy that often involve families or couples do have considerable similarity. Overall, numerous resonances exist between these two approaches to mediation and to couples or family-oriented psychotherapies, especially when differences in terminology, licensure, and training requirements are not allowed to obscure commonalities.
T
he contemporary field of alternative dispute resolution has grown in an attempt to address disputes in a manner that does not involve either violence or litigation (Slaikeu 1996). In general, the goal of the alternative dispute resolution movement has been to ensure what is felt to be reasonable and fair solutions to differences among people in conflict. What is meant by “reasonable and fair” is, of course, open to interpretation and individual perception. It sometimes appears to mediators that the
Stewart Gabel, M.D. is an organizational consultant with a special interest in healthcare related issues and disputes. He was formerly chair of the Department of Psychiatry and Behavioral Sciences at The Children’s Hospital and professor of psychiatry and pediatrics at the University of Colorado Medical School, Denver. His address is 1056 East 19th Avenue, Denver, Colorado 80218. Email:
[email protected] 0748-4526/03/1000-0315/0 © 2003 Plenum Publishing Corporation
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perception of solutions that are reasonable and fair depends not only on the value of the resource distribution that occurs, but also on the ability to address successfully various relationship issues that seem to be so much a part of many disputes. Appropriately addressing relationship and psychological aspects of a dispute may enhance the possibility that the parties involved will continue to work together harmoniously in the future. The orientation, practices, and approaches of those mediators whose personal styles, types of cases or professional situations require or lend themselves to what have been called “transformative” or facilitative mediation are sometimes likened by mediators themselves to the orientation, practices and approaches of psychotherapists. Like psychotherapists, such mediators emphasize relationship issues in their approaches, and work with couples or families in conflict. They also work to address various personal attitudes, emotions, and reactions that are felt to be helpful or harmful to the resolution of conflicts of various types. As Moore (1996: 77) states, “The mediator may focus his or her energies on changing the psychological relationship of parties to each other...He or she may aim at creating the psychological conditions that are necessary for productive negotiations.” The question of whether and in what ways a relationship exists between the practice of mediation and the practice of psychotherapy is important because consumers of services, whether they are called “parties” or “patients” should reasonably be able to anticipate what types of services will be rendered, what the process will entail and what the expected outcomes will be. Additionally, those involved in training and education, certification, regulation, and licensure also have an interest in being able to define the scope, limits, and expectations of the two different fields to the highest degree possible. This essay will review some of the basic assumptions and approaches of mediation and of psychotherapy in order to compare the two and to shed further light on the question of whether and to what degree the practice of mediation and the practice of psychotherapy are related. I shall initially provide broad definitions of mediation and of psychotherapy, and then focus the discussion on those aspects of the two fields that offer the greatest potential for meaningful comparisons.
Defining Mediation and Psychotherapy For Moore (1996: 15), mediation may be defined “as the intervention in a negotiation or a conflict of an acceptable third party who has limited or no authoritative decision-making power but who assists the involved parties in voluntarily reaching a mutually acceptable settlement of issues in dispute. In addition to addressing substantive issues, mediation may also establish or strengthen relationships of trust and respect between parties or terminate relationships in a manner that minimizes costs and psychological harm.”
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Slaikeu’s definition of mediation is similar in a number of ways. Slaikeu (1996:4-5) describes mediation as “a process through which a third party helps two or more other parties achieve their own resolution on one or more issues. . .Mediators do not make decisions for parties. . .they assist the parties by structuring a process for communication and negotiation that allows them to analyze problems, generate solutions, and eventually agree on a series of steps to be taken to solve a problem.” “Psychotherapy can be defined as a talking treatment that aims to relieve a patient’s symptoms by changing problematic thoughts, feelings, and behaviors that appear to be causally related to the presenting symptoms. Therapeutic change is thought to occur in the context of a supportive, professional relationship in which a patient has the opportunity to explore the underpinnings of maladaptive behavior patterns and then to develop new, more adaptive ways to function” (O’Brien, Woody, and Mercer 1995: 1882). Taken from textbooks that are written for members of the two separate fields, these definitions of mediation and psychotherapy emphasize that the respective activities are interventions by a third party who is supportive but not authoritarian in the sense of having control or decision making power in a given situation. They both seem to emphasize that the goal of the intervention is to change the status quo so that negative feelings and actual or potential conflicts or disputes are lessened or resolved. Both mediation and psychotherapy recognize that the participants involved in the process feel that the current situation is undesirable in some manner. There are numerous other possible points of comparison between the two fields, however, although comparisons are made more difficult because of the lack of standardization, uniform practice, and universally-held assumptions and beliefs in both mediation and in psychotherapy. Many exceptions and individual differences in approach and style exist in both fields. The differing terminology employed in the respective definitions of mediation and psychotherapy also may obscure potentially useful points of comparison. Before going further, however, it seems advisable to establish which areas in the two fields reasonably can be compared. There are reportedly over 100 types of psychotherapy (O’Brien, Woody, and Mercer 1995) and a smaller number of nonetheless distinct orientations in mediation (Moore 1996). The question of relationships between the two fields can meaningfully be applied only to particular practice areas or approaches in the two fields that have some similarities on face value.
Types of Mediation The practice of mediation can be conceptualized as falling along a spectrum. As Moore (1996: 74) states: “Mediators vary significantly in the ways they define their role and involvement in promoting successful negotiations. The differences are generally rooted in mediators’ judgments about how much they should focus on process or substance.” On one end of the spectrum lies the “transformative” approach to mediation. According to Bush and Folger (1994:12), this approach concentrates Negotiation Journal
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“on empowering parties to define issues and decide settlement terms for themselves and on helping parties to better understand one another’s perspectives. The effect of this approach is to avoid the directiveness associated with problem-solving mediation. Equally important, transformative mediation helps parties recognize and exploit the opportunities for moral growth inherently presented by the conflict. It aims at changing the parties themselves for the better, as human beings. In the course of doing so, it often results in parties finding genuine solutions to their real problems.” Close to this rather idealistic emphasis of the transformative approach to mediation, and merging with it in terms of technique and goals, is the process-oriented or “facilitative” approach to mediation. In the facilitative approach, the mediator uses his or her expertise in processes related to dispute resolution, relationship development, and communication to aid the parties to define their own outcome and results in the substantive or resource-based components of the dispute. The emphasis here is on the “procedural” aspects of the mediation. This form of mediation is sometimes termed “integrative” or “interest-based” in that it looks to underlying personal or group interests to help understand and define the mediation approach and outcome. Here too, the possibilities of the parties for personal growth, perspective taking and building the potential for continued or improved relationships with the other party are highly valued. At the other end of the spectrum of mediation is the “evaluative” or problem-solving approach which, in contrast, emphasizes a “substance” orientation. In this type of mediation, the mediator, having a degree of expertise in the area under dispute, recommends (but does not formally direct or determine) a particular substantive or resource-based outcome or settlement. This type of mediation does not emphasize particular personal or psychological needs or “interests” of the disputants, but focuses heavily on the legal and concrete resource issues involved in the dispute. Evaluative mediation is also termed “distributive” in that its resource-based orientation involves the distribution of resources, such as money, in a business conflict. Many mediators, of course, actually practice somewhere between the transformative/facilitative and evaluative ends of the spectrum. Individual style, the setting, and the type of conflict or dispute encountered also shift the focus of particular mediations. But it is the various aspects of the transformative/facilitative forms of mediation that share similarities with certain interpersonal aspects of psychotherapy.
Types of Psychotherapy The origins of psychotherapy, and much of its current style and practice, are grounded by an “individual” orientation in which one person (the patient or client) is treated by the psychotherapist in sessions of variable frequency and number. The format of mediation and the format of family or couples-oriented psychotherapy are more similar to one another than is the format of individual psychotherapy and any form of mediation. However, the range of 318
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psychotherapies is broad and falls along a spectrum as large, if not larger than, the spectrum of types of mediation. Individual psychotherapy. The types of individual psychotherapies are many and varied. The spectrum ranges from psychoanalysis, which involves individual patients (or clients or “analysands”) who receive treatment by the psychotherapist (termed the “psychoanalyst”) intensively (often about four times per week) to a less well-defined, but more commonly practiced group of individual psychotherapies that involve less frequent treatment sessions and maintain different goals and expectations. These latter other forms of psychotherapy, which are of most interest to us here, are termed “brief,” “supportive,” “psychoeducational,” and/or “time-limited,” depending on the particular approach. The application of one of these latter forms of psychotherapy compared to another depends on the setting, the psychotherapist’s assessment of the situation, and his or her expertise. Brief, supportive, psychoeducational and/or time-limited psychotherapy. These forms of individual psychotherapy have their own particular and unique characteristics, although the practices in this group also have considerable overlap. They provide variable lengths of treatment, have more limited goals than psychoanalysis, focus on specific issues or problems in the patient’s life, and/or attempt to aid psychological adaptation during a time of crisis or medical deterioration. They do not characteristically aim at “uncovering” deeply held and long-standing conflicts of which the patient is unaware, as is true in psychoanalysis (Karasu:1995), but help to clarify and resolve problematic issues in the present, and to aid adaptation. Fenton and McGlashan (1995: 1013), in discussing the aims of supportive psychotherapy in relation to patients with a particularly severe form of mental disorder, describe goals for this approach that apply more generally. These goals include “relief from the immediate crisis or direct reduction of the acute disequilibrium. . .the mobilization and the preservation of healthy aspects of the patient to enable optimal functioning with any continuing deficit. Functional or social recovery, rather than personality change, is the primary aim of treatment.” For others with differing needs, therapy may be brief and mainly educational, as in discussions of family planning issues or parent management techniques for parents of children with particular behavioral problems. In general, brief therapies have more limited goals than lengthy or intensive psychoanalytic treatment or “insight-oriented” psychotherapy that is based on psychoanalytic theory. Brief psychotherapy “purposely limits goals, tailors its techniques, and presumes or even defines a limit in time or number of sessions in order to achieve a specific identified clinical goal” (Mohl 1995: 1873). The psychotherapies that emphasize brevity and focus in their attempts to resolve problematic situations or conflicts and those that focus on support, education, and information to patients about particular issues share a
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framework and practical orientation that overlaps with approaches used in some forms of mediation. Psychotherapy involving more than one person. Psychotherapies have evolved to a focus that in many cases includes more than one person as the identified patients or clients. While these forms of psychotherapy frequently rely on techniques that were developed from work with patients in individual psychotherapy, new techniques also have been developed, and psychotherapeutic work has been extended to group, family and couples contexts. The format of psychotherapy with groups, families, and particularly, with couples, resembles the format in many mediation sessions. • Group therapy. Group therapy itself exists in many forms. It uses the group itself, and its members, as a vehicle to enable psychological change. Commonly, the work of the group is enhanced as conflicts of various types develop within the group. The trained group leader then helps the group members to understand and to resolve these conflicts in a manner that promotes self understanding. “Group psychotherapy. . .uses therapeutic forces within the group, constructive interactions between members, and interventions of a trained leader to change the maladaptive behavior, thoughts, and feelings of emotionally ill persons” (Wong 1995: 1821). • Family therapy. Family therapy is based on the supposition that, although only one family member may be experiencing particular symptoms, or only one member may have been referred for mental health treatment or become involved with the law because of criminal behavior, the entire family system is involved with conflicted or problem areas in some way. It emphasizes that improvement and/or resolution of conflict or problem areas for the individual and for the family itself involves a working with and understanding of the overall family system. “Family therapy is a form of psychotherapy designed to assess and treat various psychiatric disorders through (1) an understanding of how the interactional dynamics of the family relates to individual psychopathology, (2) a mobilization of the family’s inherent strengths and functional resources, (3) a restructuring of maladaptive family behavioral styles, and (4) a strengthening of family problem-solving behaviors” (Steinglass 1995:1838). • Marital therapy or couples therapy. Mediators will see immediately certain relationships between many mediation sessions, such as those involving divorce mediation, and the approaches of marital or couples counseling or therapy. Marital therapy, couples therapy, or relationship therapy, as it is sometimes conceptualized, is intended to assess and then to address conflict areas between people in a dyadic relationship. “Marital therapy or couples therapy refers specifically to the treatment of the relationship or to the using of the relationship in the treatment...” (Kadis and McClendon 1995: 1857).
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Figure One depicts the spectrum of approaches that one will find in the fields of mediation, individual psychotherapy, and psychotherapy involving more than one person. This is not intended as a comprehensive depiction but is aimed at providing the reader with a sense of the diversity along the three spectra. Figure One The Spectra of Mediation and of Psychotherapy Mediation Transformative
Facilitative
Evaluative
Individual Psychotherapy Psychoanalysis
“Insight oriented”
Brief, supportive, focused, behavioral orientation
Psychotherapy with More than One Person Group
Family
Couples
Comparing the Two Fields Based on the definitions I have just presented, some forms of psychotherapy (e.g., psychoanalysis) and some forms of mediation (e.g., evaluative) are quite far apart in basic assumptions and approaches. On the other hand, it also should be clear that some forms of mediation (i.e., transformative and facilitative) and some forms of psychotherapy (e.g., couples counseling or psychotherapy with couples) have a great deal in common. My observations here deal only with part of the spectrum of mediation that I term “transformative/facilitative” and that part of the spectrum of psychotherapy that I term “family/couples/ brief /focused.” In my opinion, it is among these groups that the greatest apparent similarities lie. Six specific domains will be discussed: the importance of conflict; theoretical assumptions about the nature and cause of interpersonal disputes; goals, course, and outcome of the intervention; third party terminology and roles; client terminology and its possible implications; training and licensure requirements.
The Importance of Conflict Conflict (or the potential of conflict) is a central concept for both mediation and psychotherapy. Mediation is based on conflict, or its potential development, between people in a myriad of human situations. The foundations of Negotiation Journal
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psychotherapy also rest on conflict. Psychoanalysis and other forms of psychotherapy emphasize that internal or “intrapsychic” conflict is very common. On a psychological level, it sometimes is difficult for a person to recognize, accept, or reconcile different feelings or emotions about a particular issue. The conflict that is present as a result of these irreconcilable feelings may produce particular psychological problems, abnormal behaviors or “symptoms” such as anxiety, depression, somatic pain and the like. Other forms of psychotherapy (such as group therapy, family therapy or couples counseling) begin with the view that conflicts (which initially may be internal to one individual in the situation) are expressed in the context of a relationship with others in the group, family or couple. In family therapy it is commonly assumed by some family members that other(s) in the family system are at fault for the negative or painful feelings that various different members of the family system experience. Conflict in these situations may be recognized by violence, arguments, interpersonal anger, withdrawal, and various forms of estrangement. It is the psychotherapist’s responsibility to help clarify the source of the conflict in the individual or in the interpersonal system, and help the individuals to understand and resolve the conflicts that are present in order to reduce the “symptoms” or problems that the individual or members of the family or couple experience. From the perspective of the third party or “neutral” in mediation, the “parties” usually have a conflict also, but this is more commonly expressed, at least initially, in terms of specific actions or behaviors that have been taken or might be taken by one or more individuals or groups (the parties) because of the disagreement. The issue of feelings or particular personal or emotional interests of the conflicting parties may not be addressed initially or may not be foremost in the minds of the parties themselves or in the mind of the mediator. In psychotherapy, most commonly, the issue of the feelings underlying the dispute or conflict between individuals is higher on the agenda of what is discussed initially in the sessions. It often is somewhat later in mediation (depending on the type of mediation and the problem addressed) that the issue of the parties’ feelings or subjective “interests” is addressed. There is an important exception to note, however. The form of psychotherapy considered “behavioral” in orientation emphasizes the importance of early intervention to change specific behaviors of those in the therapy. Rewards and consequences (contingencies) for specific behaviors are a crucial aspect of this form of psychotherapy, and the behaviorally-oriented psychotherapist, working with the clients, develops contracts and expectations of behavior for both sides. The assumption here is that the conflict can be resolved best by addressing specific behaviors that are at issue, and that the negative emotions that are a part of the conflict will be improved once behavioral change has occurred. This “behavioral” approach to psychotherapy seems to have clear links to more specific behavioral 322
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agreements that are developed in facilitative forms of mediation in which the development of agreements is important.
Theoretical Assumptions about the Nature and Cause of Interpersonal Disputes There are significant differences between mediation and psychotherapy in the underlying theoretical assumptions of the fields in relation to the origins or maintenance of psychological or interpersonal difficulties in people. These differences are likely to affect the behaviors and perceptions of those providing services and those receiving services. In general, psychotherapists believe in a causation model of psychological difficulty in which problems arise because of internal or intrapsychic factors in an individual, or because of conflicting approaches or psychological or personal needs of clients who come for services, as in a family system. It is recognized that manifest activities or behaviors of individuals, families or couples are the focus of concern for those seeking psychotherapy, but there is a generally held assumption that the origin of these externally perceived conflicts and disputes arises from internal and personal needs or emotions of one or more people. There seem to be fewer underlying or theoretical assumptions in mediation regarding how conflicts or disputes arise. Rather, the initial focus is on the parties’ perceptions of the dispute, and what each feels is justified or needed to resolve the dispute in a manner that will be acceptable. The parties themselves may, of course, have numerous and conflicting theories as to the origin of the dispute, and the psychological “problems” the other party has, but the mediator, himself or herself, does not make theoretical assumptions of this type. It may be partly for this reason that mediation proceeds from the stated problem, which often is related to a substantive issue or resource, backward to positions that are personal and emotional in nature. The psychotherapist commonly starts with the “interests” of the client, which are personal and emotional in nature, before going to more substantive resource-based issues. Goals, Course and Outcome of the Intervention Goals are set in both mediation and in psychotherapy, although they are not always explicit in longer-term psychotherapy, especially of the psychoanalytic, “insight-oriented” or “uncovering” styles. In such types of psychotherapies, personal insight related to areas of conflict is the ultimate goal, although numerous other personal and life goals may emerge during the course of the psychotherapy. Goals in shorter term, more focused psychotherapy usually involve a reduction in “symptoms” or undesirable personal emotions or feelings (e.g., anxiety, anger) and/or a reduction of interpersonal conflict. Goals may be written down at the beginning of the psychotherapy and modified or changed during the course of the treatment. Depending on the type of mediation, the stated goals may be to develop a mutually acceptable allocation of resources or substantive assets. Quite often, in more facilitative mediations, the sometimes stated, but often Negotiation Journal
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unstated goals, at least initially, also include satisfying the parties’ interests, which may involve issues such as respect for feelings, recognition of accomplishments, the establishment of positive working relationships and the like. As noted, in transformative mediation, specific goals related to personal growth and interpersonal recognition are major emphases. Obtaining an actual agreement to a specific problem is secondary. (Bush and Folger 1994). Overall, it seems appropriate to observe that goals in mediation are relatively more focused on tangible outcomes than on the resolution of disturbing feelings or personal symptoms, which are stronger areas of concern for in the outcome of psychotherapeutic interventions.
Third Party Terminology and Roles The presence of a third party—called the “mediator” or “neutral” in mediation and the “psychotherapist” in psychotherapy—is central to practice in both fields. As indicated earlier, there are many similarities in the roles, expectations and behaviors of the mediator and the psychotherapist, at least when comparing the family/couples/ brief/ focused group of psychotherapies with those forms of mediation (facilitative/ transformative) that appear to be most similar. The third party in both fields is expected to be neutral and to take no side in the dispute or conflicts that are problematic. The attitude of the third party is expected to be nonjudgmental. The third party’s role is to be supportive to both sides in a dispute. The efforts of the third party are to facilitate resolution of substantive or personal conflicts or issues with the recognition that he or she does not have decision making authority in either mediation or psychotherapy. The third party’s role is one of support, advice (at times) and neutrality. The psychotherapist, like the trained mediator, is expected to have the ability to foster the appropriate expression of feelings and emotions that are relevant to the situation. The psychotherapist is likely to emphasize more the expression of these feelings and emotions and to question whether the patient is experiencing feelings that have been present in similar situations in the past since there may be important psychological patterns to understand and to treat for the present and for the future. The mediator is more likely to confine his or her intervention or facilitation of emotional expression to the dispute at hand. He or she does not take a position on the issue of repetitive causation, and generally deals with a single situation or dispute, although follow up sessions or further disputes can result in additional mediation sessions. In general, this suggests that the work of the psychotherapist fosters more readily the expression of stronger feelings and emotions than is true of the mediator, who would seek a more limited expression of feelings that is likely to be expressed only in relation to the problem at hand. This may not always be true, however, and may depend on the familiarity of the parties with one another. Family members, for example, may have longer histories with one another, and may have feelings that extend to previous situations 324
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that have been problematic. It would be expected that feelings related to these historical incidents would at times be expressed in mediation. The expectation that the psychotherapist is likely to seek parallels in similar situations or emotions in the past also is not necessarily true. Depending on the nature of the problems and the patient, the psychotherapist may confine his or her focus to the present situation entirely. He or she, like the mediator, also may work to limit or control the expression of emotions in certain situations if the expression of strong emotions is considered harmful to the well being of the patient (or party) or if this expression might hinder the goals of the psychotherapy.
Client Terminology and its Possible Implications An important difference between mediation and psychotherapy involves the terms used in referring to people receiving services, and the likely differences in expectations and perceptions of mediation compared to psychotherapy that may be reflected by the terms. People receiving mediation services are called “parties,” “disputants,” and sometimes “clients.” People receiving psychotherapy services are called “patients” or “clients.” “Patient” is a term used in the medical model of disease treatment in which there is a clear differentiation between provider and recipient of services. It implies that the receiver of services is in some way “sick” or has an illness or disease process that distinguishes that individual from others who are not symptomatic or troubled in the same manner. The “patient” in mental health treatment is a person who has some form of psychopathology or mental disorder, however mild. This condition distinguishes him or her from some actually or hypothetically “normal” individual. The term “patient” seems to reflect the psychotherapist’s lineage, which is at least partly within the medical model. The term “client” is a more neutral term now used widely in some mental health circles that seems to remove or reduce the stigma associated with the term “patient.” The term “client” seems to suggest that the person receiving psychotherapy services is not necessarily “sick” or “symptomatic” in a more medical sense. In fact, people entering psychotherapy may have no diagnosable mental disorder by commonly held current diagnostic criteria (American Psychiatric Association 1994) and may wish to receive psychotherapy services because of a variety of other problems that may be troubling, but not necessarily severe. The term “party” as used in mediation is decidedly neutral. It does not have connotations related to having a psychological problem or mental disorder. “Party” or “disputant” appears to be in keeping with the legal perspective and traditions of mediation in which there is expected to be equality among adversaries. These differences in terms may reflect subtle differences among practitioners (mediators compared to psychotherapists) and among those receiving services (parties compared to patients or clients) with regard to whether and in what way it is the responsibility of the service provider (or Negotiation Journal
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third party) to address emotional issues that are a part of so many conflicts. The focus in psychotherapy traditionally is on a patient’s or client’s experiences individually or in the context of a relationship; specifics and concrete details related to positions or actions to be taken generally are addressed later in the treatment, and are felt to derive from those personal or relational reactions or experiences. The focus initially in most mediations is on the individual’s positions, and then later on his or her personal reactions, interests or emotional needs in an agreement. The differences here are on the degree, type and focus of the psychotherapist compared to the mediator in relation to underlying reactions or feelings on one hand, and on financial or other resources or behaviors that reflect what in mediation is termed “positions.”
Training and Licensure Requirements The training and licensure requirements of mediators and of psychotherapists are vastly different, although the training of practitioners within these two fields also varies greatly. There often is no specific license or discipline designation for “psychotherapist,” as such, which is something of a generic term. Psychotherapy training is provided as part of the educational experience in several different disciplines. Many psychotherapists have doctoral degrees in psychiatry or psychology; others have master’s degrees. It is rare for a psychotherapist to be licensable by a state in the United States if that psychotherapist does not have at least a master’s degree in a mental health related field, although the intensity, scope and type of training for many of the lesser trained psychotherapists varies. There appears to be less rigor to training and practice standards overall for mediators than for psychotherapists in different states, with great differences existing in training approaches and expectations for mediators. In general, training in mediation is much less standardized and regulated than it is in psychotherapy, although there is considerable pressure for greater standardization and clarification of standards in mediation. Some lack of standardization and regulatory oversight in the practice of psychotherapy continues to exist, but to a lesser degree.
In Conclusion At the ends of the spectrum of mediation and psychotherapy, where one considers evaluative mediation and psychoanalysis, respectively, there is little meaningful comparison between the fields, even though the concept of conflict is central to both psychotherapy and to mediation. However, similarities do emerge when considering particular approaches in both fields. Psychoanalysis developed in part from a medical model, and now has yielded to a large degree to numerous other forms of psychotherapy; mediation, which developed from a legal framework, has included various relationally-oriented approaches necessary to achieve dispute resolution. If one considers the transformative and facilitative approaches at one end of the spectrum of mediation, and the types of psychotherapy that I 326
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have lumped together under a heading of family/couples/brief/focused psychotherapies together at one end of a spectrum, a great deal of similarities emerge between these groups, although terminology, education, training, and discipline issues sometimes obscure these similarities. In both of these fields the “third party” is expected to be nonjudgmental and neutral. He or she uses a variety of techniques, such as support, good listening and communication skills, and appropriate questioning and clarification to foster the appropriate expression of personal feelings and emotions that are felt important to the process. In psychotherapy, the clarification of personal feelings (individually or as part of a family or couples grouping) are of such importance that different theoretical frameworks have developed in an attempt to understand the nature of mental processes in depth. As such, the psychotherapist’s work is more oriented to discerning whether an individual, or members of a family or couple, have defined mental problems or disorders of various types that affect the individual’s or system’s functioning, be this in relationship to the development of agreements of various types or not. The mediator and the parties coming to the mediator, make the assumption that the parties are broadly “normal” in relation to mental functioning. The mediator is not wedded to, or a subscriber to, various theoretical orientations related to communication or to mental health, but would be more inclined to use techniques from any field that seemed appropriate to foster the type of relationship that is helpful in achieving the ultimate goal of the mediation. The mediator therefore generally would not address reactions, feelings or emotions that were felt to be highly exaggerated, unusual or odd during the course of the mediation as “abnormal,” or needing mental health treatment, although he or she might strongly suspect this to be the case, and might suggest it to the party in question in caucus. The psychotherapist also would be more interested than the mediator in whether similar personal reactions, patterns, or problems in an individual or couple had been present in the past, and whether these patterns had been maladaptive, and as such, might need more in depth or greater psychotherapeutic efforts than would be true or possible in relatively few sessions, as might be found in mediation. In psychotherapy, the goal usually is more heavily weighted toward understanding oneself or the relationship in question. The actual solution to a given, concrete problem may be entertained, but is secondary to the types of emotional understanding and expression I have noted. In mediation, generally the goal usually is more heavily weighted toward the achievement of a specific, concrete, detailed agreement about a problem or conflict between the parties, one or more parts of which might be to enhance the parties’ relationship in the future. The use of process and the facilitation of relationship factors in the mediation are more heavily aimed at helping to achieve the agreement itself. However, in transformative mediation personal empow-
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erment and the development of social involvement and relationships with others is more important than is the agreement itself. Are mediation and psychotherapy two sides of the same coin? The answer, of course, depends on one’s point of view. They are not exactly alike and there remain significant differences, even beyond issues of training, terminology, and discipline background. However, depending on the individual mediator, the situation, and the case, the approaches of mediation and of psychotherapy appear, at times, to share many resonances and are, in fact, quite close. NOTE I would like to acknowlege Robin N. Amadei, J.E. for her support and review of this paper.
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