Lecture notes
Two fifty-minute sessions. Session A defines; session B compares. They can be run as a single hundred-minute block with a break at the recap.
Before the session
Read the two topic pages this unit rests on — What psychotherapy is, and is not, and The transtheoretical comparison framework — and read the Daniel Okonkwo case, because a student will ask about it.
Decide your own answer to the contested question first
You will be asked, in session B, whether the differences between systems are substantive or semantic. Know your position and know why, then decline to give it. Declining convincingly requires having one; declining because you have not thought about it reads as evasion and students can tell the difference.
Prepare the two transcripts as handouts, not just slides
The opening comparison works far better on paper, because students can annotate it and look back at it while arguing. Print both on one sheet, unlabelled beyond A and B.
Materials
- Handout: transcripts A and B, one sheet, unlabelled
- Handout or card deck: the eight boundary cases for the in-class assignment
- A board or flipchart you are willing to fill — student definitions go up verbatim
- Voting method for the peer-instruction slide: hands, coloured cards, or any polling tool
- Printed copies of the Self-Survey, and envelopes if you are running the sealed version
Prior knowledge assumed
- None. This is the first session, and it is designed to be the first thing anyone hears about the field.
Running the session
Create the question before supplying any content. Both exchanges help, so students cannot fall back on "one was kind" — which is the answer they arrive with and the one that must be closed off in the first ten minutes.
Hand out the transcripts before you say anything about the course. Give thirty seconds of silence to read both.
- 1Ask for a show of hands: A, then B. Record the split on the board and leave it there for the whole session.
- 2Ask what the friend in A did. Collect three answers. Write them up: reassured, normalised, offered perspective.
- 3Point out that therapists do all three. So that is not the difference.
- 4Ask what happened to "I still think it." In A it went past. In B the therapist went towards it.
- 5Ask what "What would it mean about you?" is doing. Push until someone says it turns a symptom into a question about what the symptom is for.
Do not resolve which is psychotherapy. Say you are coming back to it, and mean it — return to the board at the recap.
On the board- A: ___ votes B: ___ votes
- What the friend did: reassured / normalised / gave perspective
- “I still think it” → A goes past it, B goes towards it
Expect thisThey think: Therapy is a conversation with a trained person. The training is the difference.
Actually: Training is how the difference is acquired, not what it consists of. The difference is that the intervention follows from a theory of what is maintaining the problem.
Surface it: Ask: if the friend had a doctorate, would A become psychotherapy? Most will say no, and then have to say what actually changed.
Expect thisThey think: The therapist in B is colder, so warmth cannot be what matters.
Actually: B is not colder; it is less reassuring, which is not the same thing. Whether the relationship is the vehicle or the active ingredient is genuinely contested.
Surface it: Name it as a real dispute, attribute it to Units 4 and 6, and park it visibly rather than correcting it.
So there is a difference, and none of us can yet say what it is. That is what a definition is for.
Move from an intuition to a criterion. The twenty-second writing task is not a warm-up: it is the pre-test that makes the post-test meaningful, and without it students leave believing they knew this already.
Twenty seconds, written, no editing. Insist on written. Take two out loud and put them on the board verbatim, without evaluating them.
Reveal the pattern: almost every attempt contains "help" or "talk", almost none contains an exclusion. Then the definition, read once, slowly.
Work the clause table by asking rather than telling: "What gets in if I delete this clause?" Let the room supply the counterexamples. They are better at this than they expect, and their own examples are what they remember.
The last clause
Slow down. "In directions that the participants deem desirable" is what separates psychotherapy from social control. Make the argument that conversion practices fail this clause definitionally — before and independently of the evidence of harm and the legal position.
On the board- Two student definitions, verbatim
- Informed & intentional | clinical methods & stances | psychological principles | assisting to modify | directions the participants deem desirable
- Under each: what walks in if we delete it
Expect thisThey think: A definition is a formality we get past before the real content.
Actually: This definition is doing the work that decides whether coaching, an app, a chaplain or a conversion practice is in scope — and one of those is a live regulatory question.
Surface it: Delete a clause in front of them and ask what just became psychotherapy. The room does the work.
Expect thisThey think: “The participants deem desirable” settles the autonomy question.
Actually: It does not. A child brought by a parent, a court-mandated client, and a patient whose family wants them changed all strain it.
Surface it: Someone will raise it. Confirm the objection is correct, name it as unresolved, and attribute it forward to Units 12 and 18 rather than improvising an answer.
The definition tells us what is in scope. It tells us nothing about how to compare the four hundred things now in scope.
Apply the criterion under disagreement. Peer instruction is used here rather than discussion because the vote-argue-revote structure produces a measurable change of mind, and students believe a conclusion they watched themselves reach.
Take the neighbours quickly — counselling, coaching, peer support — and resist the instinct to rank them. Peer support is a different thing, not a lesser therapy.
Admit the weakness: the definition cannot cleanly exclude coaching. Admitting this now buys credibility for everything you assert later.
Run the poll as peer instruction, in full
- 1Silent vote. Record the split.
- 2Two minutes: find someone who disagrees and change their mind. It should be loud.
- 3Vote again. Show both splits side by side.
The two leading options are both defensible, and the vote moves because students discover that "interpersonal" is ambiguous. Do not resolve it — say the ambiguity is the finding.
Close session A with retrieval: three clauses from memory, then rewrite the definition and compare it to the twenty-second version.
On the board- Poll: vote 1 ___ / vote 2 ___
- Why it moved: “interpersonal” — literal or functional?
Expect thisThey think: There is a right answer to the app question and the lecturer is withholding it.
Actually: Two readings of the definition are live in the field, and the disagreement is itself the content.
Surface it: Show the vote split. A room that splits 60/40 after arguing is evidence that the question is genuinely open.
Second half. Four hundred names, and no agreed criterion for when two of them are the same thing.
Replace brand-name learning with a procedure. This is the highest-leverage twenty minutes in the course: everything after it is an application of the two questions introduced here.
Walk the brand-proliferation flow without cynicism. Almost nobody in that chain is acting in bad faith; the incentive is structural, and allegiance operates through many small honest decisions.
Then the move, stated flatly: stop asking a system what it is, ask what it does and where it aims.
Three processes, not ten
Take consciousness raising, counterconditioning and helping relationship, make each concrete with one system, and tell them the remaining seven are coded against all forty-five systems in the app. Do not lecture the list.
The levels, and the trap
Draw the stack, then attack it: deeper is not better. Phobia belongs at the top. A third relationship collapsing the same way does not. The skill is matching, not preferring depth.
Finish with the eight-question grid and say plainly that it is the assessment structure for the course.
On the board- Two questions: WHICH PROCESSES? · AT WHAT LEVEL?
- Processes (3 of 10): consciousness raising · counterconditioning · helping relationship
- Levels: symptom → cognition → interpersonal → family → intrapersonal
- DEEPER ≠ BETTER
Expect thisThey think: Deeper levels are more profound and therefore better therapy.
Actually: Level should be matched to the problem. For a circumscribed phobia, working at the intrapersonal level is a longer and more expensive failure, not a deeper success.
Surface it: Ask what they would want if they had a spider phobia and six sessions. Then ask what they would want if their third relationship had ended the same way. The answers differ, and they supply both.
Expect thisThey think: The framework will tell us which therapy is best.
Actually: It is a comparison instrument, not a ranking one. It shows where systems differ and where the vocabulary only makes it look as though they do.
Surface it: Ask what the grid would say if two systems scored identically. Answer: that you should be suspicious of the claim that they are different.
One distinction before you go, and it is the one that wrecks the most assignments.
Install the pathology / change / technique / stance distinction, which is the single most common failure in student case reports, and then hand over the controversy without resolving it.
Give them "the patient has maladaptive schemas" and ask which of the four it is. Pathology. Then make them supply the theory of change and the technique that would follow, and notice that the label alone commits you to nothing.
Predict before comparing
Exposure versus person-centred for panic: same process or different? Let them commit. Then reveal that these two are genuinely different, and that two brands of cognitive therapy frequently are not. The answer depends on the pair, which is why the general question has no general answer.
Hand over the controversy
Both positions at full strength, then refuse to adjudicate: "I have a view. I am not telling you until Unit 17, because if I tell you now you will spend nine weeks agreeing with me instead of looking."
Think-pair-share on the identical-outcome question. Thirty seconds silent first, or the confident student in each pair sets the answer.
Cold-call retrieval. Then the three take-away questions, and the homework, and sell the self-survey properly.
On the board- PATHOLOGY | CHANGE | TECHNIQUE | STANCE
- “maladaptive schemas” → which one?
- Substantive or semantic? — decide by Unit 17
Expect thisThey think: All therapies are secretly the same. (The fashionable overcorrection, usually acquired from a podcast.)
Actually: The gap between exposure and person-centred therapy is real and large. The gap between two manualised cognitive therapies frequently is not. Which pair you choose determines the answer.
Surface it: Make them run the two questions on a maximally different pair, out loud, before they generalise.
Expect thisThey think: A technique is a theory of change.
Actually: The technique is what you do; the theory of change is why doing it should help. Two systems can share a technique and disagree entirely about why it works.
Surface it: Ask what exposure and a psychodynamic therapist would each say is happening when a patient faces a feared situation.
Next session: where all of this came from, and why the field looks the way it does.
If you are running short
- Cut the neighbours slide (counselling / coaching / peer support). The boundary work is done better by the in-class assignment.
- Cut the brand-proliferation flow and assert the conclusion in one sentence.
- Shorten the poll to a single vote with no re-vote — but do not cut the poll itself, it is where the definition gets tested.
- Never cut: the twenty-second definition, the clause table, the levels-are-not-a-hierarchy correction, or the four-way distinction. Everything later depends on those four.
Exit check
Two minutes, before they leave, to find out whether it landed.
Two minutes before the end, on an index card or a form, unnamed:
- 1Write the definition of psychotherapy in your own words, including one thing it excludes.
- 2Name the two transtheoretical questions.
- 3What is one thing you are now less sure about than you were ninety minutes ago?