1st Edition

Communicating with Vulnerable Patients A Novel Psychological Approach

    262 Pages 73 B/W Illustrations
    by Routledge

    262 Pages 73 B/W Illustrations
    by Routledge

    Communicating with Vulnerable Patients explores ways to improve the communication process between highly vulnerable patients and the therapist, based on the assumption of the permanent presence of an ‘outsider’ or potential space in the communication field between them. In this space, the therapist and highly vulnerable patients can undergo transitional states of mind established between and within their relationship.

    Leticia Castrechini-Franieck, also known as Maria Leticia Castrechini Fernandes Franieck, presents practical methods to overcome communication issues and engage therapeutically with highly vulnerable patients suffering from personality disorders, addiction, and trauma, as well as with deprived children. Communicating with Vulnerable Patients is presented in five parts, with Part one focused on building communication through a Transient Interactive Communication Approach (TICA) and Part two applying TICA in forensic settings with five case studies illustrating the approach in a range of contexts. Part three considers TICA in intercultural settings, including work with refugees, and Part four outlines adaptations of the approach, including T-WAS (Together We Are Strong), which aims to avoid an increase of antisocial behavior in deprived children, and the use of TICA in the COVID-19 pandemic. The book concludes in Part five with reflections on outcomes and limitations of both TICA and T-WAS.

    Communicating with Vulnerable Patients will be invaluable reading for professionals, psychotherapists, group therapists, and group analysts working with at-risk populations.

    List of Contributors

    Series Editor's Foreword




    Part One: On building communication

    Chapter 1: Handling, mastering, and integrating personal and factual reality

    Chapter 2: On intercultural interactional communication

    Chapter 3: TICA –Transient Interactive Communication Approach

    Part Two: TICA in forensic settings

    Chapter 4: TICA in withdrawal therapy

    Chapter 5: TICA in pretrial detention

    Part Three: TICA in intercultural settings

    Chapter 6: TICA in short-term therapy with traumatized refugees

    Chapter 7: TICA in multicultural team supervision

    Part Four: TICA adaptations (variations)

    Chapter 8: T-WAS- Together We Are Strong

    with contribution from Niko Bittner

    Chapter 9: TICA in the COVID-19 pandemic

    with contribution from Niko Bittner

    Part Five: Reflections on TICA

    Chapter 10: Outcomes and limitations


    Maria Leticia Castrechini Fernandes Franieck, PhD, is a chartered counselling psychologist and a psychodynamic psychotherapist based in Germany. Her clinical practice is focused on working with highly vulnerable populations.

    "This fascinating book reveals, in clear and in-depth form, the vicissitudes faced by therapists dealing with people in distressing social situations. It deals with prisoners, refugees, children with antisocial tendencies and other traumatised and highly vulnerable groups. The author shows us how she carefully develops therapeutic resources that can facilitate communication among people from diverse backgrounds, allowing them to feel themselves fully human and able to live in the societies that welcome them." - Roosevelt Cassorla, Training Analyst of the Brazilian Psychoanalytic Association, Sigourney Award 2017.

    "Leticia Castrechini-Franieck has written an important book based on her forensic and psychoanalytic training in which she communicates, critically, the necessity for an experiential approach to the understanding and treatment of marginalized, traumatized and highly vulnerable individuals. The timely subject of social and cultural ‘outsiders’ is front and center. Many clinicians today find that a developmental, ontological psychoanalytic perspective that emphasizes experience rather than the deployment of knowledge, yields valuable clinical results. Castrechini-Franieck achieves this in a difficult clinical context in ways that will reward the reader. I strongly recommend this book." - Paul Williams, Psychoanalyst. Trained at The British Psychoanalytic Society