Log in
A one-day certification WEBINAR
The Therapeutic Contract: How treatment arrangements determine the effectiveness of therapy
Read more
Participate
Faculty
Date
time
FORMAT & LANGUAGE
PhD (USA)
London Time
2025
Monica Carsky
April 27
13:40-20:00
Online Education in English
The therapeutic contract is a tactic that ensures the effectiveness of the entire treatment.
  • The contract defines the reality of the therapeutic relationship. Guided by these agreements, the therapist can recognize the patient's distortions of the therapeutic relationship, which opens the “royal road” to the patient's unconscious - any deviations from the contract by the patient become objects of exploration and understanding in therapy. Without clear agreements about contact, these deviations can be elusive, leading to confusion in transference and countertransference and, in turn, to therapeutic impasse.
  • This is the first step toward consistent and successful psychotherapy, which cannot begin without establishing clear treatment parameters. The therapeutic frame and contract is not just about "time, place, and fee." It is about creating an environment in which an effective psychotherapeutic process can unfold.
  • The therapeutic contract establishes the treatment frame, delineates the responsibility of each participant, and prepares the foundation for observing, studying, and modifying the patient's psychic dynamics within the therapeutic space.
  • There are contract conditions that we discuss with each patient, as well as individual conditions formulated by the therapist based on an understanding of the aspects of the patient’s personality and lifestyle that may act as resistance to therapy.
then it is impossible to achieve these goals without a well-conducted stage of establishing and discussing the therapeutic contract.
If we define high-quality psychotherapy as therapy that aims to:
  • change in personality functioning - improved consistency and sense of self, characterized by stability, depth, self-awareness
  • a capacity for mutual relations with others marked by empathy and concern and the ability to understand how others think and react (mentalization)
  • satisfactory regulation of affect and self-esteem
  • satisfaction in work, love, friends, and recreation
Through the therapeutic contract, therapists:
  • Establish a mutual understanding of the issues with the patient
  • Define the reality of the therapeutic relationship
  • Set the central focus on treatment goals
  • Specify the responsibilities of both the patient and the therapist
  • Protect the patient, the therapist, and the therapy itself
  • Safeguard the therapist's ability to think clearly
  • Create a safe space for the unfolding of the patient's dynamics and affects
  • Lay the foundation for interventions regarding deviations from the contract (which provide a direct path to understanding the patient's unconscious material)
  • Establish the basis for forming the therapeutic alliance
PARTICIPATE
Patients with severe chronic acting-out behaviors—such as addictions, eating disorders, self-harming behavior (in a broad sense), and suicidal tendencies—pose a challenge for the therapist. Through the carefully discussed contract conditions with the patient, we limit such acting-out behaviors, which in turn allows us access to the aspects of the patient's psyche that they have been protecting themselves from through these acting-out behaviors.

With narcissistic patients, we often find ourselves in situations where devaluation, seeping in like carbon monoxide, leaves us questioning who actually needs the therapy—the patient or us. In such moments, relying on the reality of a well-negotiated contract allows us to "untangle" the situation by integrating into the therapeutic context the processing of rigid defenses that the patient is not aware of.

The primary function of the contract is to bring conflicting object relations into the therapeutic process—in other words, to transform chronic acting-out behaviors into identifiable and examinable component object relations.

This Webinar will be especially valuable for psychotherapists of various modalities:

For TFP-oriented therapists who are on the path to certification, this webinar is part of the required didactic program.
For whom
  • Psychodynamic (including psychoanalytic) orientations
  • Humanistic orientations
  • TFP therapists seeking to refine their application of the TFP model

Individuals with borderline and other personality disorders tend to enact their conflicts in potentially dangerous ways that can create serious difficulties in psychoanalytic psychotherapy, where the therapist may feel that their primary role is to "rescue" the patient from self-destructive behavior rather than conduct psychotherapy.

The more severe the patient's disorder and the more distorted their interpersonal interactions in the therapeutic relationship, the more powerful the primitive object relations in the transference. These evoke an intense countertransference. The therapeutic position is vulnerable to the threat of potential acting out of transference feelings by the patient and, at times, to the therapist's temptation to act out their own countertransference. Without a well-thought-out and mutually discussed therapeutic frame and contract, the mutual enactment of transference and countertransference obscures the therapist's clear understanding of the psychodynamics of what is taking place.

With higher-functioning patients, different challenges emerge. The dynamics of higher-functioning patients are more difficult to track because their reactions in therapy appear almost normal. It is not easy to notice subtle deviations, and this is where the therapeutic frame and contract also helps - minor deviations from the agreed frame open the way to exploring deeper dynamics.
I Transference-Focused Psychotherapy (TFP) Overview
II Establishing the Treatment Contract and its importance in therapy
III Clinical examples, video sessions of contracting with patients, and discussion
1. Object Relations Theory and Relationship Dyads
2. The Patient’s Internal World
3. “Bids for Reflection” as the primary therapeutic techniques
a. Clarification
b. Confrontation
c. Transference Interpretation
4. Interfering Factors in Patients and Therapists
5. Before Beginning TFP Therapy: Preparatory Steps
a. Diagnostic assessment
b. Sharing and discussing the diagnosis
c. Establishing goals
1. Overview of the Process of Establishing Treatment Parameters (Contracting)
2. Functions of the Contract
3. Contract: Standard сontent for all patients
4. Treatment Contracting Process
5. Individualized contract elements
a. Behaviors Specific to a Particular Patient that need to be addressed
b. Most to least severe
6. More Severe Pathology Requires More Structure (antisocial features, secondary gain)
7. Contracting Around Suicidality in Chronically Suicidal Borderline Patients
8. The Beginning of Therapy Once the Contract is Agreed Upon
9. Offering a Second Chance
10. How Attention to the Frame Brings Patients’ Conflictual IOR/Relationship Dyads into the Treatment
  1. Is a treatment contract too controlling, or “anti-analytic?”
  2. To what extent should the therapist ask about the patient’s life outside therapy?
  3. Video of establishing a therapeutic contract with a patient with severe narcissistic pathology
  4. Video showing how referring to the treatment frame can bring acting-out into a therapy session, and how this can lead to transference analysis.

Webinar Program

Outline & Key Points
Schedule
London time. The webinar is a dynamic process, in which schedule changes are possible: shifts in blocks, breaks, or their rearrangement.
13:40-13:45
Participant entry into Zoom webinar
13:45-14:00
Opening remarks
14:00-15:30
Block 1: Overview of TFP
15:30-16:00
Break
16:00-17:30
Block 2: Didactic Session 1, Clinical Segment 1 (Video Analysis 1), Q&A
17:30-18:00
Break
18:00-20:00
Block 3: Didactic Session 1, Clinical Segment 1 (Video Analysis 1), Q&A
You will be able to create the conditions necessary for deep therapeutic exploration and working through patients' problems. This is the foundation for composure, professional satisfaction, and effective therapy.
Successful mastering and application of the webinar material will give you the sense that you are truly directing the psychotherapy.
Participate
Learn to establish a contract in a way that limits acting-out and enactment behaviors and creates conditions for reflection and exploration in therapy.
As a result of successfully mastering the webinar material, participants will:

Understand the meaning, functions, and significance of the therapeutic contract for different types of patients.
Develop the ability to manage the therapeutic framework to feel secure, even when working with severe personality disorder patients.
Understand the main therapeutic interventions
In this detailed form, the tactic of establishing a therapeutic contract has been developed in Transference-Focused Psychotherapy (TFP).
WHAT IS TFP?

Transference-Focused Psychotherapy (TFP) is a highly structured, manualized, evidence-based treatment model designed for borderline, narcissistic, and other severe personality disorders

TFP posits that the symptoms of borderline pathology arise from a lack of identity integration, which corresponds to the absence of coherence in an individual’s experience and understanding of both self and others. This results in the extreme, all-or-nothing thinking present in borderline individuals, which contributes to their problems with emotion regulation.

TFP addresses personality pathology through enhancing identity integration. The TFP treatment model includes strategies, which serve as long-term guidelines that integrate the treatment into a cohesive whole; tactics, which define the conditions for techniques and help the therapist determine where, when, and how to intervene; and techniques, which are interventions employed by the therapist moment-to-moment.

The webinar includes material on the basics of TFP and object relations theory (to the extent that the tactic of establishing a therapeutic contract becomes clear).

This webinar is important both on its own and in the context of studying and advancing in TFP.

And for those interested in the TFP model—an announcement. In the fall of 2025, we will be launching a didactic training program in Transference-Focused Psychotherapy. Understanding the fundamentals of establishing a therapeutic contract can be a valuable first step toward becoming acquainted with its core approaches.
PhD (USA)
Faculty

Monica Carsky

She has taught courses on Freud, Klein, Object-Relations theory, psychoanalytic psychotherapy, and the understanding and treatment of personality disorders and more severe psychiatric illnesses for psychiatric residents, graduate students, and postgraduate psychologists, psychiatrists and social workers in numerous settings.
Clinical Assistant Professor of Psychology in Psychiatry and Senior Fellow, Personality Disorders Institute, Weill Medical College of Cornell University
Adjunct Assistant Professor, NYU Postdoctoral Program in Psychoanalysis and Psychotherapy
Faculty, Institute for Psychoanalytic Training and Research (IPTAR)
Supervising and Training Analyst, Center for Psychoanalysis and Psychotherapy of New Jersey
The Ukrainian Institute for Personality Disorders Studies is a center where knowledge is transformed into effective practice
We assist our students in the acquisition of advanced and up-to-date models of psychotherapy. Become internationally certified. Learn in real time from the outstanding specialists recognized around the world.
Education. Workshops, trainings, and long-term programs from the world's foremost experts.
The main program coordinator
Research — conducting research on the diagnosis and effectiveness of psychotherapy
Translations of books and manuals. Current psychoanalytic literature from around the world in Ukrainian.
1306
149
students who have received professional training
hours of seminars conducted
Otto Kernberg, Frank Yeomans, Monica Carsky, Tennyson Lee, Katarzyna Gwóźdź, Veronica Steiner, Nel Draijer, Jos van Mosel, Julia Sowislo, Mathieu Norton-Poulin
The specialists we collaborate with
Countries of participants of our educational programs

Our institute's statistics

It cannot be said that therapy is entirely ineffective without a therapeutic contract. However, with a therapeutic contract in place, therapists feel more secure and confident, and achieving the goals of psychotherapy becomes realistic.
Understanding the tactic of the therapeutic contract is the foundation of effective psychotherapy.
Participation package

Discover new opportunities for high-quality therapy for yourself and your patients.

Registration for the webinar
Participant Package Includes:
Participate
$175
Participation in the seminar – Online via Zoom
Personalized electronic certificate of participation
Access to the seminar recording for 12 months
Еxclusive handouts

Past seminar attendees' testimonials

Good afternoon, Alexey! I want to express my deep gratitude to you and the entire team for organizing such a wonderful project, our training, and for creating this amazing community! Everything is important and meaningful to me: the teachers, the detailed and well-designed slides, the knowledge gained, the additional materials provided, the supervisions, the interpreteurs (!), and the way you communicate with the program participants. It always reflects respect and appreciation for everyone!
Thank you so much! ♥️
I’m really looking forward to the start of Otto's year-long program 🤓
Any event organized by TFP-Ukraine is always a well-prepared learning environment: world-class instructors who are always open to questions and clarifications, access to materials, slides, specially translated articles, book excerpts, technical support, and more. The TFP-Ukraine community is an incredible team of top-notch instructors and professional colleagues. Thank you for your work.
I also thank Oleksiy very much for the opportunity to learn from such an incredible specialist! I am in awe of the way Dr. Yeomans works with clients, his acceptance of clients and the way he is able to articulate complex things gently. Incredible organization, great translators! I'll back you up for the next module!
I especially appreciated the organizers’ attentiveness to participants' questions. I truly value the opportunity to ask questions and the confidence that they will be addressed during the training.
Organizers can be narcissistically admired. Everything is perfect. Many thanks! I look forward to the next seminars. Everything is very collegial, accessible, clinically useful
Thank you for the seminar and especially for such an interesting analysis of supervisions already on the 1st module. This clearly shows the method. And I`m ready to go to the next module!
I join my colleagues - a great organization, thank you, Oleksiy! And an excellent translation. Great gratitude to Dr. Yeomans for sharing his knowledge and experience. Worth it!
Thanks to Frank Yeomans for valuable communication, desire to provide knowledge, sincerity and correctness in communication
I also want to thank you for the excellently organized, very useful and informative training, professional work of the translators. I look forward to further actions
Great organization and the seminar itself! I look forward to the next event ❤️ Many thanks to Oleksiy and Dr. Yeomans, and everyone involved!
Thank you very much, highly topical program, very interesting and saturated materials. There is something to think about. and special thanks for the articles!
Thank you very much, Oleksiy, for this opportunity, and special thanks for the organization!
Cool organization, translators and special satisfaction from a clear setting
ANY QUESTIONS? WE KNOW THE ANSWERS

Answers to queries